通督调神针刺方案治疗女性盆底肌筋膜疼痛综合征双中心随机对照研究

注册号:

Registration number:

ITMCTR2025000458

最近更新日期:

Date of Last Refreshed on:

2025-03-04

注册时间:

Date of Registration:

2025-03-04

注册号状态:

Registration Status:

预注册

Prospective registration

注册题目:

通督调神针刺方案治疗女性盆底肌筋膜疼痛综合征双中心随机对照研究

Public title:

Efficacy of Tongdu Tiaoshen Acupuncture for Female Myofascial Pelvic Pain Syndrome:A Dual- Center Randomized Controlled Trial

注册题目简写:

English Acronym:

研究课题的正式科学名称:

通督调神针刺方案治疗女性盆底肌筋膜疼痛综合征双中心随机对照研究

Scientific title:

Efficacy of Tongdu Tiaoshen Acupuncture for Female Myofascial Pelvic Pain Syndrome:A Dual- Center Randomized Controlled Trial

研究课题的正式科学名称简写:

Scientific title acronym:

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

叶泱泱

研究负责人:

蒋丽元

Applicant:

Ye Yangyang

Study leader:

Jiang Liyuan

申请注册联系人电话:

Applicant telephone:

19858162642

研究负责人电话:

Study leader's telephone:

130 1897 6755

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

1055417355@qq.com

研究负责人电子邮件:

Study leader's E-mail:

360741751@qq.com

申请单位网址(自愿提供):

Study leader's website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website
(voluntary supply):

申请注册联系人通讯地址:

中国,浙江省杭州市西湖区教工路新宇酒店118号

研究负责人通讯地址:

中国,浙江省杭州市西湖区体育场路453号

Applicant address:

118 Xinyu Hotel Jiaogong Road Xihu District Hangzhou City Zhejiang Province China

Study leader's address:

453 Tiyuchang Road Xihu District Hangzhou City Zhejiang Province China

申请注册联系人邮政编码:

Applicant postcode:

310007

研究负责人邮政编码:

Study leader's postcode:

310007

申请人所在单位:

杭州市中医院

Applicant's institution:

Hangzhou Traditional Chinese Medicine Hospital

是否获伦理委员会批准:

Approved by ethic committee:

伦理委员会批件文号:

Approved No. of ethic committee:

2025LL003

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件

批准本研究的伦理委员会名称:

杭州市中医院临床研究伦理委员会

Name of the ethic committee:

Clinical Research Ethics Committee of Hangzhou Traditional Chinese Medicine Hospital

伦理委员会批准日期:

Date of approved by ethic committee:

2025/1/27 0:00:00

伦理委员会联系人:

张来

Contact Name of the ethic committee:

Zhang Lai

伦理委员会联系地址:

中国,浙江省杭州市西湖区体育场路453号

Contact Address of the ethic committee:

453 Tiyuchang Road Xihu District Hangzhou City Zhejiang Province China

伦理委员会联系人电话:

Contact phone of the ethic committee:

85827896

伦理委员会联系人邮箱:

Contact email of the ethic committee:

hzgxec@163.com

研究实施负责(组长)单位:

杭州市中医院

Primary sponsor:

Hangzhou Traditional Chinese Medicine Hospital

研究实施负责(组长)单位地址:

中国,浙江省杭州市西湖区体育场路453号

Primary sponsor's address:

453 Tiyuchang Road Xihu District Hangzhou City Zhejiang Province China

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

浙江省

市(区县):

杭州市

Country:

China

Province:

Zhejiang Province

City:

Hangzhou City

单位(医院):

杭州市中医院

具体地址:

中国,浙江省杭州市西湖区体育场路453号

Institution
hospital:

Hangzhou Traditional Chinese Medicine Hospital

Address:

453 Tiyuchang Road Xihu District Hangzhou City Zhejiang Province China

经费或物资来源:

国家中医针灸临床医学研究中心开放课题

Source(s) of funding:

