原发性痛经的防治

妇女在月经期,由于盆腔充血而有少腹部轻度坠胀感,这并非病理性的;当症状严重以致影响工作、学习和日常生活,并需服药,则谓之痛经。因生殖器官的器质性病变,如子宫内膜异位症、急慢性盆腔炎等引起的痛经,称继发性痛经。而月经初潮后不久的少女或未婚未孕的年轻妇女的痛经,则多为功能性的,无器质性病变,称原发性痛经。 研究证明:子宫内膜和血内前列腺素含量的增高是造成痛经的决定性因素。月经血中含有较多的前列腺素E_2(PGE_2)和前列腺素F_(2α)(PGF_(2α))。经测定,分泌型子宫内膜     

原发性痛经及其治疗

痛经（Dysmenorrhea）指月经前后或行经期间下腹及腰部有疼痛、坠胀感，严重时伴有恶心、呕吐、肢冷等症状。可分为2大类：一种是原发性痛经（Primary Dysmenorrhea，PD），又称功能性痛经，妇科检查盆腔无明显的生殖器官器质性病变，一般在初潮开始就会发生，以月经初潮后2～3年多见，多发于青年未婚女性，每次月经来潮时小腹疼痛难忍或痛达腰骶、面色苍白、手足冰冷或伴恶心，甚至剧痛晕厥。另一种是由明确疾病引起的痛经称为继发性痛经（Secondary Dysmenorrhea），与原发性痛经的区别在于是由生殖器炎症、子宫肌瘤、子官内膜异位等生殖器官疾病引起，一般在行经规律一段时间后才开始发生。     

原发性痛经的临床诊治分析

目的研究采用中医和西医相结合的方法治疗原发性痛经临床效果如何。方法选择2009年3～6月我院门诊60例原发性痛经患者,分为A组和B组,对A组患者中西医结合法治疗,B组患者用西药治疗,最后对2组治疗效果进行比较。结果 A组(中西医结合治疗组)30例病人,无效2例,显效10例,治愈18例,治愈率为93.3%。B组(西药治疗组)30例病人,无效10例,显效6例,治愈14例,治愈率为66.6%,A组比B组治愈率高。2组进行比较有统计学意义(P<0.05)。结论治疗原发性痛经,中医和西医相结合的方法效果好治愈率高,在临床上值得推广应用。     

钙镁制剂对原发性痛经改善的临床研究

目的:通过对青春期原发性痛经女性服用钙镁制剂(乐力),补充钙、镁等元素,观察其对原发性青春期痛经的改善效果。方法:选择青春期患有原发性痛经的女性158例,服用"乐力",随访其痛经程度等常见症状的改善情况。结果:在158例受试对象中,150例填写患有不同程度的痛经,占总例数的94.9%(有8例在调查表中该项目未填写,按缺失值对待)。服药后重度痛经由26例降为12例,中度痛经由46例降为26例,其中有18例完全缓解,服药前后两组比较,χ2=26.16,P<0.01,有显著性差异。结论:通过补充钙、镁等矿物质,可明显缓解原发性痛经;停药后,有症状反弹现象。     

原发性痛经及其家庭护理

妇女行经期间或行经后有轻微腹痛、下坠等不适，是正常现象。但若这些不适明显加重，以致影响工作及生活需要治疗时，则称为痛经。痛经可分为原发性和继发性两种，而原发性痛经于初潮后即开始，多为功能性，多见于未婚未育的年轻女性；疼痛多在行经数小时后，或在经前1-2天开始，经期多为腹绞痛、胀痛、坠痛，疼痛剧烈时伴有恶心、呕吐、面色苍自、四肢发冷，甚至虚脱等症状。原发性痛经一般由以下几种因素引起：     

妇女痛经丸治疗原发性痛经的临床疗效观察

目的观察妇女痛经丸治疗原发性痛经的临床疗效。方法根据随机原则,将72例原发性痛经患者分为治疗组与对照组,每组36人,分别给予妇女痛经丸及布洛芬缓释胶囊治疗3个月经周期。结果治疗组总有效率为94.4%,其中治愈15例,显效14例,有效5例,无效2例;对照组总有效率为80.6%,其中治愈5例,显效7例,有效17例,无效7例,治疗组疗效优于对照组,差异显著(P<0.05)。结论妇女痛经丸治疗原发性痛经疗效显著,且其疗效优于芬必得缓释胶囊。     

