He-Ran Zhang,Yue-Qiao Ren

1Department of Acupuncture and Moxibustion,Tianjin Gong An Hospital,Tianjin 300042,China.2School of Acupuncture &Moxibustion and Tuina,Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China.

Abstract Objective:To observe the clinical efficacy of fire needle acupuncture in treating irregular menstruation with spleen deficiency syndrome.Methods:60 patients with spleen deficiency-irregular menstruation were randomly divided into treatment group and control group of 30 each.In the treatment group,fire needle acupuncture was used to insert into Guanyuan,Qihai,Pishu,Sanyinjiao,Zusanli and Taibai points,while the filiform needle was used to needle the corresponding acupoints in the control group.After 8 weeks of treatment,menstrual cycle,menstrual period,menstrual volume,irregular menstrual symptom score and spleen deficiency symptom score were recorded.Results:Both treatments could effectively improve the menstrual cycle,menstrual period and menstrual volume,but there was no statistical significance between the two groups (P >0.05).Both treatments were effective in regulating the symptoms of menstruation,and fire needle acupuncture was better than filiform needle (P <0.05).Both treatments relieved the symptoms of spleen deficiency,and fire needle acupuncture was better than filiform needle (P <0.05).In terms of overall curative effect,the curative effect of fire needle acupuncture therapy was significantly better than filiform needle therapy,and the difference was statistically significant (P <0.05).Conclusion:Fire needle acupuncture therapy could effectively regulate menstrual volume of patients with irregular menstruation of spleen deficiency syndrome,and relieve the symptoms of traditional Chinese medicine.

Keywords:fire needle acupuncture;irregular menstruation;spleen deficiency syndrome;symptoms of traditional Chinese medicine

Background

Irregular menstruation is a common gynecological disease,mainly manifested in the abnormal menstrual cycle,menstrual period and menstrual volume,accompanying symptom such as dysmenorrhea and lumbar acid.There is a high incidence of irregular menstruation [1-3],and dizziness,fatigue,irritability,and even infertility will be led without rational therapy.Modern medicine often uses estrogen drugs to treat the disease [4-6],but it has obvious side effects.Traditional Chinese medicine (TCM) has a long history treating gynecological diseases and has good clinical advantages [7-9].In this study,fire needle acupuncture was used to treat patients with irregular menstruation of spleen deficiency type,and its effects on the menstrual cycle,menstrual period,menstrual volume and TCM symptom score were observed,so as to provide some basis for promoting the clinical application of fire needle acupuncture in gynecological diseases.

Clinical data

Baseline data

The patients came from outpatients in our hospital from November 2019 to October 2021.A total of 60 patients with spleen deficiency irregular menstruation were included.The patients were randomly divided into treatment group and control group,with 30 people in each group.Two cases fell off in each group,and a total of 56 cases were included.There was no significant difference between the two groups in baseline data such as age,course of disease,irregular menstruation symptoms and TCM symptom score (Table 1) (P>0.05),which was comparable.

In this study,the menstrual cycle of patients was more than 41 days,a total of 28 people;There are 17 people whose menstrual cycle is between 35-40 days;The menstrual cycle of another 11 patients decreased to less than 21 days;The menstrual period is mostly 8 days or more,a total of 28 people;There are 19 people whose menstrual period is between 4-7 days;The menstrual period of the other 9 patients decreased to less than 3 days;The menstrual volume is mostly 30-80 mL,a total of 33 people;17 patients with menstrual volume increased to more than 80 mL;The menstrual volume of the other 6 patients decreased to less than 30 mL;It shows that the irregular menstruation included in this study is mainly the prolongation of menstrual period and cycle and the increase of menstrual volume.The comparison between groups showed that χ2test (Table 2),there was no significant difference in menstrual cycle distribution,menstrual period distribution and menstrual volume distribution between the treatment group and the control group (P>0.05),which was comparable.

Table 1 Age,course of disease and symptom scores of the two groups before treatment

Table 2 Comparison of baseline menstrual period,cycle and menstrual volume

Table 3 Comparison of menstrual period,cycle and menstrual volume after treatment

Case selection criteria

Inclusion criteria(1).In line with the western medicine diagnosis of irregular menstruation [10];(2).It is consistent with the TCM diagnosis of irregular menstruation of spleen deficiency type[11];(3).Those who first came to our hospital for treatment for the first time or relapse did not receive acupuncture treatment before;(4).18-45 years old;(5) The subject gave informed consent and signed the informed consent form.

