世界中医药

目的：桃红四物汤配合毫火针治疗原发性痛经的近期和远期临床疗效。方法：将86例患者随机分组，桃红四物汤配合毫火针组（治疗组）43例和阿司匹林泡腾片治疗组（对照组）43例，2组研究分为治疗期（第1～3个月经周期）和随访期（第4～6个月经周期），2个阶段。对照组采用阿司匹林泡腾片，05 g/次，3次/d，月经前5 d开始服用，直到月经来潮后1 d。治疗组采用：桃红四物汤内服，1剂/d，每月行经前5 d开始服药，服至月经来潮后1 d；毫火针每月行经前5 d开始第1次治疗，至月经来潮后1 d治疗1次。记录1~6个月经周期的痛经程度(VAS)；检测治疗前后血清PGE-2和PGF2α水平；检测治疗前后血液流变学。结果：2组第2个月经周期时点，VAS评分较第1个月经周期时点下降(P<005)，2组第3、4个月经周期时点VAS评分均呈下降趋势;第5、6个月经周期时点2组VAS评分反弹，高于第4个月经周期时点(P<005)，治疗组第1~6个月经周期时点VAS评分均低于对照组(P<005)，治疗组组全血黏度、血浆黏度、全血还原黏度、纤维蛋白原和红细胞压积的改善均优于对照组(P<005)，治疗组PGE-2高于对照组，PGF2α，PGF2α/PGE-2低于对照组(P<005)结论：桃红四物汤配合毫火针治疗原发性痛经近期、远期疗效显著，其作用机制可能与改善血液循环，调节前列腺素有关。

English Summary:

To observe the curative effects of Taohong Four Ingredients Decoction combine with filiform-fire needle for primary dysmenorrheal.Methods:Total 86 patients with primary dysmenorrheal were randomized into 2 groups:Taohong Four Ingredients Decoction combine with filiform-fire needle group (the treatment group,n=43),and effervescent aspirin (control group,n=43).The treatments of the two groups were divided into treatment period (1-3 menstrual cycles) and follow-up period (4-6 menstrual cycles).Patients in the control group received effervescent aspirin,0.5 g/time,3 times/d,and the medicine was taken from 5 days before the first day of menstruation until 1 day after menstruation.Patients in the control group received Taohong Four Ingredients Decoction combine with filiform-fire needle (1.Took Taohong Four Ingredients Decoction from 5 days before the first day of menstruation until 1 day after menstruation.2.filiform-fire needle was performed at 5 days before menstruation began until after menstruation 1 days).Degree of dysmenorrhea score(VAS) was recorded from 1-6 menstrual cycles before and after treatment,and levels of serous of PGF-2 and PGE-2a were detected as well as hemorheology.Results:The VAS score of the two groups decreased at the 2nd menstrual cycle compared with the 1 st menstrual cycle (P<0.05＝).VAS scores of the two groups showed a decreasing trend at 3rd and 4th menstrual cycles; The 5th and 6th menstrual cycles VAS score rebound and became higher than the 4th menstrual cycle(P<0.05＝).VAS scores of the treatment group were always lower than the control group during the 1 st to 6th menstrual cycles.Whole blood viscosity,plasma viscosity,whole blood reduced viscosity,fibrinogen and hematocrit of the treatment group were better than the control group(P<0.05＝),PGE-2 in treatment group was higher than control group,PGF2α,PGF2α/PGE-2 in treatment group lower than the control group(P<0.05＝) Conclusion:Taohong Four Ingredients Decoction combined with filiform-fire needle has significant short-term and long-term analgesic effect in treating primary dysmenorrhear.The mechanism may be related with improving the blood circulation and regulating prostaglandin.

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