陆煜 马瑞芬 钱黎

[摘要] 目的 考察溫针灸治疗原发性痛经的临床效果与安全性评价。 方法 选取2017年1～10月我院治疗的寒凝血瘀型原发性痛经患者78例，随机分为研究组（39例）和对照组（39例），研究组患者给予温针灸治疗，对照组患者给予口服布洛芬缓释胶囊进行治疗，比较两组患者的临床治疗效果及不良反应的发生率，并检测两组患者治疗前后疼痛视觉模拟评分（visual analogue scale，VAS）及血清内的前列环素E2的水平。结果 研究组患者治疗的总有效率为94.87%，对照组为76.92%，两组相比差异具有统计学意义（P<0.05）；治疗前，两组患者的VAS评分和PGE2水平相比，差异均无统计学意义（P>0.05）；治疗后，与对照组相比，研究组患者的VAS评分和PGE2水平均显著降低，差异具有统计学意义（P<0.05）；研究组患者治疗期间不良反应的总发生率为4例（10.26%），对照组为11例（28.21%），两组相比，差异具有统计学意义（P<0.05）。结论 温针灸治疗寒凝血瘀型原发性痛经的临床效果较好，且安全性较高。

[关键词] 温针灸；原发性痛经；寒凝血瘀型；VAS评分

[中图分类号] R245 [文献标识码] B [文章编号] 1673-9701（2018）08-0134-03

Clinical effect and safety evaluation of needle warming moxibustion in treating primary dysmenorrhea

LU Yu 1，2 MA Ruifen 2 QIAN Li1

1.Department of Obstetrics and Gynecology， Jiashan Chinese Medicine Hospital in Zhejiang Province， Jiashan 314100， China； 2.Department of Obstetrics and Gynecology， Jiaxing Chinese Medicine Hospital in Zhejiang Province， Jiaxing 314001， China

[Abstract] Objective To investigate the clinical efficacy and safety of needle warming moxibustion in the treatment of primary dysmenorrhea. Methods 78 patients with primary dysmenorrhea of type of cold coagulation and blood stasis in our hospital from January to October 2017 were randomly divided into study group（39 cases） and control group （39 cases）. The study group was given needle warming moxibustion. The patients in the control group were given oral sustained-release ibuprofen capsules for treatment. The clinical efficacy and the incidence of adverse reactions were compared between the two groups. The visual analogue scale（VAS） and serum prostacyclin E2 level were detected before and after the treatment. Results The total effective rate of treatment was 37 cases（94.87%） in the study group and 30 cases （76.92%） in the control group， where the difference was statistically significant（P<0.05）. There was no significant difference between the two groups in VAS score and PGE2 level（P>0.05） before treatment. While after treatment， the VAS score and the PGE2 level in study group were significantly decreased compared with control group， where the difference was statistically significant（P<0.05）. The total incidence of adverse reactions in study group was 4 cases （10.26%） during the treatment period， while the incidence of adverse reactions in the control group was 11 cases （28.21%）. The difference was statistically significant（P<0.05）. Conclusion Needle warming moxibustion treatment for primary dysmenorrhea with the type of cold coagulation and blood stasis showed better clinical efficacy and higher safety.

[Key words] Needle warming moxibustion； Primary dysmenorrhea； The type of cold coagulation and blood stasis； VAS score 原发性痛经（primary dysmenorrheal，PD）是妇科常见的疾病，临床主要表现为小腹部、腰部痉挛性的疼痛、乳房胀痛、腰酸及乏力等，多见于未婚的青年女性[1-3]，西医多采用非甾体抗炎类镇痛药物进行治疗，短期内效果较好，但具有一定的副作用，中医认为痛经的基本病机主要是“不通”，寒凝、血瘀、气血虚弱等均可导致气血运行不畅[4]，温针灸是祖国传统医学的治疗方法之一，既往研究发现温针灸在治疗痛经上具有良好的治疗效果[5]。基于此，本研究考察温针灸治疗原发性痛经的临床效果与安全性评价，现报道如下。

1 资料与方法

1.1 一般资料

选取2017年1～10月我院治疗的寒凝血瘀型原发性痛经患者78例，纳入标准[6]：①参照第7版的《中医妇科学》中关于原发性痛经的诊断标准[6]；……