认识原发性痛经

柳絮月经来的晚,14岁才初潮。刚开始惜懵懂懂的不知道,此后每次月经来临时都会发生小腹疼痛。那时年龄小,羞于求医,以为女人来月经都是如此,就一直忍着。拖到现在19岁了,最近一年来感觉经前疼痛越来越重,有时痛得浑身发抖,手脚冒虚汗,还觉得恶心想吐,严重时小肚子就像在痉挛。实在受不了了,这才在室友的劝说下来到医院,医生诊断说是原发性痛经。     

穴位埋线治疗未育女性原发性痛经的临床研究

目的探讨穴位埋线疗法对未育女性原发性痛经的疗效。方法选取2012年11月--2013年11月我科就诊的原发性痛经患者65例,随机分为实验组与对照组;实验组于经前对关元、子宫、三阴交进行穴位埋线治疗;对照组常规服用药物治疗,比较2组治疗效果。结果实验组的疗效明显高于对照组（P〈0．05）。结论微创穴位埋线疗法对未育女性原发性痛经安全有效,患者治疗依从性高,值得,临床推广。     

工间操结合暖宫贴对缓解女性原发性痛经的疗效

目的评价工间操结合暖宫贴治疗方法对缓解电子行业流水线作业女工原发性痛经的疗效,为女工生殖保健提供参考。方法采用前瞻性研究方法,将105名流水线作业的原发性痛经女工随机分为观察组(65名)和对照组(40名)。对照组进行工间操干预治疗,观察组在工间操基础上加用暖宫贴下腹部敷贴,两组治疗时间均为3个月经周期。结果观察组和对照组患者治疗后痛经程度均有所减轻,治疗前后痛经评分差异有统计学意义(χ2=5.99,χ2=3.72,P0.05)。两组重度痛经患者治疗总有效率比较,差异有统计学意义(P0.05);显效率分别为66.7%和23.5%,两组的差异有统计学意义(P0.01)。结论工间操结合暖宫贴对流水线作业女工原发性痛经治疗有一定作用。     

Comorbid pain experiences in young women with dysmenorrhea

ABSTRACT

The association among dysmenorrhea, chronic pain, and conditions classified as central sensitivity syndromes (CSS) is largely unknown. We investigated the co-occurrence of dysmenorrhea with chronic pain and other CSS (e.g., fibromyalgia, migraines); and, whether severity of menstrual symptoms was associated with severity of chronic pain and of somatic symptoms. Women from a mid-sized Canadian university women (N = 248, Mage = 21.52) completed measures of menstrual pain severity, chronic pain severity, somatic symptoms severity, and the presence of comorbid CSS. Pearson’s correlations assessed the relationship between severity of dysmenorrhea, chronic pain, and somatic symptoms. MANOVA procedures assessed the interaction between dysmenorrhea and chronic pain and χ² analyses were used to test the frequency of CSS among women with dysmenorrhea. Higher ratings of menstrual symptom severity were associated with increased chronic pain severity (r =.66, p <.001), and somatic symptom severity (r =.66, p <.001). Women with dysmenorrhea were not more likely to experience chronic pain, but were more likely to report a CSS, χ² (1) = 5.12, p <.05. Dysmenorrhea symptoms may extend beyond the menstrual phase and be associated with more severe symptoms among women with comorbid pain and somatic concerns.     

Skipping breakfast is associated with dysmenorrhea in young women in Japan

To evaluate the effects of breakfast habits on the quality of life in young women in Japan, the relation between breakfast habits and menstrual and intestinal disorders was estimated by responses to a questionnaire. Subjects were recruited from young Japanese female students of Ashiya College ranging in age from 18 to 20 years. Breakfast habits were classified into three groups (group I, having breakfast every morning, n=289; group II, having breakfast one to six times per week, n=106; group III, having breakfast less than once a week, n=44). The intensity of dysmenorrhea was classified into three grades (score 1, free of pain or painful, but without need for analgesic; score 2, painful, requiring analgesic; score 3, painful, not relieved by analgesic). The grades of bowel movement were classified into three groups (score 1, no more than once a week; score 2, two to six times a week; score 3, every day). Group II and group III had significantly higher scores for dysmenorrhea compared with group I. Students in group III showed a tendency toward constipation. Since dysmenorrhea is a risk factor for psychological disorders as well as gynecological diseases, the present study suggests the importance of eating breakfast to the quality of life of young women.     

