| There is a long history of acupuncture treatment of gynecologic disorder. Many clinical observations indicated that acupuncturing LI4 and SP6 could shorten labor duration, reinforce uterine contraction, improve cervical ripening, relieve pain during delivery, and decrease postpartum haemorrhage. It reported that acupuncture is also effective for primary dysmenorrhea the major reason for which is increasing of the ectopic uterine motility. The mechanism is suggested that acupuncture relieves primary dysmenorrhea by inhibiting uterine contractility. Acupuncture increases uterine contractility during delivery on one hand, and on the other hand it inhibits uterine contractility of dysmenorrhea. The reason for the controversial results remains unclear. Clinically, systematical reviews on randomized clinical trials for acupuncture treatment of primary dysmenorrhea are very few. The efficacy of acupuncture for dysmenorrhea lacks of sufficient evidance supported by the result from systematical review. Furthermore, It is suggested that Acupuncture regulates uterine contractility by regulating hypothalamus-pituitary-gonadal function. The expression of the oxytocin receptor, estrogen receptor and progesterone receptor, and prostaglandin E2 in the brain and how acupuncture effect it is seldom studied. In this study, we did a systematical review on acupuncture for primary dysmenorrhea, recorded the contractility of the uterus and detected the expression of oxytocin receptor, estrogen receptor and progesterone receptor, and prostaglandin E2 in the brain after electroacupuncture oof the 18-day pregnancy rat. 1. Acupuncture for primary dysmenorrheaArticles dealing with acupuncture for primary dysmenorrhea from all of the Journals including published and unpublished were searched by hand in China from 1949 to 2004. They were Acupuncture Research, Chinese Journal of Acupuncture and Moxibustion, Journal of IntegratedTraditional and Western Medicine, the paper compilation of the national conference of acupuncture and acupuncture analgesia in four sessions, and The articles in the Cochrane Controlled Trials Register (CCRT) on the Cochrane libarery; China Information Service System on Traditional Chinese Medicine; China National Knowledge Infrastructure(www.cnki.net, CNKI). Chinese Biology Medicine Disk(CBMdisk); MEDLINE, Pubmed; EMBASE; BIOSIS were searched by electronic approach.There were totally 9 clinical trials comparing acupuncture with any type of control intervention for the treatment of primary dysmenorrhea. Among which 5 studies were from China, 4 studies in English. The majority of trials had methodological and/or reporting shortcomings. Results on dysmenorrhea frequency and intensity were divided into two types including dichotomous and continuous. Quantitative meta-analysis was done with Revman4. 1 software. Overall, the existing evidence supports effect of acupuncture for the treatment of dysmenorrhea.2. Effect of electroacupuncture on uterine contractility of the 18-day pregnancy ratExperiments were performed on female Wistar rat with 18-day pregnancy. Effect of electroacupuncture on uterine contractility of the 18-day pregnancy rat after injecting P and OT late pregnancy rats was studied.The animals were anesthetized with mixture solution of 25% urethane and 1. 5% chloralose (i. p). After opening the abdominal cavity and exposing left uterus, pared stainless steel electrode were put in the middle piece uterine serosa. The basic uterine contractility was recorded for 20mins. The "SP6" was stimulated for 20mins, and released for 30mins. After that, "P6" was stimulated for 20mins, and released 30 mins. Then P and OT solution were injected respectively into the metra smooth muscle near the recording electrodes, and simultenously acupuncture the points respectively with a time order for 20mins, recording electrical activities of uterus for 30mins.Signal was put into RM-6000 multipurpose polygraph bioelectric amplifier connecting to PowerLab organism signal acquisition and analysis system.Results showed that 1) In the normal 18-day pregnancy rats, EA "SP6", the uterine contractilities were excited. Mean amplitude of burst wave at EA 20min increased to 79. 0%; frequency of the burst waves also increased to 166. 0% at EA 20min. There were significant increases after EA than before it (P<0. 05). EA "P6", mean amplitude of burst wave of 9 animals was inhibited, and that is increased in four rats. EA "SP6" also made amplitude of slow wave increased, and EA "P6" made frequency of slow wave increased in four rats, and decreased in 9 rats(p<0. 