Exclusion criteria(1).Irregular menstruation caused by organic diseases;(2).Larger surgery,the latter;(3).Patients with serious primary diseases of other systems and psychosis;(4).Pregnant or pregnant.

Methods

Ethical approval

All the participants signed informed consent form.The study was approved by the Tianjin Public Security Hospital's ethics committee(2022006) and signed informed consent was provided by patients or their families.

Treatment

The treatment group received fire needle acupuncture therapy and He's medium thick fire needle.Acupoint selection: Guan yuan,Qihai,Pishu (bilateral),Sanyinjiao (bilateral),Zusanli (bilateral) and Taibai(bilateral).Operation method: after burning the needle with fire needle,quickly stab the above acupoints vertically 90° and take it out immediately.The depth of acupuncture is 0.5-1 inch,and no needle is left.Generally once a week,8 times as a course of treatment,do not touch water within 24 hours after the needle.Treatment was suspended during menstruation.

The control group received filiform needle treatment and selected Xinglin brand 0.3 ＊ 40 mm filiform needle.Take the same points as above,vertically enter the needle at 90°,the acupuncture depth is 0.5-1 inch,keep the needle for 30 minutes,once a week,8 times as a course of treatment.Treatment was suspended during menstruation.

Observation indicators

Before and after treatment,the cycle,menstrual period,menstrual volume,irregular menstruation symptom score and spleen deficiency symptom score were recorded.

Efficacy evaluation

According to the guiding principles for clinical research of new traditional Chinese medicine [12],the criteria for judging the efficacy of irregular menstruation:

Cure: after treatment,the menstrual period returned to normal,the cycle and menstrual volume were normal,other symptoms disappeared,and the score decreased by ≥95%.

Remarkable effect: after treatment,the cycle returns to normal for 28 ± 7 days.For those with excessive menstruation,the menstrual volume is reduced by 1/3 or <100 mL compared with that before treatment.The menstrual period recovers within 7 days,and other symptoms disappear or alleviate.Integral reduction ≥75%.

Effective: the menstrual cycle,menstrual volume and menstrual period after treatment are improved compared with those before treatment,and other symptoms are reduced compared with those before treatment.Integral reduction ≥30%.

Ineffective: there was no change in menstrual period,cycle and menstrual volume after treatment.Integral reduction ≤30%.

Statistical methods

Spss 21.0 software for corresponding statistical test,take α ＝0.05 is the test standard,P<0.05 means the difference is statistically significant.All measurement data are expressed as mean ± standard deviation (± s).After the data are tested by normality and homogeneity of variance,Wilcoxon test is used for the data before and after treatment in the group,and Mann Whitney U test is used for the comparison between groups;The counting data are described by frequency and percentage,and compared by chi square test.

Results

Comparison of menstrual cycle,menstrual period and menstrual volume between the two groups after treatment

In terms of menstrual cycle after treatment,most patients in the treatment group returned to the normal cycle of 28 ± 7 days.In the control group,there were still 2 people whose cycle was less than 21 days and 4 people whose cycle was more than 36 days;In terms of menstrual period,most of the patients in the treatment group recovered to 4-7 days after treatment.In the control group,one person's menstrual period was less than 4 days and five people's menstrual period was more than 7 days;In terms of menstrual volume,most of the patients in the treatment group recovered to 30-80 mL,which was 27,but there was still one patient whose menstrual volume was greater than 80 mL;After treatment,26 patients in the control group returned to normal menstrual volume,and 2 patients had menstrual volume greater than 80 mL (see Table 3).The comparison between the two groups showed that there was no significant difference in the improvement cycle,menstrual period and menstrual volume between the two treatment methods(P>0.05).

Comparison of irregular menstruation symptom scores between the two groups before and after treatment

Compared with before treatment,the symptom score of irregular menstruation in the treatment group decreased significantly after treatment,and the difference was statistically significant (Z= -4.641,P<0.001);The symptom score of irregular menstruation in the control group decreased significantly after treatment,and the difference was statistically significant (Z= -4.638,P<0.001);After treatment,the total score of the treatment group was lower than that of the control group,and the difference was statistically significant (Z= -4.83,P<0.001) (Table 4),indicating that the two treatments can improve the symptoms of patients with irregular menstruation of spleen deficiency type,but fire needle acupunctureis better than filiform acupuncture.

Comparison of spleen deficiency symptom scores between the two groups before and after treatment.

Compared with before treatment,the symptom score of spleen deficiency in the treatment group decreased significantly after treatment (Z= -4.638,P<0.001);The symptom score of spleen deficiency in the control group decreased significantly after treatment(Z= -4.549,P<0.001).After treatment,the total score of the treatment group was lower than that of the control group,and the difference was statistically significant (Z= -3.83,P<0.001) (Table 5),indicating that the two treatments can improve the symptoms of spleen deficiency,but fire needle acupunctureis better than filiform acupuncture.

