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  • Title: [Different stimulation methods on auricular points for primary dysmenorrhea: a randomized controlled trial].
    Author: Lu CX, Deng XJ, Chen M, Xiao CH, Cui J.
    Journal: Zhongguo Zhen Jiu; 2021 Jul 12; 41(7):737-41. PubMed ID: 34259404.
    Abstract:
    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 (TF2), Neifenmi (CO18), Shenmen (TF4), Shen (CO10), Jiaogan (AH6a), Gan (CO12) and Pizhixia (AT4) 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 PGF2αand PGE2 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 PGF2α were decreased (P<0.05) and the serum levels of PGE2 were increased (P<0.05) in the auricular intradermal needling group and the auricular point sticking group, and the serum levels of PGF2α were lower than the placebo group (P<0.05), the serum levels of PGE2 were higher than the placebo group (P<0.05) in the two groups. Compared with the auricular point sticking group, the serum level of PGF2 was decreased (P<0.05), the serum level of PGE2α 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 PGF2α and PGE2. The therapeutic effect of auricular intradermal needling is superior to auricular point sticking, and the placebo effect can be preliminarily excluded. 目的：验证耳穴揿针、耳穴贴压治疗原发性痛经的临床疗效，并探讨其作用机制。方法：将90例原发性痛经患者随机分为耳穴揿针组、耳穴贴压组和安慰针组，每组30例。3组均选取内生殖器、内分泌、神门、肾、交感、肝、皮质下，耳穴揿针组、耳穴贴压组分别予揿针针刺及王不留行籽贴压，安慰针组采用去除针尖的揿针胶布粘贴，每日按压3~4次，每次3~4 min，均于月经来潮前5 d开始干预，隔日更换1次，每个月经周期治疗4次，为一疗程，共治疗3个疗程，并于治疗结束后下1个月经周期来潮时进行随访。比较3组患者治疗前，治疗1、2、3个疗程及随访时痛经症状量表（CMSS）评分、视觉模拟量表（VAS）评分和焦虑自评量表（SAS）评分，检测3组患者治疗前后血清前列腺素F2α（PGF2α）、前列腺素E2（PGE2）含量，并评价临床疗效。结果：耳穴揿针组患者治疗后各时间点，耳穴贴压组患者治疗2、3个疗程及随访时，安慰针组治疗3个疗程后CMSS、VAS及SAS评分较治疗前降低（P<0.001，P<0.05）；耳穴揿针组治疗后各时间点CMSS评分，治疗1、2个疗程及随访时VAS评分低于耳穴贴压组（P<0.05）；耳穴揿针组治疗后各时间点、耳穴贴压组治疗3个疗程及随访时CMSS评分低于安慰针组（P<0.001，P<0.05），耳穴揿针组及耳穴贴压组治疗后各时间点VAS评分均低于安慰针组（P<0.001，P<0.05）。耳穴揿针组及耳穴贴压组患者治疗后血清PGF2α均较治疗前降低（P<0.05），血清PGE2含量均较治疗前升高（P<0.05）；治疗后，耳穴揿针组、耳穴贴压组患者血清PGF2α含量低于安慰针组（P<0.05），血清PGE2含量高于安慰针组（P<0.05），且耳穴揿针组血清PGF2α含量低于耳穴贴压组、血清PGE2含量高于耳穴贴压组（P<0.05）。耳穴揿针组、耳穴贴压组总有效率分别为93.3%（28/30）及80.0%（24/30），均高于安慰针组的63.3%（19/30，P<0.05）。结论：耳穴揿针、耳穴贴压均可改善原发性痛经临床症状，减轻患者疼痛及焦虑情绪，其作用机制可能与调节血清PGF2α、PGE2水平有关。耳穴揿针的整体作用优于耳穴贴压，可初步排除两种耳穴疗法的安慰效应。.
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