结核病一级目标人群健康教育形式研究

目的探索结核病健康教育的有效形式,改善结核病患者治疗依从性,提高结核病治愈率,提高结核病控制工作质量。方法运用多种健康教育载体,强化结核病患者治疗前教育。结果2003~2005年,初诊患者就诊率、涂阳患者登记率、涂阳患者治愈率等指标逐年提高,患者中断治疗率逐年下降。结论科学的健康教育形式、方法和载体是提高健康教育质量的保证,是结核病控制不可或缺的重要组成部分。     

硫酸沙丁胺醇治疗重度原发性痛经的临床观察

目的 探讨应用硫酸沙丁胺醇治疗重度原发性痛经的临床效果.方法 将100例重度原发痛经患者随机分为实验组和对照组各50例,给予实验组患者硫酸沙丁胺醇4.8mg,每6小时1次口服,治疗至症状消失,给予对照组患者布洛芬0.4g,每8小时1次口服,治疗至症状消失.结果 实验组中显效率和总有效率分别为80%和100%,对照组分别为12%和24%,两组经比较具有显著性差异(u分别为6.83和7.84,均P<0.01);实验组有效率为20%,对照组有效率为12%,两者比较无显著性差异(u=1.09,P>0.05).结论 硫酸沙丁胺醇治疗重度原发性痛经安全高效,经济方便.     

Thinness among young Japanese women

OBJECTIVES: We described changes in body mass index (BMI) and the prevalence of thinness among young Japanese women (aged 15-29 years) from 1976 to 2000 by reanalyzing the nationwide data in the National Nutrition Survey, Japan. METHODS: We used height and weight data sets for 30 903 nonpregnant, nonlactating women during the 25-year period. We calculated the mean values of BMI and the prevalence of thinness for 3 age groups (15-19, 20-24, and 25-29 years of age). RESULTS: Changes in BMI per 10 years were -0.17 kg/m2, -0.22 kg/m2, and -0.34 kg/m2 for each age group, respectively. Extreme thinness (BMI < 17 kg/m2) increased from 2.4% in 1976-1980 to 4.2% in 1996-2000. CONCLUSIONS: Further studies regarding topics such as increased smoking prevalence are needed to identify the underlying causes of increasing thinness.     

医专女生原发性痛经自我管理健康教育干预效果分析

评估自我管理健康教育对医专女生原发性痛经的干预效果,为有效降低女生原发性痛经的发生提供参考.方法 在邵阳医学高等专科学校按分层整群随机抽样方法,经问卷调查和临床检查筛选出符合纳入标准的原发性痛经者320名,随机分为干预组和对照组各160名.干预组实施自我管理健康教育,对照组不采取任何干预措施,追踪观察6个月后比较干预前后两组的痛经频率、痛经症状积分和生命质量.结果 干预后,干预组的痛经频率(2.16±1.01)次、痛经症状积分(7.57±2.56)较干预前明显下降[(4.63±0.73)次,(10.26±3.45)分](t值分别为26.866,11.969,P值均<0.01),与对照组[(4.45±1.02)次,(9.88±2.59)分]比较差异也均有统计学意义(t值分别为20.232,8.036,P值均<0.01);干预组生命质量维度中躯体疼痛、总健康状况、情感职能、生理健康总分和心理健康总分均高于干预前,且躯体疼痛、活力、生理健康总分均高于对照组(P值均<0.05).结论 自我管理健康教育能减少原发性痛经女生的痛经频率、减轻痛经症状,提高生命质量.     

