针灸治疗痛经
什么是痛经
痛经是指妇女在行经前后或行经期间出现的周期性的小腹及腰骶部疼痛。疼痛剧烈者可伴有面色苍白，头面冷汗，恶心呕吐，手足厥冷等症，给患者带来很大痛苦。痛经在年轻女性中多见。
痛经的原因及分类
痛经可分为原发性痛经和继发性痛经两大类。原发性痛经也称功能性痛经，是指经过仔细的妇科检查，生殖器官并无器质性病变者。继发性痛经是指由于某些生殖器官器质性病变而发生的痛经。常可继发痛经的病变如子宫发育不良，子宫过于前屈和后倾，子宫颈狭窄，子宫内膜异位症，急性盆腔炎等。
中医学理论认为不通则痛，因此本病的发病机制为冲任气血的运行不畅。其原因有虚有实，实者可因气滞血瘀，寒湿凝滞；虚者可因气血亏虚，肝肾不足引起。经前经期腹痛多为实证，经后腹痛者多虚证。疼痛拒按者多实，痛时蜷缩喜揉喜按者多虚。
痛经的治疗
无论原发性还是继发性，均可采用针灸疗法进行治疗。针灸对原发性痛经，不仅能制止疼痛，还常可根治。至于器质性痛经，也有一定的止痛作用，但难以根治。
针灸治疗痛经优先选用毫针刺法，一般针刺中极、三阴交、地机、次髎等穴，再根据证型不同配伍其它穴位。对寒湿凝滞和气血不足者可以加灸。
（1）耳穴压豆
对于惧怕针刺的患者也可以采用耳穴压豆（用王不留行籽或其它植物种子压在耳朵上的响应穴位），常选内分泌、内生殖器、肝、肾、皮质下等穴位，每次3~5穴，每次压豆可保持2-3天。
（2）皮肤针叩刺
取腰骶部、下腹部、肾经和肝经的相关穴位，循经叩刺，以皮肤潮红为度。
- 穴位贴敷
取神阙穴，用吴茱萸、白芍、元胡、艾叶等，共研细末，用白酒调成糊状贴敷。
针灸治疗痛经的疗效和治疗时机
针刺治疗痛经的疗效不仅被两千年的中国针灸实践证实，也已经在世界多个国家进行的现代临床试验所证实，并被世界卫生组织列为针灸治疗有效疾病之一推荐使用。
针灸治疗痛经有非常好的及时止痛效果，尤其是对原发性痛经，在痛经发生时针刺，可以很快减缓疼痛甚至使疼痛消失。针灸治疗痛经不仅有很好的止痛效果，如果按规律进行治疗，还可以根治痛经，尤其是对原发性痛经。
痛经是周期发生的，所以要想根治痛经需要遵循一定的治疗时间。痛经的最佳治疗时间为经前一周和行经期，发作期每天治疗1次，非发作期隔日治疗1次，一般连续治疗2~4个月经周期。
其他建议
注意经间期卫生和保暖，避免过食生冷，精神刺激和过度劳累。
医案
女，20岁，学生
每于月经第一天和第二天小腹部和腰骶部疼痛难忍，坐卧不安，饮食减少，睡眠不安，饮姜糖水稍有缓解。就诊时为月经第一天，疼痛难忍，神情疲惫，原本预约来做针灸治疗胃痛的，因痛经难忍于是为其针灸治疗痛经。取双侧次髎及十七椎下。针刺后10分钟，疼痛缓解。继续留针30分钟，疼痛消失，起针。患者高兴异常，热烈拥抱医者。遂建议其注意休息及保暖，以防受凉劳累引发疼痛。第二天上午询问其痛经有无再发，答曰基本没有再痛，非常感谢。
Acupuncture for Dysmenorrhea
What is Dysmenorrhea
Dysmenorrhea, also known as painful periods, or menstrual cramps, refers the pain in the lower abdomen and lumbosacral region prior to, during or after the menstruation period. The It is commonly seen in young women.
Types and Causes of the Dysmenorrhea
There are two types of dysmenorrhea: Primary and Secondary. Primary dysmenorrhea, also called functional dysmenorrhea, refers to a condition without pathological changes of the genitalia. Secondary dysmenorrhea is caused by diseases such as endometriosis, acute or chronic pelvic inflammation, tumors, blockage or cervical stenostomia.
In Chinese medicine, Dysmenorrhea is due to stagnation of qi and blood. The factors may be emtion change, cold and dumpness, deficiency of qi and blood. Emotion changes cause blockage of qi, then cause pain; cold cause contraction of vessel, also cause pain; deficiency of qi and blood, on the one hand could blockage of qi and blood, on the other hand, could not nutrish the muscles and internal organs and cause pain.
Treatment Dysmenorrhea with Acupuncture
Primary and secondary dysmenorrhea can be treated with acupuncture. For primary dysmenorrhea, acupunture not only can stop the pain instantly, also can stop pain forever after several sessions of treatment. For secondary dysmenorrhea, after stop pain with acupuncture, we’d better to treat the diseases that causes Dysmenorrhea.
Primary treatment
Usually we use body acupuncture to treat dysmenorrhea. The common points for treating dysmenorrhea are Zhongji, Sanyinjao, Diji, Ciliao. We will add some points according to different patterns and we may use moxibustion for dysmenorrhea caused by cold and deffiency of qi and blood.
Other treatment
Some people may be afraid of body acupuncture. There are other options for treating Dysmenorrhea with acupuncture, such as seven star acupuncture and auricular acupuncture. Seven star needles does not get into the skin. We only tap the skin until it becomes red. We also use auricular acupuncture to treat Dysmenorrhea. We put some plant seeds on some points of your ears, keep it for 2 to 3 days and you press them until you feel a little bit pain.
The effective and the best timing of treating Dysmenorrhea with acupuncture
All above methods can help you relieve your pain during your periods. Treating Dysmenorrhea with acupuncture not only has been practiced by Chinese people over thousands years, it also has been proved -through controlled trials -to be effective. WHO has already listed acupuncture as an effective treatment for Dysmenorrhea.
Acupuncture usually relives pain just after treatment. For some case, it may need more times. For primary Dysmenorrhea, In order to cure it, the treatment should begins 5 to 7 days prior to menstruation, approximately 5-7 treatments are administrated in one course and a continuous treatment should be administrated for 2-4 months.
For secondary Dysmenorrhea, symptoms may be relieved after acupuncture treatment, but the primary disease should be treated properly.
Other advices
The patient should avoid strong physical exertion and mental irritation. Maintaining good hygiene especially during the menstruation, avoiding the cold and not eating too much raw and cold food is important for the patient.
Case 1:
Female, 20, university student. 2pm
She has had pain in the low abdomen and low back on the first and second day of her menstruation for several years. Her period came in the morning and she had sever pain in her low abdomen and low back from the morning. She looked pale and she put her hand on her low abdomen when she was in clinic. She was very tired, blue and no appetite. After several questions, i inserted three needles into the Ciliao and ashi, . Around 10 minutes, she began to feel comfortable. 30 minutes later, she had no pain at all. She was so happy and gave me a big hug. Next morning i called her and she said she just had a little bit uncomfortable but no pain any more.
