間接灸關元穴（CV40）及神闕穴（CV8）以治療寒凝氣滯型原發性痛經──統合分析

Indirect Moxibustion at Guanyuan(CV4) and Shenque(CV8) for Primary Dysmenorrhea Patients with Qi Stagnation due to Cold Congealing: A Meta-Analysis

痛經是臨床上常見的婦科疾病。本研究針對寒凝氣滯型原發性痛經隔薑灸神闕穴、關元穴，及隔藥灸神闕穴，採用整合分析其臨床療效，使用月經失調、痛經、關元、神闕、針灸、灸療等關鍵詞查詢，查詢相關期刊到2018年1月共61篇，去除不符合資格者50篇，留下11篇文獻進行統合分析，4篇隔薑灸神闕、關元穴，7篇為隔藥灸神闕穴。因11篇文獻之間不具異質性（I2＜1％ and p＝0.98）使用固定效應模型來進行統計分析，經過整合分析得出的勝算比值為0.23（95％ CI：0.15－0.35），結果顯示不管是隔藥灸、隔薑灸神闕穴，均緩解原發性痛經的症狀。單獨隔藥灸神闕穴的勝算比值為0.21（95％ CI：0.12－0.36），同時隔薑灸神闕穴和關元穴的勝算比值為0.26（95％ CI：0.14－0.48）。結果顯示在臨床上不管是隔薑灸神闕、關元穴，或者隔藥灸神闕穴，治療寒凝氣滯型原發性痛經都有效。且此方式比針灸更溫和，對皮膚無侵入傷害性治療，且操作簡單，其臨床價值是值得推廣的。

Dysmenorrhea is a common clinical gynecological disease. This research targets dysmenorrhea treatments in patients with qi stagnation due to cold congealing, specifically moxibustion on ginger at Shenque (CV8) and Guanyuan (CV4) and moxibustion on herb at Shenque (CV8). The clinical effect was assessed using a meta-analysis of articles published through January 2018. Keywords used for the inquiry included menstrual disorders, dysmenorrhea, Guanyuan, Shenque, acupuncture, moxibustion, and others. Of the 61 relevant articles found, 50 did not meet the research criteria. Among the 11 articles available for comprehensive analysis, four analyzed moxibustion on ginger at Shenque (CV8) and Guanyuan (CV4) and seven analyzed moxibustion on herb at Shenque (CV8). There was no heterogeneity between the 11 papers (I2 <1% and p value = 0.98). The fixed-effect model was used for the statistical analysis. After the integrated analysis of the 11 papers, the OR value was 0.23, while the 95% confidence interval (CI) was 0.15-0.35, meaning that both moxibustion on herb and moxibustion on ginger at Shenque (CV8) were shown to reduce the symptoms of primary dysmenorrhea. The OR value of sole moxibustion on herb Shenque (CV8) was 0.21 (95% CI: 0.12-0.36). The OR value of moxibustion on ginger Shenque (CV8) and Guanyuan (CV4) was 0.26 (95% CI: 0.14-0.48). The meta-analysis showed that both moxibustion on ginger at Shenque (CV8) and Guanyuan (CV) as well as moxibustion on herb at Shenque (CV8) are effective in the clinical treatment of dysmenorrhea in patients with qi stagnation due to cold congealing. The treatment is gentle, not harmful to the skin, deemed acceptable by patients. It is easy to perform and its clinical value is worth promoting.