隔药灸治疗前后不同证型原发性痛经患者生殖激素水平检测研究

目的探讨隔药灸治疗前、后不同证型原发性痛经患者血清生殖激素水平变化情况。方法选取采用隔药灸治疗的原发性痛经患者280例为研究对象,根据中医辩证分型分为气滞血瘀型98例、寒湿凝滞型65例、湿热瘀结型50例、气血虚弱型35例和肝肾亏损型32例,比较不同证型原发性痛经患者采用隔药灸治疗的总有效率及治疗前、后血清雌二醇(E_2)、孕酮(P)、前列腺素F2α(PGF2α)和前列腺素E_2(PGE_2)含量水平。结果原发性痛经气滞血瘀型临床疗效优于寒湿凝滞、湿热瘀结、气血虚弱和肝肾亏损型,差异有统计学意义(P0.01)。气滞血瘀型能降低患者E_2和PGF2α含量,升高P和PGE_2含量,差异有统计学意义(P0.01)。寒湿凝滞型也能降低患者E_2和PGF2α含量,升高P和PGE_2含量,差异有统计学意义(P0.01)。而气血虚弱型和肝肾亏损型治疗前、后比较差异无统计学意义(P0.05)。结论隔药灸脐法治疗原发性痛经气滞血瘀型和寒湿凝滞型疗效显著,其作用机制可能与降低血清E_2、PGF2α水平及升高P和PGE_2含量参与调节机体生殖内分泌水平有关。     

原发性痛经患者与外周血白细胞介素相关性研究

目的:探讨原发性痛经病人中免疫发病机制。方法:临床随机病例对照研究。选取原发性痛经患者64例,平均年龄(22.3±7.1)岁,正常对照组健康女性60例,平均年龄(21.5±5.4)岁,比较外周血白细胞介素-3(IL-3),IL-4,IL-5,IL-10和INF-γ水平。结果:原发性痛经组病人经期IL-10(23.95±5.71)pg/ml显著高于经前(10.53±1.33)pg/ml及正常对照组经前(11.14±1.41)pg/ml和经期(16.25±2.99)pg/ml(P<0.01),IL-3,IL-4,IL-5和INF-γ各组间差异无统计学意义(P>0.05)。结论:原发性痛经病人中存在Th1/Th2细胞因子分泌水平改变,表现为Th2型细胞因子IL-10分泌水平增高。     

大学生原发性痛经行为干预效果分析

目的目前,女大学生痛经发生率较高,其症状严重影响了大学生经期生活质量。本研究了解健康教育和综合干预对女大学生痛经的改善效果,综合分析痛经女大学生对综合干预措施的具体实施情况。方法选择2018-09-01—2019-06-30就读于吉首大学的130例痛经大学生为研究对象,按照报名参与干预的先后顺序分为对照组和试验组,对其进行对症处理、运动、睡眠、饮食和日常生活等行为干预,试验组在此基础上进行健康教育和综合干预。干预6个月后,观察两组干预效果和行为改变情况。结果干预6个月后,试验组总有效率为75.71%,高于对照组的43.33%,差异有统计学意义,χ~2=14.209,P<0.001。干预前试验组和对照组各项行为差异无统计学意义,均P>0.05。干预后两组运动(χ~2=16.081,P<0.001)、睡眠(χ~2=21.840,P<0.001)、饮食(χ~2=27.695,P<0.001)及保暖(χ~2=23.675,P<0.001)行为比较,差异有统计学意义;卫生及经期禁忌行为差异无统计学意义,均P>0.05。结论针对性健康教育和综合干预措施,可有效缓解女大学生痛经的痛苦,提高高校女生经期生活质量和健康水平。健康合理生活习惯对改善痛经有重要意义。     

Diet during adolescence is a trigger for subsequent development of dysmenorrhea in young women

Recently many young women in Japan have been restricting their dietary intake for cosmetic purposes. In this study, the relation between diet and menstrual disorders was investigated by responses to a questionnaire. Subjects ranging from 18 to 20 years old were recruited from 716 female students at Ashiya College. Dietary habits were classified into group I (having no experience with dieting), group II (those currently on a diet) and group III (those with a history of dieting). The intensity of dysmenorrhea was classified into three grades. All participants were divided into two groups as having regular or irregular menstruation. The frequency of irregular menstruation in group II was higher than that in the other groups, while group III had higher intensity of dysmenorrhea than the other groups. These findings suggest that diet during adolescence has long-lasting adverse effects on reproductive function in young women.