A clinical trial of acupuncture about time-varying treatment and points selection in primary dysmenorrhea
Graphical abstract
we acupunctured single point Shiqizhui (EX-B8) and multi-points including Shiqizhui (EX-B8), Sanyinjiao (SP6), Diji (SP8) and Ciliao (BL32) in time-varying treatment for primary dysmenorrhea in order to observe the clinical therapeutic effects.
Introduction
Dysmenorrhea is a painful uterine contraction during menstruation and is one of the most common disorders in women (Shah-Hosseini et al., 2005). It affects almost half of them, with symptoms becoming too severe in 10% of the half women to disturb their routine activities (Daniels et al., 2005, Holtzman et al., 2008). Primary dysmenorrhea (PD), which is defined as painful menses in women with normal pelvic anatomy, usually begins during adolescence. Depending on the measurement used, 20% to 90% of young girls report primary dysmenorrheal (Harel, 2006, Latthe et al., 2006, Patel et al., 2006).
Evidence of efficacy supports use of pharmacological agents such as NSAIDs (Wong et al., 2009), and the use of oral contraceptives (Sundell et al., 1990) to alleviate menstrual pain. However, side effects may not be well tolerated or pain relief may be inadequate for some women. Acupuncture has been proven by a great number of randomized controlled trials (RCTs) that it is effective in treatment of chronic low back pain (Witt et al., 2006), knee osteoarthritis (Witt et al., 2005), migraine (Li et al., 2009), chronic neck pain (Willich et al., 2006), and other conditions. Acupuncture has been used to treat dysmenorrhea for over 2000 years in China. Recent developments of acupuncture in Australia indicate that through adequate and appropriate evaluation, it is being integrated into mainstream health care in Australia (Changli Xue et al., 2009). A clinical study showed both acupuncture and western medication are effective for primary dysmenorrhea and acupuncture treatment is better than Ibuprofen (Bing and Xiaohua 2011).
Acupuncture on treatment of primary dysmenorrhea is usually started before the menstruation in clinical. Several studies have used different time sequences of acupressure in dysmenorrheal (Wayne et al., 2008, Cho and Hwang, 2010, Lin et al., 2010). There are short of the evidence-based medicine about the point selection and time of intervention in primary dysmenorrhea. The aim of our study was to examine the effectiveness of acupuncture in time-varying treatment with single point and multi-points, and to screen out the best therapeutic regimen for primary dysmenorrhea. The program is registered with its own identifier (ChiCTR-TRC-09000471) by Chinese Clinical Trial Register in China.
Section snippets
Patients
Women were recruited for the study from five centers: Shandong University of Traditional Chinese Medicine, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Zhejiang University of Traditional Chinese Medicine Institute of Acupuncture and Massage, Affiliated Hospital of Shandong Provincial Research Academy of Traditional Chinese Medicine between March 2008 and January 2010. All the volunteers
Menstrual abdominal pain in the CMSS scores
The severities of menstrual abdominal pain and the whole time of menstrual pain shown by CMSS scores in different groups were listed in Tables 1 and 2. Compared with Group E, the significant relief was found in all acupuncture groups after the three cycles of treatment and three months of follow-up (P<0.01). Compared with the first cycle of treatment, it showed that the significant relief in Group A from the second cycle of treatment till follow-up (P<0.01). Group B, Group C and Group D also
Discussion
Acupuncture is now considered by the general public as one of the most popular treatments of complementary and alternative medicine (CAM) (Xue et al., 2007). The studies are usually about the efficacy and safety of acupuncture or others, such as points using in primary dysmenorrheal (Kashefi et al., 2010, Neda Mirbagher-Ajorpaz and Msaebi, 2011, Smith et al., 2011).
In our trial, patients with primary dysmenorrhea were treated before the menstruation or as soon as pain occurrence by different
Conclusion
This trial shows that acupuncture after three months treatment relieved menstrual pain for women with primary dysmenorrhea lasting the follow-up, and it proves acupuncture have recent and long-term effect for primary dysmenorrhea. Immediate pain relief is showed after acupuncture in 5 min for primary dysmenorrhea by single point Shiqizhui (EX-B8). And we can choose Shiqizhui (EX-B8) as a simple, convenient, effective therapy, such as a preferential therapeutic regimen. Acupuncture before the
Acknowledgments
This research was supported by the “11th Five-Year Plan” from National Key Technology R&D program of China (2006BAI12B06). We thank the women participating in the study, and all the researchers for their serious work. We also thank Professor Daniel J. Cox permitting us to use the CMSS.
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These two authors and their affiliations contribute equally to this article.