翰怡灸对寒凝血瘀型原发性痛经的疗效观察

发布时间：2018-01-22 01:35

  本文关键词： 原发性痛经 翰怡灸 暖宫贴 寒凝血瘀　出处：《广州中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：痛经是指行经前后或月经期间出现的下腹部及腰骶部痉挛性疼痛,同时可伴有腰酸、坠胀、恶心、呕吐、手足厥冷、腹泻及头痛等不适症状,随月经而发,严重者甚至昏厥,严重影响生活质量。原发性痛经是妇科常见疾病,又称功能性痛经,75%的原发性痛经发生在初潮后的第1年内。我国1980年全国抽样调查结果表明[1],痛经发生率达33.19%,其中原发性痛经占36.06%,其疼痛轻度占44.6%,中度占38.81%,严重影响工作的重度占14%。翰怡灸是麦粒灸的一种,介于麦粒灸和压灸之间。因翰怡灸艾柱小,施灸时作用部位小而精确,温补之力直透穴位,直达经络脏腑,疗效比其他疗法较高。透过热力迅速刺激穴位,麦粒灸作为药引使药力迅速引进致各个经络脏腑。目的:此次临床研究使用翰怡灸治疗寒凝血瘀型原发性痛经并对其进行临床观察,评估其临床疗效并探讨其作用机理。方法:病例来源选取于2015年1月至2017年2月广州中医药大学的学生;符合诊断为寒凝血瘀型原发性痛经患者共90例,随机分为试验组30例、对照组30例和空白对照组30例。三组患者均于经期后一周开始接受治疗。试验组30例患者使用翰怡灸治疗三个月经周期,治疗用品由张超翰医师提供。治疗时间:每周治疗2-3次,于痛经发生疼痛时可给予治疗,连续3个疗程,3个疗程后观察疗效。对照组30例患者使用暖宫贴治疗三个月经周期。治疗时间:每周使用2-3次,痛经发生疼痛时可使用暖宫贴,连续3个疗程,3个疗程后观察疗效。空白对照组30例不给予任何治疗。观察时间:3个月经周期。观察其治疗前后疼痛程度评分、痛经情况评分以及中医症候评分。结果:1.疼痛程度积分比较:1.1三组治疗第三个月疼痛程度积分比较,P0.001,差异有统计学意义,且显示治疗组积分小于对照组及空白组,对照组积分小于空白组。1.2疗程结束后一个月疼痛程度积分,P0.001,差异有统计学意义,且显示治疗组积分小于对照组及空白组,对照组积分等于空白组。1.3治疗组和对照组治疗前和治疗第三个月疼痛程度积分比较,P0.05,差异有统计学意义,且积分小于治疗前。1.4治疗组和对照组治疗第三个月和疗程结束后一个月疼痛程度积分比较,治疗组积分差异P0.001,差异有统计学意义,显示疗程结束后一个积分小于治疗第三个月。1.5治疗组和对照组治疗前和治疗第三个月疼痛程度积分差值比较,P0.001,差异有统计学意义,且差值均为治疗组大于对照组。2.痛经情况积分比较:2.1三组治疗第三个月痛经情况积分比较,P0.001,差异有统计学意义,且显示治疗组积分小于对照组及空白组,对照组积分小于空白组。2.2疗程结束后一个月痛经情况积分,p0.001,差异有统计学意义,且显示治疗组积分小于对照组及空白组,对照组积分等于空白组。2.3治疗组和对照组治疗前和治疗第三个月痛经情况积分比较,P0.001,差异有统计学意义,显示积分小于治疗前。2.4治疗组和对照组治疗第三个月和疗程结束后一个月痛经情况积分比较,治疗组和对照组治积分差异,P0.001,差异有统计学意义,且显示治疗组疗程结束后一个月痛经情况积分小于治疗第三个月,对照组疗程结束后一个月痛经情况积分大于治疗第三个月。2.5治疗组和对照组治疗前和治疗第三个月痛经情况积分差值比较,P0.001,差异有统计学意义,且积分差值均为治疗组大于对照组。3.中医症状积分比较:3.1三组治疗第三个月中医症状积分比较,P0.001,差异有统计学意义,且显示治疗组积分小于对照组及空白组,对照组积分小于空白组。3.2疗程结束后一个月中医症状积分,P0.001,差异有统计学意义,且显示显示治疗组积分小于对照组及空白组,对照组积分小于空白组。3.3治疗组和对照组治疗前和治疗第三个月中医症状积分进行比较,治疗组治疗前和治疗第三个月中医症状积分差异有统计学意义(P0.05),显示积分小于治疗前。3.4治疗组和对照组治疗第三个月和疗程结束后一个月中医症状积分比较,治疗组积分差异,P0.05,差异有统计学意义,显示积分小于治疗第三个月。3.5治疗组和对照组治疗前和治疗第三个月中医症状积分差值比较,P0.001,差异有统计学意义,且差值均为治疗组大于对照组。3.6治疗组和对照组治疗前和治疗第三个月中医各症状积分差值比较,两组间经前/经期小腹怕冷得热则缓、经前/经期小腹疼痛、经血量少、经血色暗、夹血块、乳房胀痛、手足不温和恶心呕吐差值均数差异,P0.05,有统计学意义,且治疗组差值大于对照组。4三组间临床疗效比较:三组间的临床疗效,结果显示三组间临床疗效差异有统计学意义(P0.001),治疗组临床疗效有效率高于对照组和空白组。治疗组患者中12例有效,13例显著,总有效率100%;对照组患者中29例无效,1例有效,总有效率3.3%;空白组患者29例无效,1例有效,总有效率3.3%。5.三组间疼痛疗效比较:三组间的疼痛疗效,结果显示三组间疼痛疗效差异有统计学意义(P0.001),治疗组疼痛疗效有效率高于对照组和空白组。治疗组患者4例痊愈,5例显著,14例有效,2例无效,总有效率92%;对照组9例有效,21例无效,总有效率30%;空白组4例有效,26例无效,总有效率13.3%。结论:本次研究结果显示:(1)翰怡灸有温经散寒、活血化瘀之效,用以治疗寒凝血型原发性痛经能有效改善痛经的疼痛程度。(2)翰怡灸有效调理月经周期经量血块等中医症候。(3)翰怡灸能温通经络从而促使经络畅通。综合上述三点,本研究发现翰怡灸对原发性痛经之寒凝血瘀症的主要症状和次症都有较明显的缓解作甩并且对一些较严重的痛经情况能减轻或根治。翰怡灸有温经散寒、活血化瘀之效,能温通经络从而促使经络畅通。翰怡灸因穴位经过熏熨或温灼,刺激穴位及令药中的功效发挥作用,令药汁的药效经热力引入各个脏腑经络,并因为是压炙,令其功效得以持续,这种效果可以维持一至两天。
[Abstract]:Dysmenorrhea refers to during menstruation or menstruation before and after the abdomen and lumbosacral spasm pain, accompanied by backache, bulge, nausea, vomiting, diarrhea and cold limbs, headache and other symptoms, and with menstruation, serious even fainting, seriously affecting the quality of life of primary dysmenorrhea. Is a common gynecological diseases, called functional dysmenorrhea, 75% primary dysmenorrhea occurred at menarche after first years. The results of the national sample survey in 1980 showed that [1], the incidence of dysmenorrhea was 33.19%, of which the primary dysmenorrhea accounted for 36.06%, which accounted for 44.6% of mild pain, accounted for 38.81%, seriously affecting work the severe 14%. Han Yi is a kind of moxibustion moxibustion, moxibustion and moxibustion between pressure. Yinhan Yi moxibustion moxa moxibustion effect, part of the small and precise temperature compensation of the force