创伤与急危重病医学

目的探讨针刺联合膈下逐瘀汤治疗气滞血瘀型痛经患者的疗效及对前列腺素E2(PGE2)、前列腺素F2α(PGF2α)、β-内啡肽(β-EP)的影响。方法选取自2018年6月至2019年11月邢台医学高等专科学校附属医院中医科治疗的100例气滞血瘀型痛经患者为研究对象,按照随机数字表法分为单针组与针汤组,每组50例。单针组给予穴位针刺治疗,针汤组在此基础上给予膈下逐瘀汤治疗,比较两组患者的PGF2α、PGE2、β-EP、痛经症状、疼痛程度、疗效及不良反应发生率。结果治疗前,两组患者的PGE2、PGF2α、β-EP、痛经症状评分及视觉模拟疼痛评分(VAS)比较,差异无统计学意义(P>0.05)。治疗后,两组患者的PGE2、β-EP明显升高,PGF2α、痛经症状评分、VAS评分明显降低,且针汤组变化更显著,差异均有统计学意义(P<0.05)。针汤组的治疗有效率[96.0%(48/50)]明显高于单针组[80.0%(40/50)],差异有统计学意义(P<0.05)。两组的不良反应发生率比较,差异无统计学意义(P>0.05)。结论针刺联合膈下逐瘀汤可有效改善气滞血瘀型痛经患者的PGF2α、PGE2、β-EP水平,减轻痛经症状及程度,疗效较好,安全性高。

Objective To investigate the therapeutic effect of acupuncture combined with Gexiazhuyu decoction on dysmenorrhea of qi stagnation and blood stasis type and its effects on prostaglandin E2(PGE2),prostaglandin F2α(PGF2α),β-endorphin(β-EP).Methods A retrospective study was performed on 100 cases of patients with dysmenorrhea cased by qi stagnation and blood stasis who were admitted from June 2018 to November 2019.Patients were randomly divided into the single acupuncture group and the acupuncture combined decoction group,with 50 patients in each group.The single acupuncture group of patients were given acupoint acupuncture treatment,and the acupuncture combined decoction group of patients were Gexiazhuyu decoction treatment on this basis.PGF2,PGF2α,β-EP,dysmenorrhea symptom,pain degree,curative effect and adverse reaction rate were compared between two groups.Results Before treatment,there was no significant difference in PGE2,PGF2α,β-EP,dysmenorrhea symptom score and visual analogue scale(VAS)between the two groups(P>0.05).After treatment,PGE2 and β-EP of the both groups increased significantly,the dysmorrhea symptom score and VAS score of the two groups reduced significantly,and the change of acupuncture combined decoction group was more significant(P<0.05).The effective rate of acupuncture combined decoction group(96.0%,48/50) was significantly higher than that of single acupuncture group[(80.0%,40/50),P<0.05].There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Acupuncture combined with Gexia Zhuyu decoction can effectively improve the PGF2α,PGE2,β-EP and other pain factors in patients with dysmenorrhea caused by qi stagnation and blood stasis,reduce the symptoms and degree of dysmenorrhea,with good curative effect and high safety.