The effects of acupuncture on clinical efficacy and steady-state visual evoked potentials in insomnia patients with emotional disorders: A randomized single-blind sham-controlled trial.

The aim of this study was to observe the clinical effects and brain electrical potential changes following acupuncture in the treatment of insomnia patients with mood disorders. Ninety patients with insomnia who met the inclusion criteria were randomly divided into the active acupuncture group (AA group, n = 44) and sham acupuncture group (SA group, n = 46) at a ratio of 1:1. The primary outcome was the total score of the Pittsburgh Sleep Quality Index (PSQI), and the secondary outcomes were the total effective rate, Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS) scores, and values of steady-state visual evoked potentials (SSVEP). The two groups received acupuncture or sham acupuncture 10 times (2 weeks). Finally, the total PSQI scores of the AA group and SA group were significantly different (p < 0.05) at 2 weeks (6.11 ± 2.33 vs. 10.37 ± 4.73), 6 weeks (6.27 ± 1.39 vs. 11.93 ± 3.07), 18 weeks (6.32 ± 2.84 vs. 11.78 ± 2.95) and 42 weeks (8.05 ± 3.14 vs. 12.54 ± 2.81). Further analysis found that AA group patients received acupuncture treatment at any age after the same effect (p > 0.05). The SAS and SDS scores of the AA group were also significantly different from those of the SA group at each assessment time point (p < 0.05). The total effective rate of the AA group was 81.82%, while that of the SA group was 30.43% (p < 0.05). There was no significant difference between the AA group and SA group only in the brain potential of the parietal lobe (F4), left temporal lobe (C3) and right temporal lobe (T8) (P > 0.05), but there was a significant difference between other brain regions (P < 0.05). In addition, correlation analysis showed that there was a certain positive correlation between the total PSQI score, SAS score, efficacy level, and SSVEP value in the AA group as follows: C4 and the total PSQI score (r = 0.595, P = 0.041), F3 and SAS score (r = 0.604, P = 0.037), FPz and efficiency level of the frontal lobe (r = 0.581, P = 0.048), and O2 and efficiency level of the occipital lobe (r = 0.704, P = 0.011). Therefore, acupuncture have a good clinical effect on patients with insomnia and emotional disorders and have a significant regulatory effect on abnormally excited brain potentials.

The cerebral mechanism of acupuncture for chronic insomnia with gastrointestinal disorder: protocol for a randomized controlled trial.

BACKGROUND: Many patients with chronic insomnia disorder (CID) have gastrointestinal (GI) symptoms. First-line insomnia medications do not treat GI problems. Acupuncture has a comprehensive regulative action on both CID and GI disorder and is receiving increasing attention. Recent studies indicate that both CID and GI diseases may cause abnormal brain activity. However, the neurological mechanism underlying the effect of acupuncture on such diseases is still unclear. The aim of this study is to explore the pathological mechanisms of CID with GI discomfort, as well as the main response characteristics of acupuncture treatment from multiple perspectives using multimodal magnetic resonance imaging (MRI). METHODS: A total of 60 participants with CID and GI disorders will be randomly divided into two groups (real acupuncture group and sham acupuncture group; ratio of 1:1). Patients will receive 20 sessions (five sessions per week) of real acupuncture treatment or sham acupuncture treatment. The primary outcome is the aggregate score on the Pittsburgh Sleep Quality Index. Secondary outcomes are scores on the Gastrointestinal Symptom Rating Scale, Self-Rating Anxiety Scale, and Self-Rating Depression Scale. Multimodal MRI scans and clinical assessments will be performed both at baseline and post-treatment. Another 30 age-, sex-, and education-matched healthy subjects will be recruited as controls and will receive MRI scans and clinical evaluations. DISCUSSION: This study aims to provide scientific evidence for the mechanism of acupuncture in treating CID with GI disorder using multimodal MRI imaging data on brain structure, function, and metabolism. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR1800017092 (URL: http://www.chictr.org.cn/showproj.aspx?proj=27173 ). Registered on July 11, 2018.

The effects of active acupuncture and placebo acupuncture on insomnia patients: a randomized controlled trial.

