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  • Title: [Bloodletting at auricular dorsal vein combined with auricular point sticking for menstrual migraine of qi stagnation and blood stasis and its effect on serum levels of E2 and 5-HT].
    Author: Li R, Lu Y, Wang MM, Yang DH.
    Journal: Zhongguo Zhen Jiu; 2023 Apr 12; 43(4):427-31. PubMed ID: 37068820.
    Abstract:
    OBJECTIVE: To observe the clinical effect of bloodletting at auricular dorsal vein combined with auricular point sticking on menstrual migraine (MM) of qi stagnation and blood stasis, and explore its possible mechanism. METHODS: A total of 102 cases of MM with qi stagnation and blood stasis were randomly divided into an observation group (51 cases, 3 cases dropped off) and a control group (51 cases, 2 cases dropped off). The patients in the observation group were treated with bloodletting at auricular dorsal vein combined with auricular point sticking. The bloodletting was performed at vein at upper 1/3 of the dorsalis near the ear helix; the auricular point sticking was performed at Pizhixia (AT4), Neifenmi (CO18), Jiaogan (AH6a), Nie (AT2), Zhen (AT3), Shenmen (TF4) and Yidan (CO11). The auricular points of both ears were alternate used. From 7 days before the onset of menstruation, bloodletting at auricular dorsal vein was given once every 7 days, 3 times were taken as a course of treatment, and 1 course of treatment was given; the auricular point sticking was given once every 3 days, and 6 times of treatment were given. The patients in the control group were treated with oral administration of flunarizine hydrochloride capsules. From 7 days before the onset of menstruation, flunarizine hydrochloride was given 2 capsules per time, once a day for 3 weeks. The menstrual headache index and visual analogue scale (VAS) score of the two groups were observed before treatment, one menstrual cycle into treatment and the first and the second menstrual cycle after treatment; the migraine-specific quality of life questionnaire (MSQ) score and the serum levels of estradiol (E2) and 5-hydroxytryptamine (5-HT) were compared before treatment and one menstrual cycle into treatment; the clinical efficacy was evaluated at one menstrual cycle into treatment. RESULTS: Compared before treatment, the menstrual headache index and VAS scores were reduced at one menstrual cycle into treatment and the first and second menstrual cycle after treatment in the two groups (P<0.05), and those in the observation group were lower than the control group (P<0.05). Compared before treatment, the MSQ scores and the serum levels of E2 and 5-HT in the two groups were increased at one menstrual cycle into treatment (P<0.05), and those in the observation group were higher than the control group (P<0.05). The total effective rate was 95.8% (46/48) in the observation group, which was higher than 73.5% (36/49) in the control group (P<0.05). CONCLUSION: Bloodletting at auricular dorsal vein combined with auricular point sticking could relieve headache intensity, improve the quality of life in patients with MM of qi stagnation and blood stasis, which may be achieved by raising the serum levels of E2 and 5-HT to improve the level of hormone in the body. 目的：观察耳背静脉放血联合耳穴贴压治疗气滞血瘀型月经性偏头痛（MM）的临床疗效，探讨其可能作用机制。方法：将102例气滞血瘀型MM患者随机分为观察组（51例，脱落3例）和对照组（51例，脱落2例）。观察组予耳背静脉放血联合耳穴贴压治疗，于耳背上1/3近耳轮处充盈的静脉进行放血，于皮质下、内分泌、交感、颞、枕、神门、胰胆进行贴压，双耳交替，从月经来潮前7 d开始，耳背静脉放血每7天1次，3次为一疗程，共治疗1个疗程，耳穴贴压每3天1次，共治疗6次；对照组予口服盐酸氟桂利嗪胶囊治疗，从月经来潮前7 d开始，每次2粒，每日1次，连续治疗3周。观察两组患者治疗前、治疗1个月经周期后及治疗后第1、2个月经周期头痛指数、视觉模拟量表（VAS）评分，比较两组患者治疗前、治疗1个月经周期后偏头痛特异性生活质量问卷（MSQ）评分及血清雌二醇（E2）、5-羟色胺（5-HT）含量，于治疗1个月经周期后评定临床疗效。结果：治疗1个月经周期后及治疗后第1、2个月经周期，两组患者头痛指数、VAS评分均较治疗前降低（P<0.05），且观察组低于对照组（P<0.05）。治疗1个月经周期后，两组患者MSQ评分及血清E2、5-HT含量均较治疗前升高（P<0.05），且观察组高于对照组（P<0.05）。观察组总有效率为95.8%（46/48），高于对照组的73.5%（36/49，P<0.05）。结论：耳背静脉放血联合耳穴贴压治疗气滞血瘀型MM可缓解头痛强度，改善患者生活质量，可能是通过上调血清E2、5-HT含量，改善体内激素水平实现的。.
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