Bloodletting at auricular dorsal vein combined with auricular point sticking for menstrual migraine of qi stagnation and blood stasis and its effect on serum levels of E2 and 5-HT / 中国针灸

OBJECTIVE@#To observe the clinical effect of bloodletting at auricular dorsal vein combined with auricular point sticking on menstrual migraine (MM) of qi stagnation and blood stasis, and explore its possible mechanism.@*METHODS@#A total of 102 cases of MM with qi stagnation and blood stasis were randomly divided into an observation group (51 cases, 3 cases dropped off) and a control group (51 cases, 2 cases dropped off). The patients in the observation group were treated with bloodletting at auricular dorsal vein combined with auricular point sticking. The bloodletting was performed at vein at upper 1/3 of the dorsalis near the ear helix; the auricular point sticking was performed at Pizhixia (AT4), Neifenmi (CO18), Jiaogan (AH6a), Nie (AT2), Zhen (AT3), Shenmen (TF4) and Yidan (CO11). The auricular points of both ears were alternate used. From 7 days before the onset of menstruation, bloodletting at auricular dorsal vein was given once every 7 days, 3 times were taken as a course of treatment, and 1 course of treatment was given; the auricular point sticking was given once every 3 days, and 6 times of treatment were given. The patients in the control group were treated with oral administration of flunarizine hydrochloride capsules. From 7 days before the onset of menstruation, flunarizine hydrochloride was given 2 capsules per time, once a day for 3 weeks. The menstrual headache index and visual analogue scale (VAS) score of the two groups were observed before treatment, one menstrual cycle into treatment and the first and the second menstrual cycle after treatment; the migraine-specific quality of life questionnaire (MSQ) score and the serum levels of estradiol (E2) and 5-hydroxytryptamine (5-HT) were compared before treatment and one menstrual cycle into treatment; the clinical efficacy was evaluated at one menstrual cycle into treatment.@*RESULTS@#Compared before treatment, the menstrual headache index and VAS scores were reduced at one menstrual cycle into treatment and the first and second menstrual cycle after treatment in the two groups (P<0.05), and those in the observation group were lower than the control group (P<0.05). Compared before treatment, the MSQ scores and the serum levels of E2 and 5-HT in the two groups were increased at one menstrual cycle into treatment (P<0.05), and those in the observation group were higher than the control group (P<0.05). The total effective rate was 95.8% (46/48) in the observation group, which was higher than 73.5% (36/49) in the control group (P<0.05).@*CONCLUSION@#Bloodletting at auricular dorsal vein combined with auricular point sticking could relieve headache intensity, improve the quality of life in patients with MM of qi stagnation and blood stasis, which may be achieved by raising the serum levels of E2 and 5-HT to improve the level of hormone in the body.

Femininity and migraine management / 中风与神经疾病杂志

@#Migraine is a common neurological disorder，with a significantly higher prevalence rate in women than in men，and more than half of female patients have headache attacks associated with menstruation.Migraine in women is closely associated with the changes in hormones during the menstrual cycle，and the effect of “estrogen withdrawal” might be one of the possible mechanisms.Changes in hormones may play an important role in the development of migraine.Understanding the relationship between changes in each life stage and physiological cycle of women and headache may help to develop individualized treatment strategies，thereby improving the symptoms and prognosis of patients.

Anxiety/depression symptoms and sleep quality in patients with menstrual migraine / 四川精神卫生

ObjectiveTo assess the anxiety and depression symptoms and sleep quality in patients with menstrual migraine， so as to provide references for the prevention and treatment of menstrual migraine and its comorbidity. MethodsAccording to the diagnostic criteria of the International Classification of Headache Disorder， third edition （ICHD-3）， 501 female migraine patients， including 112 patients with menstrual migraine and 389 patients with non-menstrual migraine， who attended the outpatient clinic of the Affiliated Hospital of North Sichuan Medical College from February 2019 to February 2020， were selected for the study. The general and clinical data of the patients were collected， meantime， patients were assessed using Hamilton Anxiety Scale （HAMA）， Hamilton Depression Scale-24 item （HAMD-24）， 6-item Headache Impact Test （HIT-6） and Pittsburgh Sleep Quality Index （PSQI）. ResultsThe detection rates of pure anxiety， pure depression， comorbid anxiety-depression and sleep disorders in patients with menstrual migraine were higher than those in patients with non-menstrual migraine （χ2=4.198， 4.355， 5.236， 8.624， P<0.05 or 0.01）. Patients with menstrual migraine had higher scores of HAMA、HAMD-17、PSQI and HIT-6 than those of non-menstrual migraine patients （Z=-3.550、-2.723、-2.482、-4.717，P<0.05 or 0.01）. Correlation analysis showed that PSQI score of menstrual migraine patients was positively correlated with HAMA score （r=0.338， P<0.01）， HAMD-24 score （r=0.372， P<0.01） and HIT-6 score （r=0.192， P<0.05）. ConclusionCompared with non-menstrual migraine patients， patients with menstrual migraine experience more severe anxiety and depression symptoms and sleep problems and suffer greater negative life impacts. In addition， the influence of anxiety and depression symptoms and headache on daily life is associated with sleep quality.

