Electroacupuncture with different waveforms for primary dysmenorrhea:A randomized controlled trial

Objective:To observe and compare the clinical effects of different electroacupuncture waveforms on primary dysmenorrhea.Methods: This was a prospective,randomized,three-group,parallel-controlled trial.Participants with primary dysmenorrhea were randomly divided into dense-sparse wave,continuous wave,and discontinuous wave groups in a 1:1:1 ratio.Two lateral Ciliao(BL 32)points were used.All three groups started treatment 3–5 days before menstruation,once a day for six sessions per course of treatment,one course of treatment per menstrual cycle,and three menstrual cycles.The primary outcome measure was the proportion with an average visual analog scale(VAS)score reduction of≥50%from baseline for dysmenorrhea in the third menstrual cycle during treatment.The secondary outcome measures included changes in dysmenorrhea VAS scores,Cox Menstrual Symptom Scale scores and the proportion of patients taking analgesic drugs.Results: The proportion of cases where the average VAS score for dysmenorrhea decreased by≥50%from baseline in the third menstrual cycle was not statistically significant(P>.05).Precisely 30 min after acupuncture and regarding immediate analgesia on the most severe day of dysmenorrhea,there was a statistically significant difference in the dense-sparse wave group compared with the other two groups during the third menstrual cycle(P<.05).Additionally,there was a statistically significant difference between the dense-sparse wave and discontinuous wave groups 24 h after acupuncture(P<.05).Conclusions: Waveform electroacupuncture can alleviate primary dysmenorrhea and its related symptoms in patients.The three groups showed similar results in terms of short-and long-term analgesic efficacy and a reduction in the number of patients taking analgesic drugs.Regarding achieving immediate analgesia,the dense-sparse wave group was slightly better than the other two groups.

SPECIFIC INHIBITION OF CONNEXIN 43 GENE EXPRESSION AFTER ACUPOINTS AND ACUPUNCTURE TREATMENT FOR PRIMARY DYSMENORRHEA

Objective To investigate the effect of acupuncture treatment on silencing the expression of Oonnexin 43 （Cx43）, and to study the analgesic mechanism of acupuncture treatment for primary dysmenorrhea （PD） in rats. Methods We used estrostilben to develop the model of primary dysmenorrhea in rat, and RNA interference technology to silence the expression of Cx43 in acupoints. Fifty female rats were randomly divided into five groups （n = 10 in each group） ： normal, model, acupuncture, acupuncture ＋ interference and acupuncture＋ interference control group, pSilencer-Cx43-shRNA and pSilencer-Oon-shRNA were injected locally into the acupoints in interference group and interference-control group, respectively. The incidence rate of writhe reaction over the period of 30 min was evaluated. The expression of the oxytocin receptor （OTR） and vasopressin receptor（VasR） in rat myometrium with Semiquantitative RT-POR and immunohistochemistry. Results （1）The mRNA and protein level of Cx43 in acupoints in interference group were significantly lower those of in the acupuncture group （P〈0.05）. There was no significant difference between acupuncture and interference-control group. （2） Acupuncture could significantly prolong the latency period of writhing body and decrease the number of writhing body as compared with that of model group and interference group. （3）The level of OTR and VasR mRNA and protein in the model group were significantly higher （P〈0.05） as compared to normal group. The results in acupuncture group and interference-control group were similar to the normal group. The results in interference group were similar to the model group. Conclusions Acupuncture may be useful in the treatment of the model of primary dysmenorrhea in the rats. Local injection of Cx43 shRNA expression vetor could silence the expression of Cx43 in acupoint and markedly influence acupuncture effect, demonstrating Cx43 is involved in acupuncture effect.

