[Secondary temperature rise effect at Guanyuan (CV4) after moxibustion in patients with primary dysmenorrhea and its influence on therapeutic effect].

OBJECTIVES

To observe the secondary temperature rise effect at Guanyuan (CV4) induced by moxibustion and its correlation with therapeutic efficacy in patients with primary dysmenorrhea (PD).

METHODS

A total of 170 PD patients were divided into a non-deqi group (n=61) and a deqi group (n=109) according to the presence or absence of deqi sensation during moxibustion at CV4. After propensity score matching, 59 patients were included in each group. All patients received suspended moxibustion at CV4 for 30 min. Skin temperature at CV4 was measured before and after moxibustion. The presence or absence of secondary temperature rise effect after cessation of moxibustion was observed in both groups. Differences in effective deqi time, deqi intensity, and deqi dimensions were compared between patients with and without secondary temperature rise effect in the deqi group. Subsequently, patients in the deqi group received moxibustion treatment for 2 menstrual cycles, with (7±2) days of treatment per menstrual cycle. The short-form McGill pain questionnaire (SF-MPQ) and COX menstrual symptom scale (CMSS) were used to evaluate the influence of secondary temperature rise effect on therapeutic efficacy.

RESULTS

The incidence of secondary temperature rise effect in the deqi group was 59.32% (35/59), which was significantly higher than 3.39% (2/59) in the non-deqi group (P<0.01). In patients with secondary temperature rise effect in the deqi group, the mean degree of secondary temperature rise was (0.54±0.13) ℃, and the peak of secondary temperature rise appeared at (22.06±1.66) min after cessation of moxibustion. The cooling trend after secondary temperature rise was slower than that immediately after moxibustion (P<0.01). Compared with patients without secondary temperature rise effect, those with secondary temperature rise effect had longer effective deqi time (P<0.01), stronger deqi intensity (P<0.01), and higher incidence rates of general comfort emotional experience and autonomic response dimensions (P<0.01). The degree of secondary temperature rise was positively correlated with effective deqi time and deqi intensity (P<0.001). After treatment and at follow-up, SF-MPQ and CMSS scores in both patients with and without secondary temperature rise effect in the deqi group were lower than those before treatment (P<0.01), and scores in patients with secondary temperature rise effect were lower than those in patients without secondary temperature rise effect (P<0.05, P<0.01). The total effective rate was 95.83% (23/24) in patients with secondary temperature rise effect, which was higher than 75.00% (18/24) in patients without secondary temperature rise effect (P<0.05). The degree of secondary temperature rise was positively correlated with therapeutic efficacy (P<0.001).

CONCLUSIONS

Moxibustion at CV4 can induce a secondary temperature rise effect after deqi, which is closely related to effective deqi time, deqi intensity, and deqi dimensions. The secondary temperature rise effect at CV4 can further improve the clinical efficacy in PD patients, and a higher degree of secondary temperature rise is associated with better therapeutic effect.