目的 探讨超声引导下肌筋膜触发点针刺联合常规西医治疗原发性痛经的临床疗效。 方法 选择2023年1月至2024年8月自贡市第四人民医院麻醉科接诊的112例原发性痛经患者进行研究。以随机数字表法将患者分为两组，各56例。对照组给予布洛芬颗粒治疗，观察组在此基础上加以超声引导下肌筋膜触发点针刺。比较两组疗效、疼痛强度、痛经症状、子宫微循环情况、血清疼痛介质水平。 结果 观察组总有效率为94.64%，高于对照组的80.36%（P < 0.05）。治疗后，两组简式McGill疼痛问卷（short form McGill pain questionnaire，SF-MPQ）得分、视觉模拟评分法（visual analogue scale，VAS）得分、血流阻力指数（resistance index，RI）、搏动指数（pulsatility index，PI）、收缩期峰值/舒张期峰值（systolic/diastolic，S/D）、前列腺素E2、P物质水平均低于治疗前，且观察组均低于对照组（P < 0.05）。治疗后两组β-内啡肽水平均升高，且观察组更高（P < 0.05）。 结论 超声引导下肌筋膜触发点针刺联合常规西医治疗可显著提升原发性痛经的临床疗效，缓解疼痛、改善子宫微循环并调节疼痛相关血清介质。

Objective To evaluate the clinical efficacy of ultrasound-guided myofascial trigger point acupuncture in combination with conventional Western medicine for the treatment of primary dysmenorrhea. Methods A total of 112 patients with primary dysmenorrhea who were admitted to the Department of Anesthesiology of Zigong Fourth People’s Hospital from January 2023 to August 2024 were enrolled in the study. These patients were randomly divided into two groups （n = 56 each） by using a random number table. The control group was treated with ibuprofen granules， whereas the observation group received ultrasound-guided myofascial trigger point acupuncture in addition. Therapeutic efficacy， pain intensity， dysmenorrhea symptoms， uterine microcirculation， and serum pain-related mediators were compared between the two groups. Results The total effective rate in the observation group was 94.64%， which was significantly higher than that in the control group （80.36%， P < 0.05）. After treatment， both groups experienced reductions in scores on the Short-Form McGill Pain Questionnaire （SF-MPQ）， Visual Analog Scale （VAS）， resistance index （RI）， pulsatility index （PI）， systolic/diastolic ratio （S/D）， prostaglandin E2， and substance P levels （all P < 0.05）. Moreover， the observation group exhibited lower values than the control group in all these aspects （all P < 0.05）. Beta-endorphin levels increased in both groups after treatment， and the levels in the observation group were significantly higher （P < 0.05）. Conclusion Ultrasound-guided myofascial trigger point acupuncture， when combined with conventional Western medicine， significantly enhances clinical outcomes in primary dysmenorrhea， alleviates pain， improves uterine microcirculation， and regulates serum pain-related mediators.