电针子宫、天枢治疗围绝经期综合征疗效观察

目的:评价电针子宫、天枢加刺关元、三阴交治疗围绝经期综合征的临床疗效。方法:58例围绝经期综合征患者随机分为治疗组与对照组各29例。治疗组采用电针双侧子宫与天枢、针刺双侧关元与三阴交,刺激时间30min,每周3次,4周为一疗程,治疗2个疗程。对照组采用口服戊酸雌二醇,每次1mg,每日1次,连续用药3周,停药1周,共治疗8周;在口服戊酸雌二醇期间的最后10d,同时口服醋酸甲羟孕酮,每次8mg,每日1次。观察治疗前后和治疗结束8周后的绝经期等级评定量表(MRS)评分;检测治疗前后血清雌二醇(E2)、卵泡刺激素(FSH)和黄体生成素(LH)水平。结果:两组治疗后MRS评分较治疗前显著降低(P0.01);血清E2显著升高(P0.01),FSH与LH显著降低(P0.01)。两组治疗后各项指标及有效率的组间比较差异均无统计学意义(P0.05)。随访期的MRS评分,治疗组明显低于对照组(P0.05)。结论:电针子宫、天枢加刺关元、三阴交治疗围绝经期综合征有较好的疗效,疗效与口服西药相当,且远期疗效优于口服西药。

Effectiveness of Electroacupuncture of Zigong(EX-CA 1),etc.in Treatment of Perimenopausal Syndrome Women

Objective To evaluate the curative effect of electroacupuncture(EA)of Zigong(EX-CA 1)and Tianshu(ST 25)and acupuncture of Sanyinjiao(SP 6)and Guanyuan(CV 4)for perimenopausal syndrome(PMS).Methods Fiftyeight PMS patients were equally and randomized into acupuncture group and medication group.EA(10Hz/50 Hz,30min in duration)was applied at Zigong(EX-CA 1)and Tianshu(ST 25)in combination with manual acupuncture stimulation of Sanyinjiao(SP 6)and Guanyuan(CV 4)by twirling the acupuncture needles with small amplitude and till deqi.The treatment was conducted once every other day,three times a week,8weeks altogether.The patients of the medication group were asked to take estradiol valerate(1mg/time,qd)for 3weeks,then,to have one week's rest and continuously took estradiol valerate(1mg/d)and medroxyprogesterone 17-acetate(8mg/d)for 10 days.The therapeutic effects were assessed by Menopause Rating Scale Questionnaire[MRS,composing of 3areas:somatic(4items),psychological(4items)and urogenital(3items)domain].Serum estradiol(E2),follicle stimulating hormone(FSH)and luteotrophic hormone(LH)contents were assayed using ELISA.ResultsAfter the treatment,the scores of the MRS and the contents of serum FSH and LH were significantly decreased in both the acupuncture and medication groups(P<0.01),and serum E2 contents significantly increased in the two groups(P<0.01).No significant differences were found between the two groups in the total effective rates(P>0.05).Eight weeks' follow-up showed that the MRS score of the acupuncture group was significantly lower than that of the medication group(P<0.05).Of the two 29 PMS patients in the medication and acupuncture groups,3(10.3%)and 2(6.9%)cases were under control,22(75.9%)and 21(72.4%)experienced a marked improvement in their symptoms,3(10.3%)and 4(13.8%)were effective,1(3.4%)and 2(6.9%)invalid,with the effective rates being 96.6% and 93.1%,respectively.Eight weeks' follow-up showed that the longterm effect of the acupuncture therapy was obviously superior to that of the medication(P<0.05)according to MRS score.Conclusion Acupuncture therapy is effective in relieving clinical symptoms of PMS women by regulating endocrine hormones,being similar to medication.