| Objective: Based on the “Myofascial Trigger Points” and “acupoint sensitization characteristics” theory,the "Jiesuo Tongmai" TCM manipulation combined with Qi Gong therapy was applied to treat PD,its clinical efficacy was observed,and its possible mechanism was discussed.Methods:60 observation cases diagnosed as PD were collected.The patients were randomly divided into group A(blank group),group B(drug group)and group C(guided group),with 20 cases in each group.The subjects in the blank group were given health education(dietary guidance,work and rest time guidance,psychological counseling,etc.)during the experiment.During this period,massage,warm ironing and drug treatment were not allowed;The subjects in the drug group were treated with ibuprofen sustained-release capsule;The subjects in the guidance group were treated with "Jiesuo Tongmai" TCM manipulation combined with Qi Gong therapy.The treatment period of the three groups was three courses(one menstrual cycle was one course),At three different time nodes in seven menstrual cycles(the first menstrual cycle when the subjects were included),namely before treatment(the first menstrual cycle),at the end of the treatment course(the fourth menstrual cycle)and during the follow-up period after treatment(the seventh menstrual cycle),the subjective symptom scores of the subjects(including NRS score,abdominal pain duration(APS)score,tenderness threshold(PPT)score of dysmenorrhea related parts,dysmenorrhea symptom(CMSS)score,dysmenorrhea TCM syndrome score,anxiety / depression(SAS / SDS)score)were statistically analyzed to observe the clinical efficacy of "Jiesuo Tongmai" TCM manipulation combined with Qi Gong therapy in the treatment of PD.At the same time,according to different objective detection indexes,this study is divided into three clinical trials(Test 1: blood was drawn to detect serum PGF2 ?? PGE2?TNF-?? IL-6 content;Test 2:B-ultrasound was used to detect the hemodynamic map of uterine artery and the resting thickness of myofascial at the key pain points of abdomen;Test 3: detection of thermal metabolism in lumbar and abdominal observation area by infrared thermal imaging technology)to explore its clinical mechanism from the aspects of hormone regulation level,uterine hemodynamics,muscle and fascia tissue structure of abdominal key pain points,and infrared thermography of waist and abdomen(energy metabolism).Results:1.Symptom score: after three courses of treatment,NRS score,abdominal pain duration(APS)score,tenderness threshold(PPT)score of dysmenorrhea related parts,dysmenorrhea symptom(CMSs)score,dysmenorrhea TCM syndrome score,anxiety / depression(SAS / SDS)score and serum PGF2 in groups B and C ??PGE2?TNF-??The content of IL-6 was significantly improved compared with that before treatment(P < 0.01),and the improvement degree of group C was significantly better than that of group B(P < 0.01).There was significant difference between the follow-up value in group B and that at the end of the course of treatment(P < 0.01).The follow-up value in group B and group C rebounded compared with that at the end of the course of treatment.The value of follow-up period in group C was not statistically significant compared with that at the end of the course of treatment(P > 0.05);Compared with group A and group B,the value of group C increased significantly(P < 0.01).2.Clinical efficacy: the clinical symptoms of all patients in group B and group C were improved,and there was no significant difference in the total effective rate between the two groups(P > 0.05).There was significant difference in the significant healing rate between the two groups(P < 0.01).Group C was significantly better than group B,indicating that group C and group B had better short-term clinical efficacy,but the recent significant healing rate of group C was significantly better than group B;In the follow-up period,the total effective rate and significant healing rate of patients had no significant change in group C and decreased in group B,indicating that the long-term clinical effect of group C was significantly better than that of group B.3.Uterine hemodynamics: compared with that before treatment,PSV and EDV at the end of treatment in group B and C were significantly higher than those before treatment,while PI,RI and S / D were significantly lower than those before treatment(P < 0.01).However,the improvement degree of group C was significantly better than that of group B and group A(P < 0.01).At the same time,the difference between group B and group A was also statistically significant(P < 0.01).B.There was a certain rebound in PSV,EDV,PI,RI and S / D data between the two groups during follow-up,but the difference was not significant(P > 0.05).4.Histomorphology of abdominal key pain points: after treatment,the resting thickness of rectus abdominis fascia at bilateral Tianshu point and bilateral Huihui point in group C decreased significantly compared with that before treatment(P < 0.01),and there was no change in group A and B(P > 0.05).During the follow-up period of group C,the resting thickness of rectus abdominis fascia at bilateral Tianshu point and bilateral Huihui point rebounded to a certain extent,but there was no significant difference compared with that at the end of the course of treatment(P > 0.05).5.Thermal metabolism?t in lumbar and abdominal observation area: there was significant difference between group B and group C at the end of treatment and before treatment(P < 0.01),but group C was significantly better than group B(P < 0.01);There was significant difference between the follow-up period and the end of the course of treatment in group B(P < 0.01),but there was no significant difference between the follow-up period and the end of the course of treatment in group C(P > 0.05).Conclusion:1.After three courses of "Jiesuo Tongmai" TCM manipulation combined with Qi Gong therapy,PD subjects found that the pain degree,pain duration,dysmenorrhea symptom score,TCM symptom score,SAS score and SDS score of patients with dysmenorrhea were significantly improved,and the total effective rate reached 100%,indicating that "Jiesuo Tongmai" TCM manipulation combined with Qi Gong therapy has a significant effect on female PD,and has a high long-term cure rate in the follow-up period(3months after the end of the course of treatment).Compared with group B,the short-term and long-term effects of group C were better than those of group B.2."Jiesuo Tongmai" TCM manipulation combined with Qi Gong therapy in the treatment of PD can effectively reduce the pain sensitivity of patients,and the curative effect is lasting and stable.3.Serum PGF2 was measured by "Jiesuo Tongmai" TCM manipulation combined with Qi Gong therapy according to the conduction method PGF2??TNF-??IL-6 can significantly improve and reduce serum PGE2.At the same time,it can increase capillary permeability,expand uterine smooth muscle artery and reduce the pressure in uterine artery,so as to effectively improve the symptoms of dysmenorrhea and maintain the long-term effect.4.The effect of "Jiesuo Tongmai" TCM manipulation combined with Qi Gong therapy on improving uterine artery blood flow in PD patients is better than that of analgesic drug treatment.5.Analgesic drugs have no effect on the resting thickness of muscle and fascia at abdominal pain excitation points in PD patients.The "Jiesuo Tongmai" TCM manipulation combined with Qi Gong therapy can effectively improve the resting thickness of muscle and fascia at key pain excitation points related to dysmenorrhea in PD patients,and has long-term stable curative effect.6."Jiesuo Tongmai" TCM manipulation combined with Qi Gong therapy can effectively improve the heat metabolism in the lumbar and abdominal observation area of PD patients,and its short-term and long-term effects are significantly better than analgesic drug treatment. |
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