不同剂量桂枝茯苓胶囊治疗原发性痛经疗效探索研究

评价不同剂量桂枝茯苓胶囊治疗原发性痛经的临床有效性及安全性.将240例年龄18~30岁的原发性痛经患者按1∶1∶1的比例随机分为试验高剂量组、试验低剂量组和安慰剂组,每组各80例,连续治疗3个月经周期并随访3个月经周期,采用视觉模拟标尺法(VAS)对痛经疼痛程度进行比较.治疗期试验高剂量组、试验低剂量组、安慰剂组治疗期有效率分别为68.42%,67.57%,47.89%,试验组均优于安慰剂组(P<0.001);随访期试验高剂量组、试验低剂量组、安慰剂组有效率分别为73.68%,72.97%,53.52%,试验组均优于安慰剂组(P<0.005);治疗期试验高剂量组、试验低剂量组、安慰剂组疼痛持续时间分别下降57.88%,46.17%,30.40%;随访期试验高剂量组、试验低剂量组和安慰剂组疼痛持续时间分别下降67.93%,53.56%,47.46%,试验组疼痛持续时间下降率均优于安慰剂组,差异有显著性统计学意义(P<0.000 1),试验高剂量组疼痛持续时间下降率优于低剂量组,差异有统计学意义(P<0.05).试验高剂量组与低剂量组疗效呈现出一定的量效趋势,均无严重不良反应.桂枝茯苓胶囊高剂量组及低剂量组均能够显著缓解患者疼痛、改善患者症状,减少疼痛持续时间,对原发性痛经患者具有较好的总体治疗效果和远期治疗效应.     

Effects of Electroacupuncture and Electroacupuncture Plus Tao Hong Si Wu Wan in Treating Primary Dysmenorrhea

This study investigated the efficacies of electroacupuncture and electroacupuncture combined with Tao Hong Si Wu Wan in treating primary dysmenorrhea and compared the results with those obtained using conventional medical treatment. One treatment group, group 1, was administered Tao Hong Si Wu Wan (2625 mg) while the other, group 2, was administered a placebo (2625 mg) twice daily for 3 months. Electroacupuncture was used in both treatment groups: two sessions per menstrual cycle for three menstrual cycles. The reference group, group 3, was administered ibuprofen, 600 mg, twice daily, for five menstrual cycles. Uses of the herb, placebo and ibuprofen were blinded. A ridit analysis was used for testing and interpreting the effects of treatment. Pain intensity was determined using a qualitative grading method in a blinded manner. The ridit scores in groups 1 and 2 were significantly higher than those in reference group immediately after treatment and three months later. Twelve months after the treatment, group 1 had a higher ridit score than group 2. In comparison to the reference group, groups 1 and 2 achieved better menstrual pain relief both immediately and 3 months after treatment. In addition, group 1 had better long-term pain relief than group 2.     

RESEARCH ON THE REFLECTION OF SP6 TO DYSMENORRHEA

Objective: To verify the relationship between dysmenorrhea and SP6.Methods: Sixty females between 15 and 35 years old were enrolled into the trial, 30 with primary dysmenorrhea as the test group, and 30 healthy ones without dysmenorrhea as the control group.The subjects in the test group must be with a score of COX menstrual symptoms(CMSS) above 8, visual analog scale(VAS) of the lower abdominal pain during menstruation above 40.The VAS value and pain threshold were used to evaluate the tenderness of SP6 on both sides in menstrual period when abdominal pain occurred and in the non-menstrual period in the test group, and the menstrual period and non-menstrual period in the control group.Results: The VAS value in menstrual period of the test group was significantly higher than that in non-menstrual period and that in the control group(P0.05), and the pain threshold in menstrual period of the test group was significantly lower than that in non-menstrual period and that in the control group(P0.05).In the control group, there was no significant difference in VAS value and pain threshold between menstrual period and non-menstrual period.In non-menstrual period, there was no significant difference for VAS value and pain threshold between the test group and the control group(PP').Conclusion: In the healthy physiological addition, there is no positive reflection at SP6 during menstruation.When the lower abdominal pain occurs in the primary dysmenorrhea patients, there is an obvious positive reflection at SP6.     

