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By creating a modern literature database of acupuncture for the treatment of primary dysmenorrhea (PD), and using data mining technology combined with evidence-based medical methodology, the advantages of acupuncture in the treatment of PD were screened out and the clinical efficacy advantages were tried, in order to provide a research basis for the formulation of clinical diagnosis and treatment plans for acupuncture for PD.
Primary dysmenorrhea (PD) refers to the absence of organic lesions of the reproductive organs, pain and swelling in the lower abdomen, accompanied by backache or other discomfort, and symptoms seriously affect the quality of life.
Primary dysmenorrhea accounts for more than 90% of dysmenorrhea, and is more common in adolescence. In recent years, with the rapid development of society, the pace of work and life has accelerated, the competition and pressure faced by women have increased, and the incidence of PD has tended to increase. The prevalence of dysmenorrhea abroad ranges from 20% to 90%. According to domestic sample surveys, the incidence of dysmenorrhea among Chinese women is 33.1%.
Primary dysmenorrhea accounts for 53. A number of surveys have shown that female college students are the highest incidence group of primary dysmenorrhea, with an incidence rate of 43.6%-83.77%.
It can be seen that primary dysmenorrhea has become one of the common diseases affecting the quality of women's life and work. At present, for the treatment of PD clinically, Western medicine mainly chooses non-steroidal anti-inflammatory drugs, calcium ion antagonists, contraceptives, etc., and surgical therapy can be taken for intractable dysmenorrhea.
It is undeniable that Western medicine drug therapy has a significant effect in alleviating the symptoms of dysmenorrhea, but it is difficult to cure it fundamentally, and its long-term dependence is large, which not only brings economic burden to patients, but also has obvious adverse reactions of the central nervous system and digestive system. Therefore, more and more patients are currently receiving TCM treatment.
As one of the characteristic therapies of traditional Chinese medicine, acupuncture is widely used in the clinical treatment of PD because of its obvious curative effect, simple operation and non-toxic side effects.
Based on the in-depth research of modern acupuncture, the mechanism of action of acupuncture in the treatment of PD is gradually clear, such as the neuro-endocrine regulation mechanism, etc., making its clinical efficacy more scientifically supported, therefore, more patients in the clinic report "fast-acting" psychology.
In the face of the increasing demand of patients, clinicians' treatment technology urgently needs to be consolidated and improved. In view of the status quo of multi-therapy and multi-scheme of acupuncture and moxibustion treatment of PD, the existing relevant data mining literature in China can summarize and summarize the application law of acupuncture and moxibustion treatment of PD in acupoints and meridians.
However, the exploration of the factors influencing the efficacy such as intervention, intervention time, stimulation amount, acupoint matching, the association between acupoint and moxibustion method, and the difference in effect are scattered or lacking, and it is not possible to systematically and clearly provide specific advantageous treatment options.
In view of this, this study aims to summarize the treatment rules of modern acupuncture treatment PD in terms of acupoint selection, intervention and intervention timing through data mining technology, and combine the concept of evidence-based medicine and the "Clinical Practice Guidelines for Evidence-based Acupuncture: Primary Dysmenorrhea" formulated by the Chinese Acupuncture Society in 2014 to screen out the advantages of acupuncture for the treatment of PD.
The efficacy differences between 'dominant acupoint prescriptions' and 'other acupoint prescriptions' were compared through meta-analysis. Finally, through the combination of data mining technology and evidence-based medicine, a clinical advantage scheme is recommended for the treatment of PD by acupuncture.
Primary dysmenorrhea is classified as "dysmenorrhea" and "menstrual abdominal pain" in traditional medicine, which refers to menstrual diseases in which women suffer from pain or pain in the lower abdomen or lower back and lumbosacral pain and lumbosacral before or during menstruation, and occur every menstrual cycle.
The earliest description of dysmenorrhea can be traced back to the "Jin Kui Essentials - Evidence of Women's Miscellaneous Diseases": "Bring down, menstrual water is not good, less abdominal pain, see you in January." "Jingyue Quanshu Women's Rule" first appeared the name "mengxing abdominal pain".
And the person who clearly proposed the name and concept of dysmenorrhea is the book "The Secret Legend of Hua Tuo Divine Doctor", which mentions that "when a woman is menstruating, her navel and abdomen are like hanging, which is called dysmenorrhea." Dysmenorrhea occurs with the cycle of menstruation and is closely related to the special physiological state of women during menstruation and before and after menstruation.