The purpose of this study was to observe and compare the clinical efficacy of active acupuncture and placebo acupuncture in the treatment of insomnia and mood disorders. 96 patients with insomnia in Chengdu were randomly divided into two groups (1:1). The active acupuncture group (AA group n = 48) received the tube of Park sham device with deep needle insertion. The placebo acupuncture group (PA group n = 48) received the tube of Park sham device with a retractable needle shaft and a blunt tip. The same acupuncture points and treatment cycles were used in both groups. The overall score for the Pittsburgh Sleep Quality Index (PSQI) is the primary outcome. Secondary outcomes recorded sleep rate, self-reported depression scale (SDS), self-assessment anxiety scale (SAS), the 'six component' scores of PSQI, and 'Deqi' scale scores. Eventually, 90 patients completed the study. After 2 weeks of treatment, the total score of PSQI in the AA group was 4.6 ± 2.4 and in the PA group was 12.9 ± 1.8 (ES = 3.91, p < .1). The SAS, SDS score in the AA group were 39.9 ± 5.6/39.9 ± 5.9 and in the PA group were 59.7 ± 6.1/61.2 ± 4.4 (ES = 3.38/4.9, p < .1). The sleep rate were 93.8% and 25.0% (p < .1). During the 1 month follow-up period, the PSQI total score in the AA group (5.2 ± 1.9) was superior to the PA group (13.1 ± 1.8) (ES = 4.27, p < .1). The SAS, SDS score in the AA group were 40.4 ± 5.1/42.7 ± 6.6 and in the PA group were 63.7 ± 6.6/63.5 ± 4.8 (ES = 3.95/3.60, p < .1). Throughout the study period, the 'six component' scores of PSQI in the AA group was superior to the PA group (each p < .1). Except for tingling and cooling, other acupuncture sensations were significant differences (each p < .1). Compared to the placebo acupuncture, active acupuncture can significantly improve insomnia, and clinical efficacy is maintained for at least 6 weeks.

[Consideration and analysis on "Effect of acupuncture vs sham acupuncture on live births among women undergoing in vitro fertilization: a randomized clinical trial" in JAMA].

The article "Effect of acupuncture vs sham acupuncture on live births among women undergoing in vitro fertilization: a randomized clinical trial", published in JAMA in May 2018, has concluded that acupuncture does not improve the rate of live births among women undergoing IVF. Through careful study of the article, the author analyzes its reliability from acupuncture therapeutic plan and specific acupuncture operation. As a result, although the research showed no significant difference between the acupuncture group and the sham acupuncture group, it could not prove no therapeutic effect in the sham acupuncture group, so the conclusion that the acupuncture did not improve the therapeutic effect could not be drawn; the compatibility of acupoints was inconsistent with the previous protocol, and its rationality was controversial; whether the frequency and duration of acupuncture treatment could highlight the live birth rate should be further discussed. In addition, the selection of acupuncturists may be another reason for the failure of the research aim.

Effects of acupuncture in treating insomnia due to spleen-stomach disharmony syndrome and its influence on intestinal microbiome: Study protocol for a randomized controlled trial.

BACKGROUND: Insomnia is a common complaint that is closely related to gastrointestinal symptoms, which is consistent with the traditional Chinese medicine classical theory of "stomach disharmony leading to restless sleep." Acupuncture is an effective complementary and alternative medicine therapy to improve gastrointestinal function and restore the normal sleep-wake cycle. However, studies on the effectiveness of acupuncture for insomnia due to spleen-stomach disharmony syndrome are limited to case reports and few randomized controlled trials; deeper research on its mechanism is still lacking. This randomized controlled trial aims to assess the treatment efficacy of "harmonizing stomach to tranquilize mind" acupuncture for insomnia and its influence on the intestinal microbiome. METHODS/DESIGN: This is a randomized, single-blind, parallel-group study. Sixty eligible patients with insomnia due to spleen-stomach disharmony syndrome will be randomly divided into two groups (1:1 allocation ratio). The intervention group will use "harmonizing stomach to tranquilize mind" acupuncture, and the control group will receive sham acupuncture. Participants will receive 5 acupuncture treatment sessions per week for 4 consecutive weeks. The Pittsburgh Sleep Quality Index will be used to evaluate the clinical efficacy of acupuncture treatment by making assessments at baseline, the end of treatment and the end of the follow-up. High-throughput 16S ribosomal ribonucleic acid gene sequencing will be performed to detect changes in the intestinal microbial composition before and after treatment. DISCUSSION: The results of this trial are expected to confirm that "harmonizing stomach to tranquilize mind" acupuncture can effectively relieve insomnia and alter the intestinal microbiome. TRIAL REGISTRATION: Chinese Clinical Trials Registry: ChiCTR1800017092.

Non-pharmacological and pharmacological interventions relieve insomnia symptoms by modulating a shared network: A controlled longitudinal study.

