ความก้าวหน้าด้านงานวิจัยในการรักษาอาการปวดประจำเดือนชนิดปฐมภูมิด้วยจุดกวนหยวน

Main Article Content

ปภาวรินทร์ อัศวเดชเมธากุล
ธิดารัตน์ องค์ศรีตระกูล

บทคัดย่อ

โรคปวดประจำเดือนชนิดปฐมภูมิ เป็นโรคที่พบบ่อยทางนรีเวช ซึ่งส่งผลกระทบต่อคุณภาพชีวิตและการทำงานของสตรี ในศาสตร์การแพทย์แผนจีน จุดกวนหยวน Guanyuan (关元, CV4) มีบันทึกมายาวนานในการใช้รักษาโรคทางนรีเวช รวมถึงอาการปวดประจำเดือน บทความนี้ได้รวบรวมและสรุปงานวิจัย วิธีการรักษาต่างๆ จุดฝังเข็มร่วมที่ใช้บ่อยคู่กับจุดกวนหยวน Guanyuan (关元, CV4) ตลอดจนสรุปกลไกของจุดกวนหยวน Guanyuan (关元, CV4) ในการรักษาโรคนี้ โดยอาศัยฐานข้อมูลจาก PubMed และ CNKI เพื่อเป็นแนวทางการรักษาทางคลินิก

Article Details

ประเภทบทความ
บทความปริทัศน์

เอกสารอ้างอิง

Kho KA, Shields JK. Diagnosis and management of primary dysmenorrhea. JAMA. 2020;323(3):268-9.

Itani R, Soubra L, Karout S, Rahme D, Karout L, Khojah HMJ. Primary dysmenorrhea: pathophysiology, diagnosis, and treatment updates. Korean J Fam Med. 2022;43(2):101-8.

Armour M, Smith CA, Steel KA, Macmillan F. The effectiveness of self-care and lifestyle interventions in primary dysmenorrhea: a systematic review and meta-analysis. BMC Complement and Altern Med. 2019;19(1):22.

Ferries-Rowe E, Corey E, Archer JS. Primary dysmenorrhea: diagnosis and therapy. Obstet Gynecol. 2020;136(5):1047-58.

Yacubovich Y, Cohen N, Tene L, Kalichman L. The prevalence of primary dysmenorrhea among students and its association with musculoskeletal and myofascial pain. J Bodyw Mov Ther. 2019;23(4):785-91.

Aboualsoltani F, Bastani P, Khodaie L, Fazjou SMB. Non-pharmacological treatments of primary dysmenorrhea: a systematic review. Arch Pharm Pract. 2020;11(1):136-42.

Liu WT, Wang CC, Lee KH, Ma XP, Kang TL. Efficacy and safety of acupuncture and or moxibustion for managing primary dysmenorrhea: a systematic review and meta-analysis. Clin Nurs Res. 2022;31(7):1362-75.

Xuan YC, Zhang HF, Liu DY, Huang YY, Li LH, Cao QN, et al. The efficacy and safety of simple-needling for the treatment of primary dysmenorrhea compared with ibuprofen: a systematic review and meta-analysis. Medicine (Baltimore). 2022;101(7):e28919.

Lozano F. Basic theories of traditional Chinese medicine. In: Lin YC, Hsu EZ, editors. Acupuncture for pain management. New York: Springer; 2014. p.13-43.

Li F, He T, Xu Q, Lin LT, Li H, Liu Y, et al. What is the acupoint? A preliminary review of acupoints. Pain Med. 2015;16(10):1905–15.

Xu DH, Luo YH, Fang G, Yan PY. Current situation analysis of clinical randomized controlled trials of TCM in treating primary dysmenorrhea. Journal of Base Chinese Medicine. 2022;28(11):1824-8. (in Chinese)

Gong CR. Study on the law of acupoint selection of acupuncture and moxibustion in treating dysmenorrhea based on CNKI database. China Medical Herald. 2021;18(22):125-8.

Kou RZ, Zou YY, Zhang JB. Discussion of biological effects of moxibustion at Guanyuan (CV4) and its influence factors. Chinese Acupuncture & Moxibustion. 2016;36(12):1273-7.

Xu T, Li ZR. The application and mechanism of Guanyuan point in gynecological disease. Liaoning Journal of Traditional Chinese Medicine. 2010;37(5):953-5. (in Chinese)

De Sanctis V, Soliman A, Bernasconi S, Bianchin L, Bona G, Bozzola M, et al. Primary dysmenorrhea in adolescents: prevalence, impact and recent knowledge. Pediatr Endocrinol Rev. 2015;13(2):512-20.

