مقایسه اثر موضعی روغن زنجبیل با زنجبیل خوراکی بر علائم همراه دیسمنوره اولیه: کارآزمایی بالینی

نوع مقاله: اصیل پژوهشی

نویسندگان

1 متخصص طب سنتی، دانشکده طب سنتی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

2 استادیار گروه داروسازی سنتی، مرکز تحقیقات طب سنتی و مفردات پزشکی، دانشکده طب سنتی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

3 استادیار مؤسسه تحقیقات طب اسلامی و مکمل، دانشگاه علوم پزشکی ایران، تهران، ایران.

4 استادیار گروه طب سنتی، دانشکده طب سنتی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

چکیده

مقدمه: دیسمنوره ‌اولیه در همراهی با علائم‌ همراه، عواقب فراوانی به‌دنبال ‌‌دارد. از دیدگاه طب ‌سنتی ‌ایران و مطالعات، زنجبیل خوراکی و موضعی بر درد دیسمنوره ‌اولیه مؤثر هستند، لذا مطالعه حاضر با هدف بررسی اثر خوراکی کپسول زنجبیل و اثر موضعی روغن زنجبیل تهیه شده به روش ماسراسیون بر علائم همراه دیسمنوره و مقایسه اثرات آن‌ها انجام شد.
روش‌کار‌: این مطالعه کارآزمایی ‌بالینی یک‌سوکور در سال 96-1395 بر روی 70 دانشجوی مبتلا به دیسمنوره متوسط و شدید و ساکن در خوابگاه دانشگاه علوم پزشکی شهید بهشتی تهران انجام شد. علائم همراه دیسمنوره در این دانشجویان در سیکل اول بر اساس معیار چند بُعدی کلامی ارزیابی ‌شد، سپس بیماران به‌طور تصادفی به دو گروه خوراکی و موضعی تقسیم‌ شدند و طی سه سیکل بعدی دارو را از دو روز قبل از شروع قاعدگی تا روز سوم قاعدگی دریافت ‌کردند. گروه خوراکی هر 6 ساعت یک عدد کپسول زنجبیل مصرف ‌کردند و گروه موضعی هر 6 ساعت پنج قطره روغن زنجبیل زیر شکم مالیدند. علائم همراه دیسمنوره در هر سیکل بر اساس معیار چند بُعدی ‌کلامی ارزیابی و سپس مقایسه ‌شد.تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS ‌(نسخه 17) و آزمون‌های من‌ویتنی و ویلکاکسون انجام شد. میزان p کمتر از 05/0 معنادار در نظر گرفته ‌شد.
یافته‌ها: خستگی، بی‌حالی، نفخ، سردرد، کمردرد و گرفتگی‌ عضلات ‌پا در هر دو ﮔﺮوه نسبت به قبل از مداخله ﻛﺎﻫﺶ یافت (05/0p<). تهوع، استفراغ و اسهال در گروه خوراکی و تغییر حالات ‌عصبی و پادرد در گروه موضعی بعد از مداخله کاهش ‌یافت (05/0p<). عارضه جانبی فقط در گروه خوراکی مشاهده ‌شد (60%).
نتیجه‌گیری: هر دو فرم زنجبیل موجب کاهش مشابه علائم عمومی و عصبی همراه دیسمنوره ‌شدند و فرم خوراکی تعداد بیشتری از علائم گوارشی و فرم موضعی تعداد بیشتری از علائم عضلانی- اسکلتی همراه دیسمنوره را کاهش‌ داد. همچنین از آنجا که فرم موضعی بهتر از فرم خوراکی توسط بیماران تحمل شد، به‌نظر می‌رسد مالیدن موضعی روغن زنجبیل انتخاب بهتری در کاهش علائم عمومی و عصبی همراه دیسمنوره ‌باشد.

