THE JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE

Volume 16, Number 10, 2010, pp. 1073–1078

ª Mary Ann Liebert, Inc.
DOI: 10.1089/acm.2009.0326

Immediate Effect of Acupuncture at Sanyinjiao (SP6)

and Xuanzhong (GB39) on Uterine Arterial Blood Flow
in Primary Dysmenorrhea

Yan-Pu Yu, MD,1,*,{ Liang-Xiao Ma, MD, PhD,2,* Yu-Xiang Ma,3 Yu-Xia Ma, MD, PhD,1 Yu-Qi Liu, MD,2
Cun-Zhi Liu, MD, PhD,4 Jie-Ping Xie, MD, PhD,2 Shu-Zhong Gao, MD,1,* and Jiang Zhu, MD 2,*

Abstract

Objective: The objective of this study was to compare immediate effect of acupuncture at SP6 on uterine arterial
blood flow in primary dysmenorrhea with that of GB39.
Design: This was a prospective, randomized clinical trial.
Setting: Sixty-six (66) patients with primary dysmenorrhea from the Affiliated Hospital of Shangdong University
of Traditional Chinese Medicine were recruited.
Interventions: The SP6 group (n ¼ 32) was treated with manual acupuncture at bilateral SP6 for 5 minutes after
obtaining needling sensation (de qi) during the period of menstrual pain, whereas the control group (n ¼ 34) was
needled at GB39 of both sides for 5 minutes when they suffered menstrual pain.
Main outcome measures: Differences in pulsatility index (PI), resistance index (RI), and ratio of systolic peak and
diastolic peak (A/B) in uterine arteries were the main outcome measures.
Results: Highly significant reductions were observed in the SP6 treatment group 5 minutes after treatment in
menstrual pain scores (8.17  1.90 versus 11.20  2.66; p < 0.001), values of PI (1.75  0.48 versus 2.32  0.70;
p < 0.001), RI (0.72  0.11 versus 0.78  0.07; p < 0.001), and A/B (4.33  1.37 versus 5.23  1.67; p < 0.001).
Compared with the GB39 control group, patients in the SP6 treatment group showed significant reductions in 5
minutes after treatment in the changes of menstrual pain scores (3.03  2.36 versus 0.00  0.29; p < 0.001), values
of PI (0.57  0.42 versus 0.10  0.58; p < 0.001), RI (0.06  0.08 versus 0.03  0.15; p < 0.01), and A/B
(0.90  0.87 versus 0.23  1.02; p < 0.01). There were no significant changes in menstrual pain scores, values of PI,
RI, or A/B before and after treatment in the GB39 control group ( p > 0.05). No adverse events from treatment
were reported.
Conclusions: This study suggests that needling at SP6 can immediately improve uterine arterial blood flow of
patients with primary dysmenorrhea, while GB39 does not have these effects.

Introduction in abnormal uterine hypercontractility, impeded uterine

P rimary dysmenorrhea is a common gynecologic com-
plaint, especially among young women.1 It is the leading
cause of recurrent short-term school absence in adolescent
girls and a common problem in women of reproductive age.2
Current data show that excessive production and release of
endometrial prostaglandins (PGs) during menstruation result
blood flow, uterine hypoxia, and hypersensitization of pain
fibers by PGs.3–5 Women with primary dysmenorrhea have
elevated Doppler indices throughout the whole cycle, sug-
gesting high impedance against blood flow within the uterus.6
Many studies have shown that acupuncture is effective
for pain relief in primary dysmenorrhea.7–9 According to
the principles of Chinese medicine, Sanyinjiao (SP6) is the

1
School of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine, Jinan, China.
2
School of Acupuncture and Moxibustion, Beijing University of Chinese Medicine, Beijing, China.
3
Shandong Institute of Medical Imaging, Jinan, China.
4
Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University, Beijing, China.
*These authors and their affiliations of Shandong University of Traditional Chinese Medicine and Beijing University of Chinese Medicine
contributed equally to this work.
{
Present address: Affiliated Hospital of Shandong Provincial Medical Science Academy, Jinan, China.