Barcikowska Z, Rajkowska-Labon E, Grzybowska ME, Hansdorfer-Korzon R, Zorena K. Inflammatory markers in dysmenorrhea and therapeutic options. Int J of Environ Res Public Health. 2020;17(4):1191.

Guimaraes I, Povoa AM. Primary dysmenorrhea: assessment and treatment. Rev Bras Ginecol Obstet. 2020;42(8):501–7.

Bajalan Z, Moafi F, MoradiBaglooei M, Alimoradi Z. Mental health and primary dysmenorrhea: a systematic review. J Psychosom Obstet Gynaecol. 2019;40(3):185-94.

Zhang Y, Yang YP, Chen YC. Analysis of the treatment of dysmenorrhea by blood syndrome differentiation from Shao Shi medical records. Journal of Zhejiang Chinese Medical University. 2019;43(1):51-3. (in Chinese)

Chen J, Yang DX, Cao Y, Ma YY, Wen CB, Huang XW. Syndrome differentiation and treatment algorithm model in traditional Chinese medicine based on disease cause, location, characteristics and conditions. IEEE Access. 2018;6:71801-13.

Ren MC, Huang HY, Zhou YX, Cao QW, Bu Y, Gao Y. TCM-SD: a benchmark for probing syndrome differentiation via natural language processing. In: Sun MS, Liu Y, Che WX, Feng Y, Qiu XP, Rao GQ, et al, Proceeding of the 21st Chinese National Conference on Computational Linguistics. Nanchang: Chinese Information Processing Society of China; 2022. p. 908–20.

Xu DH, Luo YH, Fang G, Yan PY. A summary of the progress in understanding the etiology and pathogenesis of dysmenorrhea in ancient literature. Journal of Liaoning University of Traditional Chinese Medicine. 2023;25(4):77-80. (in Chinese)

Li ZB. Regulating the Penetrating and Conception Vessels to treat dysmenorrhea two case histories. J Tradit Chin Med. 2003;73:13.

Zhang YT. Traditional Chinese medicine collection: Lingshujing (photocopy of the proofread version). 1st ed. Beijing: China Press of Traditional Chinese Medicine; 2019. (in Chinese)

Hu L, Xu P. Ancient literature-based research on indication of acupoints in confluence points of ren channel. Chinese Archives of Traditional Chinese Medicine. 2016;34(7):1569-72. (in Chinese)

Liang FR, Wang H. Acupuncture and moxibustion. 5th ed. Beijing: China Press of Traditional Chinese Medicine; 2021. (in Chinese)

Li FWH, Tang HT, Jiang CY, Wu S. Overview of ancient and modern research on treatment of gynecological disease with Guanyuan acupoint (RN4). Shandong Journal of Traditional Chinese Medicine. 2021;40(9):1017-21. (in Chinese)

Chang GQ, Feng GX. A shallow analysis of clinical practice of Guanyuan acupoint in great compendium of acupuncture and moxibustion. Chinese and Foreign Medical Research. 2022;20(12):177-80. (in Chinese)

Fu YN, Yin ZH, Xiao QW, Xu GX, Zhou J, Liang FR. Bibliometric analysis of the clinical therapeutic rules of sensitized and non-sensitized Guanyuan acupoint (CV4) in recent 5 years. Modernization of traditional Chinese Medicine and Materia Medica-World Science and Technology. 2021;23(7):2410-9. (in Chinese)

Zhou JS, Jin ZG, Tao ZL. The segmental distribution of the primary sensory neuron of the acupoints Guanyuan in the spinal ganglion. Shanghai Journal of Acupuncture and Moxibustion. 2001;20(3):40-1. (in Chinese)

Kong Y, Bu YQ, Du YJ, Jia HL. Comparative study on the therapeutic efficacy of acupuncture at Ciliao (BL32) versus Guanyuan (CV4) for primary dysmenorrhea. Shanghai Journal of Acupuncture and Moxibustion. 2016;35(2):172-4. (in Chinese)

Wang H, Zhang X, Yu YP, Ma YX. Comparison of therapeutic effects of acupuncture at Guanyuan and Shiqizhui acupoints on primary dysmenorrhea. Shanxi Journal of Traditional Chinese Medicine. 2015;31(8):35-6. (in Chinese)

Zhu FT. Study on the mechanism of the effect of needling at Guanyuan point on the hemodynamics of uterine arteries in patients with primary dysmenorrhea [dissertation]. Chengdu: Chengdu University of Traditional Chinese Medicine; 2021. (in Chinese)

Pan S, Wang S, Li J, Yuan H, Xue X, Liu Y, et al. Moxibustion for primary dysmenorrhea: an adjuvant therapy for pain relief. Evid Based Complement Alternat Med. 2022 Jan 27;2022:6864195.

