针灸治疗气虚血瘀型子宫内膜异位症痛经的效果分析

Effect analysis of acupuncture in the treatment of dysmenorrhea in endometriosis with qi deficiency and blood stasis

关键词:  针灸  气虚血瘀型  子宫内膜异位症  痛经

Key words:  acupuncture  qi deficiency and blood stasis type  endometriosis  dysmenorrhea

摘要:

[目的] 分析针灸治疗气虚血瘀型子宫内膜异位症痛经的效果。[方法] 选取河北省中医院及河北医科大学第一医院2022年1月—2022年6月诊治的60例气虚血瘀型子宫内膜异位症痛经患者，按照随机数字表法分为三组，分别为西药组（口服屈螺酮炔雌醇片(Ⅱ)）20例、中药组（益气化瘀中药免煎颗粒）20例、针灸组（主穴：中脘、气海、关元、中极穴等）20例，比较三组治疗效果。[结果] 针灸组总有效率高于中药组、西药组（P＜0.05）；治疗前，三组疼痛控制情况比较（P＞0.05）；治疗第4周、8周、12周，针灸组VAS评分低于中药组、西药组（P＜0.05）；治疗前，三组中医证候评分比较（P＞0.05）；治疗后，针灸组中医证候评分低于中药组、西药组（P＜0.05）；治疗前，三组血流动力学指标比较（P＞0.05）；治疗后，针灸组子宫内膜血流搏动指数（PI）、阻力指数（RI）低于中药组、西药组（P＜0.05）；治疗前，三组免疫功能指标比较（P＞0.05）；治疗后，针灸组CD4⁺/CD8⁺、CD4⁺高于中药组、西药组（P＜0.05），CD8⁺低于中药组、西药组（P＜0.05）；治疗前，三组生存质量评分比较（P＞0.05）；治疗后，针灸组生存质量评分低于中药组、西药组（P＜0.05）。组间不良反应发生对比无显著差异（P＞0.05）。[结论] 针灸治疗气虚血瘀型子宫内膜异位症痛经，可改善患者内分泌功能与血流动力学状态，增强患者的免疫功能，提高镇痛效果。

Abstract:

[Objective] To analyze the effect of acupuncture in the treatment of endometriosis dysmenorrhea with qi deficiency and blood stasis. [Methods] A total of 60 patients with endometriosis with qi deficiency and blood stasis and dysmenorrhea diagnosed and treated by Hebei Provincial Hospital of Traditional Chinese Medicine and the First Hospital of Hebei Medical University from January 2022 to June 2022 were selected and divided into three groups according to the random number table method，including 20 cases in the Western medicine group（oral drospirenone ethinylestradiol tablets（Ⅱ.），20 cases in the traditional Chinese medicine group（Chinese medicine non-decoction granules for qi and blood stasis），and 20 cases in the acupuncture group（main acupoints: Zhongguan，Qihai，Guan Yuan，Zhongji acupoints，etc.），and the treatment effects of the three groups were compared From January 2022 to June 2022，60 patients with endometriosis dysmenorrhea diagnosed and treated by our hospital were selected and divided into three groups according to the random number table method，including 20 cases in the western medicine group，20 cases in the traditional Chinese medicine group and 20 cases in the acupuncture group，and the treatment effects of the three groups were compared. [Results] The total effective rate of the acupuncture and moxibustion group was higher than that of the traditional Chinese medicine group and the western medicine group（P<0.05）；Comparison of pain control among the three groups before treatment（P>0.05）；At the 4th，8th and 12th week of treatment，the VAS score of the acupuncture and moxibustion group was lower than that of the traditional Chinese medicine group and the western medicine group（P<0.05）；Before treatment，compare the TCM syndrome scores of the three groups（P>0.05）；After treatment，the TCM syndrome score of the acupuncture and moxibustion group was lower than that of the traditional Chinese medicine group and the western medicine group（P<0.05）；Comparison of hemodynamic indicators among the three groups before treatment（P>0.05）；After treatment，the pulsation index（PI） and resistance index（RI） of endometrial blood flow in the acupuncture and moxibustion group were lower than those in the traditional Chinese medicine group and the western medicine group（P<0.05）；Before treatment，compare the immune function indicators of the three groups（P>0.05）；After treatment，CD4⁺/CD8⁺ and CD4⁺ in the acupuncture and moxibustion group were higher than those in the traditional Chinese medicine group and western medicine group（P<0.05），while CD8⁺ was lower than those in the traditional Chinese medicine group and western medicine group（P<0.05）；Comparison of quality of life scores among the three groups before treatment（P>0.05）；After treatment，the quality-of-life score of the acupuncture and moxibustion group was lower than that of the traditional Chinese medicine group and the western medicine group（P<0.05）；There was no significant difference in the occurrence of adverse reactions between groups（P>0.05）. [Conclusion] Acupuncture for the treatment of endometriosis dysmenorrhea with qi deficiency and blood stasis can improve the endocrine function and hemodynamic status of patients，enhance the immune function of patients，and improve the analgesic effect.