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This article summarizes Professor TIAN Conghuo 's key points and features of acupuncture for primary dysmenorrhea. Professor TIAN believes that the location of dysmenorrhea is in the uterus, and the fundamental pathogenesis is the disharmony of both form and spirit. During clinical treatment, he first conducts abdominal palpation, often detecting cord-like nodules around Guilai (ST 29), Huangshu (KI 16), and Zigong (EX-CA 1). Needling reaches the depth of these nodules. Additionally, the use of four acupoints around the navel (Shuifen [CV 9], bilateral Huangshu (KI 16), and Yinjiao [CV 7]), and four back- shu points (Ganshu [BL 18], Pishu [BL 20], Shenshu [BL 23], and Geshu [BL 17]) is applied to regulate the spirit and strengthen the body. Point selection is further based on syndrome differentiation. The "Three layers" needling technique is used, emphasizing the mental and emotional state of the patients, calming the spirit and regulating qi and blood, to achieve a harmonious treatment of both form and spirit for dysmenorrhea.

Objective: To observe the clinical efficacy of Fu 's subcutaneous needling combined with monkshood cake-separated moxibustion for primary dysmenorrhea with cold congealing and blood stasis., Methods: Sixty patients with primary dysmenorrhea of cold congealing and blood stasis were randomly divided into an observation group (30 cases, 1 case dropped out) and a control group (30 cases, 2 cases dropped out). The control group received monkshood cake-separated moxibustion at Shenque (CV 8) and bilateral Zigong (EX-CA 1), while the observation group received Fu 's subcutaneous needling based on the control group. The muscles were palpated and the affected muscles were determined. Needles were inserted 5-10 cm away from the affected muscles and reperfusion activity was performed simultaneously. All the treatment started on the first day of menstrual cycle pain, once a day, for 3 days, totaling for 3 menstrual cycles. The visual analogue scale (VAS) score, Cox menstrual symptom scale (CMSS) score, and traditional Chinese medicine (TCM) syndrome score in the two groups were observed before treatment, after 2 treatment courses and after 3 treatment courses. The serum prostaglandin F2α(PGF2α) levels before and after 3 treatment courses were measured, and the clinical efficacy of the two groups was evaluated., Results: After 2 and 3 treatment courses, the VAS scores, CMSS scores, and TCM syndrome scores in the two groups were lower than those before treatment ( P <0.05), and the scores in the observation group were lower than those in the control group ( P <0.05). After 3 treatment courses, the PGF2α level in the observation group was decreased ( P <0.05), and were lower than that in the control group ( P <0.05). The total effective rate was 96.6% (28/29) in the observation group, which was higher than 64.3% (18/28) in the control group ( P <0.05)., Conclusion: Fu 's subcutaneous needling combined with monkshood cake-separated moxibustion could effectively reduce the pain intensity, improve clinical symptoms of dysmenorrhea, and lower PGF2α level in patients with primary dysmenorrhea of cold congealing and blood stasis.

Objective: To observe the skin surface microcirculation of acupoints of conception vessel, governor vessel and thoroughfare vessel in patients with primary dysmenorrhea using laser speckle contrast imaging (LSCI), and provide acupoint selection basis of acupuncture-moxibustion for primary dysmenorrhea., Methods: Ninety-nine healthy female college students with regular menstrual cycles (normal group) and 94 female college students with primary dysmenorrhea (dysmenorrhea group) were recruited. Before menstrual period, on the first day of menstruation, and on the third day after menstruation, LSCI was used to observe the surface microcirculation at the abdominal acupoints of conception vessel, i. e. Yinjiao (CV 7), Qihai (CV 6), Shimen (CV 5), Guanyuan (CV 4), Zhongji (CV 3) and Qugou (CV 2), acupoints of thoroughfare vessel, i. e. Huangshu (KI 16), Zhongzhu (KI 15), Siman (KI 14), Qixue (KI 13), Dahe (KI 12), Henggu (KI 11) and acupoints of lumbosacral region of governor vessel, i. e. Xuanshu (GV 5), Mingmen (GV 4), Yaoyangguan (GV 3), Yaoshu (GV 2) as well as two non-acupoints., Results: Before menstrual period, there was no significant difference in the surface blood perfusion of the acupoints between the dysmenorrhea group and the normal group ( P >0.05). On the first day of menstruation, the surface blood perfusion of Xuanshu (GV 5), Mingmen (GV 4), Yaoyangguan (GV 3) and right Huangshu (KI 16) in the dysmenorrhea group was higher than that in the normal group ( P <0.05, P <0.01). On the third day after menstruation, the surface blood perfusion of the right Henggu (KI 11) in the dysmenorrhea group was lower than that in the normal group ( P <0.05)., Conclusion: In patients with primary dysmenorrhea, on the first day of menstruation, the surface blood perfusion of Xuanshu (GV 5), Mingmen (GV 4), Yaoyangguan (GV 3) of governor vessel, and the right Huangshu (KI 16) of thoroughfare vessel is increased, while on the third day after menstruation, the surface blood perfusion of the right Henggu (KI 11) of thoroughfare vessel is decreased. These findings might provide a basis for acupoint selection in the acupuncture-moxibustion treatment of primary dysmenorrhea.

Objective: To investigate the effect of acupuncture on the brain functional activities of the patients with primary dysmenorrhea based on the resting-state functional magnetic resonance imaging (rs-fMRI), and to provide visual evidence for the central mechanism of acupuncture in treatment of primary dysmenorrhea., Methods: Forty-two patients of primary dysmenorrhea were enrolled and randomly divided into an observation group (21 cases, 1 case dropped off) and a control group (21 cases, 2 cases dropped off, 3 cases withdrawal). In the observation group, acupuncture was exerted at Sanyinjiao (SP 6) and Guanyuan (CV 4), started 5-7 days before menstrual flow, once a day till menstrual onset, for a total of 3 menstrual cycles. No intervention was applied in the control group. The scores of visual analogue scale (VAS) and Cox menstrual symptom scale (CMSS) were observed in both groups before and after treatment. Based on rs-fMRI, the data of resting-state functional magnetic resonance were collected from two groups before and after treatment. Combined with functional connectivity strength (FCS) and functional connectivity (FC) analysis, the differences of brain regions before and after treatment were compared between the two groups and the correlation was analyzed between their functional connectivity changes and the improvements in VAS and CMSS scores of the patients in the observation group., Results: In the observation group, the scores of VAS and CMSS were all decreased after treatment ( P <0.05), while the scores related to the symptom time in CMSS was reduced in comparison with that before treatment in the control group ( P <0.05). The score reducing ranges of VAS and CMSS in the observation group were larger than the control group ( P <0.05). Compared before treatment, FCS of the right middle cingulate cortex and the left cuneus was increased, while FCS of the left inferior parietal lobule was decreased after treatment in the observation group. In the control group, FCS of the left orbital frontal cortex was increased after treatment. Compared with the control group, FCS of the left anterior insula was increased in the observation group after treatment. FC analysis was performed using the left anterior insula as the seed point. In comparison with the control group, FC of the left anterior insula was increased either with the inferior temporal gyrus or with the right hippocampus; and was decreased either with the middle occipital lobe or with the right dorsolateral prefrontal cortex in the observation group after treatment. In the observation group, FC between the left anterior insula and the right hippocampus was positively correlated with the improvements in symptom severity ( r =0.385, P <0.05) and symptom time ( r =0.510, P <0.05) of CMSS, and FC between the right dorsolateral prefrontal cortex and the left anterior insula was negatively correlated with the improvement in symptom severity of CMSS after treatment ( r =-0.373, P <0.05)., Conclusion: The anterior insula may be the key brain region in treatment of primary dysmenorrhea with acupuncture. Acupuncture may relieve dysmenorrhea and the related symptoms through strengthening the functional connectivity of anterior insula-limbic system and anterior insula-control network.