Li GF, Gao ML, Liu WS, Wang YJ. Research advances in the mechanism of action of moxibustion treatment on primary dysmenorrhea. Shanghai Journal of Acupuncture and Moxibustion. 2020;39(4):508-13. (in Chinese)

Huang QR, Sa ZY, Dong YQ, Wan L, Xu JS. Effects of moxibustion at Guanyuan (RN4) acupointion conception vessel temperature in primary dysmenorrhea due to stagnation of colddampness syndrome based on infrared thermal imaging technology. Journal of Gansu University of Chinese Medicine. 2020;37(4):72-5. (in Chinese)

Lin SS, Zheng F, Liang DF, Chen LH. Clinical research on effects of the treatment of primary dysmenorrhea with moxibustion in different times. China Health Standard Management. 2017;8(24):92-3. (in Chinese)

Zhang BY. Study on the influence mechanism of brain function of moxibustion at Guanyuan point for primary dysmenorrhea based on ASL-FMRI technology [dissertation]. Beijing: Beijing University of Traditional Chinese Medicine; 2019. (in Chinese)

Xiong J, Xu SZ, Zhou XC, Xie HW, Xiang J. Study on the immediate brain effect of moxbustion at Guanyuan point in patients with primary dysmenorrhea based on rs-fMRI technology. Chinese Manipulation and Rehabilitation Medicine.2022;13(15):1-7. (in Chinese)

Zhou XC. Based on rs-fMRI technology to study the brain function regulation mechanism of the heat-sensitive Guanyuan point in patients with primary dysmenorrhea with moxibustion [dissertation]. Nanchang: Jiangxi University of Traditional Chinese Medicine; 2021. (in Chinese)

Qi JL. Clinical observation of Chinese herbs acupoint stick on Guanyuan to treat primary dysmenorrhea of cold coagulation and blood stasis. Journal of Liaoning University of Traditional Chinese Medicine. 2016;18(1):201-3. (in Chinese).

Huang Q, Lin H, Wang NS, Chen Y. Clinical observation of Tongjing patch in the treatment of primary dysmenorrhea of cold coagulation and blood stasis. Guangming Journal of Chinese Medicine. 2016;31(2):174-6. (in Chinese)

Huang HQ. Clinical comparative study on single point application and multi point application in the treatment of primary dysmenorrhea in adolescence [dissertation]. Changchun: Changchun University of Chinese Medicine; 2023. (in Chinese)

Mohammadi A, Fard MRA, Ma LX, Mu JD, Sun TY, Yu WY, et al. Analgesic effects and hemodynamic mechanisms of perpendicular and transverse needling at Sanyinjiao (SP6) in patients with primary dysmenorrhea: a randomized controlled trial. J Tradit Chin Med Sci. 2021;8(3):248-56.

Zheng M, Fan NN, Yu YP, Ma YX. Clinical study of analgesia effect of compatibility of acupuncture on Guanyuan (CV4) and Guanyuan (CV4), Sanyinjiao (SP6) acupoints on primary dysmenorrhea. Journal of Shandong University of Traditional Chinese Medicine. 2015;39(6):527-8. (in Chinese)

Liu Q, Li XM, Ren KY, Yang S. Effects of mild moxibustion on the uterine microcirculation in patients of primary dysmenorrhea. Chinese Acupuncture & Moxibustion. 2018;38(7):717-20. (in Chinese)

Wang HB, Cui JM, Zhao S, Li XQ, Ma SX, Li Q, et al. Effect on primary dysmenorrhea treated by acupuncture and moxibustion. Chinese Archives of Traditional Chinese Medicine. 2014;32(4):869-71. (in Chinese)

Luo Y. Clinical study of moxibustion Shenque and Guanyuan combined with auricular point sticking for primary dysmenorrhea of blood stasis type [dissertation]. Wuhan: Hubei University of Chinese Medicine; 2020. (in Chinese)

Liu YH, Wang X. Clinical observation of 147 patients of primary dysmenorrhea of cold and blood stagnation syndrome in treatment with moxibustion. World Journal of Integrated Tradition and Western Medicine. 2019;14(9):1316-8. (in Chinese)

Yu J, Zhao WC, Li N. Effect of time of moxibustion on plasma PFG2α content in the patient with primary dysmenorrhea due to cold coagulation and blood stasis. Journal of Liaoning University of Traditional Chinese Medicine. 2017;19(12):118-20. (in Chinese)

