مقایسه تأثیر ماکسیباسشن و طب فشاری در نقطه SP6 بر شدت علائم سیستمیک همراه با دیسمنوره

نوع مقاله: اصیل پژوهشی

نویسندگان

1 کارشناس ارشد مامایی، دانشکده پرستاری و مامایی، شعبه بین الملل، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

2 مربی گروه مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

3 استاد گروه آمار زیستی، دانشکده پیراپزشکی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

4 متخصص طب سوزنی، انجمن طب سوزنی ایران، تهران، ایران.

چکیده

مقدمه: با توجه به اینکه دیسمنوره اولیه یکی از اختلالات ژنیکولوژیک شایع در سنین باروری زنان می­باشد که گاهی با یک یا چند علائم سیستمیک همراه می باشد، مطالعه حاضر با هدف مقایسه تأثیر ماکسیباسشن و طب فشاری در نقطه SP6 بر شدت علائم سیستمیک همراه دیسمنوره انجام شد.
روش‌کار: این مطالعه کارآزمایی بالینی تصادفی شده در سال 1394 بر روی 100 نفر از دانشجویان ساکن خوابگاه­های دانشگاه آزاد اسلامی سبزوار انجام شد. افراد در دو گروه 50 نفری ماکسیباسشن و طب فشاری قرار گرفتند. در گروه ماکسیباسشن چوب موکسای استیک به مدت 10 دقیقه به نقطه SP6 چسبانده می‌شد و در گروه طب فشاری با انگشت شست و به‌طور عمود فشار بر نقطه SP6 فشار وارد می‌شد (10 دقیقه برای هر پا). این مداخلات 2 بار در طی هفته آخر سیکل و روز اول و دوم خونریزی قاعدگی صورت می­گرفت. شدت علائم سیستمیک با استفاده از سیستم معیار چند بُعدی کلامی، قبل از مداخله و در طی دو سیکل مداخله پیگیری و مقایسه گردید. تجزیه و تحلیل داده­ها با استفاده از نرم‌افزار آماری SPSS‌ (نسخه 16) و آزمون­های من ویتنی و فریدمن انجام شد. میزان p‌ کمتر از 05/0 معنادار در نظر گرفته شد.
یافته‌ها: در هر دو گروه تمام علائم نسبت به قبل از مداخله کاهش معنی‌داری داشت (05/0˂p)، ولی در مقایسه علائم سیستمیک بین دو گروه، تمامی علائم به‌جز تهوع، استفراغ و غش در گروه ماکسیباسشن نسبت به گروه طب فشاری بعد از مداخله کاهش معناداری داشت (05/0˂p).
نتیجه‌گیری: هر دو روش ماکسیباسشن و طب فشاری منجر به کاهش علائم سیستمیک می­شوند، ولی تکنیک ماکسیباسشن نسبت به طب فشاری مؤثرتر است.
 

کلیدواژه‌ها


عنوان مقاله [English]

The effect of SP6 moxibustion and acupressure on the severity of systemic symptoms associated with dysmenorrhea

نویسندگان [English]

  • Azam Yaghobinejad 1
  • Sedigheh Amir Ali Akbari 2
  • Hamid Alavimajd 3
  • Reza Heshmat 4
1 M.Sc. in Midwifery, School of Nursing and Midwifery, International Branch, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2 Instructor, Department of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
3 Professor, Department of Biostatics, School of Paramedicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
4 Acupressure specialist, Iran Acupressure Institute, Tehran, Iran.
چکیده [English]

