| ObjectivesBy examining the positive reactants and tenderness of lower leg segment of Zusanyin meridian of patients with secondary dysmenorrhea and primary dysmenorrhea due to adenomyosis,the similarities and differences of meridian acupoint reaction of patients with secondary dysmenorrhea and primary dysmenorrhea under different physiological and pathological conditions were compared.MethodsThirty patients with secondary dysmenorrhea due to adenomyosis(secondary group)and 30 patients with primary dysmenorrhea(primary group)were selected as the study subjects,and the meridian diagnosis of the two groups of patients was carried out by traditional meridian examination methods during and without menstruation respectively.The examiner used the thumb and finger abdomen to cut the patients’ lower leg along the meridian with light,medium and severe strength respectively,and explores whether there are abnormal manifestations such as strips,nodules,depressions and tenderness in the order of spleen meridian,liver meridian and kidney meridian.The positive reactants and tenderness found in the examination were marked with a marker pen,and the distance between them and the tip of the medial malleolus was measured and recorded in the meridian examination result record table.The tenderness points of each meridian were recorded and VAS scored,and then the tenderness threshold was measured with a quantitative mechanical tester of human tenderness.The subjects’ bilateral calves were independently examined,measured and recorded.Results1 Intra-group comparison of patients with secondary dysmenorrhea due to adenomyosis1.1 Intra-group comparison of Zusanyin meridian examination①The occurrence rate of positive reactants:the occurrence rate of total positive reactants(nodules,stripes,depressions,etc.)of the Zusanyin menstruation in the secondary group was 49.4%,and that of the non-menstrual group was 42.2%,and there was no statistical difference(P>0.05).The occurrence rate of positive reactants of the spleen menstruation and liver menstruation of the patients with and without menstruation was greater than that of the kidney menstruation.There was significant difference(P<0.01).②The occurrence rate of tenderness:the occurrence rate of total tenderness of Zusanyin menstruation in the secondary group was 93.3%,and that of non-menstrual group was 92.2%,and there was no statistical difference(P>0.05).The occurrence rate of tenderness of spleen menstruation and liver menstruation in the secondary group was 100%in both menstrual and non-menstrual periods,and was greater than that of kidney menstruation.There was significant difference(P<0.01).1.2 Intra-group comparison of spleen meridian acupoints①Positive reactants and tenderness of acupoints:positive reactants and tenderness of spleen meridian in secondary group,during menstruation and non-menstruation,were concentrated near Yinlingquan,Diji and Sanyinjiao,and there was no statistical difference in the intra-group comparison of positive reactants and tenderness occurrence rate of the above acupoints(P>0.05).②VAS value and tenderness threshold(PT)of acupoints:VAS value of Yinlingquan,Diji,Lougu,Sanyinjiao and other acupoints in the secondary group was greater than that in the non-menstrual period,and PT value of the above acupoints in the menstrual period was less than that in the non-menstrual period.There was a statistical difference between the two groups(P<0.05).1.3 Intra-group comparison of liver meridian acupoints(1)Positive reactants and tenderness of acupoints:during menstruation and non-menstruation,positive reactants and tenderness of liver meridian in the secondary group were concentrated near the three acupoints,namely Xiguan,Ligou and Zhongdu,and there was no statistical difference within the group(P>0.05).(2)VAS value and tenderness threshold(PT)of acupoints:VAS value of liver meridian at Xiguan and Ligou acupoints during menstruation was greater than that of non-menstruation and PT value was smaller than that of non-menstruation in the secondary group.The VAS value and PT value of Ligou acupoints were significantly different in the intra-group comparison(P<0.05).1.4 Intra-group comparison of kidney meridian acupoints①Positive reactants of acupoints and tenderness:During menstruation and non-menstruation,the positive reactants of kidney meridians were lower in the secondary group,and tenderness mainly occurred near Jiaotong,Zhubin and Yingu acupoints.There was no statistical difference P>0.05).②VAS value and tenderness threshold(PT)of acupoints:VAS value of kidney meridian in Zhubin and Jiaotong in secondary menstrual period group was greater than that in non-menstrual period while PT value was smaller than that in non-menstrual period,and there was no statistical difference in the intra-group comparison(P>0.05)2 Intra-group comparison of patients with primary dysmenorrhea2.1 Intra-group comparison of the Zusanyin meridian examination①The occurrence rate of positive reactants:the total occurrence rate of positive reactants in the primary group was 26.7%during the menstrual period and 22.2%during the non-menstrual period.There was no statistical difference within the group(P>0.05).The occurrence rate of positive reactants in the spleen and liver meridians was greater than that in the kidney meridians.There was significant difference(P<0.01).②The occurrence rate of tenderness:the occurrence rate of total tenderness during menstruation was 88.3%in the primary group and 87.2%in the non-menstrual group,and there was no statistical difference within the group(P>0.05).The occurrence rate of tenderness in spleen meridian during menstrual and non-menstrual was both 100%.The occurrence rate of tenderness in spleen and liver meridians was greater than that of kidney meridian with significant difference(P<0.01).2.2 Intra-group comparison of spleen meridian acupoints①Positive reactants and tenderness of acupoints:during menstruation and non-menstruation,positive reactants and tenderness of spleen meridian in primary group were concentrated near Yinlingquan,Diji and Sanyinjiao points,and there was no statistical difference in the positive reactions and tenderness rates of the above acupoints in the intra-group comparison(P>0.05).The occurrence rate of tenderness in Yinlingquan and Sanyinjiao in the primary group was higher than that in Diji and Lougu acupoints with significant difference(P<0.01).