Factors Associated with Increased Pain in Primary Dysmenorrhea: Analysis Using a Multivariate Ordered Logistic Regression Model

Study Objective

In the literature about primary dysmenorrhea (PD), either a pain gradient has been studied just in women with PD or pain was assessed as a binary variable (presence or absence). Accordingly, we decided to carry out a study in young women to determine possible factors associated with intense pain.

针刺三阴交穴治疗痛经的即时临床疗效观察

目的：观察针刺三阴交治疗痛经的即时临床疗效。方法：对36例痛经患者应用针刺三阴交穴治疗疗,并与用芬必得胶囊治疗36例进行即时临床疗效对比。结果：自身对照分析治疗前,治疗后30min,治疗后12h,VAS比较差异均有统计学意义（P〈0．05）,治疗后VAS评分下降。两组治疗前比较（P=0．32〉0．05）两组具有可比性。两组治疗后30rain比较（P〈0．05）治疗组明显优于对照组。两组治疗后12h比较（P〈0．05）治疗组明显优于对照组。结论：针刺三阴交配合艾灸神阙穴治疗痛经有确切疗效。     

针灸治疗原发性痛经的临床疗效及对血液流变学的影响

目的探讨针灸治疗原发性痛经的临床疗效及对血液流变学的影响。方法选择我院2014年4月—2016年3月收治的76例原发性痛经患者为研究对象,以随机数字表法分组,观察组与对照组各38例,对照组单用药物治疗,观察组在药物基础上加针灸治疗,对两组患者疗效与血液流变学水平进行观察。结果观察组与对照组治疗总有效率分别为89.47%、65.79%,两组差异有统计学意义(P0.05);两组患者治疗前的全血黏度、血浆黏度、红细胞压积等血液流变学参数无明显差异(P0.05),治疗后均有改善,且观察组血液流变学参数均低于对照组,差异有统计学意义(P0.05)。结论针灸应用于原发性痛经治疗中效果满意,可有效调节血液流变学,对缓解临床症状具有显著作用,值得临床推广。     

The effectiveness of an educational intervention on proper analgesic use for dysmenorrhea

Objectives

Primary dysmenorrhea is a common gynecologic disorder, but is often inappropriately managed due to ignorance and misunderstanding of its pharmacotherapy in many young women. The aim of this study was to assess the effectiveness of an educational intervention on proper analgesic use for dysmenorrhea among Korean female university students.

Study design

In March 2008, an educational intervention, a 10-min lecture using supplementary educational printed materials, was given to the intervention group (n = 98). Two months later, changes and differences in knowledge, actual medication behavior, coping strategies, dysmenorrhea severity (VAS score), and Korean health-related quality of life (KQOLS) were assessed between the intervention and control (n = 105) groups.

Results

The prevalence of dysmenorrhea in the intervention and control groups was 75.1% and 77.1%, respectively. After the educational intervention, the medication rate of the intervention group was significantly increased (from 36.1% to 51.0%, P = 0.007), and the knowledge of and actual behavior relating to the proper analgesic use were also significantly improved in this group. The VAS scores were significantly decreased among participants with dysmenorrhea in the intervention group (from 48.6 ± 22.0 to 37.8 ± 22.5, P < 0.001). In addition, significant improvements in two domains of the KQOLS, physical function (from 89.3 ± 11.1 to 93.1 ± 8.8, P = 0.007) and pain (from 80.4 ± 19.9 to 87.4 ± 14.3, P = 0.001), were observed in the intervention group.

Conclusions

The findings of this prospective study suggest that a brief educational intervention can improve the severity of dysmenorrhea and the quality of life by enhancing medication knowledge and actual analgesic behavior in Korean female university students.     

Synergistic relaxing effect of the paracetamol and pyrilamine combination in isolated human myometrium

Objective

To evaluate the interaction type of the human uterine relaxant effect of the paracetamol-pyrilamine combination (PPC) in vitro.

Study design

Uterine strips were contracted with KCl (60 mM) and treated with vehicle or increasing concentrations of paracetamol (100-3200 μM), pyrilamine (3.2-100 μM) or the PPC. The relaxing effects of the drugs alone and in combination were measured. Isobolographic analysis was used to determine the pharmacologic interaction type.

Results

Paracetamol, pyrilamine and the PPC produced a significant relaxing effect on non-pregnant human uterine strips pre-contracted with KCl (60 mM). The EC₃₀ values for paracetamol and pyrilamine on the uterine contraction were 2391.3 ± 595.3 μM and 14.7 ± 1.7 μM, respectively. The derived experimental EC₃₀ for the PPC was 401.8 ± 129.8 μM. This value was significantly lower (p < 0.05) than the theoretical EC₃₀ expected for a purely additive interaction, which was 1203.0 ± 297.7 μM for the PPC. The interaction index (γ) was 0.33 ± 0.14 for PPC, being statistically different from unity.