05).2) After OT injection, amplitude and frequency of burst wave of the rat obviously increased, and that of slow wave obviously increased. EA "LI4" or "LI4"+ "SP6" significantly inhibited higher amplitude and frequency caused bu OT. EA "SP6" or "P6" can also inhibit it, but no significant difference.3) After injecting P, mean amplitude and frequency of burst wave and slow wave obviously decreased. EA "LI4"+ "SP6" obviously reversed inhibition effect by P injection, in amplitude and frequency of burst wave, obviously increased amplitude and frequency of slow wave; EA "LI4" and "P6" can obviously against the inhibition effect of amplitude of slow wave after P injection.The results suggested that EA points may regulate uterine contractilety, but the effect of individual point is different. The same point or the same group of points has different influence on contractility in different functional status of the uterus, for example: EA "LI4" + "SP6" may inhibit amplitude and frequency of burst wave increasing caused by OT, but excited inhibition effect caused by P injection. EA "SP6" has the samilar rasults as EA "LI4" + "SP6", but weaker than the later. EA "LI4" has obviously inhibitive effect on increased of amplitude of burst wave caused by OT. The findings showed acupuncture point posses relative specificity and bi-directional regulatory action.3. Acupuncture regulation of the expression of sex hormones in the hypothalamus of the pregnancy rat.Acupuncture regulation of the function of the sexual hormones produced by hypothalamus. The mechanism of the regulation function of acupuncture remains unclear. So, the expression of OTR, PR, ER and PGE2 in the hypothalamus of the pregnancy rat affected by acupuncture was studied.36 Female Wistar rats, weighing 200—230g, were randomly divided into normal group, SP6 group, P6 group and Pregnancy control group (N=9 in each group). The individual animal of the SP6, P6 and Pregnancy control group was put in each cage for mating with a male. From 15-days of pregnancy the animals were received acupuncture ( 2Hz, 5V, lOmins, one time per day).15mins after acupuncture at 18-day pregnancy, the animals were deeply anesthetized by overdose of 1% pentobarbital and perfused with 0.9% sodium chloride 50 ml followed by 4 % paraformaldyhyde and 1% glutaraldehyde in 0. 1M phosphate buffer 300 ml. The brain of the animal was taken out and put into 20% glucose phosphate buffer at 4 °C over night. The brain was cut in sections and stained with immnohistochemical procedure.3. 1. ERa positive immuno-reactivity neurons were observed under light microscope in the experiment animals. The positive neurons are in dark brawn in color, and small, middle and large in size and triangle, round and fusiform in shape, and the most is large. They distributed in hypothalamus nuclei inducing supraoptic nucleus, paraventricular nucleus, periventricular nucleus, ventro- median nucleus, dorso-ventral nucleus and acuate nucleus. The neurons of Er ocpositive reaction in pregnancy group is more than that in normal non pregnancy group, and the gray density is also higher. The number of neurons and gray density of acupuncture group is even higher than that of the normal and pregnancy groups.3.2. PR positive neurons appeared in ventromedian hypothalamus and in supraoptical nucleus of the hypothalamus. There are few positive neurons in normal group. The number of PR positive neurons in pregnancy group was increased significantly and that in acupuncture group iseven higher. The number and the gray density of the PR positive neurons in the later three groups is significantly higher than that in normal group. And there is no significant difference among the later three groups.3. 3. The expression of OTR immno-reaction positive neurons in the brainis very seldom observed. It is significantly increased in the paraventricular nucleus and supraoptic nucleus of the hypothalamus of the pregnancy rat.After acupuncture is is increase, the number and gray density of OTR positive neurons in the acupuncture groupsis significantly higher than that in normal and pregnancy control groups (P<0. 01).3.4. PGE2 immuno-reaction positive neurons were observed in cortex, amagdala, hypothalamic nuclei(spraoptic nucleus, paraventricular nucleus, periventricular nucleus, acuate nucleus, ventromedian and posterior nucleus), in the brain of the normal animal. After acupuncture PGE2 positive neurons increased in these areas. The number and gray density of the PGE2 positive neurons are higher in SP6 and P6 groups than that in normal and pregnancy control groups (P<0. 05).Summary1. At first time, we analyzed the 9 RCT articles by using systematical review and got positive result that supports the acupuncture effect for primary dysmenorrhea.2. EA points may regulate uterine contractility, but the effect of individual point is different. The same point or the same group of points has different influence on contractility in different functional status of the uterus. The result supports the hypotheses that effect of point posses relative specific.3. Ea could decrease the increasing amplitude and frequency of burst and slow wave caused by OT, and could increase the decreasing amplitude and frequency of burst and slow wave caused by P.4. EA could regulate the expression of ERa, OTR, PR and PGE2 in the brain of the pregnancy rat.5. The mechanism of the effect of acupuncture for primary dysmenorrhea...
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