Comparison Of Clinical Curative Effect Of Dysmenorrhea And Heat Paste On Primary Dysmenorrhea

BACKGROUND:Primary dysmenorrhea (PD) is a common gynaecological disease with a high prevalence worldwide. According to a nationwide random survey done in 2000, the prevalence of PD in China was 56.06%. Clinical presentation of PD includes lower abdomen pain, sometimes radiating to the lower back and thighs, occurring before, after or during the menstrual cycle,with associated symptoms such as nausea and vomiting, headaches, dizziness, fatigue, diarrhea,etc. Tongjingjiu is an acupoint treatment patch for dysmenorrhea which contains Radix Angelicae Sinensis(RAS) powder and an iron thermal patch. PD patients often use heat patches available on the market for pain relief, while RAS can regulate the menstrual cycle, alleviate pain, nourish blood and enhance blood circulation. Modern research has also proven that RAS reduces endometrial myometrium contraction, acts as an analgesic and also improves uterine blood circulation. This study was designed to compare the treatment efficacy of Tongjingjiu versus regular thermal patches, to find out whether the transdermal delivery of RAS increases the therapeutic effect of regular thermal patches, in the hope of providing patients with a 3-in-1 treatment method that combines the pharmacological properties of RAS, heat therapy and acupoint stimulation.METHOD; 89 participants (15-35years old) with the diagnosis of PD were enrolled for this trial. The participants were randomly assigned into either the Tongjingjiu group (45 cases) or the regular thermal patch group (44 cases, out of which 4 discontinued treatment). Treatment and clinical observation of pain severity and other menstrual symptoms was carried out for 3 consecutive menstrual cycles. Pain severity was recorded using the Visual Analogue Scale (VAS), menstrual symptoms were recorded using the Menstrual Symptom Scale from the 1993 Chinese Guidelines for Clinical Research on New TCM Drugs, menstrual symptom severity and duration were recorded using the Cox Menstrual Symptom Scale (CMSS). Further comparisons between treatment efficacy of different TCM syndrome types and dysmenorrhea severity of the two intervention groups were carried out. Statistical analysis was done using SPSS 19.0, for continuous data, the t-test was performed for groups with equal variances and the Mann-Whitney test for those with unequal variances; for discrete data, the chi-square test was performed. For the comparison between pre- and post-treatment scores between the two groups, the paired t-test was used for groups with equal variances and the Wilcoxon signed-rank test was used for those with unequal variances.RESULTS:Results showed that Tongjingjiu was more effective than regualr thermal patches in the alleviation of menstrual pain and its associated symptoms. According to VAS, effectiveness in pain relief was 84.44% for the Tongjingjiu group and 62.50% for the regualr thermal patches group, post-treatment VAS scores of the two groups were significantly different (p<0.05). According to the Menstrual Symptom Scale in the 1993 Chinese Guidelines for Clinical Research on New TCM Drugs, effectiveness in menstrual symptom alleviation was 66.67% for the Tongjingjiu group and 27.50% for the regualr thermal patch group, post-treatment scores of the two groups were significantly different (p<0.01). According to the CMSS for symptom severity, post-treatment scores for the Tongjingjiu group were significantly lower than that of the regualr thermal patch group (p<0.01). Tongjingjiu was more effective than regualr thermal patches in the treatment of dysmenorrhea for participants with moderate(p<0.01) to severe (p<0.05) dysmenorrhea. Tongjingjiu was also more effective than regualr thermal patches in the treatment of dysmenorrhea for participants with the cold-damp syndrome (p<0.01) and the qi-blood stagnation syndrome (p<0.05); however there was no significant difference between the two groups for the treatment of participants with the liver stagnation-damp heat syndrome, qi-blood deficiency syndrome and liver-kidney deficiency syndrome (p>0.05).CONCLUSION:In conclusion, Tongjingjiu combines the pharmalogical effects of RAS, the heat-releasing effect of iron oxidation and the stimulation of the guanyuan (RN4) acupoint, hence is more effective than regular thermal patches in reduction of pain duration, reduction of pain severity and alleviation of dysmenorrhea associated symptoms, and more effective for treatment of participants with moderate to severe dysmenorrhea and those of the cold-damp syndrome and the qi-blood stagnation syndrome types. Tongjingjiu provides modern PD patients with a convenient and effective treatment alternative with few side effects.