into direct acupoints, meridians and organs, the higher efficacy than the other therapy. Through rapid thermal stimulation, wheat As the grain moxibustion is a rapid introduction of various drugs caused by meridian viscera. Objective: This clinical study using John Yi moxibustion in the treatment of cold coagulation and blood stasis type primary dysmenorrhea and its clinical observation, evaluate the clinical efficacy and to explore its mechanism. Methods: from January 2015 to February 2017 were selected from students of Guangzhou University of Chinese Medicine; diagnosis for patients with cold stasis type primary dysmenorrhea in 90 cases, 30 cases randomly divided into experimental group and control group of 30 cases and 30 cases of blank control group. Three groups of patients in the period of one week after treatment. 30 patients in the test group in the treatment of three menstrual cycles by John Yi moxibustion treatment supplies by Dr. Zhang Chaohan. The treatment time: treatment 2-3 times a week, can be treated in dysmenorrhea pain, 3 consecutive courses, to observe the curative effect after 3 courses of treatment. 30 patients in the control group using Nuangongtie treatment of three menstrual cycle treatment. The time of therapy: use 2-3 times a week, dysmenorrhea pain can be used Nuangongtie, 3 consecutive courses, to observe the curative effect after 3 courses of treatment. 30 cases in the control group did not receive any treatment. The observation time: 3 menstrual cycles. The degree of pain scores before and after treatment were observed, dysmenorrhea score and TCM syndrome score. Results: 1. pain score comparison: three groups of 1.1 third months of treatment pain scores, P0.001, the difference was statistically significant, and the treatment group scores less than the control group and the blank group, the control group over the control group of.1.2 score of less than one month after the course the degree of pain score, P0.001, and the difference was statistically significant. The treatment group scores less than the control group and the blank group, the control group is equal to the integral control group.1.3 treatment group and control group before treatment and third months of pain scores, P0.05, the difference was statistically significant, and the integral Less than before treatment.1.4 treatment group and compared the degree of pain over a month integral group third months after treatment and control group, treatment differences of scores of P0.001, the difference was statistically significant after treatment, showed a score of less than third months of treatment,.1.5 treatment group and control group before treatment and third months of treatment the degree of pain P0.001 score difference, the difference was statistically significant, and the difference is greater than the treatment group compared with the control group.2. pain scores: 2.1 three third months treatment dysmenorrhea scores, P0.001, the difference was statistically significant, and the treatment group scores less than the control group and the blank group, the control group score of less than the end of the blank group.2.2 one month after treatment of dysmenorrhea score, p0.001, the difference was statistically significant, and the treatment group scores less than the control group and the blank group, the control group is equal to the integral of the.2.3 treatment group and blank group The control group before treatment and third months, dysmenorrhea