Hospital based Cross-Sectional Study of Menstrual Migraine in an Urban Slum Population

Introduction: Prevalence of migraine is higher in womenthan men.Incidence of menstrual migraine is more incomparison to premenstrual migraine.Migraine is a complexcondition with headache and sensory disturbances. This studywas carried out to analyze the incidence of different type ofmenstrual migraine in varying age group.Material and methods: In this study 155 women of agegroup 17 to 31 years taken. They were complaining of at leasttwo times migraine attack per month during menstrual cycle.They were advised to record the day of migraine i.e. on 5thdays before menstruation, 2 days before menstruation and 1stday of menstruation to 3 days following bleedingwith historyof headache, severity, attack duration and disability at workand association with aura or without aura, for 3 months.Thestatistical analysis was done under SPSS software by usingchi-square test.Results: We found that severe attacks occurred during thepremenstrual phase i.e. 5 days before onset of menstruationand it is more severe before 2 days of onset of menstruation.The severity of migraine in age group (17-21) years is higherthan other age groups. The incidence of migraine duringmenstrual period is more in comparison with the premenstrualperiod.Relative incidence of only migraine during menstrualperiod is found more i.e.70.09%, whereas migraine with aurafound more in premenstrual period, i.e.75%.Conclusion: The incidence of migraine in female increasesduring adolescent period and peaks during menarche due todelay in decline of oestrogen level. So preventive measures formigraine can be taken by individual awareness, establishmentof a stable oestrogen state and use of non-steroidal antiinflammatory agents.

Clinical study on the treatment of menstrual migraine by acupuncture taichong and yongquan points / 西安交通大学学报(医学版)

Objective: To explore the clinical effect of the treatment of menstrual migraine (MM) by acupuncture taichong and yongquan points. Methods: We selected 90 patients with confirmed diagnosis of MM from January 2017 to January 2018 and randomly divided them into three groups: acupuncture treatment group, drug therapy, and acupuncture + medication group, with 30 cases in each group. In the acupuncture treatment group, the patients were treated by using acupuncture taichong and yongquan points. Those in the drug treatment group received oral medication of fluoroguirizine hydrochloride capsules. The combined therapy group received both body acupuncture treatment and oral fluoroguirizine hydrochloride capsule treatment. We compared the total headache score, the migraine specific quality of life questionnaire (MSQ), plasma calcitonin gene-associated peptide (CGRP) and 5-hydroxytryptamine (5-HT) before and after treatment. The clinical efficacy of the three groups was compared. Results: Before treatment, the headache score, MSQ, CGRP and 5-HT in the three groups did not differ (P>0.05). After treatment, the headache score, MSQ, CGRP and 5-HT of the three groups had decreased (P<0.05). Compared with the acupuncture treatment group and the drug therapy, the headache score, MSQ, CGRP and 5-HT of the three groups decreased in the acupuncture + drug therapy group (P<0.05). The total effective rate of the combination group was significantly higher than that of the other two groups (P<0.05). Conclusion: The clinical effect of acupuncture taichong and yongquan points on the treatment of menstrual migraine is significant. It can significantly improve the patients' headache symptoms and lift their quality of life.

<b>Assessment of Types of Menstrual Migraine Treated with Periodical Application of Goreisan in Combination with G</b><b>oshuyuto</b> / 日本東洋医学雑誌

<p><b>Background </b>: Menstrual migraine is more resistant to treatment than that of nonmenstrual episodes. Hormonal progesterone changes may cause <i>sui </i>(water/fluid) disturbance, in Kampo medicine terms. We therefore treated patients with menstrual migraine in which goshuyuto was ineffective, with the combination of goreisan and goshuyuto.<br><b>Subjects & Methods </b>: Subjects were 37 female patients with coldness (mean age 37 years, age range 23-48 years), whose migraine during their intra-menstrual periods was successfully treated with goshuyuto for 3 months. In order to treat migraine in the menstrual period, goreisan was added to goshuyuto from 1 week before onset, until the end of their menstrual period. <b>Results </b>: Among 37 patients, the treatment was effective in 26 patients (70%). Significant variables were found to be dull headache (p = 0.003), edema (p = 0.006), vertigo (p = 0.014) and oliguria (p = 0.014) during attacks, as well as worsening before rain (p = 0.004). <b>Conclusion </b>: The periodical combination of goreisan and goshuyuto seems to be effective in patients with menstrual migraine who report symptoms of <i>sui </i>disturbance, such as dull headache and oliguria during their attacks.</p>