Objective: To prove the therapeutic effect of auricular intradermal needling and auricular point sticking on primary dysmenorrhea (PD), and to explore its mechanism., Methods: A total of 90 patients with PD were randomized into an auricular intradermal needling group, an auricular point sticking group and a placebo group, 30 cases in each one. Neishengzhiqi (TF 2 ), Neifenmi (CO 18 ), Shenmen (TF 4 ), Shen (CO 10 ), Jiaogan (AH 6a ), Gan (CO 12 ) and Pizhixia (AT 4 ) were selected in the 3 groups, intradermal needling and cowherb seed sticking were applied respectively in the auricular intradermal needling group and the auricular point sticking group, adhesive tape without needle was stuck in the placebo group. Pressing and kneading for 3 to 4 times were required each day, 3 to 4 min each time, and the intervention was started 5 d before menstruation, once every other day, 4 times each menstrual cycle were as one course, and totally 3 courses were required in the 3 groups. The follow-up was adopted at the next menstruation after treatment. The Cox menstrual symptom scale (CMSS) score, the visual analogue scale (VAS) score and the self-rating anxiety scale (SAS) score before treatment, 1,2,3 courses into treatment and at follow-up were compared, the serum levels of PGF 2α and PGE 2 before and after treatment were detected, and the clinical therapeutic effect was evaluated in the 3 groups., Results: Compared before treatment, the scores of CMSS, VAS and SAS were decreased at each time point of treatment in the auricular intradermal needling group, 2, 3 courses into treatment and at follow-up in the auricular point sticking group and 3 courses into treatment in the placebo group ( P <0.001, P <0.05). Compared with the auricular point sticking group, the CMSS scores at each time point of treatment and the VAS scores of 1, 2 courses and at follow-up were decreased in the auricular intradermal needling group ( P <0.05). Compared with the placebo group, the CMSS scores were decreased at each time point of treatment in the auricular intradermal needling group and 3 courses into treatment and at follow-up in the auricular point sticking group ( P <0.001, P <0.05); the VAS scores were decreased at each time point of treatment in the auricular intradermal needling group and the auricular point sticking group ( P <0.001, P <0.05). After treatment, the serum levels of PGF 2α were decreased ( P <0.05) and the serum levels of PGE 2 were increased ( P <0.05) in the auricular intradermal needling group and the auricular point sticking group, and the serum levels of PGF 2α were lower than the placebo group ( P <0.05), the serum levels of PGE 2 were higher than the placebo group ( P <0.05) in the two groups. Compared with the auricular point sticking group, the serum level of PGF 2 was decreased ( P <0.05), the serum level of PGE 2α was increased in the auricular intradermal needling group ( P <0.05). The total effective rates were 93.3% (28/30) in the auricular intradermal needling group and 80.0% (24/30) in the auricular point sticking group, which were both superior to 63.3% (19/30) in the placebo group ( P <0.05)., Conclusion: Auricular intradermal needling and auricular point sticking can both improve the clinical symptom of primary dysmenorrhea, relieve the pain and anxiety, their mechanism may be related to regulating the serum levels of PGF 2α and PGE 2 . The therapeutic effect of auricular intradermal needling is superior to auricular point sticking, and the placebo effect can be preliminarily excluded.

Under the guidance of the theory and technique of arrival of qi of heat-sensitive moxibustion, the technical elements of umbilical refining of moxibustion proposed in The Guide to Medicine by LI Yan were analyzed. It is believed that the parameters of moxibustion temperature and time are the key points. The standard of "quantitative moxa" is established to achieve the appropriate moxibustion temperature and moxibustion time. The umbilical refining of heat-sensitive moxibustion is established to reappear the magic effect of LI Yan 's umbilical refining of moxibustion. The umbilical refining of heat-sensitive moxibustion is recommended for stomachache, diarrhea, constipation, dysmenorrhea, impotence, etc. with significant curative effect.

Objective: To observe the clinical effect of acupuncture by stages on secondary dysmenorrhea of adenomyosis through prospective case-series study., Methods: A total of 36 cases of adenomyosis patients with moderate-to-severe dysmenorrhea were treated with acupuncture by stages. The acupoints of Diji (SP 8), Sanyinjiao (SP 6), Ciliao (BL 32) and Shiqizhui (EX-B 8) were selected and acupuncture was given once a day during menstrual period; the acupoints of Guanyuan (CV 4), Zigong (EX-CA1), Sanyinjiao (SP 6) and Zusanli (ST 36) ect. were selected and acupuncture was given twice per week during non-menstrual period. All the treatment was given for three menstrual cycles. The visual analogue scale (VAS), Cox menstrual symptom scale (CMSS), Endometriosis Health Profile-5 (EHP-5) scores and the menstrual blood volume of pictorial blood loss assessment chart (PBAC) were observed before treatment and at the 1st, 2nd and 3rd menstrual cycle into treatment. Before treatment and at the 3rd menstrual cycle into treatment, the volume of uterus was measured by transvaginal ultrasound and the correlation among the quality of life, the severity of pain and symptoms was analyzed., Results: The VAS, CMSS and EHP-5 scores at the 1st, 2nd and 3rd menstrual cycle into treatment were lower than those before treatment ( P <0.01, P <0.05), and the PBAC scores were reduced but without statistical different ( P >0.05). Compared before treatment, at the 1st, 2nd and 3rd menstrual cycle into treatment, the PBAC scores were reduced in patients with PBAC>100 points ( P <0.01). Compared between 2nd and 1st menstrual cycle into treatment, between 3rd and 2nd menstrual cycle into treatment, the VAS, CMSS scores were all decreased ( P <0.01, P <0.05). There was a significant positive correlation between the severity score of CMSS and EHP-5 at the corresponding time points of the 1st, 2nd and 3rd menstrual cycle into treatment ( P <0.01)., Conclusion: The acupuncture by stages has significant analgesic effect in patients with secondary dysmenorrhea of adenomyosis, and has the advantages of relieving the menstruation-related symptoms, regulating menstrual blood volume and improving the quality of life.

Objective: To observe the clinical therapeutic effect of herb-separated moxibustion on dysmenorrhea in ovarian endometriosis., Methods: A total of 54 patients with ovarian endometriosis dysmenorrhea were randomized into a herb-separated moxibustion group and a waiting-list group, 27 cases in each one (3 cases dropped off in the herb-separated moxibustion group, 4 cases dropped off in the waiting-list group). Herb-separated moxibustion was applied at hypogastrium and lumbosacral area for 30 min in the herb-separated moxibustion group, once a week for 3 months, and oral ibuprofen sustained-release capsule was given to relieve pain when necessary. Excepting giving ibuprofen sustained-release capsule when necessary, no more intervention was adopted in the waiting-list group. Before and after treatment and in 3 months follow-up, visual analogue scale (VAS) score, days of dysmenorrhea, total dose of oral painkiller were observed., Results: Compared before treatment, the VAS scores after tratment and in follow-up were decreased in the herb-separated moxibustion group ( P <0.05), and were less than those in the waiting-list group ( P <0.05); the days of dysmenorrhea and the total doses of oral painkiller after tratment and in follow-up were decreased in the herb-separated moxibustion group ( P <0.05), and were less than those in the waiting-list group ( P <0.05)., Conclusion: Herb-separated moxibustion can effectively improve dysmenorrhea symptom and shorten dysmenorrhea days in patients with ovarian endometriosis.

Evidence - based Clinical Practice Guideline of Acupuncture and Moxibustion for Primary Dysmenorrhea ( Guideline ) is clarified from three aspects: the development method, contents and clinical application, which could provide clinical practical strategies suitable for most patients for clinicians. Based on comprehensive literature search and summary of acupuncture practice, the best clinical research evidence is obtained according to the evidence-based method, the evidence-quality evaluation and recommendation grading are introduced. With ancient literature, famous experts' experience and expert consensus, the recommendations of acupuncture-moxibustion for primary dysmenorrhea are developed, which are safe, effective and applicable for clinical treatment. The Guideline could standardize the acupuncture treatment plan for primary dysmenorrhea.

The clinical experience of professor ZUO Chang-bo in treatment of dysmenorrhea with "three-regulation and one-harmonization" therapy of acupuncture was introduced. Professor ZUO Chang-bo invented a needling technique for "three-regulation and one-harmonization", meaning qi regulation, blood regulation and regulation of meridian tendon region as well as the spirit ( shen ) harmonization. In qi regulation, the extreme fine needles are used to regulate qi movement of the whole function with the coordination of respiration and the corresponding acupoint prescriptions. In blood regulation, the special small bleeding device is selected and the bloodletting theory is improved for bloodletting at the specific stagnant site. In the regulation of meridian tendon region, a special sterile injection needle is chosen to release the cord-like mass. The spirit harmonization is exerted in combination with qi regulation. During acupuncture, the spirit of both the clinical practitioner and the patient should be in a harmonized spirit condition, coordinated with respiration regulation. In the treatment with acupuncture therapy of "three-regulation and one-harmonization" for dysmenorrhea, bloodletting therapy is used firstly to remove stasis, secondly, the "releasing cord-like mass" technique is followed to regulate meridian tendon region, finally, the fine needling technique is adopted to regulate qi and harmonize spirit. The clinical effect is definite in clinical practice.