"Neijing" Yun "Tianxi to, Ren Pulse Tong, Tai Chong Pulse Flourishing, Menstrual Affairs to the Present", descendants of Chinese medicine scholars summarized as "Kidney Qi-Tianxi-Chong Ren-Cella Palace", Chinese medicine believes that kidney qi metaplasia Tianxi is dominant; Tianxi is a substance of yuan yin, which shows the dynamic effect of metaplastic menstruation;
Chong Ren is regulated and restrained by the supervision belt, funded by the qi and blood of the internal organs, and under the action of Tianxi, the blood of the internal organs is widely gathered, and the sea of blood is full on time, overflowing in the cell palace, metaplasia of menstrual blood, and making menstruation come on schedule.
It is generally believed that adolescent women and young women have not filled their kidney qi, and their ability to harmonize qi and blood is relatively weak, so they cannot well unblock the rapid changes in qi and blood during menstruation and before and after menstruation, or the awareness of health care during menarche is not strong, and the menstrual period or menstrual period is affected by pathogenic factors, and the meridians are blocked or cold, the flow of qi and blood is not smooth, and the circulation of menstrual blood in the uterus is hindered, so that it is painful;
Or rushing to the task, the uterus is lost in nourishment, and it is not honorable and painful. Therefore, dysmenorrhea is located in the uterus, rushing, mainly responsible for the poor operation of qi and blood, any abnormal operation of qi and blood, such as qi stasis and blood stasis, cold coagulation cell uterus, humid heat bet, weak qi and blood, etc. can lead to the onset of dysmenorrhea, and its pathogenesis is mainly summarized as "pain if it is not common" and "pain if it is not honorable".
In terms of clinical treatment, in principle, it is mainly to regulate the qi and blood, and it is carried out in stages according to the etiology and pathogenesis, and the pain is relieved to treat the symptoms, and the dialectical examination of the cause is usually used to cure the root cause. On this basis, the famous old Chinese medicine practitioners of contemporary gynecology also put forward the following points: Pay attention to the internal organs, and take the liver, spleen and kidney as the priority.
The internal organs are the foundation of the human body and the source of biochemical qi and blood; women take blood as the foundation, the spleen is the source of biochemical qi and blood, the liver is the organ that hides blood, the main drainage, the kidney is the innate foundation, the essence is stored inside, and the physiological and pathological changes of the liver, spleen, and kidney are closely related to the diseases of women's births.
Emphasize the role of liver and kidney in the menstrual cycle, and premenstrual liver qi is more vigorous than liver thinning and regulating menstruation; Postmenstrual renal qi depletion focuses on replenishing the source to improve its roots. It is believed that women take blood gas as the basis, but the disease of qi and blood must be attributed to the internal organs, and the clinical treatment is more targeted, and the clinical evidence is especially serious about the liver, kidney and spleen.
Pay attention to regulating qi and blood. Women take blood as the foundation, take blood as the use, and blood and qi, and closely related, advocate that women's qi and blood depend on each other, in order to maintain the normality of menstrual blood, treatment emphasizes harmony as smooth, adjust qi and blood, correct the deviation between virtual and real, and make it tend to balance.
Inheriting the ancestor's viewpoint emphasizes that qi and blood are the foundation of human life, and qi and blood are valued for smoothness. According to the characteristics of women's temperament and depression, it emphasizes that women's menstrual conditions rely on blood as the foundation and qi as the driving force, and advocates the academic idea of "qi is smooth, blood is supplemented by regulation," and "communication and regulation" are combined.
The clinical certificate adopts the main regulation, blood nourishment first, rational qi as the key, and the liver thinning and qi management method as a commonly used method in gynecology. Advocate cyclical governance.
Menstrual cramps have distinct cyclical nature, and "kidney qi-tianxi-chong ren-cell palace" shows periodic fluctuations and changes in qi and blood, so through phased adjustment, it can better fundamentally improve physical fitness, eliminate the cause, and play a role in curing the disease. It is emphasized that those who still have cycles should be maintained, and those who have lost cycles should be established.