针刺下肢阳性反应点治疗原发性痛经的疗效观察

目的观察针刺下肢阳性反应点治疗原发性痛经(PD)的临床疗效。 方法选取24例2018年3月至2018年10月之间招募的PD患者。通过手指循经按压下肢,以痛感较强的阳性反应点作为针刺点。于痛经发作日开始进行连续3日的毫针治疗,连续治疗3个月经周期。观察治疗前后视觉模拟评分法(VAS)的变化并进行疗效评价。 结果24例患者治疗前VAS评分为(6.17±1.85)分,治疗3个月经周期后VAS评分为(3.52±1.36)分,治疗前后VAS评分比较,差异具有统计学意义(t＝2.093,P<0.05)。24例患者中治愈9例,好转14例,无效1例,总有效率95.83%(23/24)。 结论针刺下肢阳性反应点治疗PD疗效确切,值得临床推广。     

长蛇灸治疗气血虚弱型原发性痛经临床观察

目的 通过观察长蛇灸与口服布洛芬胶囊治疗原发性痛经的临床疗效差异,证实长蛇灸治疗气血虚弱型原发性痛经的优越性。方法 将60例符合纳入标准的原发性痛经患者随机分为治疗组和对照组,每组30例,治疗组在患者大椎至腰俞之间铺以5 cm宽、2.5 cm高的姜泥1条,姜泥条上铺3 cm宽、2 cm高的艾绒（约200 g）,每灸3壮,一周1次,连续治疗3个月经周期,对照组经前1 d开始服用布洛芬胶囊,每日2次,每次1粒,连续服用3 d,连续治疗3个月经周期。比较2组患者治疗前后疼痛症状积分以及VAS视觉模拟评分差异。结果 经过3个月经周期的治疗,二者均可有效缓解痛经症状,2组痛经患者的疼痛症状积分以及VAS视觉模拟评分均较治疗前有显著改善（P<0.001）,但治疗组改善程度明显优于对照组,其中治疗组总有效率93.3%(28/30),对照组总有效率为80.0%(24/30),2组比较差异有统计学意义（P<0.01）。结论 长蛇灸组治疗原发性痛经疗效优于口服布洛芬组,值得临床推广。     

辨证治疗原发性痛经40例临床观察

[目的]观察中医辨证治疗原发性痛经的临床效果。[方法]将80例原发性痛经患者随机分为治疗组和对照组,对照组给予口服安宫黄体酮片,4 mg/次,1次/日,以及中成药元胡止痛片,5片/次,3次/日口服,治疗组在对照组的基础上给予逐瘀止痛汤加减口服,3个月经周期为1个疗程。[结果]治疗组总有效率为97.5%,显著高于对照组的75.0%(P<0.05)。[结论]中医辨证治疗原发性痛经有显著疗效。     

痛经患者三阴交穴压痛反应研究

目的:研究原发性痛经患者月经期三阴交穴的压痛反应。方法:将30例原发性痛经患者(痛经组)和30例健康女性(健康组)纳入本试验。分别在两组受试者的月(痛)经期和非经期进行三阴交穴压痛的视觉模拟评分(VAS)值和压痛阈值评估,并进行比较。结果:痛经组痛经期的三阴交穴VAS值显著高于非经期、健康组月经期(P0.01);痛经组痛经期的三阴交穴压痛阈值显著低于非经期、健康组月经期(P0.01);健康组和痛经组的非经期三阴交穴VAS值和压痛阈值分别比较,差异均无统计学意义(P0.05)。结论:痛经的急性发作可使三阴交穴压痛反应更敏感。     

立极针法治疗原发性痛经（寒湿凝滞型）远期疗效观察

目的：评价立极针法治疗寒湿凝滞型原发性痛经的远期疗效。方法：将76例寒湿凝滞型原发性痛经患者随机分为立极针法组和体针组,每组各38例,治疗3个月经周期,并在治疗后第3个月经周期及半年后随访。使用腹痛视觉模拟评分量表、痛经症状评分量表等作为疗效观察指标,排除脱落患者后,比较2组患者的远期疗效和各项指标的评分。此外,认真观察并记录研究中可能出现的不良反应或副作用。结果：立极针法组脱落2例,传统体针法脱落1例,经过治疗后,立极针法组患者的临床综合疗效优于体针组（P < 0.05）,2组VAS评分、痛经症状评分在治疗后及随访期间均有不同程度的下降（P < 0.05）,其中体针组半年后随访数据较治疗后第3个月经周期随访数据有所上升,2组间比较,治疗后第3个月经周期随访（P < 0.05）、半年后随访（P < 0.01）,立极针法组明显优于传统体针法。立极针法和体针组治疗满意率分别为91.67%、72.97%。2组患者在研究期间均未出现不良反应。结论：立极针法能有效缓解痛经症状及其引起的全身不适,远期疗效稳定持久,治疗寒湿凝滞型原发性痛经的远期疗效确切;此外,患者对立极针法的治疗满意率更高,值得临床推广应用。     

