针刺及推拿治疗原发性痛经的临床观察

目的 观察针刺及推拿治疗原发性痛经的临床疗效及对经血中前列腺素F2α（PGF2α）含量的影响。方法 将90例原发性痛经患者分为针刺组、推拿组和药物组（服用去痛片），每组各30例。连续治疗3个月经周期。治疗前后采用数字评分法（numerical rating scale，NRS）对患者的疼痛程度进行定量评价，并观察经血中前列腺素F2α含量的变化。结果 治疗后3组疼痛分值均下降(P＜0.05)，针刺组的疼痛分值（0.60±0.67）分，推拿组（0.53±0.63）分，均明显低于药物组（2.30±1.73）分（P<0.01）。治疗后3组经血中前列腺素F2α水平均低于治疗前(P＜0.05)，针刺组〔（176.58±17.85）ng/L〕与推拿组〔（171.32±17.15）ng/L〕亦显著低于药物组〔（220.56±54.47）ng/L，P<0.01〕。推拿组的疼痛分值和经血前列腺素F2α水平与针刺组比较差异无统计学意义（P>0.05）。结论 针刺及推拿治疗原发性痛经的临床疗效均优于口服去痛片，其作用机制可能与降低患者经血中前列腺素F2α水平有关。

Clinical Observation on Treatment of Primary Dysmenorrhea with Acupuncture and Massage

OBJECTIVE: To observe the clinical therapeutic effect of acupuncture massage for primary dysmenorrhea and its influence on prostaglandin F2alpha level in menstrual fluid. METHODS: Ninety patients with primary dysmenorrhea were assigned equally to the acupuncture group, the massage group and the control group (oral administrated with Somiton tablet). The treatment course was 3 menstrual cycles. The effect in relieving menalgia was evaluated using numerical rating scale (NRS) before and after treatment and change of PGF2alpha content in menstrual fluid was tested as well. RESULTS: The NRS score was 0.60 +/- 0.67 in the acupuncture group and 0.53 +/- 0.63 in the massage group respectively, significantly lower than that in the control group, which was 2.30 +/- 1.73 (P < 0.01). The PGF2alpha level after treatment was significantly lower in the acupuncture group (176.58 +/- 17.85 ng/L) and the massage group (171.32 +/- 17.15 ng/L) than that in the control group (220.56 +/- 54.47 ng/L), respectively (P <0.01). There showed no difference in the two aspects between the acupuncture group and the massage group (P >0.05). CONCLUSION: Acupuncture and massage has a reliable therapeutic effect on primary dysmenorrhea, which is superior to that of Somiton tablet, and its mechanism might be exerted by regulating PGF2alpha level in menstrual fluid.