Introduction: Since primary dysmenorrhea is one of the common gynecological disorder in women of reproductive which is sometimes associated with one or more systemic symptoms, this study was performed with aim to compare the effect of SP6 moxibustion and acupressure on the severity of systemic symptoms associated with dysmenorrhea.
Methods: This randomized clinical trial study was conducted on 100 students living in dormitories of Sabzevar Islamic Azad University in 2015. The subjects were randomly assigned into two groups of 50 cases in moxibustion and acupressure groups. The SP6 moxibustion group was asked to hold a burning moxa stick to the SP6 point, and the acupressure group was asked to press their thumb perpendicularly on the SP6 point (10 minutes of for each leg). The intervention was performed twice during the last week of cycle and the first and second day of menstrual bleeding. Severity of the systemic symptoms associated with dysmenorrhea was assessed with a verbal multidimensional scoring system before and during two cycles of the intervention. Data were analyzed using SPSS software (version 16), and using Mann-Whitney and Friedman test. P<0.05 was considered significant.
Results: In both groups, all symptoms were significantly reduced compared with before the intervention (P<0.05), but when compare the systemic symptoms between two groups, all symptoms except nausea, vomiting and faint were significantly reduced in moxibustion group compared to acupressure group after the intervention (P<0.05).
Conclusion: Both moxibustion and acupressure methods reduce the severity of the systemic symptoms; however, moxibustion is more effective than acupressure.

کلیدواژه‌ها [English]