BACKGROUND: Primary insomnia (PI) is one of the most common complaints among the general population. Both non-pharmacological and pharmacological therapies have proven effective in treating primary insomnia. However, the underlying mechanism of treatment remains unclear, and no studies have compared the underlying mechanisms of different treatments. METHODS: In this study, we investigated gray matter volume (GMV) and resting-state functional connectivity (rsFC) changes following both pharmacological and non-pharmacological treatments in patients with PI. A total of 67 PI patients were randomized into benzodiazepine treatment, cupping treatment, or a wait-list control group for 4 weeks. The Pittsburgh Sleep Quality Index (PSQI), gray matter volume (GMV), and resting-state functional connectivity (rsFC) of the hippocampus were measured at the beginning and end of the experiment. RESULTS: We found 1) significantly decreased PSQI scores in the cupping and benzodiazepine treatment groups compared to the control group with no significant differences between the two treatment groups; 2) significant GMV increases in the cupping group compared to the control group at the right hippocampus after 4 weeks of treatment; 3) significantly increased rsFC between the right hippocampus and left rostral anterior cingulate cortex/medial prefrontal cortex (rACC/mPFC) in the two treatment groups, which was significantly associated with PSQI score decreases. DISCUSSION: Our findings suggest that benzodiazepine and cupping may share a common mechanism to relieve the symptoms of patients with PI.

Acupoint herbal plaster for patients with primary dysmenorrhea: study protocol for a randomized controlled trial.

BACKGROUND: Primary dysmenorrhea (PD), is one of main gynecological complaints in women of child-bearing age. Common medications for PD do not always achieve satisfactory outcome of pain relief. Hence, both health professionals and patients are seeking help from complementary and alternative medicine. The acupoint herbal plaster (AHP), which appears to be a safe and effective way to alleviate menstrual pain, as well as to improve other PD-related symptoms. Despite similar clinical studies for this condition in the past, no high-quality methodology-based clinical trial has been reported to date. The current study aims to assess the efficacy of the AHP compared with the acupoint placebo plaster (APP) and being placed on a waiting-list control group in patients with primary dysmenorrhea. METHODS/DESIGN: This study is a randomized, single-center, placebo-controlled clinical trial. A total of 180 women with PD will be included and randomly allocated to the AHP, APP and waiting-list (WL) groups in a 1:1:1 ratio. Patients in the AHP group will be provided with herbal plasters (Shaofuzhuyu decoction) on various acupoints: Shenque (CV8), Guanyuan (CV4), Qihai (CV5), Ciliao (BL32) and Zigong (EX-CA1). Women in the APP group will receive placebo plasters on the same acupoints, and no intervention will be given to the WL group until completion of the study. The primary outcome will be pain intensity reduction measured by a Visual Analog Scale (VAS), with other outcome measurements including the Cox Menstrual Symptom Scale (CMSS), the 12-Item Short Form Health Survey (SF-12) and the Participant Global Impression of Change (PGIC). All assessments will be performed at baseline, each menstrual cycle during the treatment course and the follow-up course. Any adverse events will be recorded throughout the study. DISCUSSION: This is the first study to compare the changes in menstrual pain after three different interventions: the active intervention (AHP), the placebo intervention (APP), and a period of no intervention (WL). This three-arm randomized controlled trial (RCT) aims to investigate the relative contributions of the specific (AHP vs. APP) and non-specific (APP vs. WL) effects to the overall clinical effects of the active AHP on women with PDM. The scientific and rigorous methodology design of this trial should gather good evidence to assess the curative effects and safety of the AHP on PD. Moreover, the results of this study may provide evidence-based references for the treatment of menstrual pain in future. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ID: ChiCTR-TRC-16008701. Registered on 22 July 2016.

[Analysis on Randomized Controlled Trials for Acupuncture Treatment of Simple Obesity Collected from PubMed].