Objective: To explore the clinical effects on primary dysmenorrhea treated with moxibustion at Shenque (CV 8) and warm needling at Guanyuan (CV 4) and Sanyinjiao (SP 6)., Methods: A total of 120 patients with primary dysmenorrhea were randomized into an observation group and a control group, 60 cases in each one. In the control group, the warm needling technique was used at Guanyuan (CV 4) and Sanyinjiao (SP 6). In the observation group, besides the same treatment as the control group, moxibustion was added at Shenque (CV 8). The treatment was given for 4 menstrual cycles consecutively. Before and after treatment, the score of the severity and the score of the total frequency in the retrospective scale of dysmenorrhea symptoms as well as the score of the visual analog scale (VAS) were recorded and compared in the patients between the two groups. Additionally, the safety of the two therapeutic methods was evaluated., Results: After treatment, the score of severity and the score of total frequency as well as VAS score of menstrual pain were all reduced as compared with those before treatment in the patients of the two groups (all P <0.05). The scores in the observation group were more obvious as compared with the control group (all P <0.05). Regarding the safety evaluation, the difference was not significant between the two groups ( P >0.05)., Conclusion: The combined treatment of moxibustion at Shenque (CV 8) with the warm needling technique at Guanyuan (CV 4) and Sanyinjiao (SP 6) achieves the better clinical effects on primary dysmenorrhea as compared with the simple application of the warm needling technique at Guanyuan (CV 4) and Sanyinjiao (SP 6). This therapy is safety in clinical practice.

The"categorization by analogy"is one of the most primitive thinking methods for ancient people to explore the world, which has exerted far-reaching impact on the origin and development of TCM. With examples of Sanjian (LI 3) for neck pain, Chize (LU 5) for low back pain and Chengshan (BL 57) for dysmenorrhea, the clinical application of"categorization by analogy"in acupuncture for pain syndromes was discussed, hoping more acupuncturists will pay attention to the guiding role of"categorization by analogy"in acupuncture clinical treatment.

To discuss the acupuncture and moxibustion thoughts of diagnosis and treatment for secondary dysmenorrhea of adenomyosis on the basis of disease location and pathogenesis. In clinic, we take the "principle, method, prescription, acupoint and technic" as the outline, paying attention to identify disease location and establishing the method of "promoting blood to remove stasis, regulating thoroughfare vessel and conception vessel" on the basis of the pathogenesis of "stasis obstructing uterus, disharmony of thoroughfare vessel and conception vessel". The prescription combines "dredging" with "conditioning", and the emphasis should be different in different periods. In menstrual period, we put emphasis on activating the circulation of qi and blood as well as clearing meridians to relieve pain and choose the acupoints on the spleen meridian of foot- taiyin and experimental points, such as Diji (SP 8), Sanyinjiao (SP 6), Ciliao (BL 32), Shiqizhui (EX-B 8). In the intermenstrual period, we regulate the qi and blood of thoroughfare vessel and conception vessel, and the function of viscera. The acupoints for the disease root are mainly at spleen meridian of foot- taiyin and conception vessel, such as Sanyinjiao (SP 6), Guanyuan (CV 4), Zigong (EX-CA 1), Zusanli (ST 36). And the reinforcing and reducing technic are applied accordingly.

The paper is a systematic review on the efficacy of acupuncture manipulation on primary dysmenorrhea. Ten medical literatures database at home and abroad were retrieved, including CNKI, VIP, CBM, WANFANG, MEDLINE, Cochrane, CENTRAL, CINAHL PLUS, EMBASE, AMED and PsycINFO, as well as 6 clinical trial registration platforms. All of randomized controlled trials (RCTs) on primary dysmenorrhea treated with different acupuncture manipulations were collected. The data were extracted by two persons. Finally, RevMa 5.3 software was used for statistical analysis. Totally, 5 148 pieces of literature were retrieved and 8 pieces on RCTs were screened with 644 cases included. According to the results of statistical analysis on the total effective rate and other indicators of pain degree, it was showed that the effects of the manipulation with filiform needle, deep puncture with strong stimulation, and specific reinforcing and reducing needling technique were better than those without manipulation applied or with shallow puncture and weak stimulation and even needling technique in the treatment of primary dysmenorrhea. It is believed initially that acupuncture manipulation contributes to the improvement of the therapeutic effects of primary dysmenorrheal, but much higher quality studies are required for the further confirmation. Protocol registration number:PROSPERO:CRD42016038515.

The effects of deqi (arrival of qi ) on acupoint effects in patients with primary dysmenorrhea (PD) were evaluated.Ten literature databases,including China National Knowledge Infrastructure (CNKI),VIP Database,Wanfang Database,Chinese Biomedical Literature Database (CBM),Cochrane Library CENTRAL,MEDLINE,Embase,AMED, CINAHL Plus,PsycINFO were selected.In addition,5 registers of ongoing trials,the reference lists of included articles and grey literature website OpenGrey were added.The search time was from date of database establishment to August 2016;no restrictions were made on language or status of publication.All randomized controlled trials (RCTs) and quasi-randomized controlled trials (q-RCTs) which compared the effects of deqi and non- deqi on PD or compared the effects of different deqi elements on PD were included.The research quality was assessed according to Cochrane bias risk evaluation tool 5.1.0.The RevMan 5.3.5 was applied for quantitative analysis if insignificant clinical heterogenicity with I 2 ≤ 75%,otherwise the results was summarized by qualitative analysis.As a result,6 RCTs involving 645 patients were included.Because of considerable clinical heterogeneity,only qualitative analysis was performed,which indicated ① acupuncture could reduce pain and anxiety regardless of deqi ,and the effects of deqi on pain relief were superior or equivalent to that of none- deqi ,and the effects of deqi on anxiety relief were similar to that of none- deqi ;② the more intensity of deqi and higher number of acupoints selected,the better effects on pain alleviation,symptom relief and pain duration;③ the higher rate of deqi had a better acupoint effect on alleviating anxiety,but was not on pain relief;④ deqi appeared early and propagated to affected area could lead to faster onset on pain relief;⑤ the effects on relieving pain and symptoms was better when warm sensation in deqi or qi reaching affected area.Due to the few number,low quality and potential bias of included studies,it was not sufficient to draw clear conclusion regarding the effects of deqi on PD patients.This study protocol was registered in PROSPERO (CRD42016038518).

Objective: To analyze the relationship between deqi and effect by data mining technique with retrieving clinical literature about acupuncture deqi since the founding of the country., Methods: The modern computerization and data mining technologies were adopted to set up clinical literature about acupuncture deqi database. The relevant clinical literature was collected, screened, extracted, and statistical and correlation analyses were used so as to explore the relationship between deqi and effect., Results: 82.1% (46/56) of the studies considered that deqi was related to the effect; 17.9% (10/56) of the studies considered that deqi was unrelated to the effect. The support of deqi related to the effect is 100% on dysmenorrhea and facial paralysis. 72% (18/25) of the the articles of pain syndrome considered that deqi was related to the effect; 28% (7/25)of the studies considered that deqi was unrelated to the effect. In the research of the relationship between the features of deqi and effect, 60.7% of the studies suggested that the sense of conduction was positively correlated with the effect. There were 21 studies on the relationship between the intensity of deqi and effect, involving a variety of diseases, which was related to the type of the disease. 58.3% (7/12) of the articles on dysmenorrhea and 63% (34/54) on pain syndrome supported conduction positively correlated to effect, showing the highest frequencies. 50% (3/6) of the papers on facial paralysis supported weak deqi sensation positively correlated to effect, which was the highest frequency., Conclusions: Most studies considered that deqi can improve clinical efficacy. The relationship between different features of deqi and effect is closely related to the disease. Further study may focus on high quality research on the relationship between deqi and the obvious effect achieved by acupuncture so as to summarize the law of deqi .