  • Acupressure
  • Dysmenorrhea
  • Moxibustion
  • SP6 point
  1. Chongpensuklert Y, Kaewrudee S, Soontrapa S, Sakondhavut C. Dysmenorrhea in Thai secondary school students. Thai J Obstet Gynecol 2008; 16:47-53.
  2. Younesy S, Amiraliakbari S, Esmaeili S, Alavimajd H, Nouraei S. Effects of fenugreek seed on the severity and systemic symptoms of dysmenorrhea. Journal of reproduction & infertility. 2014;15(1):41-8.
  3. Sehar N, Ahmad T, Ahmad V, Sajwan S. Diagnosis and management of dysmenorrhea in Unani (Greeko-Arab) system of medicine. Int J Adv Ayurveda Yoga Unani Siddha Homeopathy 2015; 4(1):252-61.
  4. Atallahi M, Akbari SAA, Mojab F, Majd HA. Effects of wheat germ extract on the severity and systemic symptoms of primary dysmenorrhea: a randomized controlled clinical trial. Iranian Red Crescent Medical Journal. 2014;16(8).
  5. McEvoy M, Chang J, Coupey SM. Common menstrual disorders in adolescence: nursing interventions. MCN Am J Matern Child Nurs 2004; 29(1):41-9.
  6. Gagua T, Tkeshelashvili B, Gagua D. Primary dysmenorrhea: prevalence in adolescent population of Tbilisi, Georgia and risk factors. J Turk Ger Gynecol Assoc 2012; 13(3):162-8.
  7. Eby GA. Zinc treatment prevents dysmenorrhea. Med Hypotheses 2007; 69(2):297-301.
  8. Bertone-Johnson ER, Ronnenberg AG, Houghton SC, Nobles C, Zagarins SE, Takashima-Uebelhoer BB, et al. Association of inflammation markers with menstrual symptom severity and premenstrual syndrome in young women. Hum Reprod 2014; 29(9):1987-94.
  9. Raisi Dehkordi Z, Hosseini Baharanchi FS, Bekhradi R. Effect of lavender inhalation on the symptoms of primary dysmenorrhea and the amount of menstrual bleeding: a randomized clinical trial. Complement Ther Med 2014; 22(2):212-9.
  10. Chen MN, Chien LW, Liu CF. Acupuncture or acupressure at the sanyinjiao (SP6) acupoint for the treatment of primary dysmenorrhea: a meta-analysis. Evid Based Complement Alternat Med 2013; 2013:1-8.
  11. Lefebvre G, Pinsonneault O, Antao V, Black A, Burnett M, Feldman K, et al. Primary dysmenorrhea consensus guideline. J Obstet Gynaecol Can 2005; 27(12):1117-46.
  12. Yeh ML, Hung YL, Chen HH, Lin JG, Wang YJ. Auricular acupressure combined with an internet-based intervention or alone for primary dysmenorrhea: a control study. Evid Based Complement Alternat Med 2013; 2013:232-9.
  13. Smith CA, Zhu X, He L, Song J. Acupuncture for dysmenorrhoea. Cochrane Database Syst Rev 2011; 1(1):1-60.
  14. Wang SM, Kain ZN, White P. Acupuncture analgesia: I. The scientific basis. Anesth Analg 2008; 106(2):602-10.
  15. Phan S. Effects of acupuncture versus non-acupuncture treatment on pain. Undergraduate review. J Undergrad Stud Res 2015; 16(1):36-44.
  16. Stux G, Pomeranz B. Acupuncture: textbook and atlas. Tokyo: Springer Science & Business Media; 2012. P. 342.
  17. Deng SZ, Zhao XF, Huang LH, He S, Wen Y, Zhang C, et al. The quantity-effect relationship and physiological mechanisms of different acupuncture manipulations on posterior circulation ischemia with vertigo: study protocol for a randomized controlled trial. Trials 2015; 16(1):152.
  18. Akhavan Amjadi M, Shahbazzadegan S, Shakiba M. Comparison of acupressure effect on two points, sanyinjiao versus tai chong, on primary dysmenorrhea. J Ardabil Univ Med Sci 2015; 15(1):97-106.
  19. Chao MT, Wade CM, Abercrombie PD, Gomolak D. An innovative acupuncture treatment for primary dysmenorrhea: a randomized cross-over pilot study. Alternat Ther Health Med 2014; 20(1):49-56.
  20. Deng H, Shen X. The mechanism of moxibustion: ancient theory and modern research. Evid Based Complement Alternat Med 2013; 2013:379291.
  21. Lin JG, Chen YH, Gao XY, Lao L, Lee H, Litscher G. Clinical efficacy, mechanisms, and safety of acupuncture and moxibustion. Evid Based Complement Alternat Med 2014; 2014:11-3.
  22. Li Z, Pei L. A survey of acupuncture treatment for primary dysmenorrhea. J Tradit Chin Med 2009; 29(1):71-6.
