平冲化瘀通络法联合灸法 治疗子宫内膜异位症痛经32例的临床研究

目的: 探讨平冲化瘀通络法联合灸法治疗子宫内膜异位症(Ems)痛经的疗效及神经生长因子(NGF)和前列腺素(PGs)的影响。方法: 63例Ems痛经患者随机按数字法分为对照组31例和观察组32例。对照组采用布洛芬缓释胶囊,0.3 g/次,必要时服用;观察组采用平冲化瘀通络法加艾灸治疗。疗程均为3个月经周期。观察痛经视觉模型评分法(VAS),采用改良的B&B多维量表评价临床症状,检测血清神经生长因子(NGF)、前列腺素F_{2 a}(PGF_{2 a})、前列腺素E₂(PGE₂)、6酮前列腺素F_1a(6-keto-PGF_1a)水平。结果: 观察组综合疗效100%优于对照组的80.6%(P<0.05);治疗后第2、3个月经周期及随访期,观察组痛经VAS评分均低于对照组(P<0.01);治疗后观察组B&B多维量表评分低于对照组(P<0.01);治疗后观察组血清NGF,PGF_2a,PGE₂水平低于对照组(P<0.01),观察组6-keto-PGF_1a高于对照组(P<0.01)。结论: 平冲化瘀通络法联合灸法治疗子宫内膜异位症痛经疗效显著,作用持久,其作用机制可能与其降低NGF水平,调节PGs水平有关。

Clinical Therapeutic Effect of Pingchong Huayu Tongluo Method Combined with Moxibustion Therapy on Treating 32 Cases of Endometriosis Dysmenorrhea

Objective: To discuss the clinical efficacy of Pingchong Huayu Tongluo method combined with moxibustion therapy on treating endometriosis dysmenorrhea and the influence on nerve growth tactor(NGF) and prostaglandin(PGs). Method: Sixty-three patients with endometriosis dysmenorrhea were randomly divided into observation group (n=32) and control group (n=31). Patients in the two groups were both treated with moxibustion therapy. Pingchong Huayu Tongluo method was used to treat the observation group. Three menstrual cycles as one cycle. Dysmenorrhea Visual Analogue Scale(VAS) score was observed and modified B & B multidimensional scaling was used to evaluate the clinical symptoms. Serum NGF,PGF_2a, PGE₂ and 6-keto-PGF_1a levels were tested. Result: The integrated effect of observation group(100%) was better than the control group(80.6%)(P<0.05); on the 2-3 weeks after treatment and follow-up period of the menstrual cycle, the observation group dysmenorrhea VAS scores were lower than the control group (P<0.01); After treatment, B & B multidimensional scale scores of observation group was lower than the control group (P<0.01), serum NGF, PGF_2a, PGE₂ levels of observation group was lower than the control group (P<0.01), 6-keto-PGF_1a of the observation group was higher than the control group (P<0.01). Conclusion: Pingchong Huayu Tongluo method combined with moxibustion therapy on treating endometriosis dysmenorrhea has significant effect, its mechanism may be related to decreased NGF levels and adjust the level of PGs.