Abstract：
OBJECTIVE: To observe the differences in the effects of different dosages of grain-sized moxibustion on uterine artery blood flow in patients with cold and dampness primary dysmenorrhea (PD).
METHODS: A total of 60 patients with PD were randomly divided into 3 groups with 20 cases in each group. Acupoints Sanyinjiao (SP6), Diji (SP8) and Xuehai (SP10) were selected in all the 3 groups, and different dosages of grain-sized moxibustion were used (3 moxa cones, 6 moxa cones, 9 moxa cones) respectively. Treatment started 7 days before menstruation for 3 times, lasting for a total of 3 menstrual cycles. The values of uterine artery blood flow parameters including pulsatility index (PI), resistance index (RI), and systolic/diastolic ratio (S/D) were recorded before and after treatment. The visual analog scale (VAS) score and cox menstrual symptom scale (CMSS) score (including severity ［CMSS-S］ and time of duration ［CMSS-T］) were evaluated before treatment, at the end of each menstrual cycle, and one menstrual cycle after treatment.
RESULTS: The values of uterine artery blood flow parameters (PI, RI, S/D) after treatment in the 9 moxa cones group were lower than those before treatment, as well as lower than those in the 3 and 6 moxa cones groups after treatment (P<0.05). The VAS scores of the 3 moxa cones group were lower than those before treatment in the first and second cycle (P<0.05). The VAS scores of the 6 and 9 moxa cones groups were lower than those before treatment at each observation point (P<0.05), and were lower than those of the 3 moxa cones group in the third cycle of treatment and follow-up period (P<0.05). And the VAS score of the 9 moxa cones group was lower than that of the 6 moxa cones group during the follow-up period (P<0.05). Compared with the scores before treatment, the CMSS-T scores at each observation point after treatment were lower in the 9 moxa cones group (P<0.05)；the CMSS-T scores in the second and third cycle after treatment, and follow-up period were lower in the 6 moxa cones group (P<0.05), with the CMSS-S scores in the second and third cycle after treatment, and follow-up period lower in the 6 and 9 moxa cones groups (P<0.05). The CMSS-T and CMSS-S scores of the 6 and 9 moxa cones groups were lower than those of the 3 moxa cones group in the third cycle and follow-up period (P<0.05). The CMSS-T and CMSS-S scores of the 9 moxa cones group were lower than those of the 6 moxa cones group during the follow-up period (P<0.05).
CONCLUSIONS: Grain-Sized moxibustion has dose-effect relationship in the treatment of PD. Compared with 3 and 6 moxa cones groups, 9 moxa cones group has advantages in improving uterine artery blood flow parameters and alleviating dysmenorrhea symptoms in PD patients.
目的: 观察不同剂量麦粒灸对寒湿凝滞型原发性痛经（PD）患者子宫动脉血流影响的差异。方法: 将60例PD患者随机分3壮组、6壮组和9壮组，每组20例。3组均选取三阴交、地机、血海进行治疗，分别采用3壮、6壮和9壮3种不同剂量的麦粒灸，月经来潮前7 d开始治疗3次，共治疗3个月经周期。治疗前后记录患者子宫动脉血流参数指标搏动指数（PI）、阻力指数（RI）、血流比值（S/D）；评价治疗前1个月、治疗第1、2、3个月经周期及治疗结束后第1个月经周期的视觉模拟量尺（VAS）评分、Cox痛经症状量表严重程度（CMSS-S）及持续时间（CMSS-T）积分。结果: 治疗后9壮组患者的子宫动脉血流PI、RI、S/D值低于本组治疗前及同时点的3壮组和6壮组（P<0.05）。3壮组在第1周期和第2周期VAS评分低于治疗前（P<0.05）；6壮组和9壮组各观察时点VAS评分均低于本组治疗前（P<0.05），在治疗第3周期和随访期低于3壮组（P<0.05）；9壮组的VAS评分在随访期低于6壮组（P<0.05）。9壮组在治疗第1周期CMSS-T 积分较治疗前降低（P<0.05），6壮组、9壮组在治疗第2、3周期及随访期的CMSS-T积分较治疗前降低（P<0.05），6壮组和9壮组的CMSS-T积分在第3周期和随访期低于3壮组（P<0.05），9壮组的CMSS-T积分在随访期低于6壮组（P<0.05）；6壮组、9壮组在治疗第2、3周期及随访期CMSS-S积分较治疗前降低（P<0.05），6壮组和9壮组在第3周期和随访期的CMSS-S积分低于3壮组（P<0.05），9壮组的CMSS-S积分在随访期低于6壮组（P<0.05）。结论: 麦粒灸治疗原发性痛经具有量效关系，麦粒灸9壮较6壮、3壮在改善PD患者的子宫动脉血流指标和减轻痛经症状等方面更有优势。.