消癥止痛汤联合孕三烯酮胶囊治疗子宫内膜异位症盆腔疼痛临床研究

目的:观察消癥止痛汤联合孕三烯酮胶囊治疗子宫内膜异位症盆腔疼痛的临床效果。方法:将80例气滞血瘀证患者随机分为对照组和观察组各40例。2组均服用孕三烯酮胶囊治疗,对照组加服血府逐瘀胶囊,观察组加服消癥止痛汤,2组均连续观察3个月经周期。痛经情况采用疼痛视觉模拟评分法(VAS)于治疗前和治疗后第1、2、3个月经周期进行评价,并应用COX痛经症状评分量表(CMSS)对痛经症状进行评价。治疗前后评定盆腔疼痛症状、体征评分和气滞血瘀证评分、子宫内膜异位症专用生存质量评价量表(EHP-5)评分。结果:治疗后,观察组改善疼痛方面的疗效优于对照组(P<0.05)。2组VAS评分均较治疗前逐渐下降(P<0.01),观察组治疗后第1~3个月经周期的VAS评分均低于同期对照组(P<0.01)。2组CMSS痛经持续时间评分和严重程度评分均较治疗前下降(P<0.01),观察组2项评分均低于对照组(P<0.01)。2组疼痛相关症状、体征评分,气滞血瘀证评分和EHP-5评分均较治疗前下降(P<0.01),观察组3项评分均低于对照组(P<0.01)。结论:在孕三烯酮胶囊治疗的基础上加予消癥止痛汤治疗子宫内膜异位症盆腔疼痛气滞血瘀证患者,可有效减轻痛经及盆腔疼痛症状、体征,提高患者的生活质量。     

Efficacy and tolerability of a standardized willow bark extract in patients with osteoarthritis: randomized placebo-controlled, double blind clinical trial.

This study assessed the clinical efficacy of a chemically standardized willow bark extract in the treatment of osteoarthritis. Willow bark extract, in a dose corresponding to 240 mg salicin/day, was compared with placebo in a 2-week, double-blind, randomized controlled trial. The primary outcome measure was the pain dimension of the WOMAC Osteoarthritis Index. Secondary outcome measures included the stiffness and physical function dimensions of the WOMAC, daily visual analogue scales (VAS) on pain and physical function, and final overall assessments by both patients and investigators. A total of 78 patients (39 willow bark extract, 39 placebo) participated in the trial. A statistically significant difference between the active treatment and the placebo group was observed in the WOMAC pain dimension (d = 6.5 mm, 95% C.I. = 0.2-12.7 mm, p = 0.047); the WOMAC pain score was reduced by 14% from the baseline level after 2 weeks of active treatment, compared with an increase of 2% in the placebo group. The patient diary VAS confirmed this result, and likewise the final overall assessments showed superiority of the willow bark extract over the placebo (patients' assessment, p = 0.0002; investigators' assessment, p = 0.0073). It is concluded that the willow bark extract showed a moderate analgesic effect in osteoarthritis and appeared to be well tolerated.     

柴附青金汤治疗原发性痛经气滞血瘀证疗效研究

目的:探讨柴附青金汤治疗原发性痛经气滞血瘀证临床疗效及对血清血小板活化因子(PAF)和β-内啡肽(β-EP)水平的影响。方法:选取原发性痛经患者104例,按随机数字表法分为对照组和观察组,各52例。对照组患者在痛经疼痛发作时给予布洛芬缓释胶囊,0.3 g/次,2 次/d。观察组在对照组基础上,给予柴附青金汤内服治疗,1 剂/d,2 次/d,两组连续用药3个月经周期。比较两组月经周期时间和月经量; 痛经程度按视觉模拟评分(VAS)、痛经症状评分评价; 比较临床疗效以及血清PAF和β-EP水平。结果:治疗后,观察组月经周期时间、月经量均多于对照组,差异具有统计学意义(P<0.01)。与对照组比较,治疗后观察组VAS和痛经症状评分均低于对照组,差异具有统计学意义(P<0.01)。观察组总有效率为92.31%,高于对照组的75.00%,差异具有统计学意义(P<0.05)。与对照组比较,治疗后观察组血清PAF水平下降更明显,β-EP水平升高更明显,差异具有统计学意义(P<0.01)。结论:柴附青金汤治疗原发性痛经气滞血瘀证的疗效较好,且对血清PAF和β-EP水平具有调节作用。     

