疏肝舒筋法针刺治疗周期性乳痛症的临床疗效观察OA

Objective:Based on the pathogenesis characteristics of liver qi stagnation and meridian obstruction in cyclical mastalgia(CM),this study aimed to evaluate the clinical efficacy of liver-soothing and tendon-relaxing acupuncture for CM and to provide a scientific basis for acupuncture treatment of CM.Methods:A multi-center,randomized,single-blind,sham acupuncture-controlled trial design was adopted.A total of 108 CM patients who were treated at three trial centers from July 2022 to December 2023 were selected and randomly divided into an acupuncture group and a sham acupuncture group in a 1:1 ratio,with 54 cases in each group.The acupuncture point prescription for the acupuncture group included Wuyi(ST 15),Rugen(ST 18),Tanzhong(CV 17),Ashi points,Tianzong(SI 11),Geshu(BL 17),Ganshu(BL 18),Hegu(LI 4),Sanyinjiao(SP 6),and Taichong(LR 3).The sham acupuncture group received sham needling with blunt-tipped needles at non-meridian and non-acupoint locations.Patients in both groups began treatment two weeks before menstruation,paused during menstruation,and received three sessions per week,totaling six treatments within one menstrual cycle,for three consecutive menstrual cycles.The primary outcome measure was the mean daily Visual Analog Scale(VAS)score for breast pain,while secondary outcomes included the number of pain days,the World Health Organization Quality of Life-BREF(WHOQOL-BREF)score,and breast ultrasound findings encompassing breast gland thickness,breast duct diameter,and breast tissue elasticity(E value).Results:At each time point after treatment,the mean daily VAS scores and pain days of both groups decreased compared to before treatment(P<0.05),and the acupuncture group was superior to the sham acupuncture group(P<0.05).The total WHOQOL-BREF scores of both groups increased compared to before treatment(P<0.05),and the score of the acupuncture group was higher than that of the sham acupuncture group(P<0.05).The thickness of the bilateral breast on transverse and longitudinal sections and the duct diameter in both groups decreased compared to before treatment(P<0.05),with no statistically significant difference between the two groups(P>0.05).The elasticity E values of the central,inner,middle,and outer regions of the bilateral breast in the acupuncture group decreased compared to before treatment(P<0.05),while there was no change in the sham acupuncture group(P>0.05).The elasticity E values of each region of the bilateral breast in the acupuncture group were lower than those in the sham acupuncture group(P<0.05).Conclusion:Liver-soothing and tendon-relaxing acupuncture can effectively alleviate breast pain symptoms in patients with CM,modulate the physical properties of breast tissue,produce good long-term effects,and improve patients'quality of life,providing a scientific basis for further clinical practice and research.