隔姜灸配合延胡索填脐治疗寒凝血瘀型原发性痛经疗效观察与机制研究

目的:探讨隔姜灸配合延胡索填脐治疗寒凝血瘀型原发性痛经的疗效并分析其机制。方法:选取151例寒凝血瘀型原发性痛经患者,按随机数字表法分为观察组77例和对照组74例。对照组给予布洛芬缓释胶囊治疗,出现痛经时开始服用,直至疼痛缓解,连续服用3个月经周期;观察组在对照组基础上给予隔姜灸配合延胡索填脐治疗,月经来潮前5 d开始施治,持续7 d,1个月经周期为1个疗程,连续灸治3个疗程。观察两组患者治疗前后视觉模拟评分法(VAS)评分、子宫微循环指标子宫动脉阻力指数(RI)、搏动指数(PI)、收缩期峰值/舒张期峰值(A/B)]、血清前列腺素F2α(PGF2α)水平,比较临床疗效。结果:治疗后两组患者VAS评分均下降(P<0.001),不同疗程间的变化趋势也呈下降分布(P<0.001),观察组的下降幅度大于对照组(P<0.001);两组患者治疗后的PI、RI及A/B值明显低于治疗前(P<0.05),观察组PI、RI及A/B值下降程度高于对照组(P<0.001);治疗后两组患者血清PGF2α水平均低于治疗前(P<0.05),观察组降低幅度大于对照组(P<0.001)。治疗后观察组总有效率为92.21%,高于对照组的81.08%(P<0.05)。结论:采用隔姜灸配合延胡索填脐治疗原发性痛经疗效显著,其机制可能与降低血清PGF2α水平、改善子宫血液循环有关。

Effect and Mechanism of Ginger Moxibustion plus Yanhusuo Filling Umbilicus on Patients with Primary Dysmenorrhea of Cold Congealing and Blood Stasis Syndrome

Objective:To investigate the effect and mechanism of ginger moxibustion plus Yanhusuo(Corydalis Rhizome)filling umbilicus on patients with primary dysmenorrhea of cold congealing and blood stasis syndrome.Methods:There were 151 patients with primary dysmenorrhea of cold congealing and blood stasis included.The patients were divided into observation group(77 cases)and control group(74 cases)using a random number table.The control group was given ibuprofen sustained-release capsules at the occurrence of dysmenorrhea,and was treated for 3 menstrual cycles.The observation group were also given ginger moxibustion plus Yanhusuo(Corydalis Rhizome)filling umbilicus,5 days before the menstruation,and for 7 days,1 menstrual cycle as 1 treatment course,and was treated for 3 treatment courses.The visual analogue scale(VAS)score,and uterine microcirculation indexesuterine artery resistance index(RI),pulsatility index(PI),peak systolic flow velocity/peak diastole flow velocity(S/D)]before and after the treatment in the two groups were observed.Serum levels of prostaglandin(PG)F2αwas measured,and clinical effectiveness was compared.Results:After treatment,the VAS scores of both groups showed a downward trend and a downward trend in each treatment course(P<0.001).The decrease of VAS in the observation group was higher than that in the control group(P<0.001).After the treatment,the PI,RI and S/D values of the two groups were significantly lower than those before the treatment(P<0.05),and the decrease of PI,RI and S/D values of the observation group was higher than that of the control group(P<0.001).After the treatment,the levels of serum PGF2αin the two groups were significantly lower than those before treatment(P<0.05).The decrease of serum PGF2αin the observation group was higher than that of control group(P<0.001).After the treatment the total effective rate was 92.21%in the observation group,and was obviously higher than that in the control group(81.08%)(P<0.05).Conclusions:Ginger moxibustion plus Yanhusuo(corydalis rhizome)filling umbilicus has a significant effect on patients with primary dysmenorrhea.The mechanism might be reducing serum PGF2αlevel and improving uterine blood circulation.