Xue X, Huang Y, Liu X, Yue ZH, Han CP. Clinical studies on different acupuncture time for primary dysmenorrhea. Journal of Acupuncture and Tuina Science. 2016;14(6):416-9. (in Chinese)

Chen WW. Different parts of compatibility acupoints acupuncture treatment of primary dysmenorrhea (cold coagulation and blood stasis type) therapeutic effect difference [dissertation]. Changchun: Changchun University of Chinese Medicine; 2021. (in Chinese)

Cheng XM, Liu RP, Wang YJ. Clinical study on acupuncture for treatment of primary dysmenorrhea of cold coagulation and blood stasis by “tonifying spleen and stomach, regulating Ren meridian”. Chinese Journal of Information on Traditional Chinese Medicine. 2021;28(2):102-6. (in Chinese)

Li N. Clinical effect of acupuncture and moxibustion with “regulating mind and fixing pain” on primary dysmenorrhea of college students [dissertation]. Yinchuan: Ningxia Medical University; 2022. (in Chinese)

Wu LY. Acupuncture combined with warm moxibustion box was used to treat primary dysmenorrhea with cold coagulation and blood stasis [dissertation]. Hefei: Anhui University of Chinese Medicine; 2023. (in Chinese)

Jiang B, Zhang SQ. Clinical effect of Dingtong Wenjing decoction with warming needle moxibustion on primary dysmenorrhea in cold coagulation blood stasis syndrome and its effect on uterine arterial blood flow mechanics, serum endorphins and pain mediators. World Journal of Integrated Traditional and Western Medicine. 2020;15(2):334-8. (in Chinese)

Li C. A study on the efficacy of herbal-cake partitioned moxibustion of acupoints on Du and Ren meridians for primary dysmenorrhea and its effect on the levels of serum estrogen and progesterone [dissertation]. Nanning: Guangxi Traditional Chinese Medicine University; 2021. (in Chinese)

Zhang Y, Gong DF, Pan YF, Jiang X. Clinical efficacy of thunder-fire moxibustion and Yinqi Guiyuan needles therapy combined with modified Danggui Sini decoction for primary dysmenorrhea of cold-damp coagulation type. Hebei Journal of Traditional Chinese Medicine. 2023;45(8):1353-7. (in Chinese)

Zhang YJ. Clinical observation of abdominal acupuncture combined with thunderfire moxibustion on seventeen vertebrae in the treatment of primary dysmenorrhea with cold coagulation and blood stasis [dissertation]. Fuzhou: University of Traditional Chinese Medicine; 2023. (in Chinese)

Zhang Y, Pan YF, Gan HY, Jiang X. Abdominal acupuncture combined with Danggui Sini Tang modified for PGF2α、PGE2 in patients with primary dysmenorrhea and the impact of pain severity. Jilin Medical Journal. 2023;44(5):1256-9. (in Chinese)

Wang MH, Zhao JP, Li JY. A randomized controlled study of abdominal acupuncture combined with auricular point sticking in the treatment of primary dysmenorrhea. Modern Journal of Integrated Traditional Chinese and Western Medicine. 2022;31(5):630-3. (in Chinese)

Zeng SJ, Zhen MQ, Weng C. Study on the regulation mechanism of fire on PGF2α and PGE2 in primary dysmenorrhea with cold coagulation and blood stasis. Chinese Manipulation and Rehabilitation Medicine. 2022;13(9):5-8. (in Chinese)

Wang XY, Chen CY, Yang SW. Discussion on the mechanism and clinical application of filiform fire needle in the treatment of primary dysmenorrhea of cold dampness stagnation type. Journal of Guangdong Pharmaceutical University. 2022;38(4):115-7. (in Chinese)

Pan QY. Effect of filiform fire needling therapy combined with needling SP6 on the Serum levels of β-EP and ET-1 in patients with primary dysmenorrhea. Journal of Clinical Acupuncture and Moxibustion. 2020;36(11):30-3. (in Chinese)

Li N, Wang JZ, Lou BD. Acupoint compatibility law of acupoint catgut embedding in the treatment of primary dysmenorrhea. Henan Traditional Chinese Medicine. 2022;42(7):1109-13. (in Chinese)

Ma YH, Gu XD. Effects of acupoint catgut embedding combined with moxibustion on uterine artery hemodynamics and VAS scores in patients with PD. Journal of Clinical Acupuncture and Moxibustion. 2022;38(3):21-5. (in Chinese)

Zheng F, Zhang XX, Hang LP, Zhao T. Clinical observation of primary dysmenorrhea treated by acupoint catgut embedding. Chinese Journal of Women and Child Health Research. 2021;32(11):1692-5. (in Chinese)

