| Objectives 1.Study of the relationship between deqi and acupoint effect:this study was a randomized, controlled trail on 68 patients with primary dysmenorrheal (PD) of qi and blood stagnation pattern, which aimed at exploring the relationship between deqi and analgesia effect and relieve anxiety effect of needling at sanyinjiao(SP6). So as to reveal the relationship between deqi and the effect of meridian points, thereby provide some evidence for the theory of "For acupuncture to be successful, the qi must arrive (qizhi)".2. Study of the influencing factor of deqi:To evaluate the effect of anxious mood before menstruation on deqi induced by needling at SP6 when dysmenorrhea attacked, which aimed at investigation the effect of physiological state and psychological state on deqi when dysmenorrhea attacked.Methods Total 68 patients with PD in cold and dampness stagnation pattern were included into our study and randomized divide into expected deqi(ED) group and expected non-deqi (END) group with a ratio of 1:3, which the cases were 17 and 51 respectively. Patients of ED group were acupunctured at SP6 by thick needle, deep insertion and some manipulation to achieve deqi. Contrary, patients of END group were acupunctured at SP6 by thin needle, superficial insertion and no manipulation to avoid deqi. On 8:00-11:00 am of the 3-7th days after the first menstruation period, the autonomic nervous system function of patient was tested and the autonomic nervous balance index (y value) was calculated by a confirmed formula. At the same time, the anxious status of patient a week before menstruation was evaluated by HAMA anxiety scale and the total HAMA score was sumed by the score of every item. On the day when abdominal pain attacked in the second menstruation period, the intensity of abdominal pain in patients was assessed by a 0-100mm visual analogue scale (VAS-P) (0=no pain, 100=intolerable pain). When the VAS score of abdominal pain(VAS-P) was≥40mm, patients were given treatment according to the random scheme. The needles were removed after 30 minutes. The intensity of abdominal pain (VAS-P) and anxiety (VAS-A) was tested before needling, and at 0,10,20,30 minutes after take out the needles. Then, clinical evaluation scale of the subjects’sensations of Acupuncture, developed by our team, was used to judge the real deqi conditions. According to the results, the patients were redivided into real deqi of ED group (A), real non-deqi of ED group (B), real deqi of END group (C) and real non-deqi of END group (D). The VAS value within group comparison was tested by t test of paired samples. Longitudinal data regression model was used to compare the VAS value between groups. The patients were redivided into autonomic nervous function normal group (E), sympathetic nerve enhance or hyperfunction group (F) and parasympathetic enhance or hyperfunction group (H) according to the autonomic nervous balance index (y value). At the same time, patients were also redivided into possible anxiety or anxiety group (M) and non anxiety group (N). The total deqi score between each group was compared by non-parametric test, and the Chi-square test was used to compare the real deqi ratio of each group. Besides, the relationship between the autonomic nervous balance index (y value) and the total HAMA anxiety score and total deqi score were tested by bivariate correlation test.Results 1.There were no significant differences of the baseline data between ED and END group (P>0.05). Within group comparison:Considering that the sample of B group was 0, we excluded the data of Bgroup according to statistical theory. The VAS-P and VAS-A values at 0,10,20,30 minutes after needling of ED, END, A, C and D group were lower than before needling (P<0.05). Comparison between groups:The VAS-P of ED group was obviously lower than END group (P<0.05), the VAS-P of A group was markablely lower than D group (P<0.05), the VAS-P of A+C group was obvious lower than B+D group (P<0.05), the VAS-P of A group was obvious lower than C group (P<0.05), besides, there was no signifincant difference between the VAS-P of C group and D group. The VAS-A of A group was obvious lower than D group (P<0.05). The VAS-A of A+C group was obvious lower than B+D group (P<0.05), besides, there were no signifincant differences between the VAS-A of ED group and END group, C group and D group, A group and C group.2. According to the autonomic nervous balance index (y value),14 patients were included into E group [14/56,25%],0 patient was included into F group and 42 patients were included into H group [42/56,75%]. Meanwhile, according to the total HAMA anxiety score,26 patients were included into M group[26/56,46.4%] and the case of N group was 30 [30/56,53.6%]. Autonomic nervous function:there was no obvisely difference of the total deqi score between E group and H group (P>0.05), and no significantly difference of the deqi ratio was found between the two groups (P>0.05). Meanwhile, there was also no significant correlation of each group (P>0.05). Total HAMA anxiety score:there was no obvisely difference of the total deqi score between M group and N group (P>0.05), and no significantly difference of the deqi ratio was found between the two groups (P>0.05). Meanwhile, there was also no significant correlation of each group (P>0.05).Conclusions 1. Study of the relationship between deqi and acupoint effect:(1) The results of pilot study showed that:①The analgesic effect and relieve anxiety effect of ED group and END group were all enhanced by needling at SP6 on PD patients, but ED group was better than END group.② The ratio of deqi induced by thick needle, deep insertion and some manipulation in ED group was higher than END group, the higher of the ratio of deqi, the better of the analgesic effect and relieve anxiety effect.2. Study of the influencing factor of deqi:There was some regularity in the autonomic nervous function and anxiety of PD patients, however, we couldn’t think that autonomic nervous function and anxiety were the factors influenced deqi.
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