Does Traditional Chinese Medicine pattern affect acupoint specific effect? Analysis of data from a multicenter, randomized, controlled trial for primary dysmenorrhea

OBJECTIVES

This study assessed the importance of the Traditional Chinese Medicine (TCM) pattern on an acupoint-specific effect.

DESIGN

This was a TCM pattern subdivision analysis of the first intervention data from a multicenter, randomized, controlled trial (ISRCTN24863192) (the main trial).

SETTINGS

The main trial recruited participants from six hospitals in three provinces in China.

SUBJECTS

Five hundred and one (501) participants diagnosed with primary dysmenorrhea (PD) were enrolled in the main trial.

INTERVENTIONS

The main trial randomly and equally divided participants into three treatment groups with bilateral electroacupuncture at three sites, respectively: Sanyinjiao (SP6), Xuanzhong (GB39), and an adjacent nonacupoint. Participants were diagnosed with TCM patterns before the treatment. The intervention was carried out when the visual analogue scale (VAS) score of participant's menstrual pain was ≥ 40 mm on the first day of menstruation and lasted for 30 minutes.

OUTCOME MEASURES

The immediate improvement of pain was measured with a 100-mm VAS before the intervention, at 5 minutes, 10 minutes, and 30 minutes during the intervention, and at 30 minutes after the completion of this intervention.

RESULTS

Three (3) TCM patterns (n=320) were eligible for analysis, including Cold and Dampness Stagnation pattern (n=184), Qi and Blood Stagnation pattern (n=84), and Qi and Blood Deficiency pattern (n=52). In Cold and Dampness Stagnation pattern, the SP6 group had a significant reduction in VAS scores compared with the GB39 group (mean difference -7.6 mm) and the nonacupoint group (mean difference -8.2 mm), respectively. There was no difference between the latter two groups. There were no group differences in VAS scores in the other two patterns.

CONCLUSIONS

It suggested that TCM pattern might affect acupoint specific effect on the immediate pain relief obtained for participants with PD.

[Analysis of plasma metabonomics of mini-swines with qi deficiency and blood stasis syndrome due to chronic myocardial ischemia]

OBJECTIVE

To study the changes of plasma metabolites of mini-swines with qi deficiency and blood stasis syndrome due to chronic myocardial ischemia and to explore the relationship between plasma metabonomics and qi deficiency and blood stasis syndrome.

METHODS

Twenty-two mini-swines were used in this study and were divided into sham-operation group (n=10) and model group (n=12). Ameroid constrictors were placed around the left anterior descending coronary artery of mini-swines in model group to induce chronic myocardial ischemia. Twelve weeks after Ameroid placement, physical signs, coronary angiography and echocardiography were used to evaluate qi deficiency and blood stasis syndrome; gas chromatography-mass spectrometry (GC-MS) and data mining method were used to analyze plasma metabolites of the mini-swines.

RESULTS

Twelve weeks after operation, mini-swines in model group were confirmed with qi deficiency and blood stasis syndrome. Principal component analysis (PCA) found that plasma GC-MS spectra of the two groups were significantly different. Compared with sham-operation group, endogenous metabolites in plasma were changed in model group. The levels of lipid metabolites such as glycerol, acetic acid and tricosadiynoic acid, myo-inositol, as well as amino acid metabolite proline were raised, while concentrations of glucose (eg. d-glucose, and a-D-glucoside), amino acid (eg. alanine, phenylalanine, and urea) and lipid metabolites (eg. hexadecanoic acid, propionic acid, butanoic acid, and octadecanoic acid) were declined.

CONCLUSION

Significant differences in metabolic spectrum exist in mini-swines with qi deficiency and blood stasis syndrome due to chronic myocardial ischemia and normal mini-swines. Disorders in glucose, amino acid and lipid metabolism result in a deterioration of coronary artery disease; citric acid, glucose, octadecanoic acid, hexadecanoic acid, glycerol and acetic acid are contributory to separation of the healthy from qi deficiency and blood stasis syndrome. These metabolites pattern may be used in clinical diagnosis and treatment of coronary artery disease, and also can provide a new approach to objective research in traditional Chinese medicine syndrome.