②VAS value and tenderness threshold(PT)of acupoints:VAS value near Yinlingquan,Diji,Lougu and Sanyinjiao in the primary group was greater than that in the non-menstrual period,and PT value was smaller than that in the non-menstrual period.The VAS and PT values of Yinlingquan and Sanyinjiao in the primary group were significantly different in the intra-group comparison(P<0.05).3 Inter-group comparisons between patients of secondary dysmenorrhea and primary dysmenorrhea3.1 Inter-group comparison between the Sanyinjiao meridian examination①The occurrence rate of positive reactants:There was a significant difference in the total positive reactants occurrence rate between the two groups during menstruation and non-menstruation(P<0.01).The occurrence rate of positive reactants in the spleen and liver meridians in the secondary group was higher than that in the primary group with significant difference(P<0.01).There was no statistical difference in the kidney meridians between the two groups(P>0.05).②The occurrence rate of tenderness:during menstruation and non-menstruation,there was no statistical difference in the occurrence rate of total tenderness between the two groups(P>0.05).The occurrence rate of tenderness of spleen meridian,liver meridian in secondary group and spleen meridian in primary group was 100%,and the occurrence rate of tenderness of spleen meridian and liver meridian was higher than that of kidney meridian.There was statistical significance(P<0.05).3.2 Inter-group comparison of Spleen meridian acupoints①Positive reactants and tenderness of acupoints:Positive reactants and tenderness of spleen meridian in both groups were concentrated near Yinlingquan,Diji,Lougu and Sanyinjiao during menstruation and non-menstruation.The occurrence rate of positive reactants at Diji acupoint was statistically different in inter-group comparison(P<0.05).The occurrence rate of tenderness at Yinlingquan and Sanyinjiao acupoints was 100%in both groups,and the occurrence rate of tenderness near Diji and Lougu acupoints was statistically different(P<0.05).The occurrence rate of tenderness at Yinlingquan,Diji and Sanyinjiaoacupoints was greater than that at Lougu acupoint with significant difference(P<0.01).② VAS value and tenderness threshold(PT)of acupoints:the VAS value and PT value of spleen meridian in Yinlingquan and Diji during menstruation and non-menstruation were statistically different in the inter-group comparison(P<0.05).The PT value of Lougu acupoint was statistically different(P<0.05)3.3 Inter-group comparison of liver meridian acupoints①Positive reactants and tenderness of acupoints:during menstruation and non-menstruation,positive reactants and tenderness of liver meridian in both groups were concentrated near Xiguan,Ligou and Zhongdu points.The occurrence rate of positive reactants and tenderness of Ligou points in secondary group was greater than that of primary group and there was statistical significance(P<0.05).The occurrence rate of tenderness was the highest at Xiguan acupoint,and there was no statistical difference in the inter-group comparison(P>0.05).In addition,the secondary group presented continuous tenderness in the segment of "Ligou-Zhongfeng"(mostly located between Ligou-3 inches below the Ligou)with significant difference in the inter-group comparison(P<0.01).The occurrence rate of tenderness at the Xiguan and Ligou acupoints in the secondary group was significantly higher than that at Zhongdu acupoint.(P<0.01).The occurrence rate of tenderness near Xiguan acupoint in the primary group was significantly higher than that near the Zhongdu and Ligou points(P<0.01).②VAS value and tenderness threshold(PT)of acupoints:the VAS value and PT value of Ligou acupoint of liver meridian in the secondary group were greater than those in the primary group during menstruation and non-menstruation.There was statistical significance(P<0.05).3.4 Inter-group comparison of kidney meridian acupoints①Positive reactants and tenderness of acupoints:The positive reactants of kidney meridians in both groups were lower and the tenderness was concentrated near Jiao tong,Zhubin and Yingu acupoints during menstruation and non-menstruation.There was no statistical difference in the occurrence rate of tenderness of the above acupoints in the inter-group comparison(P>0.05).The occurrence rate of tenderness at Yingu and Zhubin points in both groups was significantly lower than that at Jiaoxin(P<0.01)and significantly greater than that at Taixi(P<0.01).②VAS value and tenderness threshold(PT)of acupoints:during menstruation and non-menstruation,there was no significant difference in VAS value and PT value in the inter-group comparisons(P>0.05).Conclusion1.Positive reactants and tenderness of secondary dysmenorrhea and primary dysmenorrhea(PD)patients with adenomyosis(AM)occur more frequently in the spleen and liver meridians than in the kidney meridians,suggesting that dysmenorrhea,whether primary or secondary,is closely related with the spleen and liver meridians2.The positive reactants and tenderness rates of AM patients in spleen meridian and liver meridian were higher than those of PD patients,suggesting that attention should be paid to the meridian examination of spleen meridian and liver meridian for AM patients.3.Acupoints including Yinlingquan,Diji,Sanyinjiao,Lougou,Ligou,Xiguan,Zhubin and Jiaoxin all have the function of reflecting the pathological state of AM.Yinlingquan and Sanyinjiao have strong correlation with AM and PD,while Diji and Ligou acupoints have more specificity for AM secondary dysmenorrhea. |
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