1073
1074
junction point of Liver, Spleen, and Kidney meridians. It is
proposed to strengthen Spleen, regulate qi and Blood, and
nourish Liver and Kidney. Moreover, SP6 is considered to
have an internal branch that traverses the uterus and thus is
supposed to have a direct effect on the pelvic region. There-
fore, SP6 is commonly used for gynecologic indications, es-
pecially for alleviating dysmenorrhea.10–12 Xuanzhong (GB39)
is a point of Gallbladder meridian located at the lateral aspect
of calf and opposite to SP6, and it is rarely used to relieve
dysmenorrhea based on Chinese medicine, nor is it reported.
Although in Chinese medicine it is widely believed that
each acupoint has its special function, there are few research
reports about it. Therefore, the authors found it is necessary
to provide some reliable evidence for this widely believed
principle of traditional acupuncture. Considering that men-
strual pain is closely related to uterine arterial blood flow, in
order to evaluate and compare the efficacy of SP6 and GB39
on relieving menstrual pain, color Doppler ultrasonography
was applied in this study to calculate the indexes of blood
flow in uterine arteries such as pulsatility index (PI), resis-
tance index (RI) values, and ratio of systolic peak and dia-
stolic peak (A/B ratio) in women with primary
dysmenorrhea in 5 minutes before and after acupuncture,
respectively, so as to discuss the specificity of acupoints.
Materials and Methods
Subjects and setting
In this study, 66 women with primary dysmenorrhea from
the Gynecology Department of Affiliated Hospital of Shan-
dong University of Traditional Chinese Medicine, in Shang-
dong, China were recruited between October 2006 and
December 2006. The inclusion criteria were the following: (1)
patients met diagnostic criteria of primary dysmenorrhea in
Primary Dysmenorrhea Consensus Guideline13; (2) patients
had willingness to participate in the trial; (3) patients had no
severe primary diseases in liver, kidney, blood and endo-
crine systems and no psychologic disorders; and (4) patients
had no current participation in other trials. The exclusion
criteria included patients with organic diseases of repro-
ductive system, such as pelvic inflammation, tumor of
uterus, endometriosis, and so on, resulting in dysmenorrhea.
The study protocol was approved by the National Drug
and Clinical Investigation Ethics Board of Affiliated Hospital
of Shandong University of Traditional Chinese Medicine.
Each participant signed an informed consent prior to enrol-
ment.
Acupuncture intervention
Patients were randomized before treatment to either the
SP6 treatment group or GB39 control group by means of a
random number table, and baseline data were collected.
Patients were told that they would be treated with different
acupuncture points when they signed informed consent
prior to treatment. The points used in this study were located
according to Chinese National Criteria for Points Location
(GB12346-90). Direction and depth of needling were deter-
mined in accordance with the Meridians and Acupoints, which
is the textbook for national TCM universities in China.
Acupuncture interventions for both the treatment group
and control group were performed by the same acupunc-
YU ET AL.
turist throughout the entire study. The acupuncturist had
completed a 5-year full-time training in acupuncture and
Traditional Chinese Medicine (TCM), and 2 years of clinical
experience in an academic acupuncture clinic.
Treatment group. In the SP6 treatment group, partici-
pants were asked to lay on their back, then SP6 (3 cun above
the medial malleolus, at the posterior border of the medial
aspect of the tibia) was punctured perpendicularly and bi-
laterally with 400.30-mm stainless steel needles (Huatuo,
Suzhou Medical Instruments Factory, Suzhou, China) to a
depth of 2.5–4.0 cm. Basic needling techniques of lifting–
thrusting and twirling were used to induce needling sensa-
tion (de qi). After de qi, an even reinforcing–reducing method
was applied for about 1 minute, and then the needles were
retained for 5 minutes.
Control group. In the GB39 control group, participants
were asked to lay on their back, then GB39 (3 cun above the
tip of the external malleolus, at the anterior part of the fibula)
was punctured perpendicularly and bilaterally with 400.30-
mm stainless steel needles (Huatuo, Suzhou Medical In-
struments Factory) to a depth of 1.25–2.0 cm. Needling
techniques similar to those used in the treatment group were
also used in the control group for de qi. After de qi, an even
reinforcing–reducing method was applied for about 1 min-
ute, and then the needles were retained for 5 minutes.
Outcome measures
Baseline data including age, course of disease, day number
of menstrual cycle that needling was done, expression of
TCM patterns, and menstrual pain score were carefully re-
corded. Patients were identified as following five patterns,
using the criteria for TCM pattern identification of primary
dysmenorrhea in Clinical Study Guideline for New Developed
Chinese Medicine14 issued by the Ministry of Health of China
in 1993: (1) pattern of qi and Blood stagnation, (2) pattern of
Cold–Damp accumulation, (3) pattern of Heat–Damp stag-
nation, (4) pattern of qi and Blood deficiency, and (5) pattern
of Liver and Kidney deficiency.
SP6 is generally used for any of the abovementioned TCM
patterns due to its key functions.
Menstrual pain scores. Menstrual pain was assessed
before and after acupuncture intervention, respectively, ac-
cording to dysmenorrhea score criteria in Clinical Study
Guideline for New Developed Chinese Medicine.14
PI, RI, A/B ratio. Type-B ultrasonic diagnostic apparatus
ALOKA ( Japan) SSD-5500 was used to assess PI, RI values,
and A/B ratio of uterine ascending arterial flow. Patients
were asked to have a moderately filled urinary bladder for
the first measurement. Then type-B ultrasonography was
conducted after patients had a rest for 15 minutes by lying on
the examination bed. All patients were examined at 3:00–6:00
o’clock in the afternoon with 258C room temperature. The
same medical imaging technician made all measurements.
The process of our trial was as follows: (1) PI, RI values
and A/B ratio in uterine arteries in a patient were measured
5 minutes before acupuncture treatment and the respective
minimal values were recorded; (2) SP6 or GB39 was needled
ACUPUNCTURE EFFECT AT SP6 AND GB39 ON DYSMENORRHEA 1075

