I. Non-steroidal anti-inflammatory drugs
1.Mechanism of action.
The synthesis and release of prostaglandins (PG) by the uterus is an important cause of dysmenorrhea. The prostaglandin content in the endometrium and menstrual blood of dysmenorrhea is significantly higher than that of normal women, and the higher the concentration of prostaglandins in the endometrium, the more severe the dysmenorrhea.
Prostaglandins stimulate excessive contraction of the uterus and produce spasmodic pain in the lower abdomen. At the same time, excessive contraction of the uterus can cause insufficient blood supply to the uterus and ischemia and hypoxia, which stimulate pain neurons and cause pain.
The pharmacological mechanism of action of NSAID is not well understood, but the consensus view is that NSAID exerts its anti-inflammatory and analgesic effects by competitively inhibiting the activity of cyclooxygenase (COX) and 5-lipoxygenase in the metabolic pathway of arachidonic acid (AA) and preventing the synthesis of prostaglandins (PG).
NSAID inhibits local PG synthesis in inflammation, reduces the sensitivity of the body’s nociceptive receptors to inflammatory stimuli, increases the body’s pain threshold, and thus has analgesic effects. In recent years, a large number of animal experiments and electrophysiological studies on volunteers have shown that this class of drugs also has a central analgesic effect, and its mechanism may be through the central nervous system to inhibit PG synthesis and activate the downstream 5-tryptamine pathway to achieve analgesic effects.
2.Commonly used drugs.
(1) nabumetone alias and trade names: cyproheptadine, mellitone, puletine.
(2) Diclofenac sodium alias and trade names: Diclofenac, Fotarim, Intacrine.
(3) Sulindac alias and trade names: Thiorindac, Sulindac, Inflammation, Chironolactone, Tendonda, Cardolactone.
(4) f-promazine alias and trade names: phenylpropionic acid, phenylprofen, oxacin.
(5) Naproxen alias and trade names: analgesic, methoxypropionic acid.
(6) Ibuprofen alias and trade names: isobutylpropionic acid, isobutyrophen, paxil, fenbid extended-release capsules.
(7) Phenoxy ibuprofen calcium alias and trade names: fenoprofen calcium, phenoxybenzoic acid calcium.
(8) Aminoprofen alias and trade names: Mirafem, Bimatoprost.
(9) Pentoxifylline alias and trade names: pentoxifylline, pentoxifylline, feprazone
(10) Nimesulide alias and trade names: Mysonin.
(11) Asimethicin alias and trade name: Euthyroxine.
3. Common side effects.
Short-term application of therapeutic amounts of drugs have few side effects, while long-term or large amounts of applications are prone to side effects. The most common are gastrointestinal, loss of appetite, indigestion, epigastric pain and discomfort, nausea, vomiting, heavy mucosal erosion, peptic ulcer, small intestine and colon ulcer, gastric bleeding, perforation, death, etc.. Some adverse reactions have a low incidence, such as granulocytopenia, aplastic anemia, hepatitis, etc., but should be taken seriously.
Second, other drugs.
1. Cerebrolysine.
Start to take Brain Yizine 50mg 3 times a day 3 days before menstruation until the end of menstruation, 4 cycles for 1 course. Uterine muscle activity is influenced by extracellular calcium ions, and because cerebrolysine is a calcium ion antagonist, it can inhibit uterine contraction, have a direct dilating effect on vascular smooth muscle, and can counteract a variety of vasoactive substances, such as 5-HT, epinephrine, bradykinin, incretin, etc. It has the effect of relieving vascular spasm and reducing tissue ischemia and hypoxia. Therefore, it is used to treat dysmenorrhea with certain efficacy.
2.Nifedipine.
Nifedipine: This product is a calcium channel blocking drug, sublingual nifedipine 10-20mg. 5-10min after pain relief and disappearance. The next menstrual period when pre-taken orally nifedipine 10-20mg, has the effect of preventing the occurrence of dysmenorrhea.
3. Colistin.
It is a central antihypertensive drug. It has been reported to treat patients with severe dysmenorrhea (25ug orally, 2 times daily). It can be taken for 14 days as a course of treatment.
4.Compound salvia tablets.
Generally use 3 tablets of compound salvia, 3 times a day for 20 days as a course of treatment. The second course of treatment should be taken at 10-day intervals. The interval is best during menstruation. To avoid affecting menstruation.
5. Quick-acting heart pills.
Include 2-5 capsules each time. 30min after the effect can be obvious pain. Generally 3 times, there is a cure.
6.Vitamin B6
(1) Vitamin B620mg, 3 times a day, 7 days before menstruation. For those with moderate premenstrual pain.
(2) Vitamin B6, 40mg, 3 times a day. 7 days before menstruation; for severe cases requiring 1-2 cycles of treatment, followed by 40mg old 3 times, reduced to 3 days before menstruation. For severe cases requiring 3-4 cycles of treatment.
(3) Vitamin B640mg, taken orally in the early premenstrual period, followed by 40mg 4h later. 2 times in total, for postmenstrual pain cases. Vitamin B6 increases the flow of Mg2+ in the uterine myocytes. Activate ATPase. Depletion of ATP. relaxes the uterine muscle, thus achieving the purpose of treating dysmenorrhea.