Traditional Chinese medicine has significant clinical efficacy in the treatment of primary dysmenorrhea, and there are many solutions, and the treatment is mainly divided into two categories: internal treatment and external treatment. Internal treatment is mainly based on the internal administration of traditional Chinese medicine, and some studies have pointed out that the current use frequency and better efficacy of the symptom-prescription drugs are as follows:
Qi stasis type - subdiaphragmatic stasis soup, qi and blood deficiency type - Sheng Yu soup, cold and wet coagulation type - less abdomen stasis soup, cold coagulation blood stasis type - warm meridian soup, liver and kidney deficiency type - liver soup;
Through the literature statistics of modern acupuncture for the treatment of primary dysmenorrhea, it is found that the current clinical choice of milliacupuncture method, followed by milliacupuncture combined with moxibustion and simple moxibustion, and then auriculotherapy, acupoint injection, acupoint application, etc. Empirically, the laxative method is mostly used in acupuncture techniques, and it is mainly based on insertion.
Modern medicine's understanding of primary dysmenorrhea Modern medicine divides dysmenorrhea into two categories: primary dysmenorrhea and secondary dysmenorrhea. Primary dysmenorrhea.
Also known as functional dysmenorrhea, refers to the painful menstrual period caused by the absence of obvious organic lesions in women's reproductive organs, mostly occurring in adolescent girls in 2-3 years of menarche, or young women who have given birth, and its clinical manifestations are mainly crampy pain in the lower abdomen, and pain often occurs a few hours before menstruation or just when menstruation comes.
Can last for hours or 48-72 hours. Secondary dysmenorrhea refers to dysmenorrhea caused by obvious organic lesions in women's reproductive organs, and common diseases include endometriosis, adenomyosis, pelvic inflammatory disease, etc.
Traditional Medicine's Understanding of Primary Dysmenorrhea Primary dysmenorrhea is classified as "dysmenorrhea" and "menstrual abdominal pain" in traditional medicine, which refers to menstrual diseases that occur every time with the menstrual cycle in women who have pain or pain in the lower abdomen or lower back and lumbosacral pain before or during menstruation.
The description of dysmenorrhea can be traced back to the "Essential Notes of Jin Kui - Evidence of Women's Miscellaneous Diseases": "Bring down, menstrual water is not good, less abdominal pain, goodbye in January." "Jingyue Quanshu Women's Rule" first appeared the name "mengxing abdominal pain". And the person who clearly proposed the name and concept of dysmenorrhea is the book "The Secret Legend of Hua Tuo Divine Doctor", which mentions that "when a woman is menstruating, her navel and abdomen are like hanging, which is called dysmenorrhea."
Dysmenorrhea occurs with the cycle of menstruation and is closely related to the special biological state of women during menstruation and before and after menstruation.
"Neijing" Yun "Tianxi to, Ren Pulse Tong, Tai Chong Pulse Flourishing, Menstrual Affairs to the Present", descendants of Chinese medicine scholars summarized as "Kidney Qi-Tianxi-Chong Ren-Cella Palace", Chinese medicine believes that kidney qi metaplasia Tianxi is dominant; Tianxi is a substance of yuan yin, which shows the dynamic effect of metaplastic menstruation;
Chong Ren is regulated and restrained by the supervision and is funded by the qi and blood of the internal organs, and under the action of Tianxi, the blood of the internal organs is widely gathered, and the sea of blood is full on time, overflowing in the cell palace, metamorphosing menstrual blood, and making menstruation come and go on schedule.
It is generally believed that adolescent women and young women have not filled their kidney qi, and their ability to harmonize qi and blood is relatively weak, so they cannot unblock the rapid changes of qi and blood during menstruation and before and after menstruation, or the awareness of health care during menarche is not strong, and the menstrual period or before and after menstruation is affected by pathogenic factors, and the meridians are blocked or cold, the flow of qi and blood is not smooth, and the circulation of menstrual blood in the uterus is hindered, so that it is painful if it is not clear;
Or rushing to the task, the uterus is lost in nourishment, and it is not honorable and painful. Therefore, dysmenorrhea is located in the uterus, rushing, mainly responsible for the poor flow of qi and blood, any cause of abnormal operation of qi and blood, such as qi stasis and blood stasis, cold coagulation cell uterus, humid heat bet, weak qi and blood, etc. can lead to the onset of dysmenorrhea, and its pathogenesis is mainly summarized as "pain if it is not common" and "pain if it is not honorable".
In terms of clinical treatment, in principle, it is mainly based on regulating qi and blood, which is carried out in stages according to the etiology and pathogenesis, and the pain is relieved to treat the symptoms, and the dialectical examination is usually used to cure the root cause.
