董氏奇穴结合中医外治法治疗原发性痛症的研究进展

Research Progress on Dong’s Extraordinary Points Combined with External Therapies of Traditional Chinese Medicine in Treating Primary Dysmenorrhea

摘要: 原发性痛经是妇科常见病，严重影响女性生活质量。近年来，董氏奇穴配合中医外治法治疗原发性痛经取得良好效果。本文综述董氏奇穴配合浮针、火针、刺络放血、艾灸、温针灸等中医外治法治疗原发性痛经的研究进展。董氏奇穴选穴精准，疗效确切，在妇科疾病治疗方面应用广泛。浮针疗法通过皮下疏通，可以迅速缓解痛经；火针疗法利用其温热之性，温经散寒，调理冲任；刺络放血法通过局部放血，促进盆腔血液循环；艾灸与温针灸则温阳散寒，调理脾肾。临床研究显示，董氏奇穴配合以上外治法治疗原发性痛经，总有效率为85%~95%，在减轻疼痛、改善伴随症状、调节内分泌等方面均优于单纯西药治疗。其作用机制可能与调节下丘脑–垂体–卵巢轴功能、降低前列腺素水平、改善子宫血液循环有关。本综述的创新性在于首次将董氏奇穴与多种主流外治法进行系统整合与聚焦，并着重比较了不同联合疗法的作用机制异同及其与中医证型的关联性。但目前研究尚存不足，如样本量较小、随机对照设计不够完善、远期疗效观察不足及缺乏统一疗效评价标准。今后需开展更多多中心随机对照研究，制定标准化方案，深入探索其作用机制，以提供更高质量的循证医学依据。

Abstract: Primary dysmenorrhea is a common gynecological condition that severely impacts women’s quality of life. In recent years, the combination of Dong’s Extraordinary Points (DEP) and external therapies of Traditional Chinese Medicine (TCM) has achieved favorable outcomes in treating this condition. This review summarizes the research progress on DEP combined with external therapies such as floating needling, fire needling, blood-letting, moxibustion, and warm needling for primary dysmenorrhea. DEP features precise point selection and definite efficacy, widely used in gynecological disorders. Floating needling rapidly relieves pain via subcutaneous loosening; fire needling warms meridians and dispels cold; blood-letting promotes pelvic circulation; moxibustion and warm needling strengthen Yang and regulate the Spleen and Kidney. Clinical studies report a total effective rate of 85%~95%, superior to Western medicine alone in pain reduction, symptom improvement, and endocrine regulation. Mechanisms may involve regulation of the hypothalamic-pituitary-ovarian axis, reduction of prostaglandin levels, and improvement of uterine blood flow. The innovation of this review lies in its systematic integration and focus on DEP combined with multiple mainstream external therapies, with a particular emphasis on comparing the mechanistic differences and synergies of different combined therapies, as well as their relevance to TCM syndrome types. However, current research has limitations including small sample sizes, imperfect randomized controlled designs, insufficient long-term follow-up, and lack of unified efficacy evaluation criteria. Future studies should conduct more multicenter randomized controlled trials, develop standardized protocols, and further investigate the mechanisms to provide higher-quality evidence-based medical support.