Open Research Project of the National Clinical Research Center for Acupuncture and Moxibustion

研究疾病:

女性盆底肌筋膜疼痛综合征

研究疾病代码:

Target disease:

Female Myofascial Pelvic Pain Syndrome

Target disease code:

研究类型:

Study type:

干预性研究

Interventional study

研究设计:

Study design:

随机平行对照

randomized controlled trial(parallel group design)

研究所处阶段:

Study phase:

治疗新技术临床试验

New Treatment Measure Clinical Study

研究目的:

随着我国三胎政策的推进、女性孕产次增加、高龄孕妇比例上升及人口老龄化进程,盆底肌筋膜疼痛综合征(Myofascialpelvicpainsyndrome,MPPS)发病率明显上升,且多数患者(约 75%)经历重度疼痛(VAS 评分≥7 分)。MPPS 发病机制不仅涉及盆底肌肉与筋膜的损伤,还与心理因素相关,这使 MPPS 治疗成为极具挑战性的医学难题。现有治疗 MPPS 的方法存在治疗周期长、见效慢、复发率高,并受到多种禁忌症制约等问题。故探求一种安全有效且能提高患者依从性的疗法重要又必要。课题组前期研究及文献报道显示,针刺在改善盆底肌筋膜疼痛及伴随症状如漏尿、尿频尿急、便秘等方面有一定优势。但仍存在证据等级不高,缺乏统一标准方案等问题。针灸治痛重在调神,天津中医药大学第一附属医院石学敏院士开创的通督调神针法已被证实对痛症具有显著疗效,但鲜见用于盆底痛治疗的研究。因此,本研究将综合评价通督调神针刺方案治疗 MPPS 疼痛的有效性和安全性,为临床治疗 MPPS 提供参考依据。

Objectives of Study:

With the promotion of China's three child policy the increase of female pregnancy and childbirth the increase of the proportion of elderly pregnant women and the process of population aging the incidence rate of pelvic floor myofascial pain syndrome (MPPS) has significantly increased and most patients (about 75%) experience severe pain (VAS score ≥ 7 points). The pathogenesis of MPPS not only involves damage to pelvic floor muscles and fascia but is also related to psychological factors making MPPS treatment a highly challenging medical problem. The existing methods for treating MPPS have problems such as long treatment cycles slow efficacy high recurrence rates and are constrained by various contraindications. Therefore it is important and necessary to explore a safe and effective therapy that can improve patient compliance. Previous research and literature reports by the research group have shown that acupuncture has certain advantages in improving pelvic floor myofascial pain and accompanying symptoms such as urinary leakage frequent urination urgency constipation etc. However there are still issues such as low level of evidence and lack of unified standard solutions. The key point of acupuncture and moxibustion for pain treatment is to regulate the mind. The Tongdu Tiaoshen acupuncture method initiated by Academician Shi Xuemin of the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine has been proved to have a significant effect on pain but it is rarely used in the research of pelvic floor pain treatment. Therefore this study will comprehensively evaluate the effectiveness and safety of the Tongdu Tiaoshen acupuncture regimen in treating MPPS pain providing a reference for clinical treatment of MPPS.

药物成份或治疗方案详述:

Description for medicine or protocol of treatment in detail:

纳入标准:

1、符合盆底肌筋膜疼痛综合征诊断标准:MPPS的诊断需满足以下二方面。 ①症状评估:出现一个或多个以下症状,包括持续6个月以上的慢性盆腔疼痛,排尿困难(如尿频、尿急、尿痛或尿潴留),性功能障碍(如性交痛或阴道痉挛),以及排便异常(如便秘、排便痛或排便不畅)。 ②盆底触诊:经阴道对耻骨尾骨肌、髂骨尾骨肌、尾骨肌、闭孔内肌等盆底肌群进行触诊,诊断应包含以下几个特征: (1)可触摸到紧张带; (2)紧张带上有触痛性结节; (3)痛性结节是高度易激的,触摸可引起疼痛; (4)疼痛使肌肉伸展幅度有限。 2、 20-70岁,已婚女性或有性生活史的女性 3、 自觉或按压疼痛VAS评分≥3分; 4、 知情同意并签署知情同意书者。

