Efficacy of Curcumin on Cognitive Function Scores in Women with Premenstrual Syndrome and Dysmenorrhea: A Triple-Blind, Placebo-Controlled Clinical Trial

Objective: To assess the efficacy of a curcumin supplementation on cognitive abilities in women suffering from premenstrual syndrome(PMS) and dysmenorrhea. Methods: A randomized, triple-blind, placebocontrolled trial was conducted from December 2019 to March 2020. A total of 124 women who had both PMS and dysmenorrhea were enrolled, and were equally and randomly assigned to the curcumin group or placebo group, 62 cases in each. Each subject received either a capsule containing 500 mg of curcuminoid, or a placebo daily, for 10 days(7 days before and until 3 days after the onset of menstrual bleeding) over 3 menstrual cycles. The cognitive abilities questionnaire was used to measures cognitive functions in 7 specific areas. Adverse reactions were monitored during and after the trial in both groups. Results: Administration of curcumin was associated with a significant increase in memory score(P=0.002), inhibitory control and selective attention(P=0.020), and total cognitive ability task(P=0.024). In addition, significant increments were found in scores of memory(3.5±3.1 vs. 0.4±3.8 in the curcumin and placebo groups, respectively;P=0.035), inhibitory control and selective attention(3.0±3.7 vs. 0.4±3.7;P=0.027) and total cognitive abilities(8.3±12.3 vs. 2.2±12.4;P=0.025) in the curcumin group versus placebo groups. Curcumin was safe and well-tolerable in current clinical trial. Conclusion: Curcumin has a beneficial efficacy on cognitive function scores in women with PMS and dysmenorrhea, with improvements in memory, inhibitory control and selective attention.(Registration No. IRCT20191112045424N1, available at: https://www.irct.ir)

Ge-Gen Decoction attenuates oxytocin-induced uterine contraction and writhing response: potential application in primary dysmenorrhea therapy

The uterine tetanic contraction and uterine artery blood flow reduction are possible reasons for primary dysmenorrhea(PD). In the present study, we aimed to evaluate the uterine relaxant effect and the influence on uterine artery blood velocity of Ge-Gen Decoction(GGD), a well-known Chinese herbal formula. In female ICR mice, uterine contraction was induced by oxytocin exposure following estradiol benzoate pretreatment, and the uterine artery blood velocity was detected by Doppler ultrasound. Histopathological examination of the uterine tissue samples were performed by H&E staining. Ex vivo studies demonstrated that oxytocin, posterior pituitary, or acetylcholine induced contractions in isolated mouse uterus. GGD inhibited both spontaneous and stimulated contractions. In vivo study demonstrated that GGD significantly reduced oxytocin-induced writhing responses with a maximal inhibition of 87%. Further study demonstrated that GGD normalized oxytocin-induced abnormalities of prostaglandins F_2 alpha(PGF_(2α)) and Ca^(2+) in mice. In addition, injection of oxytocin induced a decrease in uterine artery blood flow velocity. Pretreatment with GGD reversed the oxytocin response on blood flow velocity. Histopathological examination showed pretreatment with GGD alleviated inflammation and edema in the uterus when compared with the model group. Both ex vivo and in vivo results indicated that GGD possessed a significant spasmolytic effect on uterine tetanic contraction as well as improvement on uterine artery blood velocity which may involve PGF_(2α) and Ca^(2+) signaling, suggesting that GGD may have a clinic potential in PD therapy.

Clinical Study on Time-effect Relation of Acupuncture for Pain due to Dysmenorrhea

Objective： To observe the time-effect relationship of needling a single point or multiple points for pain relief in patients with severe primary dysmenorrhea. Methods： A total of 20 cases with severe primary dysmenorrhea were randomly allocated into a group of single point. In each treatment, the needles retained for 30 min and 15 person times were observed in each group. The VAS （Visual Analogue Scale） values were recorded immediately before needling, 5 min, 20 min and 30 min upon insertion, and 30 min, 60 min and 120 min upon withdrawal for statistical analysis. Results： Immediate pain relief occurred following acupuncture and the pain-alleviating effect was incremented within the 30 min of needle retaining. At 20 min upon needle insertion, the pain relief from needling multiple points appeared substantially stronger than needling a single point （P〈0.05） and this effect remained until 2 h after withdraw of the needles. Conclusion： Needling a single point or multiple points can both produce remarkably immediate pain relief for patients with severe primary dysmenorrhea and share similar time-effect relationship. However, needling multiple points showed substantially better effects than needling a single point in a number of time points.