Objective: To observe the effect difference between drug-spreading moxibustion and the oral administration of meloxicam for primary dysmenorrheal with cold stagnation and to explore its mechanism., Methods: A total of 101 patients with primary dysmenorrheal were randomly assigned into a drug-moxibustion group(52 cases) and a western medication group(49 cases). Drug-spreading moxibustion was used on the lumbosacral acupoints area and then around lower abdominal five days before menstruation until the 3rd day of menstruation,once three days,while western medicine meloxicam was prescribed one day before menstruation,7.5 mg at a time,once a day and continuously for three days. The clinical effects after one course,namely three menstrual cycles,were compared between the two groups. Meanwhile,the resistance index(RI) and the pulsatility index (PI) of uterine artery and arcus arteriarum were examined through color Doppler ultrasound before and after treatment., Results: After one-course treatment,the effective rate was 92.3%(48/52) in the drug-spreading moxibustion group,which was better than 67.3%(33/49) in the western medication group( P <0.05). Also,all the RI and PI in the drug-spreading moxibustion group were obviously decreased than those before treatment(all P <0.05),and the ones were superior to those of the western medication group(all P <0.05),which showed no apparent decrease after treatment(all P >0.05)., Conclusions: Drug-spreading moxibustion can improve the symptoms of primary dysmenorrheal with cold-damp stagnation,and the effect is better than that of meloxicam. The mechanism may be related to improve the blood supply to the uterus.

For the treatment of primary dysmenorrhea, professor ZHAO Jiping focuses on meridian diagnosis and inspection, and uses pressing methods to locate the response points along the meridian, including acupoints and aishi points. During the stage of attack, it is essential to press along the spleen meridian, mainly Sanyinjiao (SP 6), Diji (SP 8) and Yinlingquan (SP 9); during the stage of remission, it is essential to press along the bladder meridian and stomach meridian, mainly Ganshu (BL 18), Pishu (BL 20), Weishu (BL 21), Shenshu (BL 23) and Zusanli (ST 36). The differences between deficiency syndrome and excess syndrome lead to the different feelings of doctors and patients. Combined with the results of meridian diagnosis and inspection, the aim of treatment can be achieved by different acupuncture methods. Professor ZHAO pays attention to the treatment of accompanied symptoms and timing of treatment, since the relief of accompanied syndromes and selection of timing are keys to relieving patient's pain.

By using data mining technology, the characteristics of acupoints selection of modern moxibustion for primary dysmenorrhea (PD) were analyzed. The modern literature regarding moxibustion for PDl was coll6cted~ from a comprehensive retrieval in Chinese Biomedical Medicine (CBM), China National Knowledge Infrastructure (CNKI), VIP and PubMed. The prescription database of moxihustion was established, and the association rule4 method of data mining technology was adopted to analyze characteristics and rules of acupoints selection of modern moxibustion for PD. As a result, a total of 35 acupoints were involved with a total frequency of 399. The acupoints, with higher selected frequency included Guanyuan (CV 4, 90 times), Sanyinjiao (SP 6, 47 times), Shenque (CV 8, 43 times), Zhongji (CV 3, 3 times) and Qihai (CV 6, 28 tirmes); the ratio of yin-meridian acupoints to1 yang-meridian acupoints was approximately 341; the utilization of the specific acupoints accountedfor68. 6% (24/35); the crossing acupoints were used mostly (203 "times), featured with high acupoints selected, especially Guanyuan (CV 4), Sanyinjiao CSP 6) and Zhongji (CV 3); the front-mu points (130 times), he-sa points (19 times) and lower he-sea points (18 times) were frequently used. The results reveal thiat acupoints selection of moxibustion of PD focuses on the local acupoints and comnbination with the distal acupoints. The yin-meridian acupoints are preferred and the specific acupoints are the main part of the prescription. This conclusion can also be used to optimize the choosing of acupoints in clinic.

Objective: To observe the difference in the analgesic effect on primary dysmenorrheal between acupuncture and sham acupuncture at Sanyinjiao (SP 6) during menstrual pain and evaluate the impact of psychological effect on acupuncture analgesia., Methods: Sixty subjects were randomized into an acupuncture group and a sham acupuncture group, 30 cases in each one. The conventional acupuncture and sham acupuncture were applied to Sanyinjiao (SP 6) on bilateral sides when menstrual pain began to attack and needles were retained for 30 min each time. Three menstrual cycles were required. The visual analogue scale (VAS) was adopted to determine the scores before and 0. 5 h, 1 h, 3 h, 6 h and 12 h after acupuncture during menstrual pain in each cycle separately., Results: In the acupuncture group, VAS score at each time point after acupuncture was reduced as compared with that at the previous one during menstrual pain in each menstrual cycle, indicating the significant difference (all P<0. 05). In the sham acupuncture group, the scores in 6 h and 12 h of acupuncture were reduced as compared with the previous one, indicating the significant difference (all P<0. 05). After acupuncture, VAS score at each time point in the acupuncture group was lower than that in the sham acupuncture group (all P<0. 05)., Conclusion: The conventional acupuncture at Sanyinjiao (SP 6) achieves the significant analgesic effect on primary dysmenorrheal. The psychological placebo effect of sham acupuncture has no obvious impact on acupuncture analgesia.

Objective: To explore the efficacy and the reproductive endocrinal mechanism of herbal-partitioned moxibustion in the treatment of primary dysmenorrhea., Methods: One hundred and seventy-one cases of primary dysmenorrhea were randomized into an herbal-partitioned moxibustion group (group A), an starch-partitioned moxibustion group (group B) and an acupuncture group (group C), 57 cases in each one. In the group A, moxibustion isolated with herbal medicine was applied to Shenque (CV 8). In the group B, moxibustion isolated with starch was used at Shenque (CV 8). In the group C, acupuncture was given at Sanyinjiao (SP 6). The changes of estradiol (E2), progesterone (P) and prostaglandin levels (PGF2alpha) were observed before and after treatment, and the therapeutic effects were compared among the 3 groups., Results: The therapeutic effect in the group A was better than those in the other two groups [compared the cured rate: 89.8% (44/49) vs 60.0% (30/50), 60.4% (32/53), both P < 0.05]. In the group A, E2 level [(110.99 +/- 12.90) pg/mL vs (83.94 +/- 8.91) pg/mL, P < 0.05] and PGF2alpha level [(24.58 +/- 3.01) pg/mL vs (14.34 +/- 1.48) pg/mL, P < 0.01] were decreased and P level was increased [(4.65 +/- 0.68) ng/mL vs (6.68 +/- 0.95) pg/mL, P < 0.05]. In the group B and C, PGF2alpha level were reduced. Concerning to the regulating of E2 and PGF2alpha levels, the results in the group A were better than those in the group B and C [(-30.16 +/- 10.20) pg/mL vs (10.79 +/- 15.01) pg/mL, (22.81 +/- 12.22) pg/mL; (-13.10 +/- 2.40) pg/mL vs (-6.52 +/- 1.88) pg/mL, (-3.14 +/- 1.19) pg/mL, (see text) P < 0.05]. Concerning to the regulation of P level, the results in the group A and B were better than that in the group C (all P < 0.05)., Conclusion: The herbal-partitioned moxibustion achieves the significant efficacy on primary dysmenorrhea, which could be related to regulating the reproductive endocrinal level. It decreases E2 and PGF2alpha levels and increases P level.

Objective: To observe the short-term and long-term efficacies on primary dysmenorrhea treated with staging acupoint embedment therapy., Methods: Seventy cases of primary dysmenorrhea were randomized into an embedment therapy group and a fenbid group, 35 cases in each one. In the embedment therapy group, the embedment therapy was applied twice during the menstrual cycle, one treatment 3 days before menstruation and one treatment during the 12th-14th days of menstruation, respectively. Guanyuan (CV 4), Zigong (EX-CA 1), Diji (SP 8) and Ciliao (BL 32) were the main acupoints in the treatment 3 days before menstruation. Shenshu (BL 23), Ganshu (BL 18) and Pishu (BL 20) were the main acupoints in the treatment during menstruation. In the fenbid group, fenbid was prescribed for oral administration, 0.3 g each time, twice a day, starting 3 days before menstruation till pain was relieved. The treatment of one menstrual cycle was one session. The continuous treatment of 3 menstrual cycles was required. The short-term and long-term efficacies were evaluated at the end of the 3rd cycle and in 3 months after the treatment terminal. The dysmenorrhea score was used to evaluate the efficacy. Visual analogue scale (VAS) and SF-36 were for the assessment of pain degree and life quality., Results: (1) The total effective rate was 91.4% (32/35) in the embedment therapy group after the 3 menstrual cycles, which was better than 74.3% (26/35) in the fenbid group (P < 0.01). In the follow-up stage, the total effective rate was 91.4% (32/35) in the embedment therapy group, which was better than 40.0% (14/35) in the fenbid group (P < 0.01). (2) The differences were not significant in dysmenorrhea score and VAS score after the 1st and 2nd menstrual cycle treatments between the two groups (all P > 0.05). In the 3rd menstrual cycle and the follow-up stage, the dysmenorrhea score and VAS score were reduced obviously in the embedment therapy group as compared with those in the fenbid group (P < 0.05, P < 0.01). The rebound effect occurred in the follow-up stage in the fenbid group. (3) In the 3rd menstrual cycle and the follow-up stage, the improvement in the total score of life quality of the embedment therapy group was superior apparently to the fenbid group (P < 0.05, P < 0. 01)., Conclusion: The staging acupoint embedment therapy achieves the superior short-term and long-term efficacies as compared with the oral administration of fenbid in the treatment of primary dysmenorrhea. As the symptoms of dysmenorrhea and pain are relieved, the life quality is improved.

