针刺结合温阳灸法治疗寒湿凝滞型原发性痛经临床研究

发布时间：2018-05-14 12:16

本文选题：寒湿凝滞 + 原发性痛经　；参考：《广西中医药大学》2016年硕士论文

【摘要】：目的:通过针刺结合温阳灸法对比布洛芬缓释胶囊对寒湿凝滞型原发性痛经(Primary dysmenorrhea of cold-damp stagnation)患者治疗前、后临床症状、体征、疼痛改善情况,来评价针刺结合温阳灸法的临床疗效。方法:在临床收集60例符合本课题纳入标准的寒湿凝滞型原发性痛经患者,采用随机对照的方法,将针刺结合温阳灸法作为治疗组,口服布洛芬缓释胶囊药物作为对照组,每组30例。治疗组分别以仰卧位及俯卧位2个体位进行治疗,仰卧位:取合谷、三阴交、太冲、关元,合谷、太冲直刺15~20mm,三阴交直刺25~35mm,关元直刺25~35mm,进针得气后,施用提插捻转平补平泻法,每10分钟行针一次,留针30分钟。关元穴在针刺治疗的同时进行施灸,每次用艾条温阳灸30分钟;俯卧位:取肾俞、次毼、命门。先针刺肾俞、次毼穴,直刺25~35mm,进针得气后,施用提插捻转平补平泻法,每10分钟行针一次,留针30分钟,肾俞、命门在针刺治疗的同时进行施灸,每次用艾条温阳灸30分钟。在每月月经来潮前10天开始治疗,每天1次,10次为1个疗程。共治疗3个疗程(3个月经周期)。对照组:疼痛出现就诊日开始服用布洛芬缓释胶囊,一日2次(早、晚各1次),一次0.3~0.6g(1~2粒)。连续服用不超过5天,连续治疗3个疗程(3个月经周期)。分别对两组患者进行治疗前、后(共3个疗程)记录痛经症状评分表、简化McGill疼痛量表(包括PRI、VAS)、痛经COX症状量表,将所得临床数据进行处理(使用统计软件SPSS22.0),根据相关结果来分析两组的临床疗效。结果:⑴治疗前对两组的年龄、病程、病情程度进行比较,均无显著性差异(P0.05),具有可比性。⑵两组治疗前后痛经症状积分均有不同程度下降(P0.01),但治疗组疗效优于对照组(P0.01)。⑶两组治疗前后PRI评分、VAS评分比较均有显著差异(P0.01),两组间积分差比较(P0.01),治疗组缓解痛经疗效优于对照组。⑷两组治疗前后痛经COX量表积分比较均有统计学意义(P0.01),组间积分差比较具有显著性差异(P0.01),治疗组优于对照组。⑸治疗组总有效率为92.85%,对照组总有效率为75.86%,治疗组总有效率高于对照组,两组疗效比较P=0.001(P0.01),差异具有显著统计学意义。结论:针刺结合温阳灸法对寒湿凝滞型原发性痛经的临床疗效显著,无论是即时、近期的临床疗效皆优于布洛芬缓释胶囊;该法对不同病情程度的患者均有较好的疗效。针刺结合温阳灸法是一种极具推广意义,临床疗效佳的中医针灸疗法。
[Abstract]:Objective: to evaluate the clinical effect of Acupuncture combined with Wenyang moxibustion on the clinical symptoms, signs and pain improvement of patients with primary dysmenorrhea of cold and dampness stagnation before and after treatment with ibuprofen sustained release capsule before and after treatment, and to evaluate the clinical efficacy of acupuncture combined with warming Yang moxibustion. Methods: sixty patients with primary dysmenorrhea of cold and wet stagnation were collected in clinical practice. The treatment group was treated with acupuncture combined with moxibustion of warm yang, and ibuprofen sustained release capsule was taken as control group. There were 30 cases in each group. The treatment group were treated in supine position and prone position, respectively. Supine position: take Hegu, Sanyinjiao, Taichong, Guan Yuan, Hegu, Taochong straight stab 1520mm, Sanyinjiao straight stab 255mm, Guan Yuan straight puncture 255mm. Needle every 10 minutes, keep needle 30 minutes. Guanyuan point in acupuncture treatment at the same time, moxibustion, each time with moxa warming moxibustion for 30 minutes; prone position: Shenshu, secondary, Shengmen. At first, acupuncture at Shenshu, Sui points, straight needling 255mm, after getting Qi, applying lifting twirling and reinforcing flat diarrhea method, every 10 minutes, needle retention 30 minutes, Shenshu, Shengmen in acupuncture treatment at the same time, 30 minutes moxibustion with moxa warm yang at the same time. Start treatment 10 days before menstruation, 10 times a day as a course of treatment. A total of 3 courses of treatment (3 menstrual cycles). In the control group, ibuprofen sustained release capsules were taken twice a day on the day of treatment (morning, evening, 0.3~0.6g(1~2). Continuously take not more than 5 days, continuous treatment for 3 courses (3 menstrual cycles). The scores of dysmenorrhea symptoms were recorded before and after treatment, and the McGill pain scale (PRI VASA, COX symptom scale) was simplified. The clinical data (SPSS 22.0) were used to analyze the clinical efficacy of the two groups. Results before the treatment, the two groups were compared with each other in terms of age, course of disease and severity of illness. The scores of dysmenorrhea symptoms in the two groups were decreased in varying degrees before and after treatment, but the curative effect in the treatment group was better than that in the control group before and after treatment. There were significant differences in the scores of PRI and PRI between the two groups before and after treatment. The curative effect of the treatment group on relieving dysmenorrhea was better than that of the control group before and after treatment (P 0.01). There was significant difference in the score difference between the two groups (P 0.01), and the treatment group was superior to the control group (P 0.01). The total effective rate of the treatment group was 92.85 and the total effective rate of the control group was 75.86. The total effective rate of the treatment group was higher than that of the control group. The curative effect of the two groups was significantly higher than that of P0. 001 and P0. 01. Conclusion: the clinical curative effect of acupuncture combined with warming yang moxibustion on primary dysmenorrhea of cold dampness and stagnation type is remarkable, and the recent clinical effect is better than ibuprofen sustained release capsule, and this method has better curative effect on patients with different degree of illness. Acupuncture combined with warming yang moxibustion is a kind of acupuncture and moxibustion with good clinical effect.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.3

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