【作者】 赵莉；

【导师】 李沛；

【作者基本信息】 福建中医学院 ， 针灸推拿学， 2008， 硕士

【摘要】 目的:观察艾灸法治疗原发性痛经(Primary Dysmenorrhea,PD)患者血浆内皮素1(Endothelin-1,ET-1)、血清一氧化氮(NitricOxide,NO)、血浆血管性假血友病因子(von willebrand Factor,vWF)的变化,从血管内皮功能障碍的角度探讨艾灸治疗原发性痛经的疗效,探讨对于本病局部取穴和局部与远端结合取穴哪种治疗效果更加理想。方法:选择年龄在20～30岁符合诊断标准的未婚原发性痛经患者60例。随机分为治疗组30例:艾灸关元穴;对照组30例:艾灸关元、足三里、三阴交穴。于经期前5天开始施灸,每日1次,灸到月经来潮为止。治疗组与对照组均以三个月经周期为观察疗程,在接受治疗前、后月经周期采集月经来潮24—48小时内肘正中静脉血,分别检测下列观察指标:ET-1、NO、vWF,并采用月经情况调查问卷表进行治疗前后临床症状疼痛评分。结果:1.治疗组及对照组均可使原发性痛经患者临床疼痛评分下降,两组积分下降程度无统计学差异(P＞0.05)。治疗组疗效及总有效率均无明显优于对照组,且两者无统计学差异(P＞0.05)。2.治疗组与对照组治疗前血浆ET-1含量无统计学差异(P＞0.05);这两组治疗后血清内皮素(ET-1)较前有明显降低,但两组降低水平无明显差异(P＞0.05)。3.治疗组与对照组治疗前血清NO含量无统计学差异(P＞0.05);两组治疗后NO均较前未见明显升高,且两组治疗后NO水平无明显差异(P＞0.05)。4.治疗组与对照组治疗前血浆vWF无统计学差异(P＞0.05);两组治疗后vWF均较前有明显升高,但两组升高水平无明显差异(P＞0.05)。结论:1.艾灸法能较好地调节内皮素、血管性假血友病因子的分泌,从而能明显改善PD患者临床疼痛症状。提示灸法可通过调节血管内皮功能从而达到治疗效果。2.关元组和关元、足三里、三阴交组均能明显改善原发性痛经患者的临床症状。3.艾灸关元治疗原发性痛经疗效与艾灸关元、足三里、三阴交相比无明显差异,提示艾灸关元与艾灸关元,足三里,三阴交均是治疗原发性痛经的有效方法。但艾灸关元操作简便易行,方便患者进行自灸,因此艾灸关元穴治疗本病是一种值得推广的治疗方法。更多还原

【Abstract】 Purpose:To observe the clinical curative effects and the changes of Endothelin—1 and NitricOxide and von Willebrand Factor of the patients of primary dysmenorrhea by treatment of Moxibustion,to research the therapeutic effects of moxibustion in terms of endothelium dysfunction.Meanwhile,to choose an ideal therapy from region acupoint and distal and region acupoint.Method:60 cases of unmarried women of child-bearing age(from the age of 20 to 30) suffering from primary dysmenorrhea were selected according to certain diagnostic criteria. They were equally divided into two groups at random:The Group of Moxibustion- Guanyuan and the Group of Moxibustion- Guanyuan and Zusanli and Sanyinjiao.We started treatment once daily five days before the menstruation until they menstruated.Three menstrual cycles make up an observing therapeutic course.We measured certain indexes before and after treatment(within 24-48 hours) respectively.In order to get the aforementioned indexes we had to(1) Taking out the blood of elbow vein to estimate the Endothelin—1(ET-1) by radioimmunoassay(RIA),the NitricOxide(NO) by colorimetry and the von Willebrand Factor(vWF) by enzyme-linked immunosorbent assay(ELISA) before and after treatment.(2) Grading the clinical symptoms of pain before and after treatment by way of questionnaires.Result:1.After treatment,both treatment group and contrast group can reduce the grade of clinical pain,and there are no statistically significant differences(P＞0.05 ).The total effective rate of treatment group was not superior to that of the contrast group,and there are no statistically significant differences(P＞0.05 ).2.Before treatment there are no statistically significant differences in the levels of ET-1 between the 2 groups.After treatment the levels of ET-1 of both groups were lower,but there are no statistically significant differences in the decreasing rate(P＞0.05).3.Before treatment there are no statistically significant differences in the levels of NO between the 2 groups.After treatment the levels of NO of both groups were no remarkable differences,and there are no statistically significant differences in the decreasing rate(P＞0.05).4.Before treatment there are no statistically significant differences in the levels of vWF between the 2 groups.After treatment the levels of vWF of both groups were higher,but there are no statistically significant differences in the increasing rate(P＞0.05). Conclusion:1.The effect of moxibustion can well modulate the secretion of ET-1 and vWF,thereby remarkably improve the clinical symptoms of pain.So we can deduce:The effect of moxibustion can reduce the over-contract of small vessels of hystera of the patients by adjusting their function of endothelial tissues to achieve the ideal therapeutic efficacy. 2.The result showed that both the Group of Moxibustion- Guanyuan and the Group of Moxibustion- Guanyuan and Zusanli and Sanyinjiao can reduce the clinical pain grade of the patients,decrease the ET-1 content and increase the vWF content.3.There were no obvious differences in curative effects between the Group of Moxibustion- Guanyuan and the Group of Moxibustion- Guanyuan and Zusanli and Sanyinjiao.Which proved that both treatments are effective in treating primary dysmenorrhea.Nonetheless,the operation of Moxibust Guanyuan is more convenient for patients to be self-treating at their leisure.Therefore Moxibust Guanyuan is a treatment worth promotion.更多还原