Inclusion criteria

1: Meets the diagnostic criteria for pelvic floor myofascial pain syndrome: The diagnosis of MPPS needs to meet the following two aspects ①Symptom assessment: one or more of the following symptoms occur including chronic pelvic pain lasting for more than 6 months dysuria (such as frequency of urination urgency of urination pain in urination or retention of urine) sexual dysfunction (such as sexual intercourse pain or vaginal spasm) and abnormal defecation (such as constipation pain in defecation or poor defecation). ② Pelvic floor palpation: Transvaginal palpation of pelvic floor muscle groups such as pubococcygeus ilium coccygeus coccygeus and obturator muscles should include the following features: (1) palpable tension zone; (2) There are tender nodules on the tension band; (3) Painful nodules are highly excitable and can cause pain upon touch; (4) Pain limits the range of muscle extension. 2: Women aged 20-70 married or with a history of sexual activity 3: Self perceived or pressing pain VAS score ≥ 3 points; 4: Individuals who have provided informed consent and signed the informed consent form.

排除标准:

1: 生殖系统、泌尿系统、消化系统等其它疾病所致的慢性盆腔疼痛; 2: 进行本研究前1个月内接受过相关治疗。 3: 针刺部位感染和(或)不能耐受针刺治疗;盆底局部皮肤破损、感染; 4: 既往严重外伤或者手术史、盆腔占位性病变等; 5: 精神意识障碍无法配合治疗者。

Exclusion criteria:

1: Chronic pelvic pain caused by other diseases of the reproductive system urinary system digestive system etc; 2: Received relevant treatment within one month prior to conducting this study 3: Infection at the acupuncture site and/or intolerance to acupuncture treatment; Local skin damage and infection in the pelvic floor 4: Previous history of severe trauma or surgery pelvic space occupying lesions etc 5: Individuals with mental disorders who are unable to cooperate with treatment.

研究实施时间:

Study execute time:

From 2024-12-01

To      2026-11-30

征募观察对象时间:

Recruiting time:

From 2025-03-31

To      2026-05-31

干预措施:

Interventions:

组别:

试验组

样本量:

90

Group:

Test group

Sample size:

干预措施:

采用“通督调神针刺法”联合针刺盆底局部穴位治疗

干预措施代码:

Intervention:

Using the "Tongdu Tiaoshen Acupuncture Method" combined with acupuncture at local acupoints in the pelvic floor for treatment

Intervention code:

组别:

对照组

样本量:

90

Group:

control group

Sample size:

干预措施:

盆底肌电刺激+生物反馈治疗

干预措施代码:

Intervention:

Pelvic floor electromyography stimulation and biofeedback therapy

Intervention code:

样本总量 Total sample size : 180

研究实施地点:

Countries of recruitment
and research settings:

国家:

中国

省(直辖市):

天津市

市(区县):

Country:

China

Province:

Tianjin City

City:

单位(医院):

天津中医药大学第一附属医院

单位级别:

综合三级甲等性中医院

Institution/hospital:

The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine

Level of the institution:

Comprehensive Grade III Grade A Traditional Chinese Medicine Hospital

国家:

中国

省(直辖市):

浙江省

市(区县):

杭州市

Country:

China

Province:

Zhejiang Province

City:

Hangzhou City

单位(医院):

杭州市中医院

单位级别:

综合三级甲等性中医院

Institution/hospital:

Hangzhou Traditional Chinese Medicine Hospital

Level of the institution:

Comprehensive Grade III Grade A Traditional Chinese Medicine Hospital

测量指标:

Outcomes:

指标中文名:

焦虑自评量表(SAS)

