Clinical Investigations On Warm Acupuncture At Baliao Acupoints To Treat Primary Dysmenorrhea Congealing Cold And Blood Stasis

Research Background:Dysmenorrhea is most common in women aged from 12 to 28 with an incidence rate of 92%.Hu Shuxia and other Chinese medicine practitioners found that among the dysmenorrhea patients,about 25.7%of them were accompanied with negative emotions such as anxiety,depression and irritability.The patients stated that the symptoms affected their work performance,school performance,physical and mental health seriously.CPPCC members put forward the idea of"statutory menstrual leave".It can be seen that dysmenorrhea has become a social concern.With many years of experience in clinical work,I agree that acupuncture and moxibustion therapy show good effects on dysmenorrhea,especially primary dysmenorrhea patients.However,in the current studies of dysmenorrhea,the problem of choosing many acupoints chaotically and operating without regulations exist.In this study,under the guidance of Professor Cao Lixing,the effects of acupuncture and moxibustion on 100 dysmenorrhea patients were observed under clinical research approach.The purpose of the study is to find out the best way to cure the disease and to plan the acupuncture treatment of "congealing cold and blood stasis".It aims at finding more secure,effective,comprehensive and standardized treatment methods to cure dysmenorrhea and provide research evidence.Research Purposes:Investigate on the recent efficacy and safety of warm acupuncture at Baliao acupoints to treat primary dysmenorrhea of the type of congealing cold and blood stasis.Research Methods:In this study,a prospective randomized controlled clinical trial was set up.Patients of primary dysmenorrhea who fulfilled observation requirements from the Hong Kong Christian Family Service Center-the Chinese University of Hong Kong Chinese medicine teaching and research center and fook ming tong Chinese medicine center were selected.A comparative study of the treatment group and the control group was conducted.A total of 100 patients with common dysmenorrhea symptoms and under observation condition were enrolled in this study.Using the principle of randomized control,100 patients were randomly divided into treatment group(50 cases)and control group(50 cases)respectively.By using the randomized selection and the SPSS17.0 statistical analysis software,the patients were randomly arranged into two groups with a ratio of 1:1.Each group consisted of 50 cases.The treatment group was treated with warm acupuncture.Several acupuncture points were chosen in the treatment,including baliao acupoints(BL31,BL32,BL 33,BL34),two sides of Hegu(LI4),Zusanli(ST36),Sanyinjiao(SP6)and taixi(KI3).The patients received moxibustion treatment after acupuncture.The control group(electro-acupuncture group)had the same acupoints selection and acupuncture method with the treatment group.Patients of both groups received treatment every other day for 7 to 10 days before the menstruation.One menstrual cycle was set as a treatment course.The study focused on a continuous treatment of 3 courses,which meant 3 menstrual cycles.The dysmenorrhea scores,pain measurement scores,TCM scores and the life qualities of the two groups were compared before the treatment and after each course to investigate the clinical treatment effect and establish a database using SPSS 17.0 for statistical analysis.Research Result:The results of the study were analyzed as follows:1.Comparison of clinical efficacyFor the treatment group,after three courses,15 patients were fully recovered.Treatment was markedly effective in 23 cases,effective in 8 cases and ineffective in 4 cases.The total effective rate was 92.0%.On the other hand,after three courses,12 cases in the control group fully recovered.Treatment was markedly effective in 10 cases,effective in 21 cases and ineffective in 7 cases.The total effective rate was 86.0%in the control group.Therefore,there was no statistical significance comparing the treatment effect of the two groups(P>0.05).Both treatments of control group and treatment group were effective,while the treatment group showed a better total effective rate.2.Comparison of dysmenorrhea scoresThe dysmenorrhea scores of the two groups throughout 3 courses of active treatment were compared.The data show:.By t-test analysis within the group,after the first course of treatment of two groups,the difference before and after treatment was statistically significant(P<0.05).From Table 5 and Fig.1,the dysmenorrhea scores were lower than those before treatment in both groups.In the treatment group,the dysmenorrhea scores decreased after each course.The difference was significant,(P<0.01).While in the control group,the dysmenorrhea scores decreased after each treatment.The difference was significant,(P<0.01).The results of the two groups at different time interval were compared using repeated measure ANOVA.Covariance matrix and Mauchly’ s sphericity test showed statistical significance(P<0.05).Therefore,by choosing the G-G(Greenhouse-Geisser)model,the model test difference showed statistical significance(F=509.76,P=0.000<0.001).Between sum of squares(BSS)also showed statistical significance(F=7.55,P=0.007<0.01).Therefore,it was considered that,on the cases of "congealing cold and blood stasis",both groups showed a good therapeutic effect and the efficacy of the treatment group is better than the control group.It can be seen from Fig.1 that the slope and the descending rate of the treatment group were larger than those of the control group after the first course of the treatment.The difference of the scores between the two groups before and after the first course showed statistical significance(P<0.01).The difference of the scores between the two groups before treatment and after the third course showed statistical significance(P<0.01).It was suggested that the analgesic effect of the treatment group was better than that of the control group.It was shown that both warm acupuncture and electro-acupuncture(control group)at Baoliao acupoints have certain effect on curing the type of "congealing cold and blood stasis" of dysmenorrhea.However,warm acupuncture and moxibustion can achieve a better efficacy of treatment than the control group and can achieve the optimum effect more quickly.3.Comparison of MPQ scores of dysmenorrhea in both groupsThe MPQ scores