Objective: To observe the clinical analgesic efficacy and the relation between clinical analgesic effect and duration of effect of two acupuncture methods of Longhu Jiaozhan (fight of dragon and tiger, an acupuncture reinforcing and reducing manipulation characterized with nine counterclockwise and six clockwise rotations) and even manipulations., Methods: Sixty-two patients with primary dysmenorrhea were randomly divided into an observation group (32 cases) and a control group (30 cases). The observation group was applied with Longhu Jiaozhan manipulation, while the control group was applied with even manipulation. Acupuncture treatment was given on both of the groups since onset of the pain. The score of the visual analogue scale (VAS) of the 2 groups was observed at different times. And 8 VAS values were recorded at the point right before acupuncture, needle remaining of 5 min, 10 min, 20 min and 30 min as well as and 30 min, 60 min, 120 min after needle withdrawal. Comparison was made on differences between the 2 groups., Results: Comparison with the same group before acupuncture showed that the VAS difference of the time from needling remaining of 5 min to 120 min after acupuncture were all with statistic significance (all P<0. 01). The score of VAS of needle remaining for 20 min and 30 min of the observation group was without significant difference (P>0. 05). The score of VAS value of needle remaining for 20 min and 30 min of the control group was with significant difference (P<0. 01). Comparison of the VAS scores before the treatment and the scores of the 2nd menstrual cycle were found with significant difference (P<0. 01). The VAS score of 2nd menstrual cycle was (28. 73 +/- 16. 15) in the observation group, which was better than (46. 93+/-12. 18) in the control group (P<0. 001). Comparison of the VAS score of the two groups at 5 min r emaining of the needle was without statistic significance between two groups (P>0. 05). However, the VAS impairment magnitude difference at that moment was with statistic significance (P<0.01). From the time of needle remaining for 10 min, 20 min, 30 min until 120 min after needling, the differences of the VAS scores and impairment range were all with statistic significance (all P<0. 01). The effects of the two acupuncture techniques could both be maintained up to 2 hours after needling., Conclusion: Both methods of acupuncture have immediate and long-term analgesic effect in a certain degree on primary dysmenorrhea. However, compared with the control group, the advantage of analgesic effect in the observation group is significantly superior. 20 min needling remaining can reach the best analgesic effect.

Objective: To compare efficacy difference among wrist-ankle needle, body-acupuncture and ibuprofen in the treatment of primary dysmenorrhea., Methods: Ninety-five cases were randomly divided into a wrist-ankle needle group (32 cases), a body-acupuncture group (31 cases) and an ibuprofen group (32 cases). Acupunc- , ture at Lower 1 and Lower 2 area was applied in the wrist-ankle needle group. Acupuncture at Guanyuan (CV 4) and Sanyinjiao (SP 6) were applied in the body-acupuncture group. Ibuprofen sustained-release capsules were given for oral administration in the ibuprofen group. The treatment began 3 days before menses, once a day, until pain was relieved. One menstrual cycle was taken as a treatment course, continuously for 3 courses and efficacy were observed in three groups. The symptom score of dysmenorrhea and visual analogue scale (VAS) were used to assess pain severity before and after treatment., Results: 1The efficacy differences in three groups were statistically significant (P<0.01), in which the total effective rate was 90. 0% (27/30) in the wrist-ankle needle group, 73.4% (22/30) in the body-acupuncture group and 46. 7% (14/30) in the ibuprofen group. 2 After the treatment, symptom score of dysmenorrhea and VAS were all obviously lower than that before the treatment in three groups (all P<0.01). Compared with ibuprofen group (7.12+/-2.70), after the treatment symptom score of dysmenorrhea in the wrist-ankle needle group (4.00+/-3.40) and body-acupuncture group (5. 53+/-2. 80) was obviously decreased (P<0.01, P<0.05), and VAS in the wrist-ankle needle group was significantly reduced (P<0.05). Compared with body-acupuncture group (5. 53+/-2.80), symptom score of dysmenorrhea in the wrist-ankle needle group (4.00+/- 3. 40) was obviously decreased (P<0. 05)., Conclusion: The wrist-ankle needle has better effect than body acupuncture and ibuprofen on the treatment of primary dysmenorrhea, which could significantly improve dysmenorrhea symptoms.

Based on the retrieval of literatures at home and abroad from 2000 to 2011, the evaluation indices of acupuncture clinical trials for primary dysmenorrhea (PD) were analyzed. The results indicated that in domestic area the reports were more concerned with the improvement of clinical symptoms and signs while paid less attention on the objective evaluation methodology, on the other hand, the studies abroad generally took many kinds of scales as their evaluation indices and focused on the patients' quality and activity of daily life. The authors suggeste that our clinical research, according to the designed intentions, should combine the general indicators with the specific indicators of diseases to have a more comprehensive evaluation on the effects of acupuncture for PD in clinical practice.

Objective: To observe the clinical curative effect of primary dysmenorrhea and the content of prostaglandin F2alpha (PGF2alpha) in peripheral blood of menstrual periods treated with eye acupuncture therapy., Methods: One hundred and ten cases of primary dysmenorrhea were randomly divided into an eye acupuncture group (60 cases) and a medication group (50 cases). In eye acupuncture group, low energizer area, liver area, kidney area, heart area and spleen area etc. were selected according to the differentiation, and the eye acupuncture therapy was applied. In medication group, Ibuprofen Sustained Release Capsules was taken with oral administration for 300 mg 1-2 days before menses coming or when the symptoms appeared, once every 12 hours, for 3-5 days totally. Three menstrual periods made one session. The content of PGF2alpha in peripheral blood, and the curative effects and recurrence 3 and 6 months after treatment were observed., Results: After 3 months treatment, compared with the curative effects between both groups, the cured rate was 55.0% (33/60) and the total effective rate was 95.0% (57/60) in eye acupuncture group, which were superior to those of 34.0% (17/50) and 82.0% (41/50) in medication group (both P < 0.05). According to the following-up after 6 menstrual periods, the recurrence rate was 9.1% (3/33), inferior to that of 35.3% (6/11) in medication group. The contents of PGF2alpha in peripheral blood of menstrual periods were all reduced after treatment in two groups (both P < 0.01)., Conclusion: The curative effect of primary dysmenorrhea treated with eye acupuncture is favorable, and the lever of PGF2alpha in peripheral blood of menstrual periods is reduced.

Objective: To explore the relationship between psychological factors and efficacy of acupuncture on primary dysmenorrhea., Methods: Sixty cases of primary dysmenorrhea were observed. Before acupuncture treatment, the self-designed confidence questionnaire was used to assess patients' confidence in acupuncture efficacy. Visual Analogue Scale (VAS) was adopted to assess patients' tension level during acupuncture. Self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were applied to assess the situations of patients' anxiety and depression. Eysenck's personality questionnaire (EPQ) and Cattell sixteen personality factors questionnaire (16PF) were provided to assess the personal characters of patients. Pain intensity, pain duration and accompanied symptoms were recorded before and after acupuncture treatment so as to assess the efficacy. Canonical correlation analysis was used to analyze the relationship between the psychological factors and acupuncture efficacy on primary dysmenorrhea., Results: There were significant differences in grading of dysmenorrhea, pain intensity score and pain duration after treatment as compared statistically with those before treatment (all P<0.001). The standardized coefficients of dominance (r=0.6797) and anxiety (r=-0.5906) in personality factors and the reduction of pain duration (r=0.9042) among efficacy indices were the highest. The overall correlation coefficients were all lower between the indices of psychological factors and canonical variables of dysmenorrhea efficacy., Conclusion: Acupuncture efficacy on primary dysmenorrhea has a certain correlation with dominance and anxiety of patients' personality factors. But, the psychological factors do not play a leading role in acupuncture treatment.