OBJECTIVE: To analyze studies published in journals included in PubMed in terms of randomized controlled trials (RCTs) examining the therapeutic effect of acupuncture for simple obesity, so as to provide a reference for subsequent RCT-related designs and results. METHODS: RCT literature about acupuncture treatment of simple obesity from the PubMed database and from 2000 to 2016 was retrieved by using keywords of "obesity" "fat" "acupuncture" "joint application of acupuncture and herbal medicine" or "auricular point" "electroacupuncture", "acupoint application", or "cupping", followed by screening, extraction and evaluation of the design methodology and outcomes using Consolidated Standards for Reporting of Trials (CONSORT) and Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA). RESULTS: Fourteen articles from six countries in Asia examining the therapeutic effect of acupuncture in the treatment of simple obesity mainly by using acupoints of the Stomach Meridian were included. Generally, acupuncture was found to be more effective than sham acupuncture. However, PubMed did not include any RCTs comparing acupuncture with western medicine for weight loss and many problems (as details of needling manipulation, etc.) remained in the the research reports available in the database. CONCLUSION: All the existing RCTs generally affirm the positive efficacy of acupuncture for simple obesity, but high-quality RCTs, particularly those comparing acupuncture with western medicines for weight loss are lacking.

[Current situation of acupuncture in New Zealand].

The beginning of TCM acupuncture in New Zealand dates back to the middle of 19th century. After self-improvement for more than 100 years, TCM acupuncture has gained a considerable development. From the perspective of history and current situation, the development of acupuncture in New Zealand was elaborated in this article; in addition, the sustainable development of acupuncture was discussed from the perspective of education and training. In New Zealand, the TCM acupuncture and dry needling have played a dominant role in acupuncture treatments, which are practiced by TCM practitioners and physical therapists. The TCM acupuncture is widely applied in department of internal medicine, surgery, gynecology, and pediatrics, etc., while the dry needling is li-mited for traumatology and pain disorder. Therefore, including TCM acupuncture into the public medical and educational system in New Zealand should be an essential policy of Ministry of Health to provide welfare for the people.

[Effect of Acupuncture at Points in Heel Vessel for Circadian Clock Genes of Period 1 and Period 2 mRNAs in the Suprachiasmatic Nucleus in Insomnia Rats].

OBJECTIVE: To investigate the influence and mechanism of acupuncture at the points in Heel Vessel for the circadian clock genes of Period (Per) 1 and Per 2 mRNAs in the suprachiasmatic nucleus (SCN) in insomnia rats. METHODS: Thirty male SD rats were randomly divided into blank, model, acupuncture groups, 10 rats in each group. Insomnia model was established by intraperitoneal injection of PCPA (suspension, 1 mL/100 g). Acupuncture at "Shenmai" (BL 62) and "Zhaohai" (KI 6) was used in the acupuncture group for continuous 7 days, 15 min/day and once daily. The circadian rhythm was observed; the expressions of Per 1 and Per 2 mRNAs in SCN were examined with real time-PCR. RESULTS: The activity in the model group in rest period everyday increased compared with that in the blank group, and the expressions of Per 1 and Per 2 mRNAs in SCN decreased (P<0.05). Compared with the model group, the activity in the acupuncture group in rest period decreased and the expressions of Per 1 and Per 2 mRNAs in the SCN increased (P<0.05). CONCLUSIONS: Acupuncture at BL 62 and KI 6 can increase the expressions of Per 1 and Per 2 mRNAs in the SCN, so as to decrease the activity in rest period, and improve the quality of sleep in insomnia rats.

Electroacupuncture is Beneficial for Primary Dysmenorrhea: The Evidence from Meta-Analysis of Randomized Controlled Trials.

Electroacupuncture (EA) is considered to be a promising alternative therapy to relieve the menstrual pain for primary dysmenorrhea (PD), but the conclusion is controversial. Here, we conducted a systematic review and meta-analysis specifically to evaluate the clinical efficacy from randomized controlled trials (RCTs) on the use of EA in patients with PD. PubMed, Embase, ISI Web of Science, CENTRAL, CNKI, and Wanfang were searched to identify RCTs that evaluated the effectiveness of EA for PD. The outcome measurements included visual analogue scale (VAS), verbal rating scale (VRS), COX retrospective symptom scale (RSS), and the curative rate. Nine RCTs with high risk of bias were included for meta-analysis. The combined VAS 30 minutes after the completion of intervention favoured EA at SP6 when compared with EA at GB39, nonacupoints, and waiting-list groups. EA was superior to pharmacological treatment when the treatment duration lasted for three menstrual cycles, evidenced by significantly higher curative rate. No statistically significant differences between EA at SP6 and control groups were found regarding the VRS, RSS-COX1, and RSS-COX2. The findings of our study suggested that EA can provide considerable immediate analgesia effect for PD. Additional studies with rigorous design and larger sample sizes are needed.

[Some issues from Effect of acupuncture and clomiphene in Chinese women with polycystic ovary syndrome in JAMA].

