| Pain is a common clinical symptom.traditional Chinese medicine believes that the production of pain is the result of the disorder of qi and blood function of the zang-fu viscera,and at the same time,the pain attack can further affect the changes of qi and blood in the zang-fu viscera.Pulse manifestation is the image of pulse touching finger,which can reflect the changes of qi and blood in the body,so ancient books recorded some painful pulse,such as string,tight,tremulous pulse,regularly intermittent pulse.but whether the above pulse is disease-specificity or not?If there are changes in the pulse of chronic paroxysmal pain with different syndromes?and what are the characteristics of pulse changes before and after pain attack in the chronic paroxysmal pain with different syndromes?Based on the above problems,this study selected the primary dysmenorrhea with a predictable pain as the research object including the syndrome of cold congelation and blood stasis,the syndrome of qi stagnation and blood stasis,and took the healthy person as the control to analyze the relationship between the change of pain and the change of pulse chart parameters.ObjectiveClinical trials were used to analyze and compare the correlation between pulse chart parameters of primary dysmenorrhea and pain disease/pain syndrome/pain,and to explore the mechanism of change from the point of view of vascular hemodynamics.Method1.Study subjects:patients with primary dysmenorrhea of the syndrome of cold congelation and blood stasis,the.syndrome of qi stagnation and blood stasis were selected as subjects,and the healthy as control.2.Selection criterias:"the clinical guidelines for primary dysmenorrhea" were used as the criteria for disease diagnosis.through expert argumentation for "the guidelines for the diagnosis and treatment of common diseases gynecology of traditional Chinese medicine" to form the common syndrome type judgment standard for this research.3.Intervention methods:patients with primary dysmenorrhea received electroacupuncture at typical onset of dysmenorrhea,the main points of electroacupuncture treatment are sanyinjiao plus zhongji,then the syndrome of cold congelation and blood stasis plus guanyuan,the syndrome of qi stagnation and blood stasis plus taichong.4.Observation time points:(1)Patients with primary dysmenorrhea:7-10 days before menstruation(T0),menstrual dysmenorrhea typical attack(T1),after the acupuncture analgesia treatment for 30 min immediately(T2),30 min after acupuncture analgesia treatment(T3);(2)The healthy control:7-10 days before menstruation(T0),the first-second days during menstruation period(T1),30 min after T1 observation(T2),30 min after T2 observation(T3).5.Observation index:made "primary dysmenorrhea information collection table",which collected Visual Analogue Scale/Score(VAS)and so on;used Daosheng DS01-C pulse meter to collect pulse chart parameters,including altitude(h1,h3),time(t1,t),width(w1),area(As,Ad),altitude ratio(h3/h1./h5/h1),time ratio(t1/t),the ratio of width to time(w1/t)and so on,and calculated the absolute value of the difference between the points at two adjacent observations;and the correlation between pulse chart parameters and VAS score in patients with primary dysmenorrhea was analyzed.6.Data analysis:SPSS20.0 software was adopted to analyze the data,comparison of VAS scores,pulse chart parameters was made by repeated measurement variance analysis,and the correlation analysis of pulse chart parameters and VAS score was described by Spearman correlation coefficient.statistical inference took 0.05 as the test level.ResultsA total of 59 patients with primary dysmenorrhea were included,including 35 cases of the syndrome of cold congelation and blood stasis,24 cases of the syndrome of qi stagnation and blood stasis,and 32 cases of healthy controls.The results of the analysis are as follows:1.Changes in pain levels in patients with primary dysmenorrhea1.1 Changes of pain degree in 59 patients with primary dysmenorrheaBefore and after dysmenorrhea onset in 59 patients with primary dysmenorrhea,that is the variation of VAS scores(mean,the same below)at four time points respectively:0.14,5.51,2.54,2.39.In group,T1,T2,T3 were all significantly higher than T0,T2,T3 were all significantly lower than T1(P<0.001).T3 was lower than T2,but the difference were not statistically significant(P>0.05).1.2 Comparison of the changes of pain degree in patients with the syndrome of cold congelation and blood stasis and the syndrome of qi stagnation and blood stasis.Among the 59 patients with primary dysmenorrhea,before and after dysmenorrhea onset in patients with the syndrome of cold congelation and blood stasis,that is the variation of VAS scores at four time points respectively:0,5.32,2.50,2.36,before and after dysmenorrhea onset in patients with the syndrome of qi stagnation and blood stasis,that is the variation of VAS scores at four time points respectively:0.35,5.78,2.60,2.43.Comparison of different time points of the same type,the pain of two types showed the same trend,.T1,T2,T3 was all significantly higher than To in each group,T2,T3 was all significantly lower than T1(P<0.001).T3 was all lower than T2,but the difference was not statistically significant(P>0.05).Comparison of two types at the same time:the pain degree of the syndrome of qi stagnation and blood stasis were higher in every time point,but only the T0 time point difference was statistically significant(P<0.05).2.Changes of pulse chart parameters in patients with primary dysmenorrhea2.1 Changes of pulse chart parameters in 59 patients with primary dysmenorrhea2.1.1 Changes of pulse chart parameters before and after dysmenorrhea