89 patients were screened Table 1. Baseline Characteristics of 60 Patients

23 did not meet in SP6 and GB39 Groups
inclusion criteria
SP6 treatment GB39 control
66 recruited and
randomized
group (n ¼ 30) group (n ¼ 30) p value

Age (years) 22.13  1.76 21.57  1.57 0.152

Course of disease 7.53  2.79 6.33  2.86 0.728
(years)
32 assigned to SP6 34 assigned to GB39 Menstrual pain 11.20  2.66 11.28  2.31 0.643
treatment group control group scores (marks)

Mean  standard deviation is given for each parameter.

30 completed measurement and 30 completed measurement and
p values are for between-group comparisons using t test.
treatment treatment
2 dropped out 4 dropped out
1 failure in holding back urine 2 failures in holding back urine
1 took analgesics due to 1 reason unclear
unbearable pain 1 took analgesics due to and the GB39 group in age (21.13  1.76 versus 21.57  1.57,
unbearable pain p ¼ 0.152 > 0.05), course of disease (7.53  2.79 versus
6.33  2.86, p ¼ 0.728 > 0.05), or menstrual pain score
Measurements of PI, RI and A/B (11.20  2.66 versus 11.28  2.31, p ¼ 0.643 > 0.05).
The day number of the menstrual cycle that needling was
done (before or after bleeding) for both groups is shown in
Needling SP6, retaining Needling GB39, retaining
Table 2. There were no differences between the two groups
needles 5 min, measuring needles 5 min, measuring
PI, RI, and A/B (n=30) PI, RI, and A/B (n=30) ( p ¼ 0.938 > 0.05). The distribution of TCM patterns in the
two groups is shown in Table 3. As is shown, there were also
no differences between them ( p ¼ 0.908 > 0.05).
30 included in analysis 30 included in analysis
Values of PI, RI, and A/B ratio before acupuncture treat-
ment for the two groups are shown in Table 4. There were
FIG. 1. Flowchart of participants through the study. PI,
also no significant differences at baseline between two
pulsatility index; RI, resistance index; A/B, ratio of systolic
peak and diastolic peak. groups in PI (2.32  0.70 versus 2.10  0.52, p ¼ 0.118 > 0.05),
RI (0.78  0.07 versus 0.79  0.08, p ¼ 0.677 > 0.05), or A/B
(5.23  1.67 versus 5.26  1.37, p ¼ 0.930 > 0.05).
and an even reinforcing–reducing method was performed for
about 1 minute and the needles were retained for 5 minutes; Comparison of menstrual pain scores, values of PI, RI,
(3) PI, RI values and A/B ratio were measured again during and A/B ratio before and after intervention
needle retention and the minimal values were recorded again;
As a subjective criterion, decreasing menstrual pain score
(4) then the needles were removed to end the trial. In the
indicates a reduction in pain. Values of PI and RI, and A/B
process of the trial, the acupuncturist was separated from the
ratio of uterine arterial flow reflect the blood circulation of
imaging technician. Thus, the imaging technician was blinded
the uterus. Decreasing the values of these indexes suggest
to treatment assignment. Figure 1 illustrates the procedure of
lower blood flow resistance and better blood supply of the
recruitment, intervention, and measurement.
uterus, which represent a reduction of menstrual pain.
Statistical analysis Compared with values before acupuncture intervention,
participants in the SP6 treatment group after intervention
All results were expressed as mean  standard deviation. had a significant reduction in pain scores (8.17  1.90 versus
The data were processed using SPSS for Windows (version 11.20  2.66, p ¼ 0.000 < 0.01), values of PI (1.75  0.48 versus
13.0, SPSS Inc., Chicago, IL). The w2 test and t test were used 2.32  0.70, p ¼ 0.000 < 0.01), RI (0.72  0.11 versus 0.78 
to analyze the homogeneity between the two groups and 0.07, p ¼ 0.000 < 0.01), and A/B (4.33  1.37 versus 5.23 
Student’s t test was used to compare the differences between 1.67, p ¼ 0.000 < 0.01) (Table 5).
the two groups. In this study, the p value was considered
significant if p < 0.05, highly significant if p < 0.01, and non-
significant if p > 0.05.
Table 2. Comparison of the Day Number
Results of Menstrual Cycle that Acupuncture Was Done
of 60 Patients in SP6 and GB39 Groups (n)
Patients
5–4 Days 3–1 Days 1st or 2nd
A total of 66 patients were recruited into the trial. Thirty- before before Day of
two (32) were assigned to the SP6 treatment group and 34 to No. of valid menstrual menstrual menstrual
the GB39 control group. Six (6) patients dropped out (2 in the cases (n) cycle cycle cycle
treatment group, 4 in the control group). Thus, 30 patients in
the SP6 treatment group and 30 patients in the GB39 control SP6 group 30 9 10 11
GB39 group 30 10 12 8
group completed baseline and final examinations. The
baseline characteristics in both groups are shown in Table 1. There were no significant differences between two groups
There were no significant differences between the SP6 group ( p ¼ 0.938 > 0.05) using w2 test.
1076 YU ET AL.

