A standardized acupuncture point treatment protocol for the management and treatment of primary dysmenorrhea pain, using a multi-point combination

• Main Author: Cameron Hall
• Other Authors: Chou Li Wei
• Format: Others
• Language: en_US
• Published: 2018
• Online Access: http://ndltd.ncl.edu.tw/handle/87w46s

碩士 === 中國醫藥大學 === 國際針灸碩士學位學程 === 106 === Background: The selection of acupuncture points in the management and treatment of primary dysmenorrhea (PD) pain and associated symptoms is often based on traditional theories and/or reputation owing to extensive clinical experience. Numerous papers from clinical trials (CTs) incorporating acupuncture points for PD have been published in respective journals, most been dedicated to the acupuncture treatment evaluation for its effectiveness of relieving pain and secondary symptoms in PD patients. From these clinical studies, review papers have been published not only evaluating the effectiveness of treatment but also studies which indicate the preferences of singular acupuncture points, channel preferences and point pairing combinations which allude to under the models of evidence-based medicine the importance of the aforementioned when employing acupuncture point stimulus for the management and treatment of PD. The research review we set out to achieve was to extract findings from available published papers in direct relation to channel, single point and point pairing preferences to propose a multi-point combination for a standardized acupuncture point subscription protocol to be employed in the clinical setting as a foundation method in the approach for the management and treatment of PD pain and its associated symptoms when employing acupuncture point simuls as the treatment model. Methods: A total of 81 published CT studies extracted from 3 data bases (PubMed, Cochrane, China Academic Journal) for the management and treatment of PD pain and secondary symptoms by the use of acupuncture point stimulation were reviewed. Accounting for a total of 8426 PD patients, 52 individual acupuncture points were employed and sourced from 11 of the 14 main channels used in acupuncture point stimulation treatment. We calculated the frequency of use for individual points, point pairings, 3-point combinations and the channels from which the points originate, in all 81 papers. Furthermore, a separate acupuncture point evaluation chart was created based on the papers which had used Visual Analog Scale (VAS) as their primary tool for outcome evaluation of which was 44.44%, to see if there was a difference in point selection priorities as VAS is an outcome measurement tool for pain evaluation specifically. Measurements of our study also included noting the percentage of papers using Traditional Chinese Medicine (TCM) pattern identification as their basis for acupuncture point selection, as well we noted the time frame of all studies in relation to the number of menstrual cycles the study was conducted over in total. Results: The most predominantly employed channel from the 81 papers was Spleen TaiYin at 72.83% followed by, Conception Vessel Ren Mai, Stomach YangMing, Bladder TaiYang and Liver JueYin respectively. The most used point was SP6 at 66.66%, REN4 GuanYuan was second. These two points were as well the most used 2point pairing accounting for 32.09% followed by SP6+LIV3 and Ren4+Ren6. Other prominent individual points were LIV3, REN6, SP8, ST36 and SP10 respectively. The most employed 3point combination was SP6+REN4+REN6 at 19.75%. Within the VAS chart the most prominent point again was SP6 at 70.27% however a change in priority is seen from our charts with respect to few points most notably SP8 and LIV3. A total of 39.50% of the papers used TCM pattern identification in their acupuncture point subscription and 50.61% of them were conducted over 3 menstrual cycles or more. Within the VAS papers chart which accounts for 44.44% in all, 75.00% of these papers did not include a TCM pattern identification. Conclusion: Our multi acupuncture point combination is proposed as a model from which to approach the treatment and management of PD pain and its related symptoms, using methods that stimulate the most commonly used traditional acupuncture points on the most significant and relevant channels after the extensive reviewing of 81 published CT research papers. This outcome we promote and suggest is of a greater importance to the prospective readers of evidence-based acupuncture, more so than a singular point or point pairing outcome hypothesis or a channel specific statistical outcome alone. This makes for a more clinically applicable treatment modality with respect to its specific purpose as a proposed foundation model in the application of a multiple acupuncture point stimulus prescription to be used within the clinical setting. We propose that our result be used with or without the inclusion of an individualized TCM pattern differentiation or its treatment principles thus accounting for a treatment protocol that is a standardized multi-point model for clinical application in the management and treatment of PD pain and its associated symptoms.