attack in 59 patients with primary dysmenorrheaBefore and after dysmenorrhea onset in 59 patients with primary dysmenorrhea,that is the variation of pulse chart parameters at four time points respectively:compared with T0,h2,h3,h3/h1,h4,w1,w2,w1/t,As,Ad of T1 all increased significantly and HR decreased significantly;compared with T1,t,t5 of T2 all increased significantly and h3/h1,w1,w2,w1/t,w2/t,t1/t,t1,HR all decreased significantly;compared with T2,h2,w1,w2,w,/t,w2/t,t1,ti/t of T3 all increased significantly and t,t3,t5 all decreased significantly.All the above differences were statistically significant(P<0.05).2.1.2 Comparison of pulse chart parameters between primary dysmenorrhea patients and the healthy control(1)Changes of pulse chart parameters at four points in 32 healthy controls:compared with T0,h1,h3,h5,h5/h1,As,Ad of T1 all increased and h3/h1,h4/h1,w1,w2,w1/t,w2/t,t1,t1/t,HR all decreased,but there was no significant difference(P>0.05).(2)Comparison of Patients with primary dysmenorrhea and the healthy control:the h1 of the primary dysmenorrhea group was significantly lower than that of the healthy control at the To time point;the h3/h1,w1,w2,w1/t were all significantly higher at the T1;thet1/t were all significantly higher and the t3 was significantly lower at the T3.All the above differences were statistically significant(P<0.05).2.2 Comparison of pulse chart parameters between the syndrome of cold congelation and blood stasis and the syndrome of qi stagnation and blood stasis2.2.1 Changes of pulse chart parameters before and after dysmenorrhea attack in the syndrome of cold congelation and blood stasis and the syndrome of qi stagnation and blood stasis(1)Before and after dysmenorrhea onset in patients with the syndrome of cold congelation and blood stasis,that is the variation of pulse chart parameters at four time points respectively:compared with T0,h2,h3,h4,t1,As of T1 all increased significantly and h5/h1 decreased significantly;compared with T1,t,t5 of T2 all increased significantly and h3/h1,w1,w2,w1/t,t1/t,t1,HR all decreased significantly;compared with T2,h3/h1,w2,w1/t,t1/t,t1 of T3 all increased significantly and t,t3 all decreased significantly.(2)Before and after dysmenorrhea onset in patients with the syndrome of qi stagnation and blood stasis,that is the variation of pulse chart parameters at four time points respectively:compared with T0,w1,w2,t4,As of T1 all increased significantly;compared with T1,w1,w2,w2/t of T2 all decreased significantly;compared with T2,t3 of T3 decreased significantly.All the above differences were statistically significant(P<0.05)2.2.2 Comparison of pulse chart parameters between the syndrome of cold congelation and blood stasis and the syndrome of qi stagnation and blood stasis(1)the syndrome of cold congelation and blood stasis and the healthy control:the h1,h2,h4 of the syndrome of cold congelation and blood stasis were all significantly lower than those in the healthy control,the t4/t5 was significantly higher at the To time point;the wi/t,t1,t1/t were all significantly higher at the T1;the t1,t1/t were all significantly higher,and the h5 was significantly lower at theT3.(2)the syndrome of qi stagnation and blood stasis and the healthy control:the t3 of the syndrome of qi stagnation and blood stasis was significantly higher than that of the healthy control at the To time point;thew1,w1/t,w2/t were all significantly higher at the T3.All the above differences were statistically significant(P<0.05).(3)the syndrome of cold congelation and blood stasis and the syndrome of qi stagnation and blood stasis:the t4,t4/t5 of the syndrome of cold congelation and blood stasis were all significantly higher than those of the syndrome of qi stagnation and blood stasis at the To time point,all the above differences were statistically significant(P<0.05);In general,the change trend of pulse chart parameters of the syndrome of cold congelation and blood stasis before and after pain attack is the same as that of primary dysmenorrhea.3.Correlation between changes of pulse parameters and degree of pain in patients with primary dysmenorrhea3.1 Correlation between changes of pulse parameters and pain degree in 59 patients with primary dysmenorrheathe pulse chart parameters that were positively correlated with the VAS score were:h2,h3,h3/h1,h4/h1,w1,w2,w1/t,t4,As,Ad;negatively correlated:h5,h5/h1.3.2 Correlation between pulse parameters and pain degree in patients with the syndrome of cold congelation and blood stasis and the syndrome of qi stagnation and blood stasis(1)the syndrome of cold congelation and blood stasis:the pulse chart parameters that were positively correlated with the VAS score were:h2,h3,h4,h3/h1,h4/h1,w1;negatively correlated:h5,h5/h1.(2)the syndrome of qi stagnation and blood stasis:the pulse chart parameters that were positi-vely correlated with the VAS score were:w1,w2,w1/t,t4,As.Comparison of correlation between the syndrome of cold congelation and blood stasis and the syndrome of qi stagnation and blood stasis:the parameters of pulse graph which were positively correlated with VAS score were all w1.All the above results were statistically significant(P<0.05).Conclusion1.Compared with before and after the onset of pain,the pulse chart parameters of patients with primary dysmenorrhea changed to a certain extent during the pain.2.The pulse chart parameters are different between the syndrome of cold congelation and blood stasis and the syndrome of qi stagnation and blood stasis before the pain,during the pain,and after the pain.3.The pulse chart parameters were correlated with the degree of pain. |
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