School of Kinesiology, Shanghai University of Sport.
Department of Rehabilitation, Shanghai Xuhui Central Hospital, Shanghai, China.
Medicine (Baltimore). 2021 Feb 5;100(5):e23798. doi: 10.1097/MD.0000000000023798.
There are scanty data to apply radial extracorporeal shock wave therapy (rESWT) on the acupuncture points in the lower abdomen to reduce the menstrual pain. This trial aimed to test the rESWT safety and efficacy for treating primary dysmenorrhea (PD).
Forty-four young-women with PD were randomly assigned to one of the three groups: to receive rESWT on the acupuncture points during the follicular phase (Group A, n = 15) or during the luteal phase (Group B, n = 14), or to apply heat patch to the acupuncture points during the follicular phase as the control (Group C, n = 15) over three menstrual cycles. The pain severity (using 0-to-10 visual analog scale), the pain duration (hours), plasma PGF2α prostaglandin F2alpha and prostaglandin E2 (PGE2), self-rating anxiety scale and menstrual blood loss were assessed before and after interventions.
The pain severity and duration significantly decreased in all groups after interventions. Although the reduced pain duration was not different among the groups, the reduced pain severity was more significant (P = .003) in Groups A (-53.8 ± 33.7%) and B (-59.3 ± 36.7%) than in Group C (-18.7 ± 27.1%). The rESWT intervention did not change plasma prostaglandins in Group A, although there was a decreased prostaglandin F2alpha (-20.5 ± 32.9%) in Group B or a decreased PGE2 (-18.9 ± 17.8%) in Group C. The anxiety level showed no change after intervention. The menstrual blood volume reduced slightly after intervention and the change of menstrual blood loss in Group B was significant (P = .038).
The rESWT applications on the abdominal acupuncture points safely and effectively reduced the menstrual pain, which was not associated with the prostaglandin changes. The rESWT-reduced pain seemed equally effective with the intervention applied during the follicular phase or luteal phase of the menstrual cycle. Heat patch placed on the abdominal acupuncture points also reduced the pain severity and duration, indicating that the improved blood flow could effectively alleviate the menstrual pain with PD. The changes in anxiety level and menstrual blood loss were slight after intervention.
应用径向体外冲击波疗法（rESWT）在腹部穴位治疗月经痛的相关数据较少。本试验旨在检验 rESWT 治疗原发性痛经（PD）的安全性和疗效。
将 44 名年轻的 PD 患者随机分为三组：卵泡期（A 组，n=15）或黄体期（B 组，n=14）接受 rESWT 治疗，卵泡期接受穴位热贴治疗作为对照组（C 组，n=15），共三个月经周期。治疗前后采用 0-10 视觉模拟评分（VAS）评估疼痛严重程度、疼痛持续时间（小时）、血浆前列腺素 F2alpha（PGF2α）和前列腺素 E2（PGE2）、焦虑自评量表和月经失血量。
治疗后三组疼痛严重程度和持续时间均显著降低。虽然各组疼痛持续时间无差异，但 A 组（-53.8±33.7%）和 B 组（-59.3±36.7%）疼痛减轻程度显著大于 C 组（-18.7±27.1%）（P=0.003）。A 组 rESWT 干预并未改变血浆前列腺素，B 组前列腺素 F2alpha 减少（-20.5±32.9%），C 组 PGE2 减少（-18.9±17.8%）。干预后焦虑水平无变化。治疗后月经出血量略有减少，B 组变化有统计学意义（P=0.038）。
rESWT 应用于腹部穴位可安全有效地减轻月经痛，与前列腺素变化无关。rESWT 减轻疼痛的效果与卵泡期或黄体期治疗相同。穴位热贴也能减轻疼痛的严重程度和持续时间，提示改善血流能有效缓解 PD 引起的月经痛。干预后焦虑水平和月经出血量变化轻微。