کلیدواژه‌ها


عنوان مقاله [English]

Comparison of local effects of ginger oil with oral ginger on associated symptoms of primary dysmenorrhea: randomized clinical trial

نویسندگان [English]

  • Pantea Shirooye 1
  • Maryam Hamzeloo-Moghadam 2
  • Fataneh Hashem-Dabaghian 3
  • Roshanak Mokaberinejad 4
1 PhD of Traditional Medicine, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2 Assistant Professor, Department of Traditional Pharmacy, Traditional Medicine and Materia Medica Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
3 Assistant Professor, Research Institute for Islamic and Complementary Medicine, Iran University of Medical Sciences, Tehran, Iran.
4 Assistant Professor, Department of Traditional Medicine, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
چکیده [English]

Introduction: Primary dysmenorrhea along with associated symptoms is followed by many consequences. According to Iranian Traditional Medicine point of view and the studies, oral and topical ginger are effective on primary dysmenorrhea. So this study was performed with aim to evaluate the effect of oral ginger capsule and topical ginger oil which are prepared by Maceration method on the associated symptoms of dysmenorrhea and comparing their effects.
Methods: This single-blind randomized clinical trial was performed on 70 students with moderate and severe dysmenorrhea who were resident in dormitory of Tehran Shahid Beheshti University of Medical Sciences in 2016-2017. The associated symptoms of dysmenorrhea in these students were assessed with verbal multidimensional scoring system in first cycle. Then, the patients were randomized into two groups of oral and topical and they received drugs two days before the start of menstruation until first three days of menstruation over next three cycles. The oral group received one ginger capsule every 6 hours and the topical group applied 5 drops of ginger oil below the abdomen every 6 hours. The associated symptoms of dysmenorrhea were assessed and compared in each cycle based on verbal multidimensional scoring system. Data were analyzed by SPSS software (version 17) and Mann-Whitney and Wilcoxon tests. P< 0.05 was considered significant.
Results: Fatigue, bloat, headache, backache and leg cramps decreased in both groups compared to before the intervention (p<0.05). Nausea, vomiting and diarrhea decreased in oral group, and mood’s changes and leg pain decreased in topical group (p<0.05) after the intervention. Side effects were observed only in oral group (60%).
Conclusion: Both forms of ginger reduced general and neurological symptoms of dysmenorrhea; the oral form decreased more gastrointestinal symptoms of dysmenorrhea and topical form decreased more musculoskeletal symptoms of dysmenorrhea. In addition, since topical form was better tolerated by patients, so it seems that topical ginger oil is a better choice for reducing the general and neurological symptoms of dysmenorrhea.

کلیدواژه‌ها [English]