指标类型:

次要指标

Outcome:

SAS scale

Type:

Secondary indicator

测量时间点:

治疗前、治疗3周后

测量方法:

让患者如实填写相关评估量表信息

Measure time point of outcome:

Before treatment and 3 weeks after treatment

Measure method:

Ask patients to truthfully fill in the relevant evaluation scale information

指标中文名:

健康相关生活质量量表(SF-36量表)

指标类型:

次要指标

Outcome:

SF-36 scale

Type:

Secondary indicator

测量时间点:

治疗前、治疗3周后

测量方法:

让患者如实填写相关评估量表信息

Measure time point of outcome:

Before treatment and 3 weeks after treatment

Measure method:

Ask patients to truthfully fill in the relevant evaluation scale information

指标中文名:

盆底障碍影响简易问卷(PFIQ-7简易问卷)

指标类型:

次要指标

Outcome:

PFIQ-7 Simplified Questionnaire

Type:

Secondary indicator

测量时间点:

治疗前、治疗3周后

测量方法:

让患者如实填写相关评估量表信息

Measure time point of outcome:

Before treatment and 3 weeks after treatment

Measure method:

Ask patients to truthfully fill in the relevant evaluation scale information

指标中文名:

盆腔疼痛的自主视觉模拟评分(数值)

指标类型:

主要指标

Outcome:

Autonomic Visual Analog Scale (VAS) for pelvic pain(numerical value)

Type:

Primary indicator

测量时间点:

治疗前、首次治疗后、治疗1周、2周、3周后

测量方法:

以盆底肌筋膜压痛视觉模拟评分记录评分数值,再参照《中药新药临床研究指导原则(试行)》,根据 VAS 评分减分率于治疗结束后评定临床疗效。

Measure time point of outcome:

Evaluate before treatment, after the first treatment, and after 1 week, 2 weeks, and 3 weeks

Measure method:

Record the score values using a visual analog scale for pelvic floor myofascial tenderness, and then refer to the "Guidelines for Clinical Research of Traditional Chinese Medicine New Drugs (Trial)" to evaluate the clinical efficacy after treatment based on the VAS score reduction rate.

指标中文名:

便秘患者生活质量量表(PAC-QOL量表)

指标类型:

次要指标

Outcome:

PAC-QOL scale

Type:

Secondary indicator

测量时间点:

治疗前、治疗3周后

测量方法:

让患者如实填写相关评估量表信息

Measure time point of outcome:

Before treatment and 3 weeks after treatment

Measure method:

Ask patients to truthfully fill in the relevant evaluation scale information

指标中文名:

盆底肌供血评估

指标类型:

主要指标

Outcome:

Pelvic floor muscle blood supply assessment

Type:

Primary indicator

测量时间点:

治疗前、治疗3周后

测量方法:

用彩色及频谱多普勒超声测量对盆底肌群血流定量检测评估盆底功能,嘱咐患者短暂屏气,待血流伪像消失后观察血流情况,找到主要供血支、测量耻骨直肠肌收缩期峰值流速(PSV)、舒张期末流速(EDV)、阻力指数(R1)、收缩/舒张比(S/D)。

Measure time point of outcome:

Before treatment and 3 weeks after treatment

Measure method:

Quantitative detection and evaluation of pelvic floor muscle blood flow using color and spectral Doppler ultrasound were performed to assess pelvic floor function. Patients were instructed to hold their breath briefly and observe blood flow after the blood flow artifact disappeared. The main blood supply branch was identified, and peak systolic velocity (PSV), end diastolic velocity (EDV), resistance index (R1), and systolic/diastolic ratio (S/D)

指标中文名:

改良Oxford盆底肌肉评分

指标类型:

次要指标

Outcome:

Improved Oxford Pelvic Floor Muscle Score

Type:

Secondary indicator

测量时间点:

治疗前、治疗3周后

测量方法:

由评估者评估患者盆底肌力

Measure time point of outcome:

Before treatment and 3 weeks after treatment

Measure method:

Assess the pelvic floor muscle strength of the patient by the evaluator

指标中文名:

盆底肌筋膜压痛视觉模拟评分(数值及减分率)。

指标类型:

主要指标

Outcome:

Visual Analog Scale (VAS) for pelvic floor myofascial tenderness(Value and deduction rate).

