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穴位注射治疗原发性痛经:一项随机、双盲、对照研究。

Acupuncture point injection treatment of primary dysmenorrhoea: a randomised, double blind, controlled study.

作者信息

Wade C, Wang L, Zhao W J, Cardini F, Kronenberg F, Gui S Q, Ying Z, Zhao N Q, Chao M T, Yu J

机构信息

Richard & Hinda Rosenthal Center for Complementary and Alternative Medicine Research, College of Physicians and Surgeons, Columbia University, New York, New York, USA Institute of East West Medicine, New York, New York, USA.

Obstetrics and Gynecology Hospital, Fudan University, Shanghai, Shanghai, China.

出版信息

BMJ Open. 2016 Jan 5;6(1):e008166. doi: 10.1136/bmjopen-2015-008166.

Abstract

OBJECTIVE

To determine if injection of vitamin K3 in an acupuncture point is optimal for the treatment of primary dysmenorrhoea, when compared with 2 other injection treatments.

SETTING

A Menstrual Disorder Centre at a public hospital in Shanghai, China.

PARTICIPANTS

Chinese women aged 14-25 years with severe primary dysmenorrhoea for at least 6 months not relieved by any other treatment were recruited. Exclusion criteria were the use of oral contraceptives, intrauterine devices or anticoagulant drugs, pregnancy, history of abdominal surgery, participation in other therapies for pain and diagnosis of secondary dysmenorrhoea. Eighty patients with primary dysmenorrhoea, as defined on a 4-grade scale, completed the study. Two patients withdrew after randomisation.

INTERVENTIONS

A double-blind, double-dummy, randomised controlled trial compared vitamin K3 acupuncture point injection to saline acupuncture point injection and vitamin K3 deep muscle injection. Patients in each group received 3 injections at a single treatment visit.

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcome was the difference in subjective perception of pain as measured by an 11 unit Numeric Rating Scale (NRS). Secondary measurements were Cox Pain Intensity and Duration scales and the consumption of analgesic tablets before and after treatment and during 6 following cycles.

RESULTS

Patients in all 3 groups experienced pain relief from the injection treatments. Differences in NRS measured mean pain scores between the 2 active control groups were less than 1 unit (-0.71, CI -1.37 to -0.05) and not significant, but the differences in average scores between the treatment hypothesised to be optimal and both active control groups (1.11, CI 0.45 to 1.78) and (1.82, CI 1.45 to 2.49) were statistically significant in adjusted mixed-effects models. Menstrual distress and use of analgesics were diminished for 6 months post-treatment.

CONCLUSIONS

Acupuncture point injection of vitamin K3 relieves menstrual pain rapidly and is a useful treatment in an urban outpatient clinic.

TRIAL REGISTRATION NUMBER

NCT00104546; Results.

摘要

目的

与其他两种注射治疗方法相比,确定穴位注射维生素K3是否为原发性痛经的最佳治疗方法。

设置

中国上海一家公立医院的月经失调中心。

参与者

招募年龄在14 - 25岁之间、患有严重原发性痛经至少6个月且未通过任何其他治疗缓解的中国女性。排除标准包括使用口服避孕药、宫内节育器或抗凝药物、怀孕、腹部手术史、参与其他疼痛治疗以及继发性痛经的诊断。80例原发性痛经患者(根据4级量表定义)完成了研究。两名患者在随机分组后退出。

干预措施

一项双盲、双模拟、随机对照试验将维生素K3穴位注射与生理盐水穴位注射及维生素K3深部肌肉注射进行了比较。每组患者在一次治疗就诊时接受3次注射。

主要和次要结局指标

主要结局是通过11单位数字评分量表(NRS)测量的疼痛主观感受差异。次要测量指标是考克斯疼痛强度和持续时间量表以及治疗前后及随后6个周期内止痛片的消耗量。

结果

所有3组患者的注射治疗均使疼痛得到缓解。两个活性对照组之间NRS测量的平均疼痛评分差异小于1个单位(-0.71,CI -1.37至-0.05)且无统计学意义,但在调整后的混合效应模型中,假设为最佳治疗组与两个活性对照组之间的平均评分差异(1.11,CI 0.45至1.78)和(1.82,CI 1.45至2.49)具有统计学意义。治疗后6个月,月经困扰和止痛片的使用减少。

结论

穴位注射维生素K3可迅速缓解经期疼痛,是城市门诊中的一种有效治疗方法。

试验注册号

NCT00104546;结果

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f57/4716272/f002f135c253/bmjopen2015008166f01.jpg

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