Dysmenorrhea refers to abdominal pain during or before and after menstruation, usually affecting normal work and daily life. It is either primary dysmenorrhea (or functional dysmenorrhea) marked by no evident changes of the genitalia or secondary dysmenorrhea due to organic pathological changes of the genitalia. The clinical manifes-tations are mainly lower abdominal pain or lumbago before and after or during menstruation, even unbearable pain and regular occurrence with menstrual cycle. This disease pertains to abdominal pain during menstruation in TCM, usually caused by stagnation of liver qi, inhibition of blood flow or attack by cold during menstruation and unsmooth circulation of qi and blood; or by malnutrition of the uterine meridian due to asthenia of qi and blood as well as liver and kidney.
Treatment
Prescription: Zhongji (CV 3), Ciliao (BL 32), Diji
(SP 8) and Sanyinjiao (SP 6).
Modification: For coagulation of cold-dampness, Guanyuan (CV 4) and Shuidao (ST 28) are added with heavy and frequent moxibustion; for qi stagnation and blood stasis, Taichong (LR 3) and Xuehai (SP 10) are added; for insufficiency of qi and blood, Pishu (BL 20) and Zusanli (ST 36) are added; for asthenia of both the liver and kidney, Ganshu (BL 18), Shenshu (BL 23) and Taixi (KI 3) are added; for nausea and vomiting, Neiguan (PC 6) and Zhongwan (CV 12) are added.
Performance: The treatment begins 3 - 5 days before menstruation. Ciliao (BL 32) is needled 1.5 cun into the posterior sacral foramen obliquely toward the spinal column with reducing needling technique and repeated manipulation to enable warm sensation to transmit to the lower abdomen; for severe pain, electropuncture can be used. Zhongji (CV 3) is needled (urination is done first) obliquely downward to enable needling sensation to trans-mit to the lower region. Diji (SP 8) is needled with re-ducing needling technique. Sanyinjiao (SP 6) is needled obliquely upward to enable needling sensation to transmit to the upper region. For the treatment of coagulation of cold-dampness, reducing needling technique can be used and local acupoints are dealt with needle-warming moxi-bustion or moxa-roll moxibustion; for qi stagnation and blood stasis, reducing needling technique is used and no moxibustion is applied; for insufficiency of qi and blood as well as asthenia of the liver and kidney, reinforcing needling technique is used with the addition of moxibustion.