OBSERVATION OF THERAPEUTIC EFFECTS OF Zhìyīn(至阴BL 67) ON 110 CASES OF PRIMARY DYSMENORRHEA WITH ACU-MOXIBUSTION

Objective To observe the clinical efficacy of primary dysmenorrhea treated with acu-moxibus- tion. Methods 220 cases of primary dysmenorrhea were randomized into control group and treatment group, 110 cases in each one. In control group, fenbid was administered. In treatment group, ZhiyTn （至阴 BL 67） was selected in combination of auricular-point pressing therapy. Results The total effective rate was 94.5% in treatment group and was 76. 4 % in control group, indicating very significant difference （P〈0. 01） in com- parison. Conclusion Acu-moxibustion on BL 67 in combination of auricular-point pressing therapy presents definite therapeutic effect on primary dysmenorrhea, thus, this therapy is worth to be promoted entirely in practice.

Effects of Acupressure and Ibuprofen on the Severity of Primary Dysmenorrhea

The present study aims at comparing the effects of acupressure using new combination of acupoints, and Ibuprofen on the severity of primary dysmenorrhea (PD). 216 female high school students, aged between 14 to 18 years, were randomly selected and divided into three groups. Each group underwent different treatment techniques: acupressure, Ibuprofen and sham acupressure as a placebo. The results indicated that the three therapeutic techniques were significantly effective in reducing the pain. However the therapeutic efficacies of acupressure and Ibuprofenwere similar with no significant difference, and were significantly better thanthe placebo. Thus acupressure, with no complications, is recommended as an alternative and also a better choice in the decrease of the severity of PD. ……

CLINICAL OBSERVATION ON 96 CASES OF PRIMARY DYSMENORRHEA TREATED BY MEDICINE-SEPARATED MOXIBUSTION AND INVESTIGATION ON ITS MECHANISMS

Objective： To observe the therapeutic effect of medicine-separated moxibustion for primary dysmenorrhea and its influence on plasma hormone level. Methods. Ninety-six patients suffering from primary dysmenorrhea were randomly and evenly divided into trealment group treated with medicine-separated moxibustion of Shenque （神阙 CV 8, 3-5 cones every time, beginning 1 week before onset of menstruation and stopping on the 3^rd day after onset, with 10 sessions being a therapeutic oourse, 3 courses all together）, and control group treated with oral administration of Yueyueshu （月月舒 menstruation-smoothing granule, 10 g/time, b.i.d, 3 courses altogether）. Menses prostaglandin E2（PGF2α） and plasma oxytocin （OT） during menstruation were determined by radioimmunoassay. Results; After the treatment, of the two 48 cases in treatment and control groups, 18 and 5 were cured, 24 and 9 had marked improvement in their symptoms, 6 and 26 had improvement, 0 and 8 failed in the treatment, with the total effective rates being 100. 096 and 83.3% respectively, the therapeutic effect of treatment group was markedly superior to that of control group （P〈0.05）. After the treatment, the contents of menses PGF2α in treatment group and plasma OT in both groups were significantly lower than those of pre-treatment （ P〈 0.01 ）. The therapeutic effect of moxibustion was significant- ly better than that of medication in lowering plasma OT. Conclusion： Medicine-separated moxibustion works well in treating primary dysmenorrhea, and moxibustion induced decrease of menses PGF2α and plasma OT may contribute to its effect in relieving dysmenorrhea.

Intervention Study on Hypnotherapy of Primary Dysmenorrhea in Female College Students

Objective:To understand the relevant situation of primary dysmenorrhea among the subjects and target the relief of pain and associated symptoms through hypnotherapy only.Methods:The study recruited a total of 23 female college students who underwent primary dysmenorrhea as objects and conducted a self-report study.The clinical effect of hypnotic suggestion on primary dysmenorrhea was analyzed using the Visual Analogue Scale and the Menstrual Distress Questionnaire as observation indexes.Results:This finding demonstrated a significant reduction in the primary pain score after treatment(t=6.59,P<0.01).Moreover,no significant difference was noted between the first time and the second and third times after treatment.A significant difference was observed in the total scores of MDQ before and after treatment,which indicated the positive effect of hypnotherapy(F=28.52,P<0.001).After treatment,the scores of pain(F=7.85,P<0.001),concentration(F=5.12,P<0.001),behavioural change(F=8.12,P<0.001),autonomic reactions(F=14.54,P<0.001),water retention(F=5.7,P<0.001)and negative effect(F=16.08,P<0.001)were significantly lower than that of before treatment.Through a comparison of the correlation between the reduction rate of pain score and suggestibility at different stages of treatment,the study noted no significant correlation(P>0.05).Conclusion:The experimental results demonstrate that hypnotherapy is effective in treating primary dysmenorrhea.hypnotherapy intervention can improve negative emotions and level of attention and promote behavior change.