Clinical efficacy of the two groups

The clinical efficacy of the two groups after treatment was compared.In the treatment group,26 were effective and 2 were ineffective,and the effective rate was 92.9%;There were 19 effective and 9 ineffective in the control group,and the effective rate was 67.9%.The difference between the two groups was statistically significant (P<0.05),indicating that compared with filiform needle,fire needle acupuncturetherapy has a better effect on irregular menstruation of spleen deficiency type,as shown in Table 6.

Table 4 Irregular menstruation symptom scores of the two groups

Table 5 Spleen deficiency symptom scores of the two groups

Table 6 Comparison of curative effects between the two groups

Discussion

Irregular menstruation is a common clinical disease.Prolonged illness is easy to increase the risk of endometrial cancer,endometrial polyps and infertility [13,14].Modern medicine believes that irregular menstruation is mainly manifested as polycystic ovary syndrome,luteal insufficiency,abnormal uterine bleeding and so on.Western medicine mostly treats this disease with estrogen and progesterone,but due to individual differences,it has a certain impact on the curative effect [15,16].Traditional Chinese medicine believes that the spleen and blood are closely related to the heart and kidney.Modern people have irregular work and rest,disordered diet and excessive work and leisure,which leads to the increase of patients with spleen deficiency type of irregular menstruation year by year.Therefore,the research group takes patients with spleen deficiency type of irregular menstruation as the research object.

Acupuncture and moxibustion is effective in the treatment of gynecological diseases [17-19],and can adjust the changes of menstrual cycle [20,21].Fire needle acupuncture therapy is a kind of acupuncture and moxibustion.It only borrows fire power.It belongs to the "warming method" of the "He's three links method" by the national medical master He Puren.He Lao believes that the human body likes temperature and dislikes cold.With the power of fire needle,Yang is prosperous and Yin is eliminated.He Lao has great advantages in treating gynecological,respiratory,neurological,skin,surgical and other diseases [22-26].In this study,Guanyuan,Qihai,Pishu,Zusanli,Sanyinjiao,Taibai and other points are selected as important points for the treatment of gynecological diseases.Sanyinjiao can dredge the Qi and blood of Sanyinjiao meridian and regulate the cycle;Guan Yuanwei is an important acupoint for regulating Chong Ren.The sea of Qi is the sea of Qi,which can control the operation of blood.Zusanli invigorates the spleen and Qi and promotes the generation of Qi and blood.Spleen Shu and Taibai can supplement the deficiency of spleen meridians and Qi.What are the uses of various points? They play the effects of conditioning cycle and Tonifying Spleen together.

Irregular menstruation is mainly characterized by the period,quantity and abnormality of menstruation.The cases included in this study are in line with this characteristic.Patients have prolonged or too short menstrual period,but they are mainly menstrual period,prolonged menstrual period and increased menstrual volume.After treatment with fire needle acupuncture and filiform needle,most of the menstrual period,cycle and menstrual volume of the two groups returned to normal,and there was no significant difference between the two treatments.However,there were still a small number of patients in the filiform needle group who had no reduction in menstrual period,cycle and menstrual volume after treatment.This may be related to the efficacy of fire needle acupuncture in warming meridians,helping Yang and transforming Qi.

The advantage of fire needle acupuncture therapy is also reflected in the improvement of TCM symptoms of irregular menstruation and spleen deficiency.The analysis of TCM symptom score of irregular menstruation and spleen deficiency symptom score found that after fire needle acupuncture and filiform acupuncture treatment,the TCM symptoms of irregular menstruation and spleen deficiency related symptoms in the two groups were significantly better than those before treatment,indicating that acupuncture and moxibustion therapy has a good curative effect in improving TCM symptoms.However,the comparison between groups showed that fire needle acupuncture was better than filiform acupuncture.In addition,in terms of overall curative effect,fire needle acupuncture therapy is more effective in the treatment of irregular menstruation of spleen deficiency type,which reflects the overall advantages of fire needle.This may be related to the fire needle acupuncture using the power of fire to regulate the function of Zang Fu organs,reconcile Qi and blood and improve the state of patients.To sum up,fire needle acupuncture treatment for irregular menstruation of spleen deficiency type can achieve the advantages of strengthening the spleen and regulating menstruation,achieve the purpose of treating both symptoms and root causes,and then effectively improve clinical symptoms.