Abstract
Background The study examined whether the acupuncture dose (number of acupoints stimulated) impacted the efficacy of acupuncture on dysmenorrhea and the relationship with autonomic nervous system regulation.Methods This three-arm randomized controlled study included a high-dose acupuncture (12 acupoints, N = 23), low-dose acupuncture (6 acupoints, N = 30) and control (N = 30) arm. The treatment course was three months. We set heart rate variation (HRV) and analgesics dependence as the primary outcome measurements; Visual Analog Scale (VAS) score, Verbal Multidimensional Scoring System (VMSS) and the 12-Item Short Form Health Survey (SF-12) quality of life questionnaires were set as secondary outcomes. SPSS version 24 was used for data analysis.Results Low-dose acupuncture was superior to high-dose in analgesics dependence (p value: low/high/control: p = 0.043/p = 0.056/p = 0.376); symptom relief (VMSS: low/high/control: p < 0.001/p = 0.007/p = 0.109); and physical quality of life (low/high/control: p < 0.001/p = 0.01/p = 0.007). The groups did not differ in HRV parameters (p > 0.05). In intergroup analysis, more significant changes were noted in the high-dose than in the low-dose group. The scattered nature of the significant changes implies that acupuncture may have a short-term effect on HRV parameters which does not correlate with the acupuncture dose.Conclusions Acupuncture can effectively treat dysmenorrheal pain, improve symptoms and reduce analgesic dependence, but the effect does not correlate with the number of acupoints stimulated. The acupuncture has short-term effect on HRV; yet whether its efficacy on dysmenorrhea is directly related to adjusting the autonomic nervous system may need more large-scale study. It is a safe and effective alternative therapy for dysmenorrhea.Trial: The Efficacy of Different Doses of Acupuncture in Dysmenorrhea, NCT03881319 at ClinicalTrials.gov,
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