Lu Chun-Xia, Deng Xue-Jiao, Chen Miao, Xiao Cai-Hong, Cui Jin
Department of Acupuncture and Moxibustion, First Affiliated Hospital of Guizhou University of TCM, Guiyang 550002, China.
School of Acupuncture-Moxibustion and Tuina, Guizhou University of TCM, Guiyang 550025.
Zhongguo Zhen Jiu. 2021 Jul 12;41(7):737-41. doi: 10.13703/j.0255-2930.20200531-k0002.
To prove the therapeutic effect of auricular intradermal needling and auricular point sticking on primary dysmenorrhea (PD), and to explore its mechanism.
A total of 90 patients with PD were randomized into an auricular intradermal needling group, an auricular point sticking group and a placebo group, 30 cases in each one. Neishengzhiqi (TF), Neifenmi (CO), Shenmen (TF), Shen (CO), Jiaogan (AH), Gan (CO) and Pizhixia (AT) were selected in the 3 groups, intradermal needling and cowherb seed sticking were applied respectively in the auricular intradermal needling group and the auricular point sticking group, adhesive tape without needle was stuck in the placebo group. Pressing and kneading for 3 to 4 times were required each day, 3 to 4 min each time, and the intervention was started 5 d before menstruation, once every other day, 4 times each menstrual cycle were as one course, and totally 3 courses were required in the 3 groups. The follow-up was adopted at the next menstruation after treatment. The Cox menstrual symptom scale (CMSS) score, the visual analogue scale (VAS) score and the self-rating anxiety scale (SAS) score before treatment, 1,2,3 courses into treatment and at follow-up were compared, the serum levels of PGFand PGE before and after treatment were detected, and the clinical therapeutic effect was evaluated in the 3 groups.
Compared before treatment, the scores of CMSS, VAS and SAS were decreased at each time point of treatment in the auricular intradermal needling group, 2, 3 courses into treatment and at follow-up in the auricular point sticking group and 3 courses into treatment in the placebo group (<0.001, <0.05). Compared with the auricular point sticking group, the CMSS scores at each time point of treatment and the VAS scores of 1, 2 courses and at follow-up were decreased in the auricular intradermal needling group (<0.05). Compared with the placebo group, the CMSS scores were decreased at each time point of treatment in the auricular intradermal needling group and 3 courses into treatment and at follow-up in the auricular point sticking group (<0.001, <0.05); the VAS scores were decreased at each time point of treatment in the auricular intradermal needling group and the auricular point sticking group (<0.001, <0.05). After treatment, the serum levels of PGF were decreased (<0.05) and the serum levels of PGE were increased (<0.05) in the auricular intradermal needling group and the auricular point sticking group, and the serum levels of PGF were lower than the placebo group (<0.05), the serum levels of PGE were higher than the placebo group (<0.05) in the two groups. Compared with the auricular point sticking group, the serum level of PGF was decreased (<0.05), the serum level of PGE was increased in the auricular intradermal needling group (<0.05). The total effective rates were 93.3% (28/30) in the auricular intradermal needling group and 80.0% (24/30) in the auricular point sticking group, which were both superior to 63.3% (19/30) in the placebo group (<0.05).
Auricular intradermal needling and auricular point sticking can both improve the clinical symptom of primary dysmenorrhea, relieve the pain and anxiety, their mechanism may be related to regulating the serum levels of PGF and PGE. The therapeutic effect of auricular intradermal needling is superior to auricular point sticking, and the placebo effect can be preliminarily excluded.
验证耳穴皮内针与耳穴贴压治疗原发性痛经(PD)的疗效,并探讨其作用机制。
将90例PD患者随机分为耳穴皮内针组、耳穴贴压组和安慰剂组,每组30例。3组均选取内生殖器(TF)、内分泌(CO)、神门(TF)、肾(CO)、交感(AH)、肝(CO)、皮质下(AT),耳穴皮内针组采用皮内针,耳穴贴压组采用王不留行籽贴压,安慰剂组贴无针胶布。每天按压揉捻3~4次,每次3~4分钟,于月经前5天开始干预,隔日1次,每个月经周期治疗4次为1个疗程,3组均治疗3个疗程。治疗后下次月经时进行随访。比较治疗前、治疗1、2、3个疗程及随访时的考克斯月经症状量表(CMSS)评分、视觉模拟评分法(VAS)评分及自评焦虑量表(SAS)评分,检测治疗前后血清PGF和PGE水平,并评价3组临床疗效。
与治疗前比较,耳穴皮内针组治疗各时间点及耳穴贴压组治疗2、3个疗程及随访时、安慰剂组治疗3个疗程时CMSS、VAS及SAS评分均降低(<0.001,<0.05)。与耳穴贴压组比较,耳穴皮内针组治疗各时间点CMSS评分及治疗1、2个疗程及随访时VAS评分降低(<0.05)。与安慰剂组比较,耳穴皮内针组治疗各时间点及耳穴贴压组治疗3个疗程及随访时CMSS评分降低(<0.001,<0.05);耳穴皮内针组和耳穴贴压组治疗各时间点VAS评分降低(<0.001,<0.05)。治疗后,耳穴皮内针组和耳穴贴压组血清PGF水平降低(<0.05),血清PGE水平升高(<0.05),且两组血清PGF水平低于安慰剂组(<0.05),血清PGE水平高于安慰剂组(<0.05)。与耳穴贴压组比较,耳穴皮内针组血清PGF水平降低(<0.05),血清PGE水平升高(<0.05)。耳穴皮内针组总有效率为93.3%(28/30),耳穴贴压组为80.0%(24/30),均优于安慰剂组的63.3%(19/30)(<0.05)。
耳穴皮内针与耳穴贴压均能改善原发性痛经临床症状,缓解疼痛与焦虑,其机制可能与调节血清PGF和PGE水平有关。耳穴皮内针疗效优于耳穴贴压,且可初步排除安慰剂效应。