Acupuncture for Primary Dysmenorrhea: A Randomized Controlled Trial

Objective： To observe the clinical therapeutic effects of acupuncture treatment for primary dysmenorrhea. Methods： 122 cases of primary dysmenorrhea were randomly divided into three groups. Fifty-two cases in the acupuncture group were treated with acupuncture. Forty cases in the medication group were treated with oral administration of Ibuprofen. Thirty cases in the placebo group were treated with oral administration of vitamin B1. The therapeutic effects were observed after treatments for three menstrual cycles. Results： The total effective rate was 96.2% in the acupuncture group, 80.0% in the medication group and 13.3% in the placebo group. By statistical management, the differences among the acupuncture group, the medication group, and placebo group were statistically significant （P〈0.05）. Conclusion： Both acupuncture and western medication are effective for primary dysmenorrhea and acupuncture treatment is better than Ibuprofen

Tongue diagnosis: relationship between sublingual tongue morphology in three tongue protrusion angles and menstrual clinical symptoms

OBJECTIVE：The morphological and color characteristics of the tongue sublingual veins（SLVs）can manifest differently within the subjects,depending on the way their tongue is curled upward.This study was conducted in order to investigate the clinical relevancy of tongue SLV diagnosis in relation to menstrual clinical symptoms（pain,clots,heavy,and scanty）,using three different inspection procedures（IP1,IP2,and IP3）.METHODS：Three-hundred and seventy-seven female patients were asked to stick out their tongues in three specifi c ways which were intended to create different tongue protrusion angles.The SLV parameters for thickness（TK）,length（LE）,color（CL）,shape（SP）,and nodules（ND）were then evaluated.RESULTS：According to the results of the Waldχ2test,IP1 provides the best model for pain（R2=0.155）,IP3 for clots（R2=0.437）,IP2 for heavy（R2=0.268）,and scanty（R2=0.192）.Abnormal SLV diagnostic parameters were most strongly associated with the clinical symptom of clots（R2=0.492）.CONCLUSION：While the study showed the relations between tongue SLV features and menstrual clinical symptoms,as well it showed that IP2 was the best overall predictor for the symptomatic indexes used in this study,and using one particular SLV inspection procedure may not be suffi cient.The application of a particular inspection method alone may cause under-or over-estimation of SLV abnormalities.

Vitamin K3 Regulates Reactive Oxygen Species and Extracellular-Regulated Protein Kinase in Differentiated PC-12 Cells within a Safe Dose Range

Objective:Acupuncture can relieve pain by acting on the mitogen-activated protein kinase(MAPK)signal pathway,which plays a critical role in the balance between hyperalgesia and inflammation.Our previous studies have suggested that acupoint injection of Vitamin K3(Vit K3)had an intensive analgesic effect on primary dyspareunia.However,the mechanism by which Vit K3 worked on nerve cells has not been elucidated.Methods:Cell apoptosis,mitochondrial membrane potential(MMP),and reactive oxygen species(ROS)changes of PC-12 cells with Vit K3 treatment,for which the concentration gradient was 0,5,10,20,40,and 60μmol/L,were quantified by flow cytometry.The expression and phosphorylation of c-Jun N-terminal kinase,p38,and extracellular-regulated protein kinase(ERK),the three critical molecules of the MAPK pathway,were further assessed using Western blotting.Results:The level of ROS first decreased and then increased with Vit K3 at 20μmol/L,but no change in neither apoptosis nor MMP was evident.In addition,only ERK level decreased at 20μmol/L and the relative phosphorylation level increased.Changes in ROS were negatively correlated with the expression of ERK.Conclusions:The rapid analgesic effect of Vit K3 acupoint injection may be through the reduction of ROS in nerve cells with a small dose of Vit K3 or by influencing the expression of ERK but without damaging the nerve cells themselves.