A Clinical Research For Acupuncture Of Climacteric Syndrome Using Traditional Acupoints And Hip's Mechanics Discriminated

Objective:A clinical research for using the dialectical and meridian to skeletal muscle with relation to meridian, hologram to select acupoints, and comparing the curative effect of acupuncture treatment for climacteric syndrome between methods using traditional acupoints and hip's mechanics discriminated.For each of the climacteric symptom of varying severity, climacteric women will suffer proportionately from not only physical and psychological discomfort but also the quality of life getting worse. Acupuncture in the treatment of menopausal syndrome. Furthermore, past studies almost focused on improving major symptoms such as hot flashes, night sweats, and insomnia. Probably, acupuncture with the mechanism of stimulating natural production of endorphins and releasing various hormones could regulate the hypothalamus, pituitary, and ovarian. For the relatively high prevalence of climacteric symptom of musculoskeletal pain, there has been few research to explore in this area. With respect to treatment of climacteric symptoms, especially for musculoskeletal pain, this study for the acupoints selection by hip's mechanics discriminated according to musculoskeletal changes not only deals with endocrine imbalance but also pay more attention to musculoskeletal pain problems.Methods:The patients enrolled in the study were climacteric women, ranging from45to60years of age with Menopause Rating Scale (MRS) score of not less than8points. the sequence according to the random number table assigned to three treatment groups, group1:master acupoints plus traditional method [master acupoints of guanyuan (RN4) and sanyinjiao (SP6), associated with Xuanzhong(GB39), Chengshan (BL57), Zhaohai (K16); totally9acupoints]; group2:hip's mechanics discriminated method [rear Yanglingquan (GB34), Zusanli (ST36), Shangqiu (SP5), xiguan (LR7), Dij I (SP8), Qiuxu (GB40); totally6acupoints]; group3:master caupoints plus hip's mechanics discriminated method [master acupoints of guanyuan (RN4) and sanyinjiao (SP6), associated with rear Yanglingquan (GB34), Zusanli (ST36), Shangqiu (SP5), xiguan (LR7), Diji (SP8), Qiuxu (GB40); totally9acupoints]. The master acupoints of guanyuan (RN4) and sanyinjiao (SP6) is to regulate endocrine disorders and selecting acupoint of traditional method and hip's mechanics discriminated is to enhance the effect of pain cure. The patients in three groups should fill in the questionnaires of MRS, Visual Analogue Scale (VAS), and The World Health Organization Quality of Life (WHOQOL-Brief), and take acupuncture of twice a week for four weeks,30minutes for each, and then closed at following week intervals, acupuncture twice a week for four weeks. Baseline scores were measured on the MRS, WHOQOL, and VAS, at the beginning of week one, as followed by further measures at the end of weeks two, fore, and five. The curative effect were assessed to explore the score differences among the baseline.Results:Of the121recruited patients,39were found to be ineligible. The principal reasons for ineligibility were failure to meet eligibility criteria (n=25), loss of interest in participation after detailed explanation (n=9), medical conditions and medications (n=0), loss to follow up after the initial visit (n=4), and no evidence of severe climacteric symptoms (n=1). In all,74(90.2%) of the initial83participants completed the5-week study without any major protocol violation.8((9.8%)) of reasons for withdrawal were failure to return.23of the initial27participants completed in group1,25of the initial27participants completed in group2, and26of the initial28participants completed in group3.(1) According to the baseline of the overall data (without separating group), the score rating of the joint pain&muscle pain ranks first on the11major symptoms of the menopause symptom, and that of fatigue ranks second. Furthermore, sleep disorders (insomnia), urethritis, urinary incontinence, irritability, nervousness is more common in clinical practice.(2) From baseline of the overall data, MRS assessment in joint pain and muscle pain, the total score of the highest indicates the joint pain and muscle pain in menopause symptoms as a very important issue. Relationship between fatigue and emotional aspects is significant.(3) After4weeks cure, the MRS score of three groups indicates the efficacy of treatments with statistically significant (P<0.05). Improvement in psychological and urogenital aspect among the three groups with efficacy ranking as group3>2>1. Improvement in somatic&vegetative aspects among the three groups with efficacy ranking as group2>3>1.(4) After4weeks cure, the VAS score of three groups indicates the efficacy of treatments with statistically significant (P<0.05). Overall improvement in pain was excellent on the efficacy of the group3, improvement in upper limb pain was excellent on the efficacy of the group1, and improvement in lumbar, back, lower limb pain was excellent on the efficacy of the group3.(5) According to the comparison of MRS for before and after treatment within each group, using paired t test, each group's P-values for0.000<0.05based on results indicated that the differences within each group is statistically significant. All of three groups after4weeks of treatment are efficacy. Based on ANCOVA reports as F=3.364 &P-value for0.040<0.05, the comparisons of MRS for before and after treatment among three groups at week4show that the differences among three Groups is statistically significant. The pairwise comparisons of adjusted means based on Least Significant Difference (LSD) test show that the difference between group1and group3is statistically significant and the Comparative efficacy of group3is better than group1, but there are no significant differences as group2compared to group1and group3respectively.Conclusion:In general, the women's menopausal problems caused by the endocrine dysfunction in addition to autonomic nervous system disorder. It seems that autonomic nervous system and trigger points may interact with each other. The acupuncture of guanyuan (RN4) and sanyinjiao (SP6) is to regulate endocrine disorders and can make a great improvements for the sleep, urinary system, and emotions.With respect to acupuncture treatment and health education, participants of menopausal women in this study mostly expressed positive feedback and obtain a great improvements in heart palpitations, chest tightness, back pain, knee pain, muscle pain, fatigue, and dreaminess. Improvement especially in urinary incontinence, sleep disorders (insomnia), and backache can achieve a70%of recovery. With a follow-up around one month after completed acupuncture treatment, they always can maintain good health in sleep, urinary incontinence, and pain, if continued to follow the health education and to take care by themselves.Discussion in hip's mechanics discriminated:anatomical variations of sacral-caudal segments caused by instability of the hip, and those variations can make a various changes in form. First to inspect location of the variations, and then to identify horizontal or vertical shift point at hip region. At last, to determine the strategy of acupuncture treatment, to reduce the sensitization of trigger points, and to solve the problems. The curative effect of acupuncture treatment for climacteric syndrome among the three groups indicates the efficacy of treatments with statistically significant. The efficacy of acupuncture treatment of the group3is better than the others.