Wong CP. Clinical study on treating primary dysmenorrhea with cold congelation and blood stasis with acupoint application therapy combined with traditional Chinese medicine granules [dissertation]. Guangdong: GuangzhouUniversity of Chinese Medicine; 2019. (in Chinese)

Li WY. Randomized controlled trail of the treating primary dysmenorrhea with Shaofu-Zhuyu decoction acupoint application [dissertation]. Chengdu: University of Traditional Chinese Medicine; 2018. (in Chinese)

Liu M. Clinical study of acupointion on primary dysmenorrhea of cold coagulation and blood stasis type. Nanchang: Jiangxi University of Chinese Medicine; 2021. (in Chinese)

Chen YP, Ling Q. Effect of acupoint application combined with health education on improving the pain intensity in patients with primary dysmenorrhea. Nursing of Integrated Traditional Chinese and Western Medicine. 2021;7(7):53-6. (in Chinese)

Wang Y, Luo L, Li XH, Zhao PF, Zhang QQ, Zhu SP, et al. Effect of acupuncture at Guanyuan (CV4) on writhing response and vasomotor substances in rats with dysmenorrhea due to coagulated cold syndrome. Shanghai Journal of Acupuncture and Moxibustion. 2016;35(6):636-8.

Luo L, Ren XX, Guo MW, Zhao YF, Li XH, Ji B, et al. Effect of acupuncture at Guanyuan (CV4) on skin temperature at bilateral Sanyinjiao (SP6) and on TXB2/6-keto-PGF1a of dysmenorrhea rats with coagulation cold pattern. Journal of Beijing University of Traditional Chinese Medicine. 2017;40(1):48-51. (in Chinese)

Yang JM, Shen XY, Zhang L, Luo L, Xu YS, Ren XX, et al. Effect and the mechanism of acupuncture at different acupoints for the uterus contractions in dysmenorrhea rats with cold congealing. Acta Chinese Medicine and Pharmacology. 2017;45(6):73-6. (in Chinese)

Cui X, Zhou J, Zhang M, Liu ZZ, Yang JM, Qi DD, et al. Different acupuncture stimulus at Guanyuan (RN4) on dysmenorrhea rats model with cold syndrome. Journal of Changchun University of Chinese Medicine. 2016;32(2):241-4. (in Chinese)

Qin ZY, Chen PB, Yang WW, Jin LM, Tang XY, Zhou YJQ, et al. Effects of herbal-cake-partitioned moxibustion of Guanyuan (RN4) on pain response and serum β-EP, uterine PGE2/PGE2α and spleen NK cell activity in primary dysmenorrhea rats. Journal of Emergency in Traditional Chinese Medicine. 2021;30(10):1701-4. (in Chinese)

Qi SS, Chen PB, Huang JM, Yan HL, Hu L. The effect of moxibustion at different acupoints on the activity of NK cells in the rat model of primary dysmenorrhea. Asia-Pacific Traditional Medicine. 2017;13(15):4-7.(in Chinese)

Liu C. Effects of ginger separated moxibustion at “Shenque” and “Guanyuan” on the levels of gene receptor expression of endocrine related molecular receptors in rats with primary dysmenorrhea of cold and dampness stagnation [dissertation]. Shijiazhuang: Hebei University of Chinese Medicine; 2021. (in Chinese)

Chen ZH. The PGF2α/PGE2 balancing homeostasis characteristics study of mild moxibustion improving uterine microcirculation of primary dysmenorrhea rats [dissertation]. Chengdu: Chengdu University of Traditional Chinese Medicine; 2020. (in Chinese)

Zhao ZF, Tang CZ. Effect of electroacupuncture at Guanyuan (CV4) and Sanyinjiao (SP6) on serum IL-2,5-HT and substance P in dysmenorrhea model rats. Global Traditional Chinese Medicine. 2017;10(5):541-3. (in Chinese)

Li GY. The pain relief effect of electro-acupuncturing Guanyuan and Sanyinjiao on rats with dysmenorrhea and its action mechanism [dissertation]. Guangdong: Guangzhou University of Chinese Medicine; 2015. (in Chinese)

Gong CR. Study on the law of acupoint selection of acupuncture and moxibustion in treating dysmenorrhea based on CNKI database. China Medical Herald. 2021;18(22):125-8. (in Chinese)

Zou Y, Sun JH, Pei LX. Analysis on acupoint selection rules for primary dysmenorrhea. Clinical Journal of Chinese Medicine. 2022; 14(3):139-44. (in Chinese)