Wenjing Zhitong recipe exhibits potential anti-primary dysmenorrhea properties by inhibiting COX2 and PKC signaling pathway in rats induced by estradiol benzoate and oxytocin

Objective:To explore the effect and mechanism of action of the Wenjing Zhitong recipe(WZR)in primary dysmenorrhea(PD)treatment.Methods:Uterine contractions were induced by estradiol benzoate and oxytocin in a PD model and WZR was administrated.The rate of change in uterine contractility and the writhing test were used to evaluate the effects of WZR.The serum levels of prostaglandin F_(2a)(PGF_(2a))and prostaglandin E_2(PGE_2),and the activity of cyclooxygenase-2(COX2)were detected by enzyme-linked immunosorbent assay(ELISA).The changes in phosphor-phospholipase C(pPLC/PLC),phosphor-protein kinase C(pPKC/PKC),and connexin 43(CX43)expression were detected using immunohistochemistry and western blot.Results:WZR significantly reduced the rate of change in uterine contractility and writhing times in the PD model.WZR treatment inhibited the enzymatic activity of COX2 and reduced the levels of PGF_(2a),PGF_(2a)/PGE2and COX2 in the PD model.WZR also significantly reduced the expression of pPLC/PLC,pPKC/PKC and CX43.Targeting the inhibition of COX2 activity,caffeic acid and 1-acetyl-β-carboline were validated as the active ingredients in WZR responsible for reducing uterine contractions.Conclusion:WZR attenuated PD by inhibiting COX2 activity,downregulating PGF_(2a)/PGE_2 expression,and inhibiting the PKC signaling pathway.

Analgesic effects and hemodynamic mechanisms of perpendicular and transverse needling at Sanyinjiao(SP 6) in patients with primary dysmenorrhea: A randomized controlled trial

Objective: To explore the analgesic effects and uterine hemodynamics of perpendicular needling(PN)and transverse needling(TN) at SP 6 in patients with primary dysmenorrhea(PD).Methods: In this randomized controlled trial, patients with PD diagnosed with cold-dampness congealing pattern were randomly assigned in a ratio of 1:1 to receive PN or TN at bilateral SP 6 for 10 min.Acupuncture was performed when the menstrual pain score was over 40 mm on the first day of menstruation, as measured using the visual analog scale for pain(VAS-P). The primary outcome was average menstrual pain(VAS-P). Secondary outcomes included the pulsatility index(PI), resistance index(RI), and systolic-diastolic peaks ratio(S/D) in uterine arteries as measured using color Doppler ultrasonography;anxiety as assessed using the Hamilton Anxiety Rating Scale(HAMA), blood pressure(BP),and heart rate(HR).Results: Forty-eight patients completed the study. The TN group exhibited a significant reduction in VAS-P scores(-5.71 mm, 95% confidence interval(CI): -8.78, -2.63, P =.001), RI values(-0.05, 95% CI:-0.09, -0.01, P=.015), and HAMA values(-2.50, 95% CI: -4.78, -0.22, P=.032) when compared with the PN group. No significant differences in PI, S/D, BP, or HR values were observed between the two groups(P >.05).Conclusion: TN at SP 6 was superior to PN in alleviating menstrual pain and anxiety in patients with PD.This analgesic effect of TN may be due to its better ability to improve uterine arterial blood flow via decreases in RI values.