Objective: To compare the time-effect rule of pain-relieving in moderate dysmenorrhea in the treatment between acupuncture on single-point and acupuncture on multi-point so as to determine the best time of needle retaining on single-point and multi-point as well as provide the reference evidences of acupuncture frequency in the treatment., Methods: Sixty-three cases of moderate dysmenorrhea were randomized into a single-point group (31 cases) and a multi-point group (32 cases). During the attack of dysmenorrhea, in single-point group, Shiqizhui (EX-B 8) was punctured; in multi-point group, Shiqizhui (EX-B 8), Diji (SP 8), Ciliao (BL 32) and Sanyinjiao (SP 6) were punctured and the needles were retained for 30 min. Visual Analogue Scale (VAS) values were recorded in the immediate time before acupuncture, in 5 min, 10 min, 20 min and 30 min after needle insertion, as well as in 30 min, 60 min and 120 min after needle withdrawal separately., Results: After needling, analgesia was generated rapidly in either group. During 30 min of needle retaining, analgesia was enhanced persistently till needle withdrawal in either group. In 10 min after needle insertion, the immediate analgesia in multi-point group was superior obviously to single-point group (P < 0.05) and this effect was maintained in 2 h after needle withdrawal. In 30 min after needle withdrawal, acupuncture analgesia was declined to the maximum., Conclusion: Either single-point acupuncture at Shiqizhui (EX-B 8) or multi-point acupuncture at Shiqizhui (EX-B 8) and other acupoints has apparent immediate analgesia on primary dysmenorrhea of moderate degree, but the effect of multi-point acupuncture is better than that of acupuncture at Shiqizhui (EX-B 8). No matter with acupuncture at Shiqizhui (EX-B 8) or at multi-point, the time of needle retaining should not be shorten than 30 min. It is suitable to give acupuncture, twice per day for the patients with moderate and persistent pain.

Objective: To compare the different therapeutic effect between acupuncture at Shiqizhui (EX-B 8) only and multi acupoints on dysmenorrhea., Methods: Thirty eight cases were randomly divided into a single acupoint group and a multi-acupoints group, 19 cases in each group. The single acupoint group was treated by acupuncture at Shiqizhui (EX-B 8) only, and the multi-acupoints group by acupuncture at Shiqizhui (EX-B 8), Sanyinjiao (SP 6), Diji (SP 8), Ciliao (BL 32). They were all treated from the first day when sudden intense pain occurs, one time each day, for 3 days in each menstrual cycle, the treatment of three menstrual cycles. The therapeutic effect and Visual Analogue Scale (VAS) were compared and the score of general frequency and severity of dysmenorrhea by using Cox Menstrual Symptom Scale (CMSS) were evaluated., Results: The cured rate was 68.4% (13/19) and the effective rate was 31.6% (6/19) in the single acupoint group, being similar to 78.9% (15/19) and 21.1% (4/19) in the multi-acupoints group (P > 0.05). VAS and the scores of general frequency and severity of dysmenorrhea were all significantly decreased after treatment in both groups (all P < 0.001), with no significant difference between the two groups (all P > 0.05)., Conclusion: Acupuncture at Shiqizhui (EX-B 8) only can be as effective as selecting multi-acupoints to cure essential dysmenorrhea.

Objective: To explore the best treatment opportunity of acupuncture at Shiqizhui (Extra) for treating primary dysmenorrhea., Methods: Eighty cases with primary dysmenorrhea were randomly divided into an acupuncture at Shiqizhui (Extra) in the premenstrual period group (group A, n = 20), an acupuncture at Shiqizhui (Extra) when pain occurs group (group B, n = 20) and a blank group (group C, n = 40). Both of acupuncture groups were treated and followed up for 3 consecutive menstrual cycles, respectively. The therapeutic effects were compared by use of the Cox Menstrual Symptom Scale (CMSS)., Results: There were no significant differences in CMSS between the two acupuncture groups during each course and the follow-up period (all P > 0.05), but the CMSS in the two acupuncture groups were all obviously lower than those in the blank group during the same period (P < 0.05, P < 0.01)., Conclusion: Acupuncture at Shiqizhui (Extra) has certain therapeutic effect on primary dysmenorrhea either in the premenstrual period or when pain occurs and there is no significant difference in acupuncture at different time.

Objective: To compare the effects of instant electroacupuncture (EA) at the different acupoints on IP3 in the uterus tissue of dysmenorrhea model rats so as to investigate the specificity of acupoints., Methods: Fifty female SD rats were randomly divided into a saline group, a model group, a Sanyinjiao (SF 6) group, a Xuehai (SP 10) group and a Hegu (LI 4) group, 10 rats in each group. The rats were given subcutaneous injection of Estradiol Beozoate injection for 10 consecutive days except those in the saline group, and intraperitoneal injection of 2U Oxytocin at 1 h after the last administration to create the dysmenorrhea rats model, and the saline group was given the same dose of saline every day. On the 10th day the rats in each EA group were given EA 20 min, and the rats in the saline group and model group were bound 20 min, and the writhing response was observed at the same time. The uterine IP3 contents were detected with enzyme-linked immunosorbent assay method., Results: (1) Compared with (0.311+/- 0.253) in the saline group, the writhing scores per minute of (5.867 +/- 3.442) in the model group and (2.311 +/- 0.957) in the Xuehai (SP 10) group were both increased significantly (P < 0.01, P < 0.05), and (1.833 +/- 1.355) in the Sanyinjiao (SP 6) group and (0.743 +/- 0.306) in the Hegu (LI 4) group showed no significant differences (P > 0.05). Compared with that in the model group, the writhing scores per minute decreased significantly (all P < 0.01) in all the EA groups, with no significant differences among all the EA groups (all P > 0.05). (2) Compared with (2.698 +/- 1.491) ng/mg in the saline group, IP3 contents of the uterus of (0.813 +/- 0.899) ng/mg in the model group, (1.740 +/- 0.375) ng/mg in the Sanyinjiao (SP 6) group and (0.692 +/- 0.212) ng/mg in the Hegu (LI 4) group were all lower significantly (P < 0.05, P < 0.01), and (0.743+/- 0.306) ng/mg in the Xuehai (SP 10) group showed no significant differences (P > 0.05). Compared with that in the model group, IP3 content of the uterus in the Hegu (LI 4) group showed no significant difference (P > 0.05), and those in the Sanyinjiao (SP 6) group and in the Xuehai (SP 10) group increased significantly (both P < 0 05), which were significantly higher than that in the Hegu (II 4) group (P < 0.05, P < 0.01)., Conclusion: There are no significant differences among the instant EA groups in improving the dysmenorrhea symptoms, but there is obvious specificity of acupoint effects in the regulation of IP3. Electroacupuncture at "Sanyinjiao (SP 6) " Xuehai (SP 10)" has more marked effect in dysmenorrhea model rats.

Objective: To observe the clinical therapeutic effect of acupuncture combined with acupoint sticking therapy for treatment of dysmenorrhea caused by endometriosis, and to probe into the best therapy for this kind of disease., Methods: Seventy-three cases of dysmenorrhea caused by endometriosis were randomly divided into an acupuncture combined with acupoint sticking therapy group (observation group) and a medication group (control group). The observation group (36 cases) was treated with acupuncture combined with acupoint sticking therapy, Zhongji (CV 3), Guanyuan (CV 4), Zigong (EX-CA 1) etc. were selected; the control group (37 cases) was treated with oral administration of Jiawei Mojie tablet. The clinical effects, pain scores, onset time of producing analgesic and duration of both groups were observed before and after treatment., Results: The short term total effective rate of 91.2% (31/34) in observation group was better than that of 83.3% (30/36) in control group (P < 0.05); the long term total effective rates were 97.1% (33/34) and 69.4% (25/36) in observation group and control group respectively, with significant difference between two groups (P < 0. 05). The pain scores of both groups were decreased after treatment, and the improvement degree was more significant in observation group (P<0. 01); the onset time in observation group was shorter than that in control group (P<0. 05), the duration of effect in observation group was longer, and with a stable effect., Conclusion: The therapeutic effect of acupuncture combined with acupoint sticking therapy is very significant for dysmenorrhea caused by endometriosis, and it is a good therapy for this kind of disease.

