EFFECTS OF ACUPUNCTURE ON THE HYPOTHALAMUS-PITUITARY-OVARY AXIS IN RATS WITH DYSMENORRHEA

Objective To observe the influence of acupuncture on hypothalamus-pituitary-ovary axis （HPOA） in rats with primary dysmenorrhea, and to explore its mechanisms. Methods Effects of acupuncture on the concentration level of β-endorphin （β-EP）, hypothalamic hormone （gonadotropin-releasing hormone, GnRH）, pituitary hormone （GnRH receptor GnRH-R, follicle stimulating hormone FSH, luteinizing hormone LH） and ovarian hormone （estrodiol E2, estrodiol receptor ER, progesterone P and progesterone receptor PR） were observed in dysmenorrheic rats. Results After receiving acupuncture treatment, the levels of 13- EP, GnRH, GnRH-R, FSH, LH, E2, ER, P and PR were changed, and this suggested that acupuncture had a regulative action on HPOA in dysmenorrheic rats. Conclusion The mechanism of acupuncture acting on the HPOA with primary dysmenorrhea might be its regulating role to the gonadal hormone of HPOA and its corresponding receptor expression.

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.

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.

ANALYSIS ON THE THERAPEUTIC EFFECT OF ACUPUNCTURE TREATMENT OF 2656 CASES OF PRIMARY TRIGEMINAL NEURALGIA

In the present paper, the clinical therapeutic effect of acupuncture therapy for treatment of primary prosopalgia was observed and its influencing factors were analyzed in 2656 patients. Yuyao (EX HN 4), Touwei (ST 8), Sibai (ST 2), Quanliao (SI 18), Xiaguan (ST 7) and Jiachengjiang were punctured selectively according to the involvement of different branches of the trigeminal nerve. After treatment, of the 2656 cases, the trigeminal neuralgia disappeared in 1469 (55.31%), 727 (27.37%) had marked improvement, 430 (16.19%) had improvement and 30 (1.13%) had no any significant effect. The three years’ follow up visit in 245 cases showed a relapse in 187 cases (76.3%). We think that the therapeutic effect is closely related to the needling manipulations. Only when an electric shock like needling sensation appeared (i.e. “qi reaching the affected area") after inserting the acupuncture needle into the chief acupoints, a better therapeutic effect would be achieved.

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.

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.

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.

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.

Acupuncture and moxibustion combined with cupping for primary dysmenorrhea in 66 cases

Objective To observe therapeutic effects of acupuncture and moxibustion combined with cupping for treating primary dysmenorrhea. Methods Sixty-six patients suffering from dysmenorrheal were treated by acupuncture at Guānyuán （关元 CV 4）, Xuèhǎi （血海 SP 10）, Dìjī （地机 SP 8）, Sānyīnjiāo （三阴交 SP 6） and Tàixī （太溪 KI 3）, as main points. Based on differentiation of syndrome, moxibustion was added at Guānyuán （关元 CV 4） and Shuǐdào （水道 ST 28） for 10 min plus cupping for 15 min. For patients with sthenic syndrome, acupuncture and cupping, but not moxibustion, were applied. One menstrual cycle was taken as one treatment course, and three courses of treatments were given. Results Total effective rate was 100.0% （66/66）. Usually, cure was achieved by 2–6 treatments, and dysmenorrhea was alleviated or eliminated by acupuncture and moxibustion for 5–30 min. Conclusion Acupuncture- moxibustion combined with cupping is a good therapy in treating primary dysmenorrhea for its efficiency in alleviating pain.