In order to avoid international experts and scholars questioning the clinical effect of acupuncture, based on the traditional acupuncture theory and research reports, some questions are proposed from the research design, acupuncture effect and outcome explanation on the study of Effect of acupuncture and clomiphene in Chinese women with polycystic ovary syndrome published in JAMA in June 2017. And some thoughts and suggestions for the future development of the clinical acupuncture study are showed.

Antagonism of cannabinoid receptor 1 attenuates the anti-inflammatory effects of electroacupuncture in a rodent model of migraine.

BACKGROUND: The anti-nociceptive effects of electroacupuncture (EA) in migraine have been documented in multiple randomised controlled trials. Neurogenic inflammation plays a key role in migraine attacks, and the anti-inflammatory effects of acupuncture have been associated with the type 1 cannabinoid (CB1) receptor. OBJECTIVE: To investigate whether CB1 receptors mediate the anti-inflammatory effects of EA on migraine attacks. METHODS: A migraine model was produced in Sprague-Dawley rats by unilateral electrical stimulation of the trigeminal ganglion (TGES). Rats received EA daily on the 5 days preceding TGES with (TGES+EA+SR141716 group) or without (TGES+EA group) intraperitoneal injections of the CB1 receptor antagonist SR141716. Another group of TGES rats (TGES+MA group) and a non-TGES sham-operated group of rats (Sham+MA group) received minimal acupuncture (MA). Calcitonin gene-related peptide (CGRP) and prostaglandin E2 (PGE2) concentrations were determined in serum obtained from the ipsilateral jugular vein at initiation of TGES and 5 min after. Postmortem interleukin (IL)-1ß and cyclooxygenase (COX)2 protein levels in the trigeminal ganglion (TG) and plasma protein extravasation (PPE) in the dura mater were assessed. RESULTS: TGES induced increases in serum CGRP and PGE2 levels (TGES+MA vs baseline and vs Sham: all p<0.001), as well as IL-1ß and COX2 protein expression in the TG, and neurogenic PPE levels (TGES+MA vs Sham+MA: all p<0.001). EA attenuated TGES-induced increases in the levels of these proteins (TGES+EA vs TGES+MA: all p<0.001). CB1 receptor antagonism reversed the effects of EA (TGES+EA+SR141716 vs TGES+EA: all p<0.05). CONCLUSIONS: CB1 receptors appear to mediate anti-inflammatory effects of EA in a rat model of migraine.

[Characteristics of acupoints selection of moxibustion for primary dysmenorrhea based on data mining technology].

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.

[Timeliness law on the immediate analgesia on acute migraine treated with electroacupuncture at shaoyang meridian points].

OBJECTIVE: To observe the differences in timely effectiveness of immediate analgesia on acute migraine between electroacupuncture (EA) at shaoyang meridian points and non-meridian points. METHODS: The randomized controlled trial method was adopted. One hundred and ten cases of acute migraine were randomized into two groups. 55 cases in each one. In the observation group, EA was applied to Fengchi (GB 20), Waiguan (TE 5), etc. In the control group. EA was applied to non-meridian points. Only one treatment was given, and the nee dies were retained for 30 min in the two groups. Separately. at 10 time points, named before acupuncture, in 5 min, 10 min. 20 min and 30 min (at the moment of needle removal), 1 h, 2 h, 4 h, 6 h and 8 h after acupuncture, the pain intensity numerical rating scale (PI-NRS) was adopted to evaluate the pain severity and the adverse reac tion was recorded. RESULTS: (1) The effective rate of imnmediate analgesia was 87. 3% (48/55) in the observation group. significantly higher than 52.7% (29/55) in the control group (P<0.01). (2) NRS of each group was re duced at each time point, from 5 min to 8 h after acupuncture (all P<0.01). (3) NRS score at 30 min after acu puncture in the control group was obviously lower than that in the observation group (P<0.05), but the scores in 2 h, 4 h, 6 h and 8 h after acupuncture in the observation group were lower apparently than those in the control group (all P<0. 01). The differences in the scores in 5 min, 10 min, 20 min and 1 h after acupuncture were not significant (all P>0. 05). (4) For the reducing amplitude of NRS score at the same time point after acupuncture, the results in 20 min, 30 min and 1 h in the control group were higher apparently than those in the observation group (all P<0. 05). But, in 2 h, 4 h, 6 h and 8 h, the results in the observation group were higher apparently than those in the control group (all F<0.05). The differences in 5 min and 10 min after acupuncture were not significant (both P>0. 05). (5) In 24 h after acupuncture, the recurrence rate of migraine was 12. 7% (7/55) in the observation group, which was lower obviously than 34. 5% (19/55) in the control group (P<0. 05). The adverse reaction was not found in the two groups. CONCLUSION: EA at the shaoyang meridian points achieves the definite immediate analgesia effect on acute migraine and presents the time effectiveness of analgesia.

