Based On Randomized Controlled Literature Of Acupuncture Treatment Of Primary Dysmenorrhea Clinical Research

Background Dysmenorrhea refers to hypogastric cyclic pain that can rad iate to the sacral and lumbar area and which appears before, during or afte r menstruation. In more severe cases the pain can be excessive and associat ed with dizziness. It corresponds in Chinese medicine to "Abdominal pain du ring menstruation" and can be classified clinically as either primary or se condary dysmenorrhea. According to Chinese medicine primary dysmenorrhea ph ysiopathology distinguishes two patterns:excess and deficiency. In the exc ess pattern there is obstruction of blood and Qi flow, with stasis in the m eridians Chong Mai and Ren Mai and obstruction.of the blood flow in the ute rus that causes pain. Pathological change is due to condensing cold, heat, humidity and Qi blockage. In the deficiency pattern there is failing in hea t and nutritional supply to the uterus, Chong Mai and Ren Mai meridians whi ch causes pain due to the lack of nutrition. Pathological change is due to Yang deficiency with internal cold, deficiency of Qi and blood and hepatore nal deficiency. Classic literature is exhaustive as for contemporary litera ture, a large amount of related articles can be found and therapeutic resul ts in dysmenorrhea acupuncture treatment are starting to get acknowledgemen t.Objective Articles on randomized controlled trial of primary dysmenorr hea acupuncture treatment were selected, on the last fifteen years period, and reviewed. Initial summary on acupuncture treatment of primary dysmenorr hea experience was carried out with investigation of the inadequacies in cl inical studies.Methods CMCI database was searched, for related papers, in the period range between 1994 and June 2010 excluding papers not relevant to primary d ysmenorrhea. Selection of papers on randomized trials with the acupuncture treatment in primary dysmenorrhea and classification according to diverging acupuncture methodology was carried out. Our source came from various data bases such as:China Academic Journal (CNKI), Chinese Biomedical Database (CBM), VIP Database, Wanfang.Results1. A total of 271 papers were retrieved of which 50 were randomized cont rolled trials which met the inclusion criteria, but only nine reported the group randomization methodology.2. Thirty six papers described control groups establishment as separatin g body needle needling and Chinese herbs treatment or pharmaceutical drug taken per os as for the control group; separating moxibustion treatment and Chinese herbs treatment or pharmaceutical drug taken per os as for the co ntrol group; separating topical application on acupuncture points and Chin ese herbs treatment or pharmaceutical drug taken per os as for the control group; ear acupuncture treatment, scrapping, cupping, injection in acupunc ture points, surgical thread embedding in acupuncture points, abdominal acu puncture and pharmaceutical drug taken per os as for the control group; in jection in acupuncture points and intramuscular injection as for the contro 1 group. Fourteen articles reported using acupuncture treatment again as th e control group.3. Regularly used acupuncture points in the treatment of primary dysmeno rrhea, according to their usage frequency listed as follow:San Yin Jiao, Guan Yuan, Ci Liao, Di Ji, Tai Chong, He Gu, Xue Hai, Zhong Ji, Qi Hai, Zi Gong, Zu San Li etc. As for topical application on acupuncture points the f ollowing points are frequently used:Shen Que and Guan Yuan.4. Most frequently used acupuncture methods include body needles needlin g, moxibustion, ear acupuncture, topical application on acupuncture points and injection on acupuncture points.5. Generally 3 menstrual cycles are considered a course of treatment.Conclusion Preliminary conclusion is based on a comprehensive analysis of the 50 papers that were retrieved.1.Most frequently used meridians in the acupuncture treatment of primar y dysmenorrhea are Ren Mai and foot Tai Yin with the following points:Guan Yuan, Qi Hai, San Yin Jiao, Di Ji ect.2. Among various acupuncture methods, body needle needling and moxibusti on are the most frequently used methods to treat dysmenorrhea.3. Clinical studies standards are still insufficient with the following inadequacies:inconsistency in inclusion criteria standards, ill-defined ra ndomization methods, lack of standards in the clinical pattern differentiat ion and flawed clinical evaluation system. Therefore setting up agreed stan dards and improving clinical evaluation system would be significant in upgr ading the quality of literature.