Objective: To observe the clinical efficacy on primary dysmenorrhea treated with isolated herbal moxibustion on Shenque (CV 8)., Methods: One hundred and two cases were randomized into isolated herbal moxibustion group and western medication group, 51 cases in each one. In isolated herbal moxibustion group, the cases were treated with isolated herbal moxibustion on Shenque (CV 8), and in western medication group, analgesic was administered., Results: In isolated herbal moxibustion group, 17 cases were cured, 21 cases effective markedly, 9 cases effective and 4 cases failed. The total effective rate was 92.2%. In western medication group, 7 cases were cured, 11 cases effective markedly, 21 cases effective and 12 cases failed. The total effective rate was 76.5%. The comparison of the total effective rates between two groups indicated significant difference in statistics (P < 0.01), in which, the result in isolated herbal moxibustion group was superior to that in western medication group. In comparison of dysmenorrhea score before and after treatment and side effects of two groups, the significant differences presented in statistics, in which, the results in isolated herbal moxibustion group were superior to those in western medication group (all P < 0.01)., Conclusion: The isolated herbal moxibustion on Shenque (CV 8) is superior to oral medication of analgesic for primary dysmenorrhea and it deserves to be promoted due to its advantages on safety, less side effect and good compliance of patients.

Objective: To observe and compare the analgesic effect of electroacupuncture (EA) at "Sanyinjiso" (SP 6), "Hegu" (LI 4) and "Xuehai" (SP 10) in dysmenorrhea rats so as to investigate the functional specificity of acupoint., Methods: One hundred SD female rats aged three-month-old in the diestrus examined by the vaginal smear screening were randomly divided into a saline group, a model group, a Sanyinjiao (SF 6) group, a Hegu (LI 4) group and a Xuehai (SF 10) group, 20 rats in each group. The rats in the last four groups were given Estradiol Benzoate combined with Oxytocin to prepare the models of dysmenorrhea and in the saline group were given the same dose of saline. Last three groups were treated with electroacupuncture (EA) at Sanyinjiao" (SF 6), "Hegu" (LI 4) and 'Xuehai" (SF 10) respectively. The writhing behaviors of the rats in each group were observed within 20 min performing electroacupuncture from the start of the pain and the waveforms of uterine contraction were recorded., Results: In terms of the writhing behaviors, the writhing latency in the Hegu (LI 4) group was extended significantly (P < 0.05, P < 0.01) and the writhing numbers in the Hegu (LI 4) group were decreased significantly (both P < 0.05) as compared with those in the Sanyinjiao (SF 6) group and in the Xuehai (SF 10) group. In terms of the waveforms of uterine contraction, compared with that in the model group, the amplitude and the activity of uterine contraction in both Sanyinjiao (SF 6) group and Hegu (LI 4) group were decreased significantly (all P < 0.05), and with no significant difference between the Xuehai (SF 10) and the model group (P > 0.05)., Conclusion: For comprehensive assessment of the analgesic effect of electroacupuncture at different acupoints by using the writhing behaviors and the waveforms of uterine contraction, "Hegu" (LI 4) is the best, "Sanyinjiao" (SP 6) is the next and "Xuehai" (SP 10) is the third. showing a relatively functional specificity of the acupoint.

Objective: To observe therapeutic effect of acupoint application on dysmenorrhea of excess syndrome and its effect on prostaglandins., Methods: The patients with primary dysmenorrhea of excess syndrome were randomly divided into an application group and a medication group. The application group of 31 cases were treated with application of Chinese medicine composed of Zhinanxing (Rhizoma Arisaematis), Sanleng (Rhizoma Sparganii), Ezhu (Rhizoma Zedoariae), etc. at Zhongji (CV 3), Guanyuan (CV 4), Qihai (CV 6); and the medication group of 30 cases were treated with oral administration of Tianqi Tongjing Capsules. The scores for the pain degrees and the duration of dysmenorrhea were observed and prostaglandin F2alpha (PGF2alpha) and prostaglandin E2 (PGE2) contents in peripheral blood were determined before and after treatment., Results: The total effective rate of 93.5% in the application group was significantly better than 73.3% in the medication group (P < 0.05); after treatment, the scores of the symptoms were significantly decreased in the two groups (both P < 0.01), with more obvious improvement in the application group than the medication group (P < 0.01). The PGE2 content was significantly increased, and the PGF2alpha content and PGF2alpha/PGE2 were significantly decreased in the application group (all P < 0.01)., Conclusion: Acupoint application has a better therapeutic effect on dysmenorrhea of excess syndrome and has benign regulative action on synthesis of prostaglandins in the patients with primary dysmenorrhea.

Objective: To probe into the mechanism of substance-partitioned moxibustion in treatment of primary dysmenorrhea (PD) of cold-damp stagnation type., Methods: The treatment group (105 cases of PD) were treated with substance-partitioned moxibustion and the control group (104 cases) were treated with Chinese drug Yueyue-shu. Their therapeutic effects were observed. Plasma beta-endorphin contents in menstrual period were determined before and after treatment in 40 patients of each group., Results: The total effective rate of 95.2% in the substance partitioned moxibustion group was better than 85.6% in the control group (P < 0.05); after treatment, plasma beta-endorphin content significantly increased in the substance-partitioned moxibustion group (P < 0.01)., Conclusion: Substance-partitioned moxibustion has obvious therapeutic effect on primary dysmenorrhea of cold-damp stagnation type, which is carried out possibly through regulating the plasma beta-endorphin content as one of the mechanisms.

Objective: To observe the influence of silencing Connexin43 (Cx43) expression of partial acupoints on acupuncture effect, so as to probe into the mechanism of acupuncture treatment for primary dysmenorrhea., Methods: The primary dysmenorrheal rat model made by oxytocin and RNA interference (RNAi) technology was used to silence the expression of Cx43 in acupoints. Fifty SD female rats were divided into five groups, a normal group (N), a model group (M), an acupuncture group (A), an acupuncture plus interference group (A+I), an acupuncture plus interference control group (A+IC). RT-PCR method was used to observe the oxytocin receptor (OTR) and vasopressin receptor (VPR) mRNA expressions in the uterus in each group. Plasma prostaglandin E2 (PGE2) and PGF2alpha levels were detected by radioimmunoassay and ELISA, respectively., Results: (1) The times of writhing body (9.43 +/- 3.87 and 10.28 +/- 4.23) were significantly lower and the latency period of writhing body (12.43 +/- 3.46, 11.00 +/- 3.65) were longer in the group A and the group A+IC as compared with (15.43 +/- 5.13, 17.00 +/- 3.87) and (7.57 +/- 1.99, 8.43 +/- 2.57) in the group M and group A+I (P < 0.05), respectively. (2) The levels of Cx43 mR NA level and protein expression of acupoint in the group A+I were significantly lower than those of the group N (P < 0.05). (3) OTR and VPR mRNA in the uterus in the group A and the group A+IC were significantly lower than those in the group M and the group A+I (P < 0.05), with no significant difference between the group M and the group A+I (P > 0.05). (4) As compared with the group M, PGE2 level increased and PGF2alpha level decreased in the group A and the group A+IC (P < 0.05)., Conclusion: Silencing Cx43 expression of partial acupoint can inhibit effectively the effect of acupuncture through decreasing OTR and VPR in endometrium of the dysmenorrheal rat and adjusting the prostaglandins (PGs) synthesis system, which possibly is one of the mechanisms of acupuncture for treatment of primary dysmenorrhea.