Effect of Th1/Th2 balance on serum prostaglandin,COX-2,AVP and OT in primary dysmenorrhea rats with cold coagulation and blood stasis syndrome

Objective:Explore the role of Th1/Th2 balance in the pathogenesis of primary dysmenorrhea through study the effect of Th1/Th2 balance drift on serum prostaglandin F_(2α),prostaglandin,6-keto-prostaglandin F_(1α),TXB2,COX-2,AVP and OT in Primary Dysmenorrhea Rats with cold coagulation and blood stasis syndrome.Method:The rat model of primary dysmenorrhea with cold coagulation and blood stasis syndrome was established.On the basis of this model,Th1 shift model and Th2 shift model were established.The rats were divided into blank group,model group,Th1 shifting group and Th2 shifting group.The writhing reaction of rats in each group was compared,and the contents of PGF_(2α),PGE_(2),6-keto-PGF_(1α),TXB2,COX-2,AVP and OT in serum were detected.Results:Writhing latency:There was no significant difference between Th1 and Th2 shifting groups(P>0.05),Th2 shifting group was shorter than Th1 shifting group(P<0.05).Writhing times in 30 minutes:Compared with the model group,the writhing times of Th1 shifting group decreased significantly(P<0.01),while Th2 shifting group increased significantly(P<0.01).Compared with the blank group,the contents of PGF_(2α),TXB2,COX-2,AVP and OT were increased(P<0.05,P<0.01),and the contents of 6-keto-PGF_(1α)and PGE_(2)were decreased(P<0.01).Compared with the model group,the contents of PGF_(2α),TXB2,COX-2 and AVP in Th1 shifting group were decreased(P<0.05,P<0.01),and the contents of 6-keto-PGF_(1α)and PGE_(2)were increased(P<0.01),while the contents of PGF_(2α),TXB2,COX-2,AVP and OT in Th2 shifting group were increased(P<0.01),and the contents of 6-keto-PGF_(1α)and PGE_(2)were decreased(P<0.01).Conclusion:The intervention of Th1/Th2 cell balance on the expression of PGF_(2α),PGE_(2),6-keto-PGF_(1α),TXB2,COX-2,AVP and OT may be one of the pathogenesis of PD with cold coagulation and blood stasis syndrome.

Research based on data mining compatibility of traditional Chinese medicine with Professor WANG Dong-mei in the treatment of primary dysmenorrhea

Objective:To study the law of compatibility of traditional Chinese medicine in the treatment of primary dysmenorrhea by Professor WANG Dong-mei.Methods:This study collected the Professor WANG Dong-mei’s prescriptions for primary dysmenorrhea cases in the outpatient department,to establish a database by Excel 2015,and to use IBM SPSS statistics 24.0 and SPSS Clementine 12.0 software for clustering analysis and association rules data mining analysis.Results:A total of 106 cases were included,106 prescriptions were collected,114 kinds of drugs were used,nd the cumulative frequency of drug use was 1876 times;the top three drugs were white peony(89 times),Xiangfu(77 times),red peony(75 times);the drugs with the most drug properties and taste frequency were warm and sweet drugs,which were mainly liver meridian;four common pair-used drug groups were Xiangfu yanhusuo,angelica white peony etc.and six groups were common clustering groups.Conclusion:Professor WANG Dong-mei usually chooses the drugs of sweet,warm or spicy in the treatment of primary dysmenorrhea.In addition to the natural efficacy,Prof.Wang also considers modern pharmacological effect in the specific drug selection.The commonly used prescription combination is Shaofu Zhuyu Decoction,which embodies Professor WANG Dong-mei's academic thought of treating primary dysmenorrhea"mainly by warming and regulating qi and blood",and for patients with reproductive needs,in addition to promoting blood circulation and relieving pain,she also adds menstruation regulating and pregnancy aiding drugs,which can not only improve the symptoms of primary dysmenorrhea,but also meet their fertility desire.

