Moxibustion With Different Interventional Times For Treating Primary Dysmenorrhea,a Randomized Controlled Trail

Objective:This study aimed to investigate the influence of moxibustion at different intervention times on the symptoms and the the levels of serum prostaglandin PGF2a, PGE2 of Primary dysmenorrhea (PD) patients so as to evaluate the efficacy and explore the potential mechanism of moxibustion at different intervention times for treating PD.Methods:140 PD patients were randomly divided into two groups, group A (moxibustion before menstruation) and group B (moxibustion during menstruation),70 participants in each group. Warming moxibustion treatment on Sanyinjiao (SP6) bilateral and Guanyuan(CV4) were continuously given to the two groups for 5-7 days in each menstrual cycle for totally 3 menstrual cycles. The moxibustion treatment of group A was started from 5 or 7 days prior to menstuation, and the treatment of group B was started from the first day of each menstrual cycle. The Cox Menstrual Symptom Scale (CMSS) and Visual analogue scale (VAS) were used to evaluate the efficacy in treatment period and follow up at the end of each menstrual cycle. The serum prostaglandin PGF2a, PGE2 were tested at the first menstrual cycle enrolled within 48 hours and the fourth menstrual cycle within 48 hours after three menstrual treatments with the blood samples extracted from the elbow vein.Results:1.132 PD patients complemented the research including 64 cases in group A and 68 cases in group B.2.The two groups had no significant differences in demographic characteristics, vital signs, disease information and serum prostaglandin PGE2 and PGF2a level at baseline (p>0.05).3. After treatment, the total effective rate of the two groups were:group A: 92.18%; group B:86.76%.4.Influence of moxibustion at different interventional time on the symptoms of PD patients:(1)Within group analysis shows that, compared with baseline, both Group A and Group B shows significant changes in the CMSS time score and severity score, total pain time score and severity score of small abdominal and VAS score after treatment and in the follow-up (p<0.05).(2)Between group analysis show that, compared with Group B, Group A show significant changes on CMSS time score and severity score, total pain time score and severity score of small abdominal and the VAS score in the period of treatment and follow-up (p<0.05).5.Effect of moxibustion on serum prostaglandin PGE2 and PGF2a levels in patients with PD:(1) Within group analysis shows that, compared with baseline, both Group A and Group B shows significant changes in serum prostaglandin PGE2, PGF2a levels after treatment (p<0.05).(2) Between group analysis show that, compared with Group B, Group A show significant changes on serum prostaglandin PGF2a levels after treatment(P<0.05).6.There was no significant difference in adverse events and Compliance between the two groups (p>0.05).Conclousion:1.Both group A and group B had significent effects for improving the symptoms of PD. Group A was superior to group B in reducing pain, shortening the time of abdominal pain and the associated symptoms, reducing the severity of abdominal pain and accompanied symptoms.2.Both group A and group B had positive influence on the levels of serum prostaglandin PGE2 and PGF2a.It suggested that the efficacy of moxibustion treatment for PD maybe related to influence the oncentration of the serum PGE2 and PGF2a.Group A was superior to group B in reducing the level of serum prostaglandin PGF2a in PD patients, prostaglandin PGE2, PGF2a and easing the uterine smooth muscle spasm.3.It was safe for moxibustion treating of PD and it had good compliance.