Clinical Study On The Treatment Of Endometriosis Dysmenorrhea With Catgut Implantation At Acupoint

Endometrial tissue (glands and interstitial substance) which is with activity appears outside the endometrium is called endometriosis (EMT). Although endometriosis is a kind of common gynecological diseases, it has malignant behavior, which usually occurs in women of childrenbearing age, and its incidence, which is increasing year by year, is5%～15. Endometriosis has these common symptoms:hypogastralgia, dysmenorrhea, irregular menstruation and sterility. Most of the patients will go to see doctors with dysmenorrheal as their main symptom, and it usually occurs in women between25to40years old. There are many treatment for Endometriosis Dysmenorrhea, including traditional Chinese medicine and western medicine. In Chinese traditional medicine aspect, there are medication, vaginally medicine, enema, abdominal application, needle therapy, electric acupuncture therapy, warmed needling with moxibustion, moxibustion, auricular acupuncture, acupoint injection therapy, acupoint application, etc, as well as coordination of all of these methods. In western medicine aspect, there are mainly medication therapy, which includes pseudo menopause therapy, pseudo pregnancy therapy, GnRH-a therapy, gestrinone therapy, mifepristone theray, etc, and surgical treatment. The medication therapy, is determined reliable effect, but has a bit considerable side-effects, and costly. The surgical therapy has high recurrence rate and will causes physical impairment except radical operation. And these lead to a certain limit of clinical application. Therefore, we designed this issue for a further study on the treatment of Endometriosis Dysmenorrhea.Objective:This issue which is under the direction traditional Chinese medicine theory is to observe the clinical efficacy of curing Endometriosis Dysmenorrhea and improving the quality of life with Catgut implantation at acupoint. The aim is to explore more effective treatments for patients to reduce indisposition which is caused by Endometriosis Dysmenorrhea, and improve quality of life.Methods:85patients which match the diagnostic criteria, inclusion criteria and exclusion criteria of the Endometriosis Dysmenorrhea subjects were divided into "Catgut implantation at acupoint" treatment group of28patients,"warmed needling with moxibustion" control group of29patients and "goserelin acetate" control group of28patients by randomization. All the patients start to be treated within1week before their menstrual period, and are totally treated for three menstrual cycles. We use Dysmenorrhea Observation Scale from guidelines of Chinese medicine treatment clinical research of pelvic endometriosis and blood CA125as our measures of evaluation before treatment, after treatment of1st and3rd menstrual cycle and3months after the whole course of treatment which would last3menstrual cycles. And we also use SF-36measuring scale as our measures of evaluation before treatment, after3rd menstrual cycle.Results:Treatment group and control groups patients in the age structure and course of disease have no significant difference by statistical tests (P>0.05), comparable. Before treatment, dysmenorrhea statistical test scores and blood CA125of treatment group and control groups have no significant difference by statistical tests (P>0.05), comparable.In the aspect of dysmenorrhea statistical test, after3rd menstrual cycle, there is significant difference between treatment group and "warmed needling with moxibustion" control group by statistical tests (P<0.05).The efficay of "Catgut implantation at acupoint" therapy in easing symptoms of dysmenorhhea is better than "warmed needling with moxibustion" therapy, and "GnRH-a" therapy falls in between.In the aspect of blood CA125, after3rd menstrual cycle, there is significant difference between "goserelin acetate" control group and "warmed needling with moxibustion" control group by statistical tests (P<0.05). The efficay of "GnRH-a" therapy in reducing numeric value of blood CA125is better than "warmed needling with moxibustion" therapy, and "Catgut implantation at acupoint" therapy falls in between.In the aspect of "Quality of life" which is evaluated by SF-36measuring scale, all three groups have significant differences between "before treatment" and "after3rd menstrual cycle" in "Physical Functioning""Role-Physical","Bodily Pain","General Health","Vitality","Social Functioning","Role-Emotional","Mental Health", by before-after controlled study。 And this means all three groups have reliable effect in improving quality of life. Meanwhile, in the aspects of "Physical Functioning","Bodily Pain""Vitality" and "Role-Emotional", there are significant differences among groups by statistical tests (P<0.05).Conclusion:The results suggest that:"Catgut implantation at acupoint" therapy,"warmed needling with moxibustion" therapy and "GnRH-a" therapy have reliable clinical efficacy in curing Endometriosis Dysmenorrhea. And respectively, each group has its advantage in easing symptoms of dysmenorhhea, reducing numeric value of blood CA125, and improving quality of life, and it worths a further study.