Type:

Primary indicator

测量时间点:

治疗前、首次治疗后、治疗1周、2周、3周后

测量方法:

以盆底肌筋膜压痛视觉模拟评分记录评分数值,再参照《中药新药临床研究指导原则(试行)》,根据 VAS 评分减分率于治疗结束后评定临床疗效。

Measure time point of outcome:

Evaluate before treatment after the first treatment and after 1 week 2 weeks and 3 weeks

Measure method:

Record the score values using a visual analog scale for pelvic floor myofascial tenderness and then refer to the "Guidelines for Clinical Research of Traditional Chinese Medicine New Drugs (Trial)" to evaluate the clinical efficacy after treatment based on the VAS score reduction rate.

指标中文名:

盆底功能评估

指标类型:

主要指标

Outcome:

Pelvic floor function assessment

Type:

Primary indicator

测量时间点:

治疗前、治疗3周

测量方法:

于治疗前、治疗3周后运用盆底3D超声及二维超声评估盆底功能。

Measure time point of outcome:

Before treatment and 3 weeks after treatment

Measure method:

Use pelvic floor 3D ultrasound and 2D ultrasound to evaluate pelvic floor function before and 3 weeks after treatment.

指标中文名:

盆底肌筋膜扳机点压痛情况评估

指标类型:

主要指标

Outcome:

Assessment of tenderness at the trigger point of pelvic floor myofascial trigger point

Type:

Primary indicator

测量时间点:

治疗前、治疗3周后

测量方法:

利用经阴道内二维超声定位盆底及盆壁肌群(耻骨直肠肌、耻尾肌、髂尾肌、尾骨肌、梨状肌、闭孔内肌),同时观察各肌肉回声、肌纤维连续性,通过按压各肌肉定位盆底肌筋膜疼痛扳机点,按照 VAS法对寻找到的扳机点进行疼痛评分并记录。

Measure time point of outcome:

Before treatment and 3 weeks after treatment

Measure method:

Using transvaginal two-dimensional ultrasound to locate the pelvic floor and pelvic wall muscle groups (puborectalis muscle, pubococcygeus muscle, iliopsoas muscle, coccyx muscle, piriformis muscle, and obturator muscle), observe the echoes and muscle fiber continuity of each muscle, locate the trigger points of pelvic floor myofascial pain by pressing each muscle, and score and record the pain at the identified trigger points using VAS method.

指标中文名:

Glazer 盆底表面肌电评估

指标类型:

次要指标

Outcome:

Glazer pelvic floor surface electromyography assessment

Type:

Secondary indicator

测量时间点:

治疗前、治疗3周

测量方法:

盆底表面肌电评估方法:采用科瑞康公司的AM1000B系统,评估时患者仰卧屈膝,保持隐私和温暖,阴道探头轻柔插入并连接三块腹部电极贴片,随后进行系统标准肌电评估。

Measure time point of outcome:

Before treatment and 3 weeks after treatment

Measure method:

Pelvic floor surface electromyography evaluation method: Using the AM1000B system from Corecon Company, the patient is evaluated while lying on their back and bending their knees, maintaining privacy and warmth. The vaginal probe is gently inserted and connected to three abdominal electrode patches, followed by standard electromyography evaluation of the system.

