[1]杨林浩,张桁,艾买提·依米尔,等.“四步改良法”推拿治疗原发性痛经疗效及影响因素[J].陕西中医,2025,46(12):1696-1701.[doi:DOI:10.3969/j.issn.1000-7369.2025.12.023]
　YANG Linhao,ZHANG Heng,YIMIER Aimaiti,et al.Exploring the therapeutic effect and influencing factors of the “four step improvement method” tuina for primary dysmenorrhea[J].,2025,46(12):1696-1701.[doi:DOI:10.3969/j.issn.1000-7369.2025.12.023]
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“四步改良法”推拿治疗原发性痛经疗效及影响因素

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
46
期数:
2025年12期
页码:
1696-1701
栏目:
针灸经络
出版日期:
2025-12-05

文章信息/Info

Title:
Exploring the therapeutic effect and influencing factors of the “four step improvement method” tuina for primary dysmenorrhea
作者:
杨林浩; 张桁; 艾买提·依米尔; 徐景崧; 严振
（上海中医药大学附属岳阳中西医结合医院推拿科，上海 200437）
Author(s):
YANG Linhao; ZHANG Heng; YIMIER Aimaiti; XU Jingsong; YAN Zhen
（Tuina Department Yueyang Hospital of Integrated Traditional Chinese and Western Medicine，Shanghai University of Traditional Chinese Medicine，Shanghai 200437,China）
关键词:
推拿; 布洛芬; 原发性痛经; 雌激素; 孕激素; C反应蛋白; 肿瘤坏死因子-α; 消炎止痛
Keywords:
Tuina; Ibuprofen; Primary dysmenorrhea; Estrogen; Progesterone; C-reactive protein; Tumor necrosis factor alpha; Relieve pain and inflammation
分类号:
R 271.113
DOI:
DOI:10.3969/j.issn.1000-7369.2025.12.023
文献标志码:
A
摘要:
目的：探究“四步改良法”推拿治疗原发性痛经的疗效，探究影响推拿治疗原发性痛经疗效的主要因素。方法：将95例原发性痛经患者分为对照组和研究组，对照组45例，研究组50例。对照组予布洛芬治疗，研究组予推拿治疗。比较两组患者治疗前后视觉模拟评分（VAS评分）、痛经症状量表（CMSS）及血清雌孕激素（E2、P）、C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）变化，并收集研究组患者部分生活习惯情况及止痛药耐药情况，探究影响推拿疗效的因素。结果：经治疗两组患者VAS评分、CMSS评分均较前显著改善（P＜0.01），研究组CMSS评分改善情况显著优于对照组（P<0.05）。两组患者治疗总有效率相近（P>0.05）。两组治疗后患者血清P、E2、CRP、TNF-α均较治疗前降低，其中E2、CRP、TNF-α差异有统计学意义（P<0.01），P水平比较差异无统计学意义（P>0.05）,研究组治疗后E2显著低于对照组（P<0.05）。研究组单因素分析得出推拿治疗的疗效可与跳餐、失眠及止痛药耐药情况相关，logistic 回归分析结果显示止痛药耐药（OR=23.727，95%CI=2.684～209.782）是与推拿疗效相关的独立影响因素。结论：推拿能有效缓解原发性痛经患者的疼痛及相关伴随症状，而止痛药耐药为影响推拿疗效的独立危险因素，其原因可能与推拿镇痛作用机制同消炎止痛药相类似有关。
Abstract:
Objective:Explore the therapeutic effect of the “Four Step Improvement Method” massage therapy on primary dysmenorrhea,and investigate the main factors affecting the therapeutic effect of massage therapy on primary dysmenorrhea.Methods:95 patients with primary dysmenorrhea were divided into a control group and a study group,with 45 patients in the control group and 50 patients in the study group.The control group received ibuprofen treatment,while the study group received massage treatment.Compare the changes in visual analog scale (VAS),dysmenorrhea symptom scale (CMSS),serum estrogen and progesterone (E2,P),C-reactive protein (CRP),and tumor necrosis factor alpha (TNF-α) before and after treatment between two groups of patients,and collect some lifestyle habits and analgesic drug resistance of the study group patients to explore the factors affecting the efficacy of massage therapy.Results:After treatment,both groups of patients showed significant improvement in VAS scores and CMSS scores compared to before (P<0.01).The improvement in CMSS scores in the study group was significantly better than that in the control group (P<0.05).The total effective rate of treatment for the two groups of patients was similar (P>0.05).After treatment,the serum levels of P,E2,CRP,and TNF-α in both groups decreased compared to before treatment.The differences in E2,CRP,and TNF-α were statistically significant (P<0.01),while there was no statistically significant difference in P (P>0.05).After treatment,the E2 level in the study group was significantly lower than that in the control group (P<0.05).The research group’s univariate analysis showed that the efficacy of massage therapy can be related to skipping meals,insomnia,and analgesic resistance.Logistic regression analysis showed that analgesic resistance (OR=23.727,95%CI=2.684-209.782) is an independent influencing factor related to massage efficacy.Conclusion:Tuina can effectively alleviate pain and related accompanying symptoms in patients with primary dysmenorrhea,and analgesic drug resistance is an independent risk factor affecting the efficacy of tuina.The reason may be related to the analgesic mechanism of tuina,which is similar to that of anti-inflammatory and analgesic drugs.

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备注/Memo

备注/Memo:
上海市临床重点专科建设项目（SHSLCZDZK04001）
更新日期/Last Update: 2025-12-08