Objective: To compare the clinical efficacy between acupuncture with Tiaochong Shugan method by stages based on syndrome differentiation and oral administration of ibuprofen sustained-release capsule in patients with menstrual headache.
Methods: A total of 90 cases with menstrual headache were randomly divided into an acupuncture group (45 cases, 1 case excluded, 3 cases dropped off) and a medication group (45 cases, 3 cases dropped off). The patients in the acupuncture group were treated with acupuncture with Tiaochong Shugan method by stages based on syndrome differentiation; during period of pain attacks, Ganshu (BL 18), Qimen (LR 14), Hegu (LI 4), Taichong (LR 3), Sizhukong (TE 23) through Shuaigu (GB 8) were selected, once a day; during period of pain relief, Qichong (ST 30), Dahe (KI 12), Guanyuan (CV 4), Taixi (KI 3) were selected, once every 1-2 days. The patients in the medication group were treated with oral administration of ibuprofen sustained-release capsule during period of pain attacks. Each menstrual cycle was taken as a course of treatment, and both groups were treated for 3 courses. The headache comprehensive score (HCS), visual analogue scale (VAS) socre, dysmenorrhea symptom score (DSS) were compared before treatment, 1, 2 and 3 courses into treatment and 1, 2, 3 menstrual cycles after treatment; the clinical efficacy was also evaluated.
Results: The HCS score at each time point after treatment was lower than that before treatment in the two groups (P<0.05); 2 and 3 menstrual cycles after treatment, the HCS socres in the acupuncture group were lower than those in the medication group (P<0.05). Except for the 2 and 3 menstrual cycles after treatment in the medication group, the VAS score at each time point after treatment was lower than that before treatment in the two groups (P<0.05). Except for 1 menstrual cycle into treatment, the DSS scores in the acupuncture group at each time point after treatment was lower than that before treatment (P<0.05); the DSS socres at 2 and 3 menstrual cycles into treatment and 1 menstrual cycle after treatment were lower than those before treatment in the medication group (P<0.05). Except for 1 menstrual cycle into treatment, the VAS score and DSS score in the acupuncture group were lower than those in the medication group at each time point after treatment (P<0.05). The total effective rate was 82.9% (34/41) in the acupuncture group, which was higher than 73.8% (31/42) in the medication group (P<0.05).
Conclusion: The analgesic effect of acupuncture with Tiaochong Shugan method by stages based on syndrome differentiation is superior to oral administration of ibuprofen sustained-release capsules, which could effectively prevent the recurrence of menstrual headache, and improve irregular menstruation-related symptoms.
目的：比较调冲疏肝法分期辨证针刺与布洛芬缓释胶囊治疗经行头痛的临床疗效。方法：将90例经行头痛患者随机分为针刺组（45例，剔除1例、脱落3例）和药物组（45例，脱落3例）。针刺组采用调冲疏肝法分期辨证针刺治疗，疼痛发作期取肝俞、期门、合谷、太冲、丝竹空透率谷等，每日针刺1次；疼痛缓解期取气冲、大赫、关元、太溪等，隔1~2 d针刺1次。药物组疼痛发作期口服布洛芬缓释胶囊。每个月经周期为一疗程，两组均治疗3个疗程。比较两组患者治疗前，治疗1、2、3个月经周期及随访期（治疗后1、2、3个月经周期）头痛综合评分、疼痛视觉模拟量表（VAS）评分、月经不调症状评分，并评定临床疗效。结果：两组患者治疗后各时间点头痛综合评分均较治疗前降低（P<0.05）；随访2、3个月经周期，针刺组头痛综合评分低于药物组（P<0.05）。除药物组随访2、3个月经周期，两组患者治疗后各时间点VAS评分较治疗前降低（P<0.05）；除治疗1个月经周期，针刺组患者治疗后各时间点月经不调症状评分较治疗前降低（P<0.05）；药物组患者治疗2、3个月经周期及随访1个月经周期月经不调症状评分较治疗前降低（P<0.05）；除治疗1个月经周期，针刺组患者治疗后各时间点VAS、月经不调症状评分低于药物组（P<0.05）。针刺组总有效率为82.9%（34/41），高于药物组的73.8%（31/42，P<0.05）。结论：调冲疏肝法分期辨证针刺治疗经行头痛止痛效果优于布洛芬缓释胶囊，可有效预防经行头痛的反复发作和改善患者月经不调相关症状。.
Keywords: Tiaochong Shugan; acupuncture; menstrual headache; syndrome differentiation by stages.