电针三阴交治疗围绝经期综合征多中心随机对照研究

目的:客观评价针刺三阴交穴治疗围绝经期综合征的临床疗效。方法:采用多中心、随机、对照、单盲临床试验,将175例患者分为针刺组(90例)和西药组(85例)。针刺组采用电针双侧三阴交穴(疏密波,2/100Hz,刺激强度8~10mA),每周治疗3次,1个月为1疗程,连续3个疗程。西药组口服尼尔雌醇,每次2mg,每月2次,连续3个月。对已绝经者,第3个月开始加用甲羟孕酮,每天6mg,连用10d。疗效评价包括:症候积分量表中症状改善程度及血清雌二醇(E2)、卵泡刺激素(FSH)、黄体生成素(LH)水平检测(化学发光分析法)。结果:3个中心共纳入175例病例,157例完成试验。针刺组在治疗后患者的疗效评价症状积分均极显著降低(P<0.01)。针刺组治疗后血清FSH、LH水平显著降低(P<0.01),血清E2水平显著升高(P<0.01),且针刺组在LH和E2水平的改善上与西药组相比差异有显著性意义(P<0.05)。表明电针三阴交能明显改善患者的临床症状,良性调整患者血清性激素水平。电针治疗组和西药对照组之间的显效率和有效率差异均无显著性意义(P>0.05)。结论:针刺三阴交穴治疗围绝经期综合征有较好的疗效。

Multicentral Randomized Controlled Clinical Trials about Treatment of Perimenopausal Syndrome with Electroacupuncture of Sanyinjiao(SP 6)

OBJECTIVE: To evaluate the effect of electroacupuncture (EA) of Sanyinjiao (SP 6) on perimenopausal syndrome (PMS). METHODS: Multicentral randomized controlled trials and single blind test were adopted in the present study. A total of 157 PMS patients were randomly divided into EA group (n=81) and medication group (n=76) . EA (2/100 Hz, 8-10 mA) was applied to bilateral Sanyinjiao (SP 6), 3 times a week and for 3 months (mon). Patients of medication group were treated by oral administration of nylestriol, 2 mg/time, twice a mon for 3 mon. For PMS patients, medroxyprogesterone (6 mg/d, for 10 days) was added from the third mon on after the treatment. The therapeutic effect was evaluated by using "symptoms-signs score scale", and changes of serum estradiol (E2), follicle stimulating hormone (FSH) and luteotrophic hormone (LH) were detected by chemiluminescence immune assay. Kupperman index was determined before and after the treatment. RESULTS: In comparison with pre-treatment, Kupperman index of EA group decreased significantly (P < 0.01). After the treatment, contents of serum FSH and LH of EA group decreased significantly (P < 0.01), while serum E2 contents of EA and medication groups increased significantly (P < 0. 01). Serum LH and E2 levels of EA group were significantly lower than those of medication group (P < 0.05). No significant differences were found between two groups in Kupperman index, markedly-effective rates and total effective rates (P > 0.05). CONCLUSION: EA of Sanyinjiao (SP 6) is able to regulate serum E2, FSH and LH levels and effectively improve perimenopausal syndrome.