Serum Metabolomic Characteristics of Primary Dysmenorrhea Rat Model Induced by Estradiol Benzoate Combined with Oxytocin

[Objectives]To investigate the serum metabolomic characteristics of primary dysmenorrhea rat model induced by estradiol benzoate combined with oxytocin,and to reveal its material basis.[Methods]20 female SD rats were randomly divided into control group and model group.The primary dysmenorrhea rat model was established by subcutaneous injection of estradiol benzoate for 10 consecutive days and intraperitoneal injection of oxytocin on the last day.The serum samples of rats in control group and model group were collected by ultra-performance liquid chromatography(UPLC)quadrupole time-of-flight mass spectrometry(Q-TOF-MS).The differential metabolites were identified by multivariable pattern recognition method and endogenous metabolite database,and the metabolic pathways were enriched by Metaboanalyst 5.0 platform.[Results]There were significant differences in serum metabolic profiles between the two groups.A total of 36 potential biomarkers of primary dysmenorrhea including L-tyrosine,glycocholic acid,citric acid,palmitoyl carnitine and cholesterol were screened and identified,mainly involving metabolic pathways such as phenylalanine,tyrosine and tryptophan biosynthesis,glycerophospholipid metabolism,and primary bile acid biosynthesis.[Conclusions]The serum metabolic profile of primary dysmenorrhea rats deviates significantly from that of healthy rats,and there are multiple metabolic pathway disorders,which are mainly related to phenylalanine,tyrosine and tryptophan biosynthesis,glycerophospholipid metabolism,and primary bile acid biosynthesis.

Use of Evidence-Based Research Approach in RCTs of Acupuncture-Related Therapies for Primary Dysmenorrhea: A Meta-Research

Objective To assess the use of evidence-based research(EBR)approach in randomized controlled trials(RCTs)of acupuncture-related therapies for primary dysmenorrhea(PD).Methods PubMed,EMBASE,Cochrane Library,China National Knowledge Infrastructure,Wanfang Database,Chinese Biomedical Database,and China Science and Technology Journal Database were searched from January 2013 to December 2022 for RCTs of acupuncture on PD.The full text and references of each RCT were read to assess whether systematic reviews(SRs)or other types of studies with similar research questions and end-users’perspectives were cited to justify and design the trial.In addition,the discussion section were analyzed to evaluate whether trials placed the new result in the existing SRs to draw a conclusion.Multivariable logistic regression was used to find variables that associated with 3 aspects of EBR approach:(1)citing clinical studies for justification,(2)citing relevant studies that obtain the perspectives of end users,and(3)citing clinical studies for results discussion.Results Of 473 RCTs included,45.67%(216)of the trials cited relevant similar studies,21.56%(102)referenced to the studies that collected end-users’perspectives,and 10.99%(52)placed result in the context of the previous research.Few RCTs appropriately applied EBR approach.Among all the included studies,3.17%(15)of the trials used SRs to inform study questions but none of them used updated SRs with acceptable quality;1.05%(5)of the trials cited SRs of end-user’s perspectives in the justification and design of the study,and only 1 trial added results in existing SR to draw a conclusion.Year of publication,language,funding,registration,ethical approval and number of sites were significantly associated with 1 of the 3 aspects of EBR approach.Conclusions Few RCTs in acupuncture-related therapies for PD used the EBR approach to minimize research redundancy.Researchers,research institutes,funding agencies,ethics committees,journals and peer reviewers in acupuncture should make efforts to use and promote the EBR approach to ensure the value of new trials.

Exploring the mechanisms of Yuanhu Zhitong oral liquid for primary dysmenorrhea through network pharmacology,molecular docking,and molecular dynamics simulation