Application of acupoints and meridians for the treatment of primary dysmenorrhea: a data mining-based literature study.

Background. Dysmenorrhea is a common problem for which acupuncture provides effective analgesia. Although acupoint selection affects the effectiveness of acupuncture, the basic rules of acupoint selection are little understood. This study aims to investigate the principles of acupoint selection and characteristics of acupoints used for primary dysmenorrhea. Methods. PubMed, China National Knowledge Infrastructure, and Chinese Biomedical Database were searched for clinical trials published in English or Chinese from January 1978 to April 2014 evaluating the effect of acupuncture on primary dysmenorrhea, with or without methods of randomization and/or control. Three authors extracted information and two reviewers inputted information on titles, journals, interventions, main acupoints, and outcomes using the self-established Data Excavation Platform of Acupoint Specificity for data mining. Results. Sanyinjiao (SP06), Guanyuan (CV04), and Qihai (CV06) were used most frequently. The most frequently used meridians were Conception Vessel, Spleen Meridian of Foot Taiyin, and Bladder Meridian of Foot Taiyang. 67.24% of acupoints used were specific acupoints. Acupoints on lower limbs were most frequently used. Conclusion. Data mining is a feasible approach to identify the characteristics of acupoint selection. Our study indicated that modern acupuncture treatment for primary dysmenorrhea is based on selection of specific acupoints according to traditional acupuncture theory.

Use of moxibustion to treat primary dysmenorrhea at two interventional times: study protocol for a randomized controlled trial.

BACKGROUND: Dysmenorrhea is a common menstrual complaint among adolescent girls and women of reproductive age. The treatment of dysmenorrhea is typically selected from multidisciplinary options, including complementary and alternative medicine such as acupuncture and moxibustion. However, there are few published randomized controlled trials concerning moxibustion treatment for dysmenorrhea. This trial aims to investigate the efficacy and safety of moxibustion for primary dysmenorrhea, and to identify the optimal time of moxibustion treatment for primary dysmenorrhea. METHODS/DESIGN: This protocol is for a randomized controlled trial in which the assessor and statistician will be blinded. A total of 222 eligible patients with dysmenorrhea will be randomly assigned to three groups in a 1:1:1 ratio as treatment group A (treated before menstruation onset), treatment group B (treated at the onset of menstruation), or control group C (waiting list group). The participants assigned to the treatment groups will receive suspended moxibustion treatment at Sanyinjiao (SP6) and Guanyuan (CV4), while the waiting list group will not receive moxibustion treatment until the completion of the study. The trial period will consist of three baseline menstrual cycles, three menstrual cycles of treatment, and three menstrual cycles in the follow-up period. The primary outcome will be measured by changes in the Cox Menstrual Symptom Scale and the secondary outcomes will be measured using the Visual Analogue Scale, Cox Retrospective Symptom Scale, diary entries, the Self-rating Depression Scale, and the Self-rating Anxiety Scale. The safety of moxibustion will be assessed at every visit. DISCUSSION: This trial aims to assess the effectiveness and safety of moxibustion for primary dysmenorrhea, as well as to determine whether the optimal time of treatment for primary dysmenorrhea in clinical practice is before or after the onset of menstrual pain. TRIAL REGISTRATION: Chinese Clinical Trial Register: ChiCTR-TRC-14004627 , registered on 9 May 2014.

[Acupoint combination method of five-door and ten-change and its clinical application].

According to two kinds of acupoint combination methods for Huahe and Huhe in five-door and ten-change theory proposed by the deceased Taiwanese famous acupuncturist Mr. ZHOU Zuo-yu, the origin of the change theory proposed by the deceased Taiwanese famous acupuncturist Mr. ZHOU Zuo-yu, the origin of the acupoint combination method of five-door and ten-change is introduced. This method combines traditional philosophy of Yi with medicine, which is featured with casual timing, casual pattern, capacity to be combined with TCM syndrome differentiation, specific application scope and pertinence. Some clinical cases are additionally presented to verify this method. Huhe method is mostly used for Bi-syndrome while Huahe method has better effects on internal medicine diseases. They open the new thinking methods for clinical acupoint selection.