  • Associated symptoms of dysmenorrhea
  • Dysmenorrhea
  • ginger
  • Ginger oil
  • Iranian Traditional Medicine
  1. Panahandeh Z, Pakzad Z, Ashouri R. Survey the prevalence, knowledge and practice of Guilan university students about dysmenorrhea. J Guilan Univ Med Sci 2008; 17(66):87-94.
  2. Ortiz MI. Primary dysmenorrhea among Mexican university students: prevalence, impact and treatment. Eur J Obstet Gynecol Reprod Biol 2010; 152(1):73-7.
  3. Rodrigues AC, Gala S, Neves A, Pinto C, Meirelles C, Frutuoso C, et al. Dysmenorrhea in adolescents and young adults: prevalence, related factors and limitations in daily living. Acta Med Port 2011; 24(Suppl 2):383-88.
  4. Grandi G, Ferrari S, Xholli A, Cannoletta M, Palma F, Romani C, et al. Prevalence of menstrual pain in young women: what is dysmenorrhea? J Pain Res 2012; 5:169-74.
  5. Banikarim C, Chacko MR, Kelder SH. Prevalence and impact of dysmenorrhea on Hispanic female adolescents. Arch Pediatr Adolesc Med 2000; 154(12):1226-9.
  6. Polat A, Celik H, Gurates B, Kaya D, Nalbant M, Kavak E, et al. Prevalence of primary dysmenorrhea in young adult female university students. Arch Gynecol Obstet 2009; 279(4):527-32.
  7. Tanmahasamut P, Chawengsettakul S. Dysmenorrhea in Siriraj medical students; prevalence, quality of life, and knowledge of management. J Med Assoc Thai 2012; 95(9):1115-21.
  8. Chuamoor K, Kaewmanee K, Tanmahasamut P. Dysmenorrhea among Siriraj nurses; prevalence, quality of life, and knowledge of management. J Med Assoc Thai 2012; 95(8):983-91.
  9. Hillen TI, Grbavac SL, Johnston PJ, Straton JA, Keogh JM. Primary dysmenorrhea in young Western Australian women: prevalence, impact, and knowledge of treatment. J Adolesc Health 1999; 25(1):40-5.
  10. Sultan C, Gaspari L, Paris F. Adolescent dysmenorrhea. Endocr Dev 2012; 22:171-80.
  11. Speroff L, Fritz MA. Clinical gynecologic endocrinology and infertility. Philadelphia: Lippincott Williams & Wilkins; 2005.
  12. Salari R, Yousefi M, Ghorbanzadeh H, Jafarinejad Bajestani M. A review of medicinal herbs with estrogenic, progesteronic, and testosteronic properties. Iran J Obstet Gyneocol Infertil 2016; 19(36):19-30. (Persian).
  13. Dmitrovic R, Kunselman AR, Legro RS. Continuous compared with cyclic oral contraceptives for the treatment of primary dysmenorrhea: a randomized controlled trial. Obstet Gynecol 2012; 119(6):1143-50.
  14. Proctor M, Murphy PA. Herbal and dietary therapies for primary and secondary dysmenorrhoea. Cochrane Database Syst Rev 2001; 3:CD002124.
  15. Kor N, Jouybari LM, Sanagoo A. The health believes and home remedies of the Turkmen people for dysmenorrhea. Jentashapir J Health Res 2012; 2(4):157-64. (Persian).
  16. Berek JS, Novak E. Berek and Novak's gynecology. 15th ed. Philadelphia: Lippincott Williams & Wilkins; 2012.
  17. 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.
  18. Marjoribanks J, Proctor M, Farquhar C, Derks RS. Nonsteroidal anti-inflammatory drugs for dysmenorrhoea. Cochrane Database Syst Rev 2010; 1:12.
  19. Henzl M. Dysmenorrhea: achievements and challenge. Sex Med Today 1985; 9:8-12.
  20. Altman RD, Marcussen KC. Effects of a ginger extract on knee pain in patients with osteoarthritis. Arthritis Rheum 2001; 44(11):2531-8.
  21. Dawood MY. Primary dysmenorrhea: advances in pathogenesis and management. Obstet Gynecol 2006; 108(2):428-41.
  22. Marjoribanks J, Ayeleke RO, Farquhar C, Proctor M. Nonsteroidal anti-inflammatory drugs for primary dysmenorrhoea. Cochrane Database Syst Rev 2009; 7:CD001751.
  23. Zaidi SA, Khatoon K, Aslam K. Role of herbal medicine in Ussuruttams (Dysmenorrhoea). J Acad Indus Res 2012; 1(3):113-7.
  24. Rahnama P, Montazeri A, Huseini HF, Kianbakht S, Naseri M. Effect of Zingiber officinale R. rhizomes (ginger) on pain relief in primary dysmenorrhea: a placebo randomized trial. BMC Complement Altern Med 2012; 12:92.
  25. Shirooye P, Afrakhteh M, Bioos S, Mokaberinejad R. Uterine pain explanation from Iranian Traditional Medicine point of view vs. pelvic pain from contemporary medicine. Iran J Obstet Gyneocol Infertil 2016; 19(3):9-25. (Persian).