Objective:Primary dysmenorrhea(PD)is a prevalent gynecological disorder.Yuanhu Zhitong oral liquid(YHZT)presents a promising alternative treatment for PD.However,the mechanisms underlying its efficacy remain unclear.This study aims to investigate the potential targets and mechanisms of action of YHZT in treating PD using network pharmacology,molecular docking,and molecular dynamics simulations.Methods:Potential compounds from YHZT were obtained from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP)and the Traditional Chinese Medicine Information Database(TCMID).The relevant targets of these compounds were identified using the similarity ensemble approach(SEA)and the Swiss Target Prediction database.PD-related targets were retrieved from the Genecards,DrugBank,and Disgenet databases.ClusterProfiler was utilized for Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis.The compound-target-pathway(CTP)network was constructed to facilitate the identification of key compounds,core targets,and signaling pathways.Finally,molecular docking and molecular dynamics simulations were performed to evaluate the interactions between the targets and compounds.Results:A total of 153 putative compounds and 129 targets of YHZT were identified.Network topology analysis revealed eight core targets and six key compounds.The effects of YHZT were mediated by genes associated with hormone and steroid metabolism,as well as pathways involved in steroid hormone biosynthesis and cytochrome P450 enzymes.Docking results showed free binding energies ranging from-6.06 to-10.85 kcal/mol,indicating strong binding affinity between the compounds and targets.Molecular dynamics simulation results further confirmed the stability of these interactions.Conclusion:This study demonstrates that YHZT treats PD by suppressing inflammatory reactions and modulating hormone and cytochrome P450 concentrations.Key compounds such as ferulic acid,(R)-canadine,(S)-canadine,canadine,and asristolone are implicated in this process.These findings offer insights into the mechanisms underlying the action of YHZT and provide a foundation for further research in this area.

Clinical observation on 90 cases of primary dysmenorrhea treated by buccal acupuncture therapy:a randomized controlled study

OBJECTIVE:To explore the short-term and long-term efficacy of buccal acupuncture therapy in the treatment of patients with primary dysmenorrhea(PD).METHODS:A total of 90 patients with PD who were admitted to the Second Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine from January 2020 to December 2021 were included in this study and randomly divided into three groups,including the observation group,the control group,and the placebo group,with 30 patients in each group.Patients in the observation group were treated according to the syndrome types of Traditional Chinese Medicine,those in the control group were treated with Saridon,and those in the placebo group received a placebo.The visual analog scale(VAS)scores of these patients were evaluated at different time points(before treatment,5 min after needle retention,30 min after needle retention,1 h after treatment,2 h after treatment,1 d after treatment,and 2 d after treatment).The Cox Menstrual Symptom Scale(CMSS)scores were assessed before the treatment and after three courses of treatment.Besides,these two scales were also evaluated during follow-up.Moreover,the pain score and adverse reactions of these patients were assessed during treatment.RESULTS:After treatment,the VAS and CMSS scores in the observation group decreased significantly(P<0.05)5 and 30 min after needle retention and after treatment.CONCLUSION:Buccal acupuncture therapy is verified to have short-term efficacy in the treatment of PD.In addition,this therapy has an immediate analgesic effect and long-term efficacy in reducing the severity and frequency of PD.

Efficacy impacts of psychological factors on primary dysmenorrhea treated with acupuncture

Objective To explore the relationship between psychological factors and efficacy of acupuncture on primary dysmenorrhea. Methods Sixty cases of primary dysmenorrhea were observed. Before acupuncture treatment, the self-designed confidence questionnaire was used to assess patients＇ confidence in acupuncture efficacy. Visual Analogue Scale （VAS） was adopted to assess patients＇ tension level during acupuncture. Self-rating anxiety scale （SAS） and self-rating depression scale （SDS） were applied to assess the situations of patients＇ anxiety and depression. Eysenck＇s personality questionnaire （EPQ） and Cattell sixteen personality factors questionnaire （16PF） were provided to assess the personal characters of patients. Pain intensity, pain duration and accompanied symptoms were recorded before and after acupuncture treatment so as to assess the efficacy. Canonical correlation analysis was used to analyze the relationship between the psychological factors and acupuncture efficacy on primary dysmenorrhea. Results There were significant differences in grading of dysmenorrhea, pain intensity score and pain duration after treatment as compared statistically with those before treatment （all P〈0.001）. The standardized coefficients of dominance （r=0.679 7） and anxiety （r=-0.590 6） in personality factors and the reduction of pain duration （r=-0.904 2） among efficacy indices were the highest. The overall correlation coefficients were all lower between the indices of psychological factors and canonical variables of dysmenorrhea efficacy. Conclusion Acupuncture efficacy on primary dysmenorrhea has a certain correlation with dominance and anxiety of patients＇ personality factors. But, the psychological factors do not play a leading role in acupuncture treatment.

