艾灸治疗147例寒凝血瘀证原发性痛经患者的临床观察

目的探索艾灸治疗寒凝血瘀证原发性痛经的临床疗效。方法选取2014年7月至2017年1月期间门诊原发性痛经患者147例,予艾灸治疗,连续治疗3个月经周期、随访3个月,观察临床有效率、中医证候、疼痛视觉模拟评分量表(visual analogue scale,VAS)评分、COX痛经症状评分(Cox Menstrual Symptom Scale,CMSS)、疼痛持续时间、止痛药的使用、生活质量各领域指标的变化。结果(1)治愈11例,好转55例,未愈81例,临床总有效率为44.89%;(2)治疗2个月经周期后患者的小腹冷痛、经量少、经色黯而有瘀块,畏寒肢冷,面色青白、证候总分均较治疗前及治疗1个月经周期后显著降低(P<0.05);治疗3个月经周期后患者的小腹冷痛、经量少、经色黯而有瘀块,畏寒肢冷,证候总分较治疗2个月经周期后显著降低(P<0.05),面色青白与治疗2个月经周期无显著差异(P>0.05);治疗1个月后寒凝血瘀证小腹冷痛、经色黯而有瘀块,畏寒肢冷,面色青白、证候总分较治疗前显著降低(P<0.05),经量少与治疗前无显著差异(P>0.05)。(3)艾灸治疗寒凝血瘀证PD患者3个月经周期后,患者的VAS、CMSS评分、疼痛持续时间、止痛药物使用率显著降低(P<0.01)。(4)艾灸治疗寒凝血瘀证PD患者3个月经周期后,患者的生存质量感受、生理领域、心理领域、社会关系领域、环境领域评分较治疗前显著增加(P<0.01)。结论艾灸治疗寒凝血瘀证原发性痛经具有一定的疗效,明显改善PD患者寒凝血瘀症候表现、痛经症状及生活质量,降低止痛药的使用。

Clinical observation of 147 patients of primary dysmenorrhea of cold and blood stagnation syndrome in treatment with moxibustion

Objective To explore the clinical effect of moxibustion on primary dysmenorrhea of cold and blood stagnation pattern.Methods From July 2014 to January 2017,147 outpatients of primary dysmenorrhea were treated with moxibustion continuously for 3 menstrual cycles and 3-month follow-up.The clinical effective rate,TCM symptoms,VAS(visual analogue scale)scores,CMSS(Cox menstrual symptom scale)score,pain persistent time,usage of painkiller and the indexes of living quality were observed.Results 1.11 cases were cured,55 cases improved and 81 cases failed.The total effective rate was 44.89%.2.After treatment for 2 to 3 menstrual cycles,the total score of the symptoms were reduced significantly as compared with the score before treatment and after 1 menstrual cycle,such as cold pain in the lower abdomen,scanty menstrual flow,dark color with clots,aversion to cold and cold limbs and pale complexion(P<0.05).After treatment for 3 menstrual cycles,the total score of the symptoms were reduced significantly as compared with the score after 2 menstrual cycle,such as cold pain in the lower abdomen,scanty menstrual flow,dark color with clots,aversion to cold and cold limbs(P<0.05).The score for pale complexion was not different significant as compared with that after treatment for 2 menstrual cycles(P>0.05).After 1 month treatment,the total score of the symptoms were reduced significantly as compared with the score before treatment,such as cold pain in the lower abdomen,dark color with clots,aversion to cold and cold limbs and pale complexion(P<0.05).The score for scanty menstrual flow was not different significantly as compared with that before treatment(P>0.05).3.After treatment for 3 menstrual cycles,VAS score,CMSS score,pain persistent time and the usage rate of painkiller were reduced(P<0.01).4.After treatment for 3 menstrual cycles,the scores in perceptive field,mental field,social relationship and environment of quality of life(QOL)were all increased significantly as compared with those before teratment(P<0.01).Conclusion Moxibustion is effective on primary dysmenorrhea of cold and blood stagnation pattern.It obviously relieves the symptoms of cold and blood stagnation,dysmenorrhea,improves QOL and reduces the usage of painkiller.