Table 3. Comparison of Distribution of Traditional Chinese Medicine Patterns

of 60 Patients in SP6 and GB39 Groups (n)

No. of valid Qi and blood Accumulation of Deficiency of Deficiency of Stagnation of

cases (n) stagnation cold & dampness qi and blood liver & kidney heat & dampness

SP6 group 30 15 10 2 3 0
GB39 group 30 14 12 1 3 0

There were no significant differences between two groups ( p ¼ 0.908 > 0.05) w2 test.

In the GB39 control group, there were no significant dif-
ferences in menstrual pain score, values of PI, RI, or A/B
ratio before and after acupuncture intervention ( p > 0.05)
(Table 5).
Differential values of menstrual pain scores, PI, RI,
and A/B ratio of SP6 treatment group versus GB39
control group
On the other hand, higher differential values (baseline
value – final value) between baseline values (before the in-
tervention) and final values (after the intervention) of PI, RI,
and A/B ratio also indicate improvements in blood supply of
the uterus, representing a reduction in uterine pain. Com-
pared with the GB39 control group, participants in the SP6
treatment group had significant higher differential values in
pain scores (3.03  2.36 versus 0.00  0.29, p ¼ 0.000 < 0.01),
PI (0.57  0.42 versus 0.10  0.58, p ¼ 0.000 < 0.01), RI
(0.06  0.08 versus 0.03  0.15, p ¼ 0.007 < 0.01), and A/B
ratio (0.90  0.87 versus 0.23  1.02, p ¼ 0.008 < 0.01) See
Table 6.
No adverse events were reported during the trial.
Discussion
Based on TCM, dysmenorrhea arises by attacking of six
exogenous pathogenic factors, internal damage caused by
seven emotions, overexertion of qi and Blood, constitutional
insufficiency, and so on, resulting in impeded flow of qi and
Blood or poor nourishment of the thoroughfare (Chong)
vessel, conception (Ren) vessel, and uterus. Thus, the location
of dysmenorrhea is the uterus and has a very close rela-
tionship with the thoroughfare and conception vessels.
Clinically, the main patterns of dysmenorrhea include
excess types such as qi and Blood stagnation, Cold–Damp or
Heat–Damp accumulation, as well as deficiency types such
as qi and Blood deficiency or Liver and Kidney deficiency.
Table 4. Baseline Characteristics of Values
of PI, RI, and A/B of Uterine Arterial Flow
of 60 Patients in SP6 and GB39 Groups
SP6 treatment GB39 control
group (n ¼ 30) group (n ¼ 30) p value
PI 2.32  0.70 2.10  0.52 0.118
RI 0.78  0.07 0.79  0.08 0.677
A/B 5.23  1.67 5.26  1.37 0.930
Mean  standard deviation is given for each parameter.
p values are for between-group comparisons using t test.
PI, pulsatility index; RI, resistance index; A/B, ratio of systolic
peak and diastolic peak.
The three yin meridians of the foot meet the conception
vessel at CV4 and CV3 and the thoroughfare vessel comes
into confluence with the Kidney meridian in the abdomen. In
addition, the thoroughfare vessel and conception vessel
originate from the uterus and regulate the flow of qi and
Blood in it. As the junction point of three yin meridians of the
foot, SP6 is closely related to the thoroughfare vessel, con-
ception vessel, and uterus. As a result, needling SP6 can af-
fect and promote the flow of qi and blood so as to improve
the nourishment of thoroughfare vessel, conception vessel,
and uterus and finally can relieve menstrual pain. There are
many records about using SP6 for treatment of dysmenor-
