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一种治疗原发性痛经的创新针灸疗法:一项随机交叉试点研究。

An innovative acupuncture treatment for primary dysmenorrhea: a randomized, crossover pilot study.

作者信息

Chao Maria T, Wade Christine M, Abercrombie Priscilla D, Gomolak Denise

出版信息

Altern Ther Health Med. 2014 Jan-Feb;20(1):49-56.

Abstract

CONTEXT

Dysmenorrhea, the occurrence of painful menstrual cramping of the uterus, is a major cause of activity restriction and absences from school and work among young women. Standard pharmaceuticals used to treat dysmenorrhea are not effective for all women and have side effects that limit their use. Studies elsewhere have shown beneficial effects for use of vitamin K1 as an acupoint treatment, but the acceptability of this treatment to women in the United States has been unknown.

OBJECTIVE

The study intended to examine the feasibility, acceptability, and preliminary effects of acupuncture point injection of vitamin K1 as an alternative treatment for primary dysmenorrhea among US women.

DESIGN

The research team conducted a pilot study using a blinded, randomized, crossover trial design.

SETTING

The study took place at the University of California, San Francisco (UCSF).

PARTICIPANTS

The study was conducted in the San Francisco Bay Area among women 18 to 25 y of age who had been diagnosed with primary dysmenorrhea. Fourteen women completed all of the study's visits.

INTERVENTION

Women with primary dysmenorrhea were randomized into 2 groups to receive bilateral injections of vitamin K1 in the Spleen-6 (SP-6) acupuncture point at the start of menstruation and then, following a 2-mo washout period, saline in a nonacupuncture point at the start of menstruation. One group received the vitamin K1 injection first, while the other group received the saline injection first.

OUTCOME MEASURE

Dysmenorrhea pain intensity was measured using a 0-10 numeric rating scale (NRS), before and after injections.

RESULTS

Women had an average 2.5-point decrease in pain after a vitamin K1 injection in the SP-6 acupoint (P < .001), as compared with a 1.8-point decrease after a saline injection (P < .001). Change scores for vitamin K1, as compared with a saline injection, approached statistical significance (P < .10). Intensity and duration of menstrual symptoms, as measured by the Cox retrospective symptom scale, also decreased following injections. After participating, 94% of the women remained agreeable to receiving the injection therapy, and 77% reported they would come every month were the treatment available.

CONCLUSIONS

Findings suggested high acceptability for an acupuncture point injection of vitamin K1 as treatment for primary dysmenorrhea among young women in San Francisco. Pain decreased with both treatments, with a trend toward greater pain reduction for the vitamin K1/SP-6 injection. This finding is consistent with outcomes from the Obstetrics and Gynecology Hospital in Shanghai, China, where the protocol was developed.

摘要

背景

痛经是子宫出现疼痛性月经痉挛,是年轻女性活动受限以及缺课和旷工的主要原因。用于治疗痛经的标准药物并非对所有女性都有效,且存在限制其使用的副作用。其他地方的研究表明,使用维生素K1进行穴位治疗有有益效果,但在美国,这种治疗方法对女性的可接受性尚不清楚。

目的

本研究旨在检验穴位注射维生素K1作为美国女性原发性痛经替代治疗方法的可行性、可接受性和初步效果。

设计

研究团队采用双盲、随机、交叉试验设计进行了一项试点研究。

地点

研究在加利福尼亚大学旧金山分校(UCSF)进行。

参与者

研究在旧金山湾区18至25岁被诊断为原发性痛经的女性中开展。14名女性完成了研究的所有访视。

干预措施

原发性痛经女性被随机分为两组,在月经开始时于双侧三阴交(SP-6)穴位注射维生素K1,然后在经过2个月的洗脱期后,在月经开始时于非穴位注射生理盐水。一组先接受维生素K1注射,另一组先接受生理盐水注射。

观察指标

在注射前后,使用0至10的数字评分量表(NRS)测量痛经疼痛强度。

结果

与注射生理盐水后疼痛平均降低1.8分(P <.001)相比,女性在三阴交穴位注射维生素K1后疼痛平均降低2.5分(P <.001)。与注射生理盐水相比,维生素K1的变化得分接近统计学显著性(P <.10)。通过Cox回顾性症状量表测量的月经症状强度和持续时间在注射后也有所降低。参与研究后,94%的女性仍愿意接受注射治疗,77%的女性表示如果有这种治疗,她们会每月前来接受治疗。

结论

研究结果表明,穴位注射维生素K1作为旧金山年轻女性原发性痛经的治疗方法具有较高的可接受性。两种治疗方法均可使疼痛减轻,维生素K1/三阴交注射的止痛效果有更大的降低趋势。这一发现与该方案的研发地中国上海第一妇婴保健院的结果一致。

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