Iran Journal of Nursing

fa اثربخشی ترکیب دارچین و زنجبیل همراه با تمرینات ورزشی بر دیسمنوره و سندرم پیش قاعدگی The Effectiveness of the Combination of Cinnamon and Ginger with Exercise Training in the Treatment of Dysmenorrhea and Premenstrual Syndrome پرستاری nursing پژوهشي Research <div style="text-align: justify;">زمینه و هدف: دیسمنوره و سندرم پیش از قاعدگی (PMS) یکی از رایج‌ترین اختلالات در زنان است که ابعاد مختلف زندگی فرد را تحت تأثیر قرار می‌دهد. هدف از مطالعه حاضر تعیین اثربخشی ترکیب دارچین و زنجبیل همراه با تمرینات ورزشی بر دیسمنوره و PMS بود. روش بررسی: در این مطالعه نیمه تجربی با طرح پیش آزمون- پس آزمون با گروه کنترل 100 زن مبتلا به دیسمنوره اولیه و اختلالات PMS ساکن شهر قائمشهر در سال 1398 به روش نمونه‌گیری در دسترس انتخاب شدند. سپس به روش قرعه کشی در چهار گروه 25 نفری تمرین ورزشی، دارچین- زنجبیل، ترکیبی (تمرین ورزشی+ دارچین- زنجبیل) و کنترل قرار گرفتند. برنامه تمرینی ورزشی شامل هشت هفته تمرین کششی و پیاده روی، سه جلسه در هفته بود. کپسول 500 میلی گرمی دارچین- زنجبیل با شروع درد و 72 ساعت اولیه قاعدگی، سه بار در روز برای دو ماه مصرف می‌شد. شرکت کنندگان قبل و هشت هفته پس از مداخله‌ها با استفاده از مقیاس دیداری شدت درد قاعدگی، ابزار غربالگری PMS و ثبت وضعیت روزانه PMS ارزیابی شدند. از آزمونهای t زوجی، من ویتنی، کروسکال والیس، آنالیز واریانس یک راهه و توکی برای تجزیه و تحلیل داده‌ها استفاده شد. یافته‌ها: پس از هشت هفته، شدت و مدت درد دیسمنوره اولیه و نمره علائم جسمانی و روانی PMS در گروه‌های مداخله پایین‌تر از گروه کنترل بود (05/0>P). به علاوه تأثیر مداخله ترکیبی بر درصد تغییرات شدت و مدت درد دیسمنوره اولیه و نمره علائم جسمانی و روانی در مقایسه با گروه‌های تمرین و دارچین- زنجبیل بیشتر بود. نتیجه‌گیری کلی: هر یک از مداخله‌های غیردارویی پیاده روی همراه با تمرینات کششی، مصرف همزمان دارچین- زنجبیل و مداخله ترکیبی، اثرات مثبتی بر کاهش شدت و مدت درد دیسمنوره اولیه و بهبود علائم جسمانی و روانی PMS دارند. بنابراین پیشنهاد می‌شود به عنوان شیوه‌های درمانی بی‌خطر و مؤثر برای درمان این اختلالات مورد توجه قرار گیرند </div> <div style="text-align: justify;">Background & Aims: Premenstrual syndrome (PMS) is a common disorder among young and middle-aged women, which is associated with various physical, cognitive, psychological, and emotional symptoms during the menstrual cycle in women. Approximately 70-80% of women experience some degrees of PMS symptoms, and 20-40% of these women, the symptoms lead to disorders in their functioning and daily life. Today, considering the high prevalence of PMS and primary dysmenorrhea in women and the unknown causes of these disorders, various treatments have been proposed for the control or reduction of the pain intensity and symptoms of the disease. Herbal and sports non-pharmacological therapies have received more attention from researchers and women owing to their variety, fewer side-effects, and cost-effectiveness. Cinnamon and ginger are among the medicinal plants that are effective in the reduction of pain intensity. Cinnamon consumption is associated with no particular risks in humans, and previous findings have confirmed the effectiveness of cinnamon consumption in the reduction of pain intensity and the systemic symptoms of primary dysmenorrhea. Ginger is also known as an effective medicine in several traditional herbal remedies, such as the treatment of nausea, increasing appetite, treatment of indigestion, fever, and infections, and body cleansing, especially in East Asian countries. Researchers have reported that regular exercise is effective in reducing the symptoms of PMS, as well as the duration and intensity of primary dysmenorrhea pain. The present study aimed to assess the effectiveness of the combination of cinnamon and ginger with walking and stretching exercises on dysmenorrhea and PMS. Materials & Methods: This quasi-experimental study was conducted with a pretest-posttest design and a control group on the young women living in Ghaemshahr, Iran in 2019. Among the volunteers participating in the study, the individuals with regular menstrual periods, PMS (minimum of five signs of PMS), and primary dysmenorrhea (moderate-to-severe pain) were sampled via convenience sampling. After obtaining written consent, the selected candidates were enrolled in the study and divided into four groups of exercise, cinnamon-ginger, combination of exercise and cinnamon-ginger, and control by drawing lots. The exercise training program comprised of stretching exercises and walking three sessions per week for eight weeks. A cinnamon-ginger capsule (500 mg) was administered thrice daily with the onset of pain within the first 72 hours of menstruation for two months. The patients were assessed before and eight weeks after the intervention using the visual analogue scale (VAS) of menstrual pain intensity, PMS screening tool, and PMS daily status. The VAS is a standard tool for the evaluation of pain intensity within the score range of 0-10, with score zero indicating no pain, scores 1-3 showing mild pain, scores 4-7 indicating moderate pain, and scores 8-10 showing severe pain. The subjects with the pain intensity score of higher than four were enrolled in the study. Cox menstrual symptom scale was used to measure the duration of pain (from the onset of pain to the end). Based on this criterion, the subjects were assigned five scores within the range of 0-4, including the absence of pain, less than/equal to half an hour of pain, half to equal to one hour of pain, more than one hour of pain, and more than one day of pain, respectively. Data analysis was performed using paired t-test, the Mann-Whitney U test, one-way analysis of variance (ANOVA), Kruskal-Wallis test, and Tukey's test.   Results: The results of one-way ANOVA indicated no significant differences in the duration and period of menstruation, pain intensity, duration of pain, psychological symptoms (mood and behavioral symptoms), and physical PMS symptoms at baseline. After eight weeks, the intensity and duration of primary dysmenorrhea pain and the scores of the physical and psychological PMS symptoms (mood and behavioral symptoms) significantly decreased in the intervention groups compared to the control group (P<0.05). Furthermore, the effects of the combination therapy on the rate of the changes in the intensity and duration of primary dysmenorrhea pain and scores of the physical and mental symptoms of PMS were more significant compared to the cinnamon-ginger and exercise groups. Meanwhile, the rate of the mean changes in the mood and physical symptoms of the cinnamon-ginger group was significantly higher compared to the exercise group. Conclusion: According to the results, the duration and intensity of dysmenorrhea pain and physical and mental symptoms of PMS (mood and behavioral symptoms) decreased after eight weeks of the consuming the combination of cinnamon and ginger, and these changes were reinforced with the physical exercises. It seems that regular exercise as a source of psychological changes could reduce the duration and intensity of dysmenorrhea pain through decreasing the disorders associated with neurotransmitters (especially serotonin and gamma-aminobutyric acid), stress reduction, development of blood circulation, increasing the endorphins and neurotransmitters, and decreasing the serum aldosterone, body fat mass, and estrogen levels, thereby improving the symptoms of PMS. In addition, the anti-inflammatory effects of ginger were exerted through the inhibition of cyclooxygenase and lipoxygenase, followed by the reduction of leukotriene and prostaglandin. The examination of cinnamon compounds and their effects also indicated that cinnamaldehyde, eugenol, and terpene in cinnamon have analgesic, tranquilizing, and anti-inflammatory properties. As a result, the non-pharmacological interventions of walking and stretching exercises, simultaneous consumption of cinnamon and ginger, and combination therapy could be considered as effective treatments in improving the physical and psychological symptoms of PMS and decreasing the intensity and duration of primary dysmenorrhea pain in young women.</div> دارچین, دیسمنوره اولیه, زنجبیل, سندرم پیش از قاعدگی, پیاده روی Cinnamon, Dysmenorrhea, Ginger, Premenstrual Syndrome, Walking 68 81 http://ijn.iums.ac.ir/browse.php?a_code=A-10-2438-2&slc_lang=fa&sid=1 B Ebrahimi Azmoudeh بهنوش ابراهیمی آزموده 10800319475328460024910 10800319475328460024910 No MS in Sports Physiology, Department of Physical Education and Sports Sciences, Islamic Azad University, Qaemshahar Branch, Qaemshahar, Iran کارشناس ارشد فیزیولوژی ورزش، گروه تربیت بدنی، واحد قائمشهر، دانشگاه آزاد اسلامی، قائمشهر، ایران M Habibian معصومه حبیبیان 10800319475328460024911 10800319475328460024911 Yes Associate Professor of Sports Physiology, Department of Physical Education and Sports Sciences, Islamic Azad University, Qaemshahar Branch, Qaemshahar, Iran (*Corresponding author) Tel: +011-42241041 Email: habibian_m@yahoo.com دانشیار فیزیولوژی ورزش، گروه تربیت بدنی، واحد قائمشهر، دانشگاه آزاد اسلامی، قائمشهر، ایران. (*نویسنده مسئول) شماره تماس: 01142241041 Email: habibian_m@yahoo.com B Askari بابی سان عسگری 10800319475328460024912 10800319475328460024912 No Assistant Professor of Sports Physiology, Department of Physical Education and Sports Sciences, Islamic Azad University, Qaemshahar Branch, Qaemshahar, Iran استادیار فیزیولوژی ورزش، گروه تربیت بدنی، واحد قائمشهر، دانشگاه آزاد اسلامی، قائمشهر، ایران