  23. Temraz A, El-Tantawy WH. Characterization of antioxidant activity of extract from Artemisia vulgaris. Pak J Pharm Sci 2008; 21(4):321-6.
  24. Barros TA, De Freitas LA, Fiho JM, Nunes XP, Giulietti AM, De Souza GE, et al. Antinociceptive and anti‐inflammatory properties of 7‐hydroxycoumarin in experimental animal models: potential therapeutic for the control of inflammatory chronic pain. J Pharm Pharmacol 2010; 62(2):205-13.
  25. Terra DA, Amorim LD, Catanho MT, Fonseca AD, Santos-Filho SD, Brandão-Neto J, et al. Effect of an extract of Artemisia vulgaris L.(Mugwort) on the in vitro labeling of red blood cells and plasma proteins with technetium-99m. Brazil Arch Biol Technol 2007; 50(1):123-8.
  26. Carotenuto M, Gallai B, Parisi L, Roccella M, Esposito M. Acupressure therapy for insomnia in adolescents: a polysomnographic study. Neuropsychiatr Dis Treat 2013; 9:157-62.
  27. Bernardo-Filho M, de Sá-Caputo Dda C, Marin PJ, Chang S. The mechanism of auriculotherapy: a case report based on the fractal structure of meridian system. Afr J Tradit Complement Alternat Med 2014; 11(3):30-7.
  28. Yu S, Yang J, Yang M, Gao Y, Chen J, Ren Y, et al. Application of acupoints and meridians for the treatment of primary dysmenorrhea: a data mining-based literature study. Evid Based Complement Alternat Med 2015; 2015:752194.
  29. Wade C, Wang L, Zhao WJ, Cardini F, Kronenberg F, Gui SQ, et al. Acupuncture point injection treatment of primary dysmenorrhoea: a randomised, double blind, controlled study. BMJ Open 2016; 6(1):1-10.
  30. Yang J, Chen J, Lao L, Yang M, Chen J, Bo L, et al. Effectiveness study of moxibustion on pain relief in primary dysmenorrhea: study protocol of a randomized controlled trial. Evid Based Complement Alternat Med 2014; 2014:1-6.
  31. Xu T, Hui L, Juan YL, Min SG, Hua WT. Effects of moxibustion or acupoint therapy for the treatment of primary dysmenorrhea: a meta-analysis. Alternat Ther Health Med 2014; 20(4):33-42.
  32. Chen HM, Wang HH, Chiu MH, Hu HM. Effects of acupressure on menstrual distress and low back pain in dysmenorrheic young adult women: an experimental study. Pain Manag Nurs 2015; 16(3):188-97.
  33. Gharloghi S, Torkzahrani S, Akbarzadeh AR, Heshmat R. The effects of acupressure on severity of primary dysmenorrhea. Patient Prefer Adherence 2012; 6:137-42.
  34. Chen WH, Zhao Y, Zeng CC, Zhang DN, Wang YP, Tang L, et al. Pain-induced pulsograph changes in patients with primary dysmenorrhea: a pilot study. Evid Based Complement Alternat Med 2015; 2015:1-7.
  35. Kim TG, Park YP, Cheon MW, Lee YS, Na CS, Youn DH, et al. Thermal characteristics analysis of moxibustion apparatus capable of controlling temperature by applying RS485 communication. Int J Control Automat 2016; 9(1):251-8.
  36. Lin LM, Wang SF, Lee RP, Hsu BG, Tsai NM, Peng TC. Changes in skin surface temperature at an acupuncture point with moxibustion. Acupunct Med 2013; 31(2):195-201.
  37. Shi XM. Indications and prospects of acupuncture-moxibustion. Zhongguo Zhen Jiu 2011; 31(11):961-4.
  38. Cheng XR, Cheng K. Survey of studies on the mechanism of acupuncture and moxibustion treating diseases abroad. Zhongguo Zhen Jiu 2008; 28(6):463-7.
  39. Vogt‐Eisele AK, Weber K, Sherkheli MA, Vielhaber G, Panten J, Gisselmann G, et al. Monoterpenoid agonists of TRPV3. Br J Pharmacol 2007; 151(4):530-40.
  40. Lin CT, Chen CJ, Lin TY, Tung JC, Wang SY. Anti-inflammation activity of fruit essential oil from Cinnamomum insularimontanum Hayata. Bioresour Technol 2008; 99(18):8783-7.
  41. Tung YT, Chua MT, Wang SY, Chang ST. Anti-inflammation activities of essential oil and its constituents from indigenous cinnamon (Cinnamomum osmophloeum) twigs. Bioresour Technol 2008; 99(9):3908-13.
  42. Bani S, Hasanpour S, Mousavi Z, Mastafa Garehbaghi P, Gojazadeh M. The effect of rosa damascena extract on primary dysmenorrhea: a double-blind cross-over clinical trial. Iran Red Crescent Med J 2014; 16(1):e14643.