推拿对原发性痛经患者子宫动脉血流动力学参数及血清前列腺素的影响

目的 观察推拿治疗原发性痛经(primary dysmenorrhea,PD)的疗效,探讨其对PD患者子宫动脉血流动力学参数和血清前列腺素的影响。     

中医外治法治疗青少年原发性痛经临床观察

目的：观察中医外治法治疗青少年原发性痛经的临床疗效。方法：所有38例患者均采用穴位注射加贴耳穴治疗,每次行经前1 d或经期疼痛时用复方当归注射液1～2 mL分别注射关元、气海、三阴交等腧穴调经止痛,配合王不留行籽贴耳穴如内生殖器、内分泌、神门、交感等耳穴,调理冲任、胞宫气血,连续治疗3个月经周期。结果：42例患者经过3个月经周期治疗后,治愈10例、显效15例、有效13例、无效4例,有效率为90.5%。结论：中医外治法治疗青少年女生原发性痛经操作简单、方便易行、疗效显著。     

Effect of Ginger (Zingiber officinale) on Heavy Menstrual Bleeding: A Placebo‐Controlled,Randomized Clinical Trial

Objective: A wide range of herbal plants have been reported to treat various gynecological problems of women. This study was set out to investigate the effect of ginger (Zingiber officinale) on heavy menstrual bleeding (HMB) in high school girls. Methods: Ninety‐two young women who experienced HMB and met the inclusion criteria were recruited in this study. Participants were evaluated for six consecutive menstrual cycles. During 3 assessment cycles, their HMB was confirmed by Pictorial Blood Assessment Chart. They were then randomly allocated to two study groups to receive either ginger or placebo capsules. The participants filled in the same chart during three intervention cycles. Results: The level of menstrual blood loss dramatically declined during the three intervention cycles in ginger‐receiving group. The decrease of blood loss in ginger‐receiving group was significantly more remarkable than that of participants receiving placebo (p < 0.001). Minimum number of participants reported adverse effects. Conclusion: HMB is highly prevalent among young women. Considering the significance of appropriate and timely treatment and also the importance of prevention of unwanted consequences, ginger may be considered as an effective therapeutic option for HMB. Copyright © 2014 John Wiley & Sons, Ltd.     

黑莴豆汤治疗原发性痛经60例疗效颜察

目的：观察黑莴豆汤治疗痛经的临床疗效。方法：对60例原发性虚寒型痛经患者运用黑莴豆汤随月经周期服用治疗，3个月经周期后统计疼痛情况的变化。结果：痊愈49例，显效7例，有效4例，无效0例，痊愈率为81．7％，愈显率为93．3％，总有效率为100％。结论：黑莴豆汤随月经周期服用治疗痛经有较好的临床疗效。     

Influence of a Specialized Trigonella foenum‐graecum Seed Extract (Libifem), on Testosterone,Estradiol and Sexual Function in Healthy Menstruating Women,a Randomised Placebo Controlled Study

The aim of the study was to evaluate the effect of Trigonella foenum‐graecum (fenugreek) seed extract on sex hormones and sexual function in healthy menstruating women who reported low sexual drive. This short term, single site, double blind, randomised, placebo‐controlled study was conducted on 80 women, aged 20 to 49 years. Participants were randomised to either an oral dose of a standardised T. foenum‐graecum seed extract (libifem) at a dose of 600 mg/day or placebo over two menstrual cycles. Dehydroepiandrosterone sulfate, progesterone, androstenedione, total and free testosterone, estradiol (E2), luteinizing hormone, follicle stimulating hormone, sex hormone binding globulin and cholesterol were measured at baseline and 8 weeks. The individual aspects of sexual function were measured using the Derogatis interview for sexual functioning and female sexual function index self‐administered questionnaires. Stress, fatigue and quality of the relationship with partner were also measured using the PSS (Perceived Stress Scale), MFI‐20 (Multidimensional Fatigue Inventory) and DAS (Dyadic Adjustment Scale) quality of life measures, respectively. There was a significant increase in free testosterone and E2 in the active group as well as sexual desire and arousal compared with the placebo group. The results indicate that this extract of T. foenum‐graecum may be a useful treatment for increasing sexual arousal and desire in women. Copyright © 2015 John Wiley & Sons, Ltd.     

