广西中医学院硕士学位论文针灸治疗寒湿凝滞型原发性痛经34例临床观察研究研究生：孙薇思导师：杜艳教授院系（部所）：国际教育学院学科专业：针灸推拿学研究方向：针灸治疗寒湿凝滞原发性痛经完成日期：2011年05月30日目录中文摘要 (1)英文摘要 (3)引言...............................................................................4-5正文 (6)1临床研究资料 (6)1.1一般资料 (6)1.2诊断标准 (6)1.2.1 西医诊断标准 (6)1.2.2 中医诊断标准 (7)1.3纳入标准 (7)1.4排除标准 (7)1.5脱落标准............................................................................7-8 2治疗方法. (8)2.1治疗组 (8)2.2对照组 (9)3疗效观察 (9)3.1观察方法 (9)3.2疗效评定 (10)4治疗结果 (10)4.1治疗前后的疼痛评分比较………………………………………… ..104.2 疗效比较 (10)5 结论.................................................................................10-11 6讨论.............................................................................. (11)6.1中医对病因病机的认识..................................................... .11 6.1.1中医对病因的认识.. (11)6.1.2中医对病机的认识 (12)6.1.3中医对痛经的辨证要点 (13)6.2 西医对痛经的认识..........................................................13-14 6.3针灸治疗的方法................................................................14-16 6.4穴位的配伍意义. (16)6.5存在的问题以及对今后研究的展望 (17)参考文献..............................................................................18-19致谢. (20)广西中医学院研究生学位论文作者声明 (21)个人简介 (22)中文摘要目的：观察针灸治疗寒湿凝滞型原发性痛经的疗效，同时也为进一步研究针灸治疗原发性痛经提供理论基础和客观的临床依据。
方法：将68例符合诊断标准、纳入标准和排除标准的受试者随机分为治疗组和对照组，治疗组和对照组各34例。
治疗组予选取关元、子宫、三阴交、地机进行针灸治疗，每日治疗1次，于月经来潮前3至5天（参照上个月经周期）开始治疗，每日治疗1次，共治疗5次，于月经期来潮1-3天内结束治疗，三个月为1个疗程。
对照组予口服吲哚美辛肠溶片对症治疗，疼痛发作时每次服25mg，每天1次，若未见不良反应，疼痛未明显减轻者，可逐渐增至每日125～150mg。
疗程同治疗组。
治疗期间不得饮酒或咖啡等刺激性饮料，不得接受其他药物、针灸、推拿等治疗，注意防寒保暖，忌食生冷寒凉，避免接触冷水。
治疗前、1个疗程结束后的第1个月经周期进行疗效评价。
后随访三个月以评价疗效。
结果：经一个疗程治疗后随访3个月经周期，治疗组痊愈12例；好转20例，无效2例，总有效率为94.12％；治疗组观察治疗34例，痊愈3例；好转21例，无效10例，总有效率为70.59％。
结论：针灸治疗原发性痛经具有治愈率高，疗效显著，无毒副作用等优点，是一种安全有效的治疗方法，值得临床推广使用及进一步研究。
关键词：寒湿凝滞；原发性痛经；针灸Clinical Observation on Cold Wet Stagnant Primary Dysmenorrhea (PD) with acupuncture and moxibustion treatmentABSTRACTObjective : To observe the clinical efficacy by acupuncture and moxibustion on cold wet stagnant Primary Dysmenorrheal (PD). At the same time, to explore and research further on the treatment of cold wet stagnant Primary Dysmenorrheal with acupuncture and moxibustion and objectively evaluate its efficacy from clinical practice.Method:68 patients diagnosed as cold wet stagnant primary dysmenorrheal were divided into two groups –1) observation group 2) control group. Each group had 34 patients.Observation group : we applied the following acupoints - guan yuan, zi gong, san yin jiao, di ji for treatment once a day. The treatment would commence 3-5 days before the menstruation period of the patients. Each course would take 5 treatments with each treatment per day. The treatment would stop 1-3 days before the patients’ next menstruat ion period starts. A complete course of treatment would take 3 months. Control group :the patients would be given pain killer drugs orally. Each time the pain started the patients would be given 25 mg once per day. If there were no effects and the pains continued, the drug would beincreased to 125-150 mg. During the treatment period, the patients would be asked to abstain alcohol, coffee and stimulating drinks, any other medicine or drugs, acupuncture and tuina. The patients would have to keep themselves warm and avoid coldness, as well as keeping away from all kinds of cold drinks.We would evaluate the results for both the above groups after 3 months of continued treatments.Results: After 3 months of completed course of treatment; the observation group had 12 patients fully recovered, 20 with improved recovery, the remaining 2 had no effects. Final efficacy rate was 94.12%. For the control group, only 3 were fully recovered, 21 improved recovery, the remaining 10 had no effects. Final efficacy rate was 70.59%. Conclusion : Using acupuncture treatment on cold wet stagnant primary dysmenorrheal had a higher efficacy and recovery rate with no side effects. It is one of the safe method of treatment for the illness. It is therefore, worth promoting its method of treatment and further research.Key words : cold wet stagnant; primary dysmenorrheal; acupuncture.引言原发性痛经(Primary Dysmenorrhea,PD)是指生殖器官无器质性病变，在行经前后或月经期出现下腹部疼痛、坠胀，伴有腰酸或其他不适，症状严重影响生活质量的患者，占痛经90%以上。
中医对痛经有独特的认识，临床治疗辨证分型方法各异，针灸治疗PD临床辨证多分为寒湿凝滞、气滞血瘀和气血不足三个证型，马来西亚气候炎热，大多数妇女衣着单薄，喜食冷饮，易为寒湿所袭，故临床上尤以寒湿凝滞型更为常见。
原发性痛经已经成为威胁当今社会女性工作，学习，生活的一大隐患，作为一种困扰现代女性工作,生活的疾病,越来越受到医学工作者的关注。
现代医学认为本病与神经、内分泌、遗传、免疫等诸多因素有关，治疗多采用镇痛解痉药及前列腺素合成酶抑制剂、避孕药、吗啡或其他强效止痛镇痛药，或手术扩张宫颈，或行骸前神经切除。
临床上所见的痛经患者有些接受过西医治疗，虽止痛作用快而强，但疗效短暂，易复发，且有一定的副作用，使临床应用受到一定限制。