of the two groups were compared at different time interval.After 3 courses of active treatment,the data showed that the MPQ scores of the two groups significantly decreased after t-test.The difference was statistically significant(P<0.01).It can be considered that the pain of both groups decreased after the treatment.As can be seen from Table 6 and Figure 2,the MPQ scores of the two groups decreased after each course of treatment.Therefore,it was shown that the abdominal pain and other symptoms of the two groups were significantly improved after three treatments.Apart from that,there was a trend of continuous improvement throughout the treatment.The efficacy of the recent treatment of the two groups was more significant.The results of the two groups at different time interval were compared using repeated measure ANOVA.Covariance matrix and Mauchly’ s sphericity test showed statistical significance(P<0.05).Therefore,by choosing the G-G(Greenhouse-Geisser)model,the model test difference showed statistical significance(F=2725.67,P=0.000<0.001).Between sum of squares(BSS)also showed statistical significance(F=33.992,P=0.000<0.01).Therefore,it could be considered that the warm acupuncture and moxibustion of the Baliao acupoints showed better analgesic effect in the treatment group than in the control group in "congealing cold and blood stasis type".As shown in Fig.2,after the end of the first course of treatment,the slope and of the treatment group was significantly larger than that of the control group.Also,the difference between the scores before and after first course was larger in treatment group than in control group.Therefore,the MPQ scores of the two groups decreased simultaneously after the first course.However,the data between the two groups showed statistical significance(P<0.01)with the treatment group having a more obvious result.Therefore,the treatment group had a more obvious and significant analgesic effect.4.Comparison of individual traditional Chinese medicine symptom in both groupsIndividual traditional Chinese medicine symptom of the two groups was compared throughout three courses of active treatment.The data show that:there is a trend of significant reduction in the three symptoms of two groups.Therefore,each individual symptom of both groups of patients improved continuously.In the treatment group,the scores of each symptom after first course significantly decreased(P<0.001).Also,comparing the scores after the third course and before the treatment,the scores significantly decreased(P<0.001).It can be considered that the warm acupuncture and moxibustion has a significant effect on the common primary dysmenorrhea of "congealing cold and blood stasis type".Therefore,Chinese Medicine can alleviate the symptoms of these patients quickly.In the control group,after the first course of treatment,the indices of "abdominal pain","little blood amount","dark blood clots","white or greasy fur","tight and sunken pulse" were compared.There is significant difference between before and after the treatment(P<0.01).Also,after the end of the third course,the scores of the symptoms decreased significantly(P<0.01)compared with those before treatment.It can be considered that in terms of individual symptoms of traditional Chinese medicine,the treatment of the control group also have a certain degree of mitigation effect.5.Changes in quality of lifeThe changes in the quality of life of the two groups were compared after 3 courses of active treatment.The data shows that the quality of life of both groups was improved.The data of the treatment group showed significant difference before and after the treatment,(P<0.01).While in the control group,there was no significant difference before and after the treatment only in the item of environment(P>0.05).However,there was significant different in other items(P<0.01).The results of the two groups at different time interval were compared using repeated measure ANOVA.The scores of the two groups before the treatment were relatively not comparable,therefore this time interval was chosen as a covariate to calibrate.Covariance matrix and Mauchly’ s sphericity test showed statistical significance(P<0.05).Therefore,by choosing the G-G(Greenhouse-Geisser)model,the model test difference showed statistical significance(F=9.82,P=0.000<0.001).Between sum of squares(BSS)also showed statistical significance(F=3.64,P=0.06>0.05)as shown in Table 7.By t-test analysis between the two groups,after the second course of treatment of two groups,the abdominal pain scores before and after treatment showed statistical significance(P<0.05).Also,from Table 7 and Fig.3,the symptom score decreased after each course.6.Comparison between safetyThere were a total of 9 cases of subcutaneous hemorrhage in both groups in the treatment,without other obvious body discomfort.Bruise disappeared after hot compressing by the patients themselves for 4-6 days.There was no other negative response in the treatment and there was no falling case of moxibustion.Therefore,treating dysmenorrhea with warm acupuncture and moxibustion is safe and reliable.Warm acupuncture and moxibustion can not only alleviate the patient’s abdominal pain,but also improve the overall quality of life of the patients.The other indicators also improved significantly apart from the environmental factor.Warm acupuncture and moxibustion have a clear therapeutic effect on the subjective feelings,physical health and mental condition of the patients.There is also a certain degree of improvement in the above indicators of the control group(electro-acupuncture group).However,the improvement of the warm acupuncture and moxibustion group was larger than that of the control group.Moreover,treating dysmenorrhea with warm acupuncture and moxibustion is safe.Conclusion:Warm acupuncture at Baliao acupoints is able to ease the abdominal pain of the patients and improve their living quality.All index improved obviously apart from the environment factor,especially their feelings,physiological and psychological factors.Control group(electro-acupuncture group)also showed certain improvement but less obvious than the treatment group.Also,clinical investigation showed that warm acupuncture is safe when applying to this type of dysmenorrheal patients.Therefore,this research showed that warm acupuncture is safer and have a better efficacy in this type of dysmenorrheal patients.