指标中文名:

盆底肌肉声学特征评估

指标类型:

主要指标

Outcome:

Assessment of acoustic characteristics of pelvic floor muscles

Type:

Primary indicator

测量时间点:

治疗前、治疗3周

测量方法:

于治疗前、治疗3周后运用二维超声动态观察盆底肌的回声、连续性、运动(收缩及舒张活动)、收缩时间,对MPPS患者进行声学特征分析。

Measure time point of outcome:

Before treatment and 3 weeks after treatment

Measure method:

Before and after 3 weeks of treatment two-dimensional ultrasound was used to dynamically observe the echo continuity movement (contraction and relaxation activity) and contraction time of pelvic floor muscles and acoustic feature analysis was performed on MPPS patients.

指标中文名:

抑郁自评量表(SDS)

指标类型:

次要指标

Outcome:

SDS scale

Type:

Secondary indicator

测量时间点:

治疗前、治疗3周

测量方法:

让患者如实填写相关评估量表信息

Measure time point of outcome:

Before treatment and 3 weeks after treatment

Measure method:

Ask patients to truthfully fill in the relevant evaluation scale information

指标中文名:

盆底功能障碍量表(PFDI-20)

指标类型:

次要指标

Outcome:

PFDI-20 scale

Type:

Secondary indicator

测量时间点:

治疗前、治疗3周

测量方法:

让患者如实填写相关评估量表信息

Measure time point of outcome:

Before treatment and 3 weeks after treatment

Measure method:

Ask patients to truthfully fill in the relevant evaluation scale information

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

组织:

Sample Name:

NO

Tissue:

人体标本去向

其它

说明

Fate of sample 

Others

Note:

征募研究对象情况:

尚未开始

Not yet recruiting

年龄范围:

最小 20
Min age years
最大 70
Max age years

Recruiting status:

Participant age:

性别:

Gender:

女性

Female

随机方法(请说明由何人用什么方法产生随机序列):

本试验由白塔公司负责本课题的中央随机化方法,对符合试验要求的患者,按照 1:1 的比例随机分为试验组和对照组。随机分配采用动态区组随机方法,以防止分组医生猜测患者分组情况,并保证两组结果的可比性。申请中央随机号通过电脑端或微信端的中央随机系统的形式进行申请。系统运用考核合格的申请者可直接登录电脑端或微信端的中央随机系统,输入项目及受试者信息,获取随机序号及分配组别。试验完成并揭盲后,主管中央随机的工作人员核对随机分配记录表是否正确,并打印随机分配表,转交研究人员粘贴在病例报告表外封面的内侧页上。

Randomization Procedure (please state who generates the random number sequence and by what method):

This experiment is conducted by Baita Company which is responsible for the central randomization method of this project. Patients who meet the experimental requirements are randomly divided into an experimental group and a control group in a 1:1 ratio. Random allocation adopts dynamic block randomization method to prevent grouping doctors from guessing the patient grouping situation and ensure the comparability of the results between the two groups. Apply for a central random number through the central random system on the computer or WeChat platform. Applicants who pass the system application assessment can directly log in to the central randomization system on the computer or WeChat enter project and subject information obtain random numbers and assign groups. After the experiment is completed and unblinded the central randomization staff in charge checks whether the random allocation record form is correct prints the random allocation form and hands it over to the researchers to paste on the inner page of the case report form.

盲法:

Blinding:

是否共享原始数据:

IPD sharing:

No

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

在研究完成,学术文章发表后,联系第一作者或通讯作者索要原始数据

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

After the research is completed and the academic article is published, contact the first author or corresponding author to request the original data

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

本试验将使用EDC系统来执行数据输入。研究助理将通过EDC系统填写所有eCRF表。研究人员将检查eCRF。eCRF修改的痕迹将留在项目数据库中。

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

This experiment will use an EDC system to perform data input. The research assistant will fill out all eCRF forms through the EDC system. Researchers will examine eCRF. The traces of eCRF modifications will remain in the project database.

数据管理委员会:

Data Managemen Committee:

No

研究计划书或研究结果报告发表信息
(杂志名称、期、卷、页,时间;或网址):

Publication information of the protocol/research results report
(name of the journal, volume, issue, pages, time; or website):

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