  43. Dai N, Fang L, Li YB, Wang YM, Yin J, Pu BC. Effect of jingqian zhitong fang on serum sex hormone levels in women with primary dysmenorrhea. Evid Based Complement Alternat Med 2014; 2014:1-7.
  44. Bazarganipour F, Lamyian M, Heshmat R. The effect of applying pressure to the third liver point on the symptoms of involved liver channel in girls with primary dysmenorrhea: a randomized clinical trial. Arak Med Univ J 2010; 13(2):17-25.
  45. Speroff L, Fritz MA. Clinical gynecology endocrinology and infertility. 8th ed. Philadelphia: Lippincott Williams & Wilkins; 2011. P. 200-580.
  46. Xue Z, Liu CZ, Gao SZ, Ma YX. The herbal-partitioned moxibustion for primary dysmenorrhea and it's impact on reproductive endocrinal function of patients. Zhongguo Zhen Jiu 2014; 34(3):209-12.
  47. Yang JJ, Sun LH, She YF, Ge JJ, Li XH, Zhang RJ. Influence of ginger-partitioned moxibustion on serum NO and plasma endothelin-1 contents in patients with primary dysmenorrhea of cold-damp stagnation type. Zhen Ci Yan Jiu 2008; 33(6):409-12.
  48. Aly SE. The effect of using common acupressure points on decreasing pain. J Am Sci 2013; 9(12):575-82.
  49. Sabouhi F, Kalani L, Valiani M, Mortazavi M, Bemanian M. Effect of acupressure on fatigue in patients on hemodialysis. Iran J Nurs Midwifery Res 2013; 18(6):429-34.
  50. Jun EM, Chang S, Kang DH, Kim S. Effects of acupressure on dysmenorrhea and skin temperature changes in college students: a non-randomized controlled trial. Int J Nurs Stud 2007; 44(6):973-81.
  51. Shin W. The effect of convalescent meridian acupressure after exercise on stress hormones and lactic acid concentration changes. J Exerc Rehabil 2013; 9(2):331-5.
  52. Bertrand SW. Inroads to integrative health care: registered nurses’ personal use of traditional Chinese medicine affects professional identity and nursing practice. Complement Health Pract Rev 2010; 15(1):14-30.
  53. He JJ, Huang Y, Wang SX. Preliminary exploitation into the acupoint selection rules for dysmenorrhea. Chin J Tradit Chin Med 2009; 21(5):467-8.
  54. Wong CL, Lai KY, Tse HM. Effects of SP6 acupressure on pain and menstrual distress in young women with dysmenorrhea. Complement Ther Clin Pract 2010; 16(2):64-9.
  55. Sabouhi F, Kalani L, Valiani M, Mortazavi M, Bemanian M. Effect of acupressure on fatigue in patients on hemodialysis. Iran J Nurs Midwifery Res 2013; 18(6):429-34.
  56. Hang-zhou L, Ming-zhuang L. Influence of moxibustion on changes of behavior and hormones of hypothalamus-pituitary-adrenal axis in rats with chronic fatigue syndrome. J Anhui Tradit Chin Med Coll 2009; 6:19.
  57. Xu HQ, Zhang HR, Gu YH. Progress of researches on prevention and treatment of sports fatigue with moxibustion therapy. Zhen Ci Yan Jiu 2014; 39(2):169-73.
  58. Lu C, Yang X, Hu J. Randomized controlled clinical trials of acupuncture and moxibustion treatment of chronic fatigue syndrome patients. Zhen Ci Yan Jiu 2014; 39(4):313-7.
  59. Sun DL, Zhang Y, Chen DL, Zhang AB, Xu M, Li ZJ, et al. Effect of moxibustion therapy plus cupping on exercise-induced fatigue in athletes. J Acupunct Tuina Sci 2012; 10(5):281-6.
  60. Tang WR, Chen WJ, Yu CT, Chang YC, Chen CM, Wang CH, et al. Effects of acupressure on fatigue of lung cancer patients undergoing chemotherapy: an experimental pilot study. Complement Ther Med 2014; 22(4):581-91.
  61. Bharadwaj S, Wu XR, Barber MD, Queener E, Graff L, Shen B. Association between gastro-intestinal symptoms and menstruation in patients with ileal pouches. Gastroenterol Rep 2014; 2(3):207-14.
  62. Jaafarpour M, Hatefi M, Najafi F, Khajavikhan J, Khani A. The effect of cinnamon on menstrual bleeding and systemic symptoms with primary dysmenorrhea. Iran Red Crescent Med J 2015; 17(4):1-7.
  63. Forouhari S, Ghaemi SZ, Roshandel A, Moshfegh Z, Rostambeigy P, Mohaghegh Z. The effect of acupressure on nausea and vomiting during pregnancy. Researcher 2014; 6(6):27-34.