score P0.001, the difference was statistically significant, showed the score of less than before treatment,.2.4 treatment group and the comparison of one month dysmenorrhea integral end group third months of treatment and after treatment group, treatment group and control group treated product difference, P0.001, the difference was statistically significant and, showing over the course of treatment was one month after the dysmenorrhea score of less than third months of treatment, the control group after treatment one month dysmenorrhea score greater than third months of treatment,.2.5 treatment group and control group before treatment and third months dysmenorrhea integral difference, P0.001, the difference was statistically significant, and the integral the difference is greater than the treatment group compared with the control group.3. TCM symptom score: comparison of three groups of 3.1, third months of treatment of TCM symptom score of P0.001, the difference was statistically significant, and the treatment group showed small points In the control group and the blank group, the control group over the control group of.3.2 score of less than one month after the course of TCM symptom score, P0.001, the difference was statistically significant, and the display of integral treatment group is less than the control group and the blank group, the control group scores less than the blank group.3.3 treatment group and control group before treatment and third months of traditional Chinese medicine symptom scores were compared, there was statistical significance in treatment group before treatment and third months of treatment of TCM symptom score difference (P0.05), showed the score of less than.3.4 before treatment in treatment group and compare a month end of TCM symptom score group third months after treatment and control group, treatment of integral difference, P0.05, the difference was statistically significant, show the score of less than third months of treatment,.3.5 treatment group and control group before treatment and third months of TCM symptom score difference comparison, P0.001, the difference was statistically significant, and the difference value for treatment Group than the control group.3.6 treatment group and control group before treatment and third months of treatment of TCM symptom score difference between the two groups by the cold / menstrual abdominal heat corrosion, premenstrual / menstrual abdominal pain, less blood, blood clots, after dark, breast pain, limb temperature and nausea vomiting difference mean difference, P0.05, have statistical significance, and the treatment group than in control group.4 the difference between the three groups to compare the clinical efficacy of clinical efficacy between the three groups. The results showed that there was significant difference in curative effect between the three groups (P0.001), the clinical efficacy of the treatment group was higher than that in the control group and blank control group. The treatment group 12 cases of patients in 13 cases were effective, the total efficiency of 100%; control group 29 cases invalid, 1 cases were effective, the total efficiency of 3.3%; control group 29 cases invalid, 1 cases were effective, the total efficiency of 3.3%.5. between the three groups: pain pain clinical efficacy between the three groups. Results 绀轰笁缁勯棿鐤肩棝鐤楁晥宸�寮傛湁缁熻�″�︽剰涔�(P0.001),娌荤枟缁勭柤鐥涚枟鏁堟湁鏁堢巼楂樹簬瀵圭収缁勫拰绌虹櫧缁，

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