rhea in TCM classical books, such as Invaluable Prescriptions
for Emergencies (Bei Ji Qian Jin Yao Fang), Supplement to the
Invaluable Prescriptions (Qian Jin Yi Fang), A Collection of Gems
of Acupuncture and Moxibustion (Zhen Jiu Ju Ying), and so on.
Currently, SP6 is commonly used for gynecologic indications
in clinical practice, especially for alleviating dysmenor-
rhea.10–12 On the other hand, as a point of Gallbladder me-
ridian, GB39 has little relationship with the thoroughfare
vessel, conception vessel, and uterus and according to the
theory of acupuncture, has almost no effect on menstrual
problems.
In this study, we tried to show the immediate effects of
SP6 on relieving dysmenorrhea and promoting blood flow of
uterine arteries, so the needles were retained only 5 minutes.
Another reason for short needle retention time is that a
common needle retention time such as 30 minutes may cause
patients to dropped out due to failure in holding back urine.
Three (3) patients were dropped out due to this reason. The
results of this study show that SP6 was clinically effective for
immediate relieving of menstrual pain and improving blood
flow in uterine arteries in primary dysmenorrhea, and there
was a significant difference in these indexes when GB39 was
used.
There was a significant decrease in menstrual pain score in
the SP6 treatment group, with an average decline of 3.03
scores from that of pretreatment. However, there was little
decrease in the GB39 control group. This suggests that SP6
can help in women with primary dysmenorrhea and that
GB39 is rarely potent.
Dysmenorrhea is caused by reduced uterine blood flow,
resulting in uterine ischemia, due to contraction of myome-
trium, which is induced by excessive secretion of prosta-
glandins,15 vasopressin, and oxytocin.16 It was reported that
the indexes of uterine arterial flow such as PI, RI values and
A/B ratio in patients with primary dysmenorrhea were
higher than those in healthy women.17–19 In this study,
during the treatment with needling SP6, there was also a
significant concomitant decrease in PI and RI value as well as
A/B ratio, with an average decline of 0.57, 0.06, and 0.90,
ACUPUNCTURE EFFECT AT SP6 AND GB39 ON DYSMENORRHEA 1077

Table 5. Changes in Menstrual Pain, and PI, RI, A/B of Uterine Arterial Flow from Baseline
to Values After Treatment in SP6 and GB39 Groups

SP6 Treatment group (n ¼ 30) GB39 Control group (n ¼ 30)

Baseline value Final value p-Valuea Baseline value Final value p-Valueb

Pain scores 11.20  2.66 8.17  1.90 0.000 11.28  2.31 11.28  2.26 1.000
PI 2.32  0.70 1.75  0.48 0.000 2.10  0.52 2.20  0.89 0.374
RI 0.78  0.07 0.72  0.11 0.000 0.79  0.08 0.82  0.13 0.351
A/B 5.23  1.67 4.33  1.37 0.000 5.26  1.37 5.03  1.36 0.220

Mean  standard deviation is given for each parameter.

a
p values are for self-group comparisons of the SP6 treatment group before and after the intervention using t test.
b
p values are for self-group comparisons of the GB39 control group before and after the intervention using t test.
PI, pulsatility index; RI, resistance index; A/B, ratio of systolic peak and diastolic peak.

respectively. However, GB39 only suppresses the A/B ratio
with a nonsignificant average reduction of 0.23 and increases
PI and RI values by 0.10 and 0.03, respectively. The results
suggest that SP6 is effective in