METHODS: A total of 60 patients with PD were randomly divided into 3 groups with 20 cases in each group. Acupoints Sanyinjiao (SP6), Diji (SP8) and Xuehai (SP10) were selected in all the 3 groups, and different dosages of grain-sized moxibustion were used (3 moxa cones, 6 moxa cones, 9 moxa cones) respectively. Treatment started 7 days before menstruation for 3 times, lasting for a total of 3 menstrual cycles. The values of uterine artery blood flow parameters including pulsatility index (PI), resistance index (RI), and systolic/diastolic ratio (S/D) were recorded before and after treatment. The visual analog scale (VAS) score and cox menstrual symptom scale (CMSS) score (including severity ［CMSS-S］ and time of duration ［CMSS-T］) were evaluated before treatment, at the end of each menstrual cycle, and one menstrual cycle after treatment.
RESULTS: The values of uterine artery blood flow parameters (PI, RI, S/D) after treatment in the 9 moxa cones group were lower than those before treatment, as well as lower than those in the 3 and 6 moxa cones groups after treatment (P<0.05). The VAS scores of the 3 moxa cones group were lower than those before treatment in the first and second cycle (P<0.05). The VAS scores of the 6 and 9 moxa cones groups were lower than those before treatment at each observation point (P<0.05), and were lower than those of the 3 moxa cones group in the third cycle of treatment and follow-up period (P<0.05). And the VAS score of the 9 moxa cones group was lower than that of the 6 moxa cones group during the follow-up period (P<0.05). Compared with the scores before treatment, the CMSS-T scores at each observation point after treatment were lower in the 9 moxa cones group (P<0.05)；the CMSS-T scores in the second and third cycle after treatment, and follow-up period were lower in the 6 moxa cones group (P<0.05), with the CMSS-S scores in the second and third cycle after treatment, and follow-up period lower in the 6 and 9 moxa cones groups (P<0.05). The CMSS-T and CMSS-S scores of the 6 and 9 moxa cones groups were lower than those of the 3 moxa cones group in the third cycle and follow-up period (P<0.05). The CMSS-T and CMSS-S scores of the 9 moxa cones group were lower than those of the 6 moxa cones group during the follow-up period (P<0.05).
CONCLUSIONS: Grain-Sized moxibustion has dose-effect relationship in the treatment of PD. Compared with 3 and 6 moxa cones groups, 9 moxa cones group has advantages in improving uterine artery blood flow parameters and alleviating dysmenorrhea symptoms in PD patients.
目的: 观察不同剂量麦粒灸对寒湿凝滞型原发性痛经（PD）患者子宫动脉血流影响的差异。方法: 将60例PD患者随机分3壮组、6壮组和9壮组，每组20例。3组均选取三阴交、地机、血海进行治疗，分别采用3壮、6壮和9壮3种不同剂量的麦粒灸，月经来潮前7 d开始治疗3次，共治疗3个月经周期。治疗前后记录患者子宫动脉血流参数指标搏动指数（PI）、阻力指数（RI）、血流比值（S/D）；评价治疗前1个月、治疗第1、2、3个月经周期及治疗结束后第1个月经周期的视觉模拟量尺（VAS）评分、Cox痛经症状量表严重程度（CMSS-S）及持续时间（CMSS-T）积分。结果: 治疗后9壮组患者的子宫动脉血流PI、RI、S/D值低于本组治疗前及同时点的3壮组和6壮组（P<0.05）。3壮组在第1周期和第2周期VAS评分低于治疗前（P<0.05）；6壮组和9壮组各观察时点VAS评分均低于本组治疗前（P<0.05），在治疗第3周期和随访期低于3壮组（P<0.05）；9壮组的VAS评分在随访期低于6壮组（P<0.05）。9壮组在治疗第1周期CMSS-T 积分较治疗前降低（P<0.05），6壮组、9壮组在治疗第2、3周期及随访期的CMSS-T积分较治疗前降低（P<0.05），6壮组和9壮组的CMSS-T积分在第3周期和随访期低于3壮组（P<0.05），9壮组的CMSS-T积分在随访期低于6壮组（P<0.05）；6壮组、9壮组在治疗第2、3周期及随访期CMSS-S积分较治疗前降低（P<0.05），6壮组和9壮组在第3周期和随访期的CMSS-S积分低于3壮组（P<0.05），9壮组的CMSS-S积分在随访期低于6壮组（P<0.05）。结论: 麦粒灸治疗原发性痛经具有量效关系，麦粒灸9壮较6壮、3壮在改善PD患者的子宫动脉血流指标和减轻痛经症状等方面更有优势。.
摘要：
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