title: The effect of moxibustion on alleviating menstrual pain in a population of young nursing students: A prospective randomized cross-over pilot study.
abstract: OBJECTIVE
  To investigate the effect of moxibustion on alleviating menstrual pain and relieving the symptoms of dysmenorrhea in a cohort of young nursing students in China.
  
  
  METHODS
  A randomized double blind clinical trial of crossover design was used. In the two-phase study, a total of 56 nursing students with menstrual pain in Guangzhou University of Chinese Medicine in China was randomly allocated into two groups. In the first treatment phase, the participants in Group A (n=28) received moxibustion therapy from five days before the menstrual period to the onset through a specific heating box in which burning moxa stick was fixed, the participants in Group B (n=28) received the same heating box but with a paper-wrapped stick incense fixed inside (placebo therapy) during the same intervention period. The acupoints Guanyuan(CV4) and Shenque(CV8) were selected for treatment. After the first treatment phase for two menstrual cycles, the intervention was stopped for three menstrual cycles during a wash period. In the second treatment phase, the intervention of two groups were switched. Group A received the placebo therapy and Group B received moxibustion therapy. NRS, VRS, PRI, VAS and BRS-6 were evaluated at the baseline and after each treatment phase.
  
  
  RESULTS
  There was no statistically significant difference in age, history of dysmenorrhea, length of menstrual cycle, age at menarche, duration of menstrual flow, PRI score, VAS score, BRS score and RSS score between Group A and Group B (p>0.05). After the first treatment phase, the score of BRS-6 has significant differences between two groups at the first menstrual cycle (p<0.05). At the second menstrual cycle, the score of VAS, BRS-6,sensory of PRI, affective dimension of PR and total score of PRI in Group A were much lower than Group B (p<0.05). NRS and VRS had significant differences between two groups with Wilcoxon Mann-Whitney test after the first treatment phase (p<0.05). The frequency rating of weakness, loss of appetite, diarrhea, and the total score had significant differences between two groups at the first menstrual cycle (p<0.05). And the frequency rating of weakness, backache, facial blemishes, loss of appetite, diarrhea, and the total score had significant differences between two groups at the second menstrual cycle (p<0.05). The severity rating of backaches, loss of appetite, sleeplessness, and the total score had significant differences between two groups after the second menstrual cycle (p<0.05). After three months' wash period, the score of VAS, BRS-6, sensory of PRI, affective of PR, total score of PRI and VRS had significant differences between two groups after the second treatment phase (p<0.01). And the frequency rating of leg aches, dizziness, nervousness and the total score had significant differences between two groups after the second treatment phase (p<0.05). And the severity rating of abdominal pain, weakness, leg aches, dizziness, nervousness and the total score had significant differences between two groups after the second treatment phase (p<0.05).
  
  
  CONCLUSIONS
  The results suggested that moxibustion therapy with a heating box was effective for alleviating menstrual pain and symptoms of young female university students in China. The effect of moxibustion might not only due to heat stimulation, but also from the burning of moxa stick. Boxing moxibustion could be recommended as a nonpharmacological pain relief intervention for university students for its cost effectiveness, practical design and relative safety, and it is easy for the university students themselves to self-administer at home.
authors.affiliation: School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou 510006, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Gao
authors.affiliation: Institute of Clinical Phamacology, Guangzhou University of Chinese Medicine, Guangzhou 510006, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Wang
authors.affiliation: The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, China.
authors.forename: Shaoxiang
authors.initials: S
authors.lastname: Xian
authors.affiliation: School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou 510006, China.
authors.forename: Yue-mei
authors.initials: YM
authors.lastname: Feng
authors.affiliation: School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou 510006, China.
authors.forename: Wei-xin
authors.initials: WX
authors.lastname: Cao
authors.affiliation: School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou 510006, China.
authors.forename: Jing-yun
authors.initials: JY
authors.lastname: Ye
authors.affiliation: School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou 510006, China.
authors.forename: Qing-qing
authors.initials: QQ
authors.lastname: Zhang
authors.affiliation: School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou 510006, China.
authors.forename: Cai-lian
authors.initials: CL
authors.lastname: Zou
authors.affiliation: School of Chinese Materia Medica, Guangzhou University of Chinese Medicine, Guangzhou 510006, China. Electronic address: zyx321@gzucm.edu.cn.
authors.forename: Qing-guang
authors.initials: QG
authors.lastname: Wu
authors.affiliation: School of Chinese Materia Medica, Guangzhou University of Chinese Medicine, Guangzhou 510006, China. Electronic address: liusijun@gzucm.edu.cn.
authors.forename: Si-jun
authors.initials: SJ
authors.lastname: Liu
mesh_terms: D000328:Adult; D002681:China; D018592:Cross-Over Studies; D004412:Dysmenorrhea / Q000503:physiopathology* / Q000628:therapy*; D005260:Female; D006801:Humans; D009071:Moxibustion / Q000379:methods*; D010147:Pain Measurement; D010865:Pilot Projects; D011446:Prospective Studies; D013338:Students, Nursing; D055815:Young Adult
keywords: Dysmenorrheal; Moxibustion; Randomized cross-over study