眼针对原发性痛经患者血浆中PGF2α的影响（英文）

目的:观察眼针疗法治疗原发性痛经的临床疗效及对经期外周血中前列腺素F2α(PGF2α)含量的影响。方法:将110例原发性痛经患者随机分为眼针组(60例)和药物组(50例)。眼针组根据辨证分型选取下焦区、肝区、肾区、心区和脾区等,采用眼针治疗。药物组于月经来潮前1~2 d或有症状时开始口服布洛芬缓释胶囊300 mg,每12 h 口服1次,连服3~5 d。两组均以3个月经周期为一疗程,观察两组患者外周血PGF2α含量及治疗结束后3个月、6个月的疗效和复发情况。结果:治疗结束3个月后两组疗效比较,眼针组痊愈率为55.0%(33/60)、总有效率为95.0%(57/60),均优于药物组的34.0%(17/50)、82.0%(41/50)(均P<0.05);治疗结束6个月经周期后随访,眼针组复发率为9.1%(3/33),明显低于药物组的35.3%(6/11);两组治疗后经期外周血PGF2α含量均明显降低(均P<0.01)。结论:眼针治疗原发性痛经疗效显著,并能降低原发性痛经患者经期外周血PGF2α水平。     

小柴胡汤加减治疗经前期综合征乳房胀痛的疗效观察

目的：观察运用小柴胡汤加减治疗经前期综合征（PMS）乳房胀痛的临床疗效。方法：选择62例PMS乳房胀痛患者,其中对照组31例采用常规疗法治疗,即应用布洛芬、氟西汀及维生素B6治疗;治疗组31例采用小柴胡汤加减治疗。结果：两组治疗第1、第2、第3个月经周期,VAS评分比较,P〈0.05,差异有统计学意义;两组第3个月经周期临床疗效上比较,P〈0.05,差异有统计学差异。结论：治疗组与对照组比较,更可以减轻疼痛,临床疗效优于对照组。     

子午流注纳甲法治疗原发性痛经的疗效观察

目的:探究子午流注纳甲法治疗原发性痛经的疗效。方法:选取2017年12月-2018年12月我院收治的原发性痛经患者80例。采用随机数字表法,将研究对象划分为观察组和对照组,各40例,观察组采用子午流注纳甲法取穴,对照组服用去痛片,对比治疗效果。结果:连续治疗3个月经周期后,观察组视觉模拟评分法(Visual Analogue Scale,VAS)评分明显比对照组低;观察组的中医症状评分显著高于对照组;观察组总有效率则高于对照组。两组之间比较差异具有统计学意义(P<0.05)。结论:子午流注纳甲法较之普通治疗对原发性痛经的症状缓解更为有效。     

温针灸联合温经汤治疗寒凝血瘀型原发性痛经的临床研究

目的:探讨温针灸联合温经汤治疗寒凝血瘀型原发性痛经的临床疗效,为本病治疗提供客观依据。方法:将80例寒凝血瘀型原发性痛经患者随机分为治疗组和对照组,每组各40例,对照组给予温经汤治疗,治疗组在此基础上联合温针灸治疗,两组均连续治疗3个月经周期后评估疗效。结果:治疗组总有效率高于对照组,两组比较差异显著(P<0.05);两组治疗后视觉疼痛模拟评分(Visual Analogue Scale,VAS)、痛经症状评分均较治疗前有所改善,但治疗组优于对照组(P<0.05);两组治疗后中医证候积分均较治疗前有所改善,但治疗组优于对照组(P<0.05);两组治疗后血清前列腺素2α(PGF2α)水平均较治疗前降低(P<0.05),前列腺素E2(PGE2)水平均较治疗前升高(P<0.05);治疗组治疗后复发率显著低于对照组,差异显著具有统计学意义(P<0.05)。结论:温针灸联合温经汤治疗寒凝血瘀型原发性痛经临床疗效显著,可有效改善患者的临床症状,且复发率低,值得临床借鉴。