Conclusion

Data suggest that low doses of the PPC can interact synergistically and therefore this drug association may represent a therapeutic advantage for the clinical treatment of dysmenorreic pain.     

Prevalence of primary dysmenorrhea in young adult female university students

Objective  To determine the prevalence of primary dysmenorrhea and attitudes and behavior toward dysmenorrhea in the female students of an university toward this problem. Materials and methods  A total of 1,266 female university students were anonymously surveyed by doctors. Results  It was found that mean age of the surveyed students was 21.02 ± 2.13 years, mean menarche age was 13.3 ± 1.4 years, and menstruation frequency was 32.58 ± 19.8 days. Of the students, 45.3% were found to suffer pain in each menstruation, 42.5% in some and 12.2% in none. Of those with primary dysmenorrhea, 66.9% were established to take analgesic drugs. Conclusion  Prevalence of primary dysmenorrhea was found higher than that cited in the literature. It was established that although the rate of consultation with health professionals about menstruation and related changes was low, use of agents known to be effective in primary dysmenorrhea treatment was highly common.     

促性腺激素释放激动剂联合宫内放置LNG-IUS对EMT患者术后复发、痛经程度及性激素和CA125水平的影响

【目的】探讨促性腺激素释放激动剂(GnRH-α)联合宫内放置左炔诺孕酮宫内缓释系统(LNG-IUS)对子宫内膜异位症(EMT)患者术后复发、痛经程度及性激素、糖抗原125(CA125)水平的影响。【方法】选取在陕西省宝鸡市眉县人民医院拟行腹腔镜手术的EMT患者107例,按照随机数表法分为观察组(n=54)和对照组(n=53)。观察组术后给予GnRH-a治疗3个周期,并宫内放置LNG-IUS,对照组术后仅给予GnRH-α治疗3个周期。比较两组患者术前、术后不同时间的痛经程度(VAS评分)、血清CA125、雌二醇(E2)、卵泡刺激素(FSH)、促黄体生成素(LH),随访24个月,统计患者的复发情况。【结果】术后3个月、12个月及24个月,观察组患者的VAS评分均显著低于对照组(P<0.05);两组患者手术前后E2、FSH、LH水平比较差异均无统计学意义(P>0.05);两组患者术前血清CA125水平比较差异无统计学意义(P>0.05);术后12个月,观察组患者的血清CA125水平显著低于对照组(P<0.05)。术后随访24个月,观察组患者复发率为1.87%(1/53),显著低于对照组的12.96%(7/54)(P<0.05),其差异有统计学意义(χ²=4.744,P=0.029)。【结论】EMT患者术后宫内放置LNOIUS,可减少复发,降低血清CA125水平,缓解痛经,值得临床推广应用。     

隔姜灸配合针刺治疗寒凝血瘀型原发性痛经的疗效分析

目的:观察隔姜灸配合针刺治疗原发性寒凝血瘀型痛经的临床疗效,并进行总结分析。方法:将符合纳入标准的原发性痛经(Primary Dysmenorrhea,PD)患者,随机分为观察组(50例)与对照组(50例)。观察组进行隔姜灸(关元、神阙、气海、双侧子宫)配合针刺(三阴交、合谷、内关)进行治疗,对照组口服双氯酚酸钠肠溶片(北京诺华制药有限公司生产,国药准字H11021640),25 mg/12 h;观察两组有效率、疼痛视觉模拟评分量表(Visual Analogue Scale,VAS)评分、前列腺素(Prostaglandin,PG)F2a、全血粘度及血浆粘度。结果:两组患者评价即时有效率,差异无统计学意义(P>0.05),VAS评分P>0.05;治疗结束后评价近期有效率,差异具有统计学意义(P<0.05),治疗后PGF2a均下降,变化幅度有差异(P<0.05);全血粘度及血浆粘度治疗后对比,P<0.05;随访结束后评价远期有效率,差异具有显著统计学意义(P<0.05),VAS评分,P<0.05。结论:隔姜灸配合针刺治疗寒凝血瘀型原发性痛经获得良好的临床效果,治疗过程安全,可推广应用。     

EFFECT OF ACUPUNCTURE STIMULATION AT SANYINJIAO （SP 6） ON CEREBRAL GLUCOSE METABOLISM IN DYSMENORRHEA PATIENTS

ABSTRACTObjective:TostudythecentralmechanismofacupuncturestimulationofSanyinjiao(三阴交SP6)inrelievingdysmenorrhea.Methods:Atotalof6dysmenorrheavolunteerpatientsweresubjectedintothis study.Onthefirstpositronemissiontomography(PET)scanexamination,theywerea…