Objective

2

To investigate the clinical efficacy and safety of myofascial trigger points （MTrPs） tuina therapy in the treatment of primary dysmenorrhea （PD）.

Methods

2

Patients were randomly divided into two groups with 62 cases each. The intervention group received MTrPs tuina therapy， starting 7 days before menstruation and stopped till menstruation， once a day for 30 minutes， based on the predicted onset of menstruation. The control group was administered with sustained-release ibuprofen capsules orally， 0.3 g each time， twice a day， when dysmenorrhea occured. Both groups received treatment for 3 consecutive menstrual cycles. Before treatment and after each menstrual cycle， assessments were conducted using the visual analog scale （VAS）， COX menstrual symptom scale （CMSS） and self-rating anxiety scale （SAS）. Serum levels of prostaglandin F

2α

（PGF

2α

） and prostaglandin E

2

（PGE

2

） were measured before treatment and after the third menstrual cycle， along with uterine artery pulsatility index （PI）， resistance index （RI）， and systolic/ diastolic flow velocity ratio （S/D） assessed by ultrasound. Liver and kidney function were monitored before and after treatment， and adverse reactions were recorded.

Results

2

After the treatment of the 1st， 2nd and 3rd menstrual cycles， the VAS pain scores， total COX duration scores and total pain severity scores decreased significantly in both groups， with lower sc

ores in the intervention group than the control group regarding the VAS pain scores and total COX duration scores （

P

＜0.05）. After the treatment of the 2nd and 3rd menstrual cycles， the intervention group showed significantly lower SAS scores compared to baseline， and were also lower than those of the control group at the same time points （

P

＜0.05）. Compared to those before treatment， the intervention group exhibited a decrease in PGF

2α

and an increase in PGE

2

after the 3rd menstrual cycle， and when compared to the control group， lower PGF

2α

and higher PGE

2

levels were shown in the intervention group （

P

＜0.05）. Uterine artery blood flow parameters including PI， RI， and S/D values were not statistically significant between groups both before and after treatment （

P

＞0.05）. No adverse reactions occurred in either group during the treatment period.

Conclusion

2

MTrPs tuina can effectively alleviate pain symptoms， improve anxiety states， and regulate prostaglandin levels in PD patients， with superior effect to sustained-release ibuprofen capsules and demonstrating sound safety.