On this basis, the famous old Chinese medicine practitioners of contemporary gynecology also put forward the following points: Pay attention to the internal organs, and take the liver, spleen and kidney as the priority. The internal organs are the foundation of the human body and the source of biochemical qi and blood; women take blood as the foundation, the spleen is the source of biochemical qi and blood, the liver is the organ that hides blood, the main drainage, the kidney is the innate foundation, the essence is stored inside, and the physiological and pathological changes of the liver, spleen, and kidney are closely related to the diseases of women's births.
Emphasize the role of liver and kidney in the menstrual cycle, and premenstrual liver qi is more vigorous than liver thinning and regulating menstruation; Postmenstrual renal qi depletion focuses on replenishing the source to improve its roots.
It is believed that women take blood gas as the basis, but the disease of qi and blood must be attributed to the internal organs, and the clinical treatment is more targeted, and the clinical evidence is especially serious about the liver, kidney and spleen. Pay attention to regulating qi and blood. Women take blood as the foundation, take blood as the use, and blood and qi are closely related, advocating that women's qi and blood depend on each other, in order to maintain the normality of menstrual blood, treatment emphasizes harmony as smooth, adjust qi and blood, correct the deviation between virtual and real, and make it tend to balance.
Inheriting the ancestor's viewpoint emphasizes that qi and blood are the foundation of human life, and qi and blood are valued for smoothness. According to the characteristics of women's temperament and depression, it emphasizes that women's menstrual conditions rely on blood as the foundation and qi as the driving force, and advocates the academic idea of "qi is smooth, blood is supplemented by regulation," and "communication and regulation" are combined.
The clinical certificate adopts the main regulation, blood nourishment first, rational qi as the key, and the liver thinning and qi management method as a commonly used method in gynecology. Advocate cyclical governance. Menstrual cramps have distinct cyclical nature, and "kidney qi-tianxi-chong ren-cell uterus" shows periodicity in terms of qi and blood
Dong Keqin believes that women take blood gas as the basis, but the disease of qi and blood must be attributed to the internal organs, and the clinical treatment is more targeted, especially the liver, kidney and spleen.
Pay attention to regulating qi and blood. Women take blood as the foundation, take blood as the use, and blood and qi are closely related, advocating that women's qi and blood depend on each other, in order to maintain the normality of menstrual blood, treatment emphasizes harmony as smooth, adjust qi and blood, correct the deviation between virtual and real, and make it tend to balance. Inheriting the ancestor's viewpoint emphasizes that qi and blood are the foundation of human life, and qi and blood are valued for smoothness.
According to the characteristics of women's temperament and depression, it emphasizes that women's menstrual conditions rely on blood as the foundation and qi as the driving force, and advocates the academic idea of "qi is smooth, blood is supplemented by regulation," and "communication and regulation" are combined.
The clinical certificate adopts the main regulation, blood nourishment first, rational qi as the key, and the liver thinning and qi management method as a commonly used method in gynecology. Advocate cyclical governance. Menstrual cramps have distinct cycles, and "kidney qi-tianxi-chong ren-cell palace" shows periodic fluctuations and changes in qi and blood, so through phased adjustment, we can better fundamentally improve physical fitness, eliminate the cause, and play the purpose of curing diseases.
Chai Songyan stressed that those who still have cycles should be maintained, and those who have lost cycles should be established. Traditional Chinese medicine has significant clinical efficacy in the treatment of primary dysmenorrhea, and there are many solutions, and the treatment is mainly divided into two categories: internal treatment and external treatment.
Some studies have pointed out that the current use frequency is more frequent and the efficacy is better symptom type - prescription drugs are as follows: qi stasis type - subdiaphragmatic stasis soup, qi and blood deficiency type - holy healing soup, cold and wet coagulation type - less abdomen and stasis soup, cold coagulation blood stasis type - warm menstrual soup, liver and kidney loss type - liver soup;
Through the literature statistics of modern acupuncture for the treatment of primary dysmenorrhea, it is found that the current clinical choice of milliacupuncture method, followed by milliacupuncture combined with moxibustion and simple moxibustion, and then auriculotherapy, acupoint injection, acupoint application, etc. Empirically, the laxative method is mostly used in acupuncture techniques, and it is mainly based on insertion.