  26. Gharshi A. Alshamel fi al-Sanaat al-Tebbiat. Tehran: Iran University of Medical Science, Research Institute for Islamic and Complementary Medicine; 2008. (Persian).
  27. Chashti MA. Exir-e Aazam. Tehran: Iran University of Medical Science; 2007. (Persian).
  28. Moamen Tonekaboni M. Tohfe al-Momenin. Tehran: Shahid Beheshti University of Medical Sciences; 2007. (Persian).
  29. Aghili Khorasani M. Makhzan al-Advie. Tehran: Iran University of Medical Science Research, Institute for Islamic and Complementary Medicine; 2008. (Persian).
  30. Rahnama PA, Fallah Huseini H, Mohammadi H, Modares MA, Khajavi Shojaee K, Askari M, et al. The effects of zingiber officinal r. on primary dysmenorrhea. J Med Plants 2010; 4(36):81-6. (Persian).
  31. Jenabi E. The effect of ginger for relieving of primary dysmenorrhoea. J Pak Med Assoc 2013; 21(1):8-10.
  32. Ozgoli G, Goli M, Moattar F. Comparison of effects of ginger, mefenamic acid, and ibuprofen on pain in women with primary dysmenorrhea. J Altern Complement Med 2009; 15(2):129-32.
  33. Hur MH, Lee MS, Seong KY, Lee MK. Aromatherapy massage on the abdomen for alleviating menstrual pain in high school girls: a preliminary controlled clinical study. Evid Based Complement Alternat Med 2012; 2012:187163.
  34. Rizk SA. Effect of aromatherapy abdominal massage using peppermint versus ginger oils on primary dysmenorrhea among adolescent girls. J Am Sci 2013; 9(11):497-505.
  35. Kim YJ, Lee MS, Yang YS, Hur MH. Self-aromatherapy massage of the abdomen for the reduction of menstrual pain and anxiety during menstruation in nurses: a placebo-controlled clinical trial. Eur J Integrat Med 2011; 3(3):165-8.
  36. Shirooye P, Hashem-Dabaghian F, Hamzeloo-Moghadam M, Afrakhteh M, Bioos S, Mokabberinezhad R. A clinical comparative study of oral and topical ginger on severity and duration of primary dysmenorrhea. Res J Pharmacog 2017; 4(1):23-32.
  37. Shirooye P, Mokaberinejad R, Ara L, Hamzeloo-Moghadam M. Volatile constituents of ginger oil prepared according to Iranian Traditional Medicine and conventional methods: a comparative study. Afr J Tradit Complement Altern Med 2016; 13(6):68-73.
  38. Atallahi M, Akbari SA, Mojab F, Roshanayi G. Effects of rose essential oil on the primary dysmenorrhea and assossiated systematic symptoms. Adv Nurs Midwifery 2015; 25(89):59-67. (Persian).
  39. Akhavan AM, Mojab F, Shahbazzadegan S. Investigation of cinnamomum selenium’ effects on primary dysmenorrhea and accompanying symptoms. J Ardabil Med Sci 2009; 9(3):204-9.
  40. Torkzahrani S, Akhavan-Amjadi M, Mojab F, Majd H. Clinical effects of foeniculum vulgare extract on primary dysmenorrhea. J Reprod Infertil 2007; 8(1):45-51.
  41. Shirooye P, Abdolhosseini S. Effect of mentha longifolia on 10 patients with primary dysmenorrhea. Asian J Clin Case Rep Tradit Alternat Med 2017; 1(1):51-6.
  42. Ibin‘Abd AA, Sina AI. Al-Qanun fi al-Tibb. Beirut: Muassasah al-Ma’arif; 2005.
  43. Shirooye P. Comparing the effect of topical ginger oil with oral ginger on primary dysmenorrhea. [Master Thesis]. Tehran, Iran: Traditional Medicine of Shahid Beheshti University Of Medical Science; 2016.
  44. Shirvani MA, Motahari-Tabari N, Alipour A. The effect of mefenamic acid and ginger on pain relief in primary dysmenorrhea: a randomized clinical trial. Arch Gynecol Obstet 2015; 291(6):1277-81.
  45. Kashefi F, Khajehei M, Tabatabaeichehr M, Alavinia M, Asili J. Comparison of the effect of ginger and zinc sulfate on primary dysmenorrhea: a placebo-controlled randomized trial. Pain Manag Nurs 2014; 15(4):826-33.
  46. Davodabady Farahani M, Seyyedzade Aghdam N. Comparison of ginger and valerian on the severity of primary dysmenorrhe: a randomized triple clinical trial. Complement Med J Facul Nurs Midwifery 2013; 3(2):494-503. (Persian).
  47. Mirabi P, Dolatian M, Mojab F, Namdari M. Effects of valerian on bleeding and systematic manifestations of menstruation. J Med Plants 2012; 11(4):155-63.