  64. Naeimi Rad M, Lamyian M, Heshmat R, Jaafarabadi MA, Yazdani S. A randomized clinical trial of the efficacy of KID21 point (Youmen) acupressure on nausea and vomiting of pregnancy. Iran Red Crescent Med J 2012; 14(11):697-701.
  65. Saberi F, Sadat Z, Abedzadeh-Kalahroodi M, Taebi M. Impact of acupressure on nausea and vomiting during pregnancy. Feyz J Kashan Univ Med Sci 2012; 16(3):212-8. (Persian).
  66. Genç F, Tan M. The effect of acupressure application on chemotherapy-induced nausea, vomiting, and anxiety in patients with breast cancer. Palliat Support Care 2015; 13(2):275-84.
  67. Noroozinia H, Mahoori A, Hasani E, Gerami-Fahim M, Sepehrvand N. The effect of acupressure on nausea and vomiting after cesarean section under spinal anesthesia. Acta Med Iran 2013; 51(3):163-7.
  68. Soltanzadeh M, Behaeen K, Pourmehdi Z, Safarimohsenabadi A. Effects of acupressure on nausea and vomiting after gynecological laparoscopy surgery for infertility investigations. Life Sci J 2012; 9(3):871-5.
  69. Liu YQ, Sun S, Dong HJ, Zhai DX, Zhang DY, Shen W, et al. Wrist-ankle acupuncture and ginger moxibustion for preventing gastrointestinal reactions to chemotherapy: a randomized controlled trial. Chin J Integrat Med 2015; 21(9):697-702.
  70. Shi J, Tang C. Clinical study on the therapeutic effect of moxibustion with ginger at sihua points on post chemotherapy side effects in lung cancer patients. Int J Clin Acupunct 2014; 23(3):103-7.
  71. Zhao JM, Lu JH, Yin XJ, Chen XK, Chen YH, Tang WJ, et al. Comparison of electroacupuncture and moxibustion on brain-gut function in patients with diarrhea-predominant irritable bowel syndrome: a randomized controlled trial. Chin J Integr Med 2015; 21(11):855-65.
  72. Zhao JM, Wu LY, Liu HR, Hu HY, Wang JY, Huang RJ, et al. Factorial study of moxibustion in treatment of diarrhea-predominant irritable bowel syndrome. World J Gastroenterol 2014; 20(37):13563-72.
  73. Ma YX, Liu X, Liu CZ, Wang LP, Guo G, Du DQ, et al. Randomized clinical trial: the clinical effects of herb-partitioned moxibustion in patients with diarrhoea-predominant irritable bowel syndrome. Evid Based Complement Alternat Med 2013; 2013:1-8.
  74. Hu H. Clinical treatment of 45 cases of intractable daybreak diarrhea by moxibustion at acupiont shenque (CV8) combined with sishen pills. Int J Clin Acupunct 2014; 23(4):189-91.
  75. Karlı N, Baykan B, Ertaş M, Zarifoğlu M, Siva A, Saip S, et al. Impact of sex hormonal changes on tension-type headache and migraine: a cross-sectional population-based survey in 2,600 women. J Headache Pain 2012; 13(7):557-65.
  76. Vetvik KG, MacGregor EA, Lundqvist C, Russell MB. Prevalence of menstrual migraine: a population-based study. Cephalalgia 2014; 34(4):280-8.
  77. Sun LH, Li XH, Li WL, Liu L, Ma HL, Liang YL. Body acupuncture combined with auricular acupressure for menstrual headache: a randomized controlled clinical trial. Zhen Ci Yan Jiu 2015; 40(1):70-4.
  78. Sun L, Liang Y, Li X, Liu L, Xu X, Ma H, et al. Efficacy of acupuncture combined with auricular point sticking on the content of serum prostaglandin F2α, and plasma arginine vasopressin in patients with menstrual headache. Zhongguo Zhen Jiu 2015; 35(2):137-40.
  79. Singh R, Goyal M, Tiwari S, Ghildiyal A, Nattu SM, Das S. Effect of examination stress on mood, performance and cortisol levels in medical students. Indian J Physiol Pharmacol 2012; 56(1):48-55.
  80. Moradi Z, Akbarzadeh M, Moradi P, Toosi M, Hadianfard MJ. The effect of acupressure at GB-21 and SP-6 acupoints on anxiety level and maternal-fetal attachment in primiparous women: a randomized controlled clinical trial. Nurs Midwifery Stud 2014; 3(3):1-7.
  81. Gharloghi S, Torkzahrani S, Akbarzadeh AR, Heshmat R. The effects of acupressure on severity of primary dysmenorrhea. Patient Prefer Adherence 2012; 6:137-42.
  82. Son CG. Safety of 4-week Indirect-moxibustion therapy at CV4 and CV8. J Acupunct Meridian Stud 2011; 4(4):262-5.