Objective: To observe the therapeutic effect of acupuncture at Siguan points with Qinglong Baizei method on primary dysmenorrhea (PD) and to study the mechanism., Methods: One hundred and eighty cases of PD were zandomly divided into group A, group B and group C, 60 cases in each group. Group A were treated by acupuncture at Hegu (LI 4) and Taichong (LR 3) with Qinglong Baiwei method; group B were treated by routine acupuncture with Sanyinjiao (SP 6), Ciliao (BL 32) selected as main points; and group C were treated by oral administration of Yueyueshu Decoction. After treatment of 3 months, the therapeutic effects were analyzed, and changes of hemorrheological indexes and prostaglandin level were observed., Results: The cured rate and the total effective rate were 75.0% and 100.0% in group A, 60.0% and 95.0% in group B, and 25.0% and 90.0% in group C, respec tively, group A and B being significantly better than group C (P < 0.01). And the analgesic effects within 30 min of treatment in both group A and group B were significantly better than that in group C (P < 0.01), and that in group A was significantly better than that in group B (P < 0.01)., Conclusion: Acupuncture at Siguan points with Qinglong Baiwei method has a significant therapeutic effect on primary dysmenorrhea. The possible mechanism is to relieve pain by improving blood circulation and inhibiting production of prostaglandin.

Objective: To probe the mechanism of acupuncture in treatment of dysmenorrhea., Methods: Adult mice with no pregnancy were randomly divided into a normal group, a model group, an acupuncture group and a medication group. The model group, the acupuncture group and the medication group were modeled by Diethylstilbestrol and Ocytocin. For the acupuncture group, at the 7th day of modeling, acupuncture was given at "Sanyinjiao" (SP 6), "Diji" (SP 8), once a day, for 5 days; and at the 7th day of modeling, Yimucao Gao 0.6 mg/g was given intragastrically to the medication group for 5 days. The stretching latent period and the number of stretching within 30 min were observed, and mRNA levels of ocytocin receptor (OctR) and vasopressin receptor (VasR) in the uterus tissue were detected with RT-PCR method., Results: Compared with the model group, the stretching latent period extended (P < 0.05) and the number of stretching within 30 min significantly decreased (P < 0.05); and there were significant differences in the mRNA levels of ocytocin receptor and vasopressin receptor in the uterus tissue in the model group as compared with those in other 3 groups (P < 0.05, P < 0.01)., Conclusion: Acupuncture can improve the dysmenorrheal symptom to a certain extent, and the mechanism is possibly related to regulative effects of acupuncture on hormones-mediating receptors in mice.

Objective: To observe therapeutic effect and prognosis of ear point taping and pressing therapy for primary dysmenorrhea., Methods: One hundred and fourteen cases were randomly divided into an ear taping and pressing group of 60 cases and a western medication group of 54 cases. The ear taping and pressing group were treated by ear point taping and pressing at Shenmen, Zigong (uterus), Neifenmi (endorine), Pizhixia (subcortex), Jiaogan (sympathesis) and Shen (kidney), which were taped and pressed by a adhesive plaster with Vaccaria seeds. The western medication group were treated with oral administration of Indomeixin enteric tablets. The therapeutic effects were assessed after treatment of 3 menstrual cycles., Results: The total effective rate was 91.7% in the ear taping and pressing group and 77.8% in the western medication group with a significant difference between the two group (P < 0.05); and the long-term therapeutic effect in the ear taping and pressing group was better than that in the western medication group., Conclusion: Ear point taping and pressing therapy has significant therapeutic effect on primary dysmenorrhea.

Objective: To observe clinical therapeutic effect of superficial needling at distal and proximal acupoints on primary dysmenorrhea (PD)., Methods: One hundred and twenty cases of PD were randomly divided into a treatment group (n =60) and a control group (n = 60). The treatment group were treated with superficial needling at Sanyinjiao (SP 6) and the control group with oral administration of indometacin entric-coater tablets., Results: Of the 120 cases, 116 cases completed the investigation. The total effective rate was 93. 3% in the treatment group and 75. 0% in the control group. The comprehensive therapeutic effect and the cured rate in the treatment group were significantly better than that in the control group (P<0. 001), with a more rapid effect and lasting a longer time than the control group., Conclusion: Clinical therapeutic effect of superficial needling at Sanyinjiao (SP 6) on primary dysmenorrhea is better than that of oral administration of indometacin entric-coater tablets.

Objective: To observe clinical therapeutic effect of substance-partitioned moxibustion on primary dysmenorrhea (PD). Methods One hundred and thirty-eight cases of PD were randomly divided into two groups, the treatment group (n=78) were treated with substance-partitioned moxibustion at Guanyuan (CV 4) and Shenque (CV 8), once a day; and the control group (n=60) treated with oral administration of Yueyueshu Powder, twice a day, 10 g each time. They were treated for 3 menstrual cycles., Results: The total effective rate and the index of therapeutic effect were 96.1% and 90.8% in the treatment group, and 88.3% and 76.2% in the control group, respectively, with a significant difference between the two groups (P < 0.05)., Conclusion: Clinical therapeutic effect of substance-partitioned moxibustion on primary dysmenorrhea is obvious.

Objective: To investigate the central modulating mechanism of acupuncture at Sanyinjiao (SP 6) in treatment of primary dysmenorrhea., Methods: 18F-FDG positron emission tomograph imaging of whole brain was performed in six patients with primary dysmenorrhea during two stimulation: pseudo acupuncture and real acupuncture at Sanyinjiao (SP 6). The areas of cerebral glycometabolism change were obtained by using statistical parametric mapping (SPM). Meanwhile the pain intensity before and after pseudo-acupuncture and real acupuncture was assessed with 0-10 numerical pain intensity scale., Results: No differences in the values of pain before and after pseudo-acupuncture (P > 0.05). The value of pain after acupuncture was significantly lower than that before acupuncture (P < 0.01). Most of the activated brain areas were shared with the areas activated by pain as described in the literature. The brain areas of increasing glycometabolism were ipsilateral lentiformn nucleus (globus pallidus, putamen), cerebellum and insula, bilateral thalamus, ipsilateral paracentral lobule, bilateral amygdala, contralateral midbrain, bilateral second somatosensory cortex, ipsilateral hippocampus and anterior cingulate, contralateral mammillary body. The brain areas of decreasing glycometabolism were limited in small cerebral cortex., Conclusion: Acupuncture at Sanyinjiao (SP 6) can relieve significantly the pain of the patient. Primary dysmenorrhea is cured mainly by activating the area involved in pain. It is indicated that acupuncture can relieve pain and balancing the pain-related central networks. Also neuroendocrine may play a role in the therapy.

Objective: To investigate the effect of four natures of medicine on therapeutic effect of acupoint sticking therapy., Methods: Sixty-one cases of primary dysmenorrhea were randomly divided into a capsaicin group (n=20), a menthol group (n=20) and a control group (n=21). They were treated respectively with capsaicin and menthol, which are extracts of Lajiao (Fructus Capsici) and Bohe (Herba Menthae) with same pungent in flavor and different cold (cool) and heat in property, and application of Tongjing Jiu Tieji (plaster for dysmenorrhea) at Shenque (CV 8). Changes of clinical symptoms before and after treatment were observed., Results: After treatment, the cumulative scores of symptoms and the scores of pain decreased significantly in the 3 groups (P < 0.01), with no significant differences among the 3 groups (P > 0.05)., Conclusion: In acupoint sticking therapy, the four natures of medicine have no obvious effect on the therapeutic effect, so the four natures of medicine should not used as main standard of medicine selection.

Objective: To observe clinical therapeutic effect of medicine-separated moxibustion on primary dysmenorrhea and study on the mechanism., Methods: Ninety-six cases of primary dysmenorrhea were randomly divided into a treatment group and a control group, 48 cases in each group. They were treated respectively with medicine-separated moxibustion and Yueyueshu Perfusing Powder for 3 consecutive months., Results: The markedly effective and cured rate and the total effective rate were 87.5% and 100.0% in the treatment group, and 29.2% and 83.8% in the control group with significant differences between the two groups (P < 0.01 and P < 0.05). After treatment, blood prosglanding F2 content in menorrhea blood and oxytocin level in plasma during menstruation decreased significantly as compared with those before treatment (P < 0.01)., Conclusion: The medicine-separated moxibustion has a reliable therapeutic effect on primary dysmenorrhea and the therapeutic effect is exerted possibly by regulating abnormal prosglanding and oxytocin levels in the patient.

Objective: To summarize advances of studies on treatment of dysmenorrhea with acupoint application in recent 10 years so as to provide references and basis for scientific research and clinical works in future., Methods: The literature about treatment of dysmenorrhea with acupoint application in the recent 10 years are reviewed from treatment based on syndrome types, acupoint selection, selection of excipients, application time, assessment of therapeutic effects, adverse effects and other aspects., Conclusion: Acupoint application has a definite therapeutic effect on dysmenorrhea, but with some problems in clinical research.