温针灸联合耳穴压豆治疗子宫腺肌病继发痛经的研究进展

Research Progress on Warm-Needle Moxibustion Combined with Auricular Point Pressing for Secondary Dysmenorrhea Due to Adenomyosis

摘要: 子宫腺肌病是育龄妇女常见妇科疾病，而子宫腺肌病引起的痛经对患者生活造成很大影响。近年来，中医药治疗对子宫腺肌病继发痛经有较好疗效。本文通过对文献进行总结分析，总结温针灸及耳穴压豆治疗子宫腺肌病继发痛经研究进展。温针灸是针刺与艾灸结合的一种治疗方法，可温经散寒、活血化瘀、调理冲任，从而减轻子宫腺肌病患者痛经症状，改善子宫内膜异位病灶，调节雌激素水平。耳穴压豆是通过对耳部某些穴位进行刺激，以达到调节神经系统和内分泌系统的目的，起到止痛、调经的作用。两者合用可以起到相辅相成的效果：从治疗原理来看，温针灸主要是针对局部病灶进行治疗，而耳穴压豆是从整体上进行调节，所以两者结合起来就可以形成局部与整体、经络与脏腑相结合的多层次治疗模式。从临床应用来看，联合治疗可以提高疗效，缩短疗程，减少副作用。目前已有较多研究表明，温针灸配合耳穴压豆治疗子宫腺肌病继发痛经总有效率为85%~95%，在缓解疼痛、减少月经量、提高生活质量等方面均优于单独使用一种方法。但是目前相关报道多数是小样本临床观察，缺少大样本、多中心的随机对照试验，在标准化治疗方案、疗效评价指标以及作用机制等方面还有待进一步研究。今后要加大基础研究力度，制定统一的诊疗标准，使这一疗法更好地应用于临床。

Abstract: Adenomyosis is a common gynecological disorder in women of reproductive age, and the dysmenorrhea it causes significantly impacts patients’ quality of life. In recent years, traditional Chinese medicine (TCM) therapies have shown promising efficacy in treating secondary dysmenorrhea due to adenomyosis. This paper reviews and analyzes the literature to summarize the research progress of warm needling (warming needle moxibustion) combined with auricular point pressing with beans (ear acupressure with seeds) in the treatment of secondary dysmenorrhea caused by adenomyosis. Warm needling is a therapeutic method that combines acupuncture with moxibustion. It can warm the meridians and dispel cold, promote blood circulation and remove blood stasis, and regulate the Chong and Ren meridians, thereby alleviating dysmenorrhea symptoms in patients with adenomyosis, improving endometrial lesions, and regulating estrogen levels. Auricular point pressing with beans involves stimulating specific acupoints on the ear to regulate the nervous and endocrine systems, achieving analgesic and menstrual-regulating effects. The combined use of these two therapies produces a synergistic effect: From the perspective of treatment principles, warm needling primarily targets local lesions, while auricular point pressing regulates the body as a whole. Thus, their combination forms a multi-level treatment model that integrates local and systemic approaches, as well as meridian and viscera regulation. From a clinical application standpoint, combined therapy can enhance efficacy, shorten treatment duration, and reduce side effects. Numerous studies have shown that the total effective rate of warm needling combined with auricular point pressing for secondary dysmenorrhea due to adenomyosis ranges from 85% to 95%. This combined approach is superior to either method alone in relieving pain, reducing menstrual blood loss, and improving quality of life. However, most current reports are based on small-sample clinical observations, lacking large-scale, multi-center randomized controlled trials. Further research is needed regarding standardized treatment protocols, efficacy evaluation indicators, and underlying mechanisms. Future efforts should strengthen basic research and establish unified diagnostic and treatment standards to facilitate better clinical application of this therapy.