首页|基于倾向性评分探讨不同灸感对原发性痛经灸疗疗效的影响:一项前瞻性队列研究

基于倾向性评分探讨不同灸感对原发性痛经灸疗疗效的影响:一项前瞻性队列研究

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目的:艾灸不同灸感原发性痛经患者关元穴,比较热敏灸感与传统灸感之间的疗效差异.方法:189例受试者依据灸感不同自然分组为热敏灸感组148例、传统灸感组41例.采用SPSS 19.0软件PSM功能均衡组间基线,纳入35对匹配患者,即热敏灸感组35例,传统灸感组35例.热敏灸感组采用热敏灸关元穴进行治疗,传统灸感组采用温和悬灸关元穴进行治疗,每个月经周期治疗(7±2)d,两组均治疗3个月经周期.观察两组治疗前后及3个月经周期后随访的简化McGill疼痛量表(MPQ)以及COX痛经症状量表(CMSS)评分情况.结果:两组年龄、病程、MPQ评分和CMSS评分在组间不均衡的协变量经匹配后均达到均衡(P>0.05).治疗后,两组MPQ评分和CMSS评分均较治疗前显著降低(P<0.01),热敏灸感组的MPQ评分和CMSS评分显著低于传统灸感组(P<0.01).随访时,热敏灸感组的MPQ评分和CMSS评分依然显著低于传统灸感组(P<0.01,P<0.05).结论:艾灸同一组穴位,热敏灸感组对原发性痛经患者的临床疗效优于传统灸感组.
Different Warm Sensations May Induce Different Therapeutic Effects in Primary Dysmenorrhea Patients Undergoing Moxibustion Treatment Based on Propensity Score: A Prospective Cohort Study
Objective To compare the effectiveness difference between the "heat-sensitive" sensation and conventional warm sensation of moxibustion stimulation of Guanyuan (GV 4) in primary dysmenorrhea (PD) patients.Methods Cohort study design was used in the present study.A total of 189 PD patients were divided into heat-sensitive group (n =148) and conventional warm sensation group (n =41) according to the patients' subjective feeling to moxibustion stimulation and the sequence of treatment.The Propensity Score Match (PSM)function of SPSS 19.0 software was used to match the patients of the two groups for balancing their baseline data (age, duration of illness, McGill and CMSS scores).Thus, 35 cases in each group were subjected into the analysis at last.Heat-sensitive moxibustion was applied to Guanyuan (GV 4) for 40 min beginning 5 days before dysmenorrheal attack, once daily for (7 ±2) days in one menstrual cycle, and for 3 menstrual cycles for heat-sensitive group, wheras routine moxibustion for conventional warm sensation group.The McGill Pain Questionnaire (MPQ) composed of pain rating index (PRI), visual analogue scale (VAS) and present pain intensity (PPI) and COX Menstrual Symptom Scale (CMSS) containing 18 items (0-4 grades/item) were used to evaluate the therapeutic effect of moxibustion treatment.Follow-up visit was conducted 3 months after the treatment.Results Compared to pre-treatment, MPQ and CMSS scores were significantly decreased in both groups after the treatment (P<0.01), and the effects of heat-sensitive group were significantly superior to those of conventional warm sensation group in lowering MPQ and CMSS scores (P<0.01).Follow-up survey showed that both MPQ and CMSS scores were still considerably lower in the heat-sensitive group than in the conventional warm sensation group (P<0.01, P<0.05).Conclusion The heat-sensitive moxibustion is superior to conventional warm moxibustion in improving symptoms in primary dysmenorrhea patients.

Primary dysmenorrheaMoxibustionHeat-sensitive reactionPropensity scoreCohort study

熊俊、张伟、焦琳、迟振海、付勇、谢丁一、陈日新

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江西中医药大学附属医院针灸科,南昌330006

原发性痛经 艾灸 热敏反应 倾向性评分 队列研究

江西省教育厅青年科学基金国家自然科学基金国家重点基础研究发展计划("973"计划

GJJ 13589812028542015 CB 554503

2015

针刺研究
中国中医研究院针灸研究所,中国针灸学会

针刺研究

CSTPCDCSCD
影响因子:1.656
ISSN:1000-0607
年,卷(期):2015.40(6)
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