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原发性痛经患者电针干预前后脉象图测量中与疼痛相关的动态变化及其与中医证型的相关性

Dynamic Pain-Related Changes in Pulse-Graph Measurements in Patients with Primary Dysmenorrhea before and after Electroacupuncture Intervention and Its Correlation with TCM Pattern.

作者信息

Yang Yingying, Wang Tianfang, Dong Jian, Tang Ling, Wang Yanping, Li Ning, Zhao Lihong

机构信息

Department of Diagnostics in Chinese Medicine, School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing 102488, China.

School of Humanities, Beijing University of Chinese Medicine, Beijing 102488, China.

出版信息

Evid Based Complement Alternat Med. 2022 Jan 27;2022:3518179. doi: 10.1155/2022/3518179. eCollection 2022.

Abstract

OBJECTIVE

To explore the dynamic changes recorded in pulse graph related to the changes in the severity of pain before and after electroacupuncture (EA) intervention among young women suffering from primary dysmenorrhea (PD).

METHODS

A total of 147 female college students were recruited in this study. Based on participants' symptoms associated with menstruation, they were divided into the PD group and the healthy control group. In addition, participants in the PD group were further sorted into the Cold Coagulation and Blood Stasis Pattern (CCBSP) and Qi Stagnation and Blood Stasis Pattern (QSBSP) based on TCM diagnoses and their pulses differences. Participants in the PD group received EA at maximal pain during menstruation. The primary acupuncture points selected were SP 6 and RN 3, additional RN 4 for CCBSP, and LR 3 for QSBSP. Four observation time points were 7-10 days before menstruation ( ), maximal pain during menstruation ( ), immediately after EA ( ), and 30 mins after EA ( ). The severity of pain was assessed by a visual analog scale (VAS) along with a pulse analyzer to record the variations of the pulse graph throughout the changes of pain level.

RESULTS

(1) The average VAS score in the PD group decreased from 5.44 ± 1.46 at to 1.72 ± 1.27 at and 1.59 ± 1.30 at . The average VAS score in participants of CCBSP at , , and was higher than that of QSBSP. (2) At , , , , and / were all significantly increased, compared with those at . At , and were both significantly increased, and /, , and / were all significantly decreased, compared with those at . At , /, , and / were all significantly increased, and and were both significantly decreased, compared with those at . (3) Comparing the pulse graphs between the healthy control and the PD groups, was significantly lower at ; / was significantly higher at ; was significantly higher at ; and and / were both significantly higher at in PD group. (4) When comparing the pulse graphs between QSBSP and CCBSP, / was significantly higher at and was significantly higher at in the CCBSP group.

CONCLUSION

EA is effective in relieving primary dysmenorrhea. Our results showed the opposite changing of the pulse graph recorded before the onset of pain to the maximum pain and that from maximum pain to pain relief. Indeed, there were differences in the recorded pulse graphs between CCBSP and QSBSP (two patterns of PD) as described in traditional Chinese pulses diagnosis. The study has been registered in the Chinese Clinical Trial Registry (registered number: ChiCTR2000040065; registered date: 2020/11/19).

摘要

目的

探讨原发性痛经(PD)年轻女性电针(EA)干预前后疼痛程度变化相关的脉象图动态变化。

方法

本研究共纳入147名女大学生。根据参与者与月经相关的症状,将她们分为PD组和健康对照组。此外,根据中医诊断和脉象差异,将PD组参与者进一步分为寒凝血瘀证(CCBSP)和气滞血瘀证(QSBSP)。PD组参与者在月经期间疼痛最剧烈时接受电针治疗。选择的主要穴位为三阴交(SP 6)和关元(RN 3),CCBSP加中极(RN 4),QSBSP加太冲(LR 3)。四个观察时间点分别为月经前7 - 10天( )、月经期间疼痛最剧烈时( )、电针治疗后即刻( )、电针治疗后30分钟( )。通过视觉模拟评分法(VAS)评估疼痛程度,并使用脉象分析仪记录脉象图在疼痛水平变化过程中的变化。

结果

(1)PD组平均VAS评分从 时的5.44±1.46降至 时的1.72±1.27和 时的1.59±1.30。CCBSP组参与者在 、 和 时的平均VAS评分高于QSBSP组。(2)与 时相比,在 、 、 、 时 / 均显著升高。与 时相比,在 时 和 均显著升高, / 、 和 / 均显著降低。与 时相比,在 时 / 、 和 / 均显著升高, 和 均显著降低。(3)比较健康对照组和PD组的脉象图,在 时 显著降低;在 时 / 显著升高;在 时 显著升高;在 时PD组的 和 / 均显著升高。(4)比较QSBSP和CCBSP的脉象图,在 时CCBSP组的 / 显著升高,在 时 显著升高。

结论

电针可有效缓解原发性痛经。我们的结果显示,疼痛发作前至疼痛最剧烈时以及从疼痛最剧烈至疼痛缓解过程中记录的脉象图变化相反。确实,如中医脉象诊断所述,CCBSP和QSBSP(两种PD证型)记录的脉象图存在差异。本研究已在中国临床试验注册中心注册(注册号:ChiCTR2000040065;注册日期:2020/11/19)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9932/8813248/71d55b4fb8d0/ECAM2022-3518179.001.jpg

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