Therapeutic effect of moxibustion on primary dysmenorrhea due to damp-cold retention

Objective To observe the therapeutic effect of moxibustion on primary dysmenorrhea due to damp- cold retention. Methods Eighty cases with primary dysmenorrhea due to damp-cold retention were randomly divided into a moxibustion group （40 cases） and a medication group （40 cases）. Moxibustion at Guonyudn （关元 CV 4） and Shiqizhui （十七椎 EX-B 8） was adopted for treatment of the moxibustion group a week before the period, which lasted for 10 days as a treatment course. Fenbid was used as oral administration for three continue menstrual periods for the medication group. The treatment lasted for 3 menstrual periods in two groups. The Cox Menstrual Symptom Scale （CMSS） was adopted to grade the menstrual symptoms, and differences between the two groups were compared. Results The total effective rate of the moxibustion group was 97.5% （39/40）, and the total effective rate of the medication group was 72.5% （29/40）. The effect of the moxibustion group was obviously better than the medication group （P〈0.05）. Before and after treatment the menstrual symptom scores of the moxibustion group were 9.78±1.86 and 2.25±3.33, while the medication group were 9.71±1.64 and 5.31±4.26. The scores of both groups decreased obviously after treatments. And the decreased amplitude of the moxibustion group was much more obvious than that of the medication group （P〈0.05）. Conclusion The effect of moxibustion on primary dysmenorrhea due to damp-cold retention is obvious, which is better than Fenbid.

Observation on immediate analgesic effect of acupuncture for primary dysmenorrheal

Objective To observe the immediate analgesic effect of acupuncture at Shiqizhui （十七椎）, etc. for primary dysmenorrhea （PD）. Methods Ninety- three cases of PD were selected, who were given acupuncture at ShfqTzhui, Diji （地机 SP 8）, SQnyinjiao （三阴交. SP 6） and Ciliao （次髎 BE 32） for 30 min. The score of visual analogue scale （VAS） was observed at immediate time before treatment, and 5, 20, 20 and 30 min after needle insertion, as well as 30, 60 and 220 min after needle withdrawal. Results Compared with immediate time before treatment, there were significant differences of the VAS score in the PD patients from 5 min after needle insertion to 220 min after needle withdrawal （all P〈O.01）. The acupuncture analgesic effect had appeared since 5 min after needle insertion, and as time went by it gradually increased until 220 min after needle withdrawal. Conclusion Acupuncture at Shiqizhui, etc. for primary dysmenorrhea has obviously immediate analgesic effect, which has important clinical significance.

Clinical efficacy observation of primary dysmenorrhea treated with the embedding catgut therapy

Objective To explore the therapeutic effect on primary dysmenorrhea treated with the embedding catgut therapy so as to discover a better therapeutic method for the treatment of this disease. Methods One hundred and fifty cases were randomized into 3 groups, 50 cases in each one. In the embedding catgut group, the embedding catgut therapy was applied to Sānyīnjiāo （三阴交 SP 6）, Cìliáo （次髎 BL 32） and Guānyuán （关元 CV 4）. In the acupuncture group, the conventional acupuncture therapy was applied to Guānyuán （关元 CV 4）, Sānyīnjiāo （三阴交 SP 6）, Dìjī （地机 SP 8） and Shíqīzhuī （十七椎 EX-B 8）. In the western medicine group, indometacin was prescribed for oral administration, 25 mg, three times a day and fenbid was supplemented for the aggravated pain, 300 mg, twice a day. One session of treatment was one month in each group and 3 sessions were required totally. Before and after treatment, the symptom scores of dysmenorrhea were observed. Results The symptom scores of dysmenorrhea were all reduced obviously in three groups after treatment （all P0.05）. The result in the embedding catgut group was much more apparent as compared with that in the western medicine group （P0.01） and the acupuncture group （P0.05） separately. Of 49 cases in the embedding catgut group, 32 cases （65.3%） were cured clinically, 10 cases （20.4%） effective remarkably, 6 cases （12.2%） effective and 1 case （2.0%） failed. The total effective rate was 98.0%. Conclusion The embedding catgut therapy achieves the significant efficacy for primary dysmenorrhea. This therapy is simple in practice and deserves to be promoted in clinic.

Effect of eye acupuncture on plasma PGF_(2α) in patients of primary dysmenorrhea

Objective To observe the clinical curative effect of eye acupuncture therapy on primary dysmenorrhea and the effect on content of prostaglandin F2α （PGF2α） in peripheral blood of menstrual periods. Methods One hundred and ten cases of primary dysmenorrhea were randomly divided into an eye acupuncture group （60 cases） and a medication group （50 cases）. In the eye acupuncture group, lower-jiao area, liver area, kidney area, heart area and spleen area, etc. were selected according to syndrome differentiation, and the eye acupuncture therapy was applied. In the medication group, 300 mg Ibuprofen sustained release capsule was orally administrated 1–2 days before menstrual onset or when the symptoms appeared, once every 12 hours, for 3–5 days totally, 3 menstrual periods constituting one therapeutic course. The content of PGF2α in peripheral blood, and the curative effects and recurrence 3 and 6 months after treatment were observed. Results Three months after treatment, the cured rate was 55.0% （33/60） and the total effective rate was 95.0% （57/60） in the eye acupuncture group, which were superior to those of 34.0% （17/50） and 82.0% （41/50） in the medication group （both P0.05）. According to the following-up after 6 menstrual cycles, the recurrence rate of 9.1% （3/33） in the acupuncture group was significantly lower than that of 35.3% （6/11） in medication group. The contents of PGF2α in peripheral blood of menstrual periods were reduced after treatment in the two groups （both P0.01）. Conclusion The curative effect of eye acupuncture on primary dysmenorrhea is significant, with the level of PGF2α in peripheral blood of menstrual periods reduced.

De-qi,Not Psychological Factors,Determines the Therapeutic Efficacy of Acupuncture Treatment for Primary Dysmenorrhea

Objective： To study the impact of De-qi （得气%, obtaining qi） and psychological factors on the efficacy of acupuncture treatment for primary dysmenorrhea, with an attempt to explore the relationship among De-qi, psychological factors, and clinical efficacy. Methods： The patients with primary dysmenorrhea were randomly assigned to a group of acupuncture with manual manipulation （manipulation group, n=67） and an acupuncture group without manipulation （non-manipulation group, n=64）. Pain intensity and pain duration were used as measures for evaluating the therapeutic efficacy of the acupuncture treatment. De-qi, the sensations a patient experienced during the acupuncture treatment, was scored on a 4-point scale by the subjects. In addition, the psychological factors, including belief in acupuncture, the level of nervousness, anxiety, and depression, were quantitatively assessed. The personality of the subject was assessed using the Eysenck personality questionnaire （EPQ） and 16 personality factor questionnaire （16PF）. Results： Complete data were obtained from 120 patients, 60 patients in each group. There were statistically significant differences in pain intensity （W=2410.0, P〈0.01 ） and pain duration （W=3181.0, P〈0.01） between the two groups. The number of De-qi acupoints （W=1150.5, P〈0.01） and the average intensity of De-qi （W=1141.0, P〈0.01） were significantly higher in the manipulation group as compared with their non-manipulation counterparts. The correlation coefficients between De-qi and therapeutic efficacy of acupuncture were greater than those between psychological factors and therapeutic efficacy. Conclusions： Compared with the psychological factors, De-qi contributed more to the pain-relieving effect of acupuncture in subjects with primary dysmenorrhea. Moreover, manual manipulation is a prerequisite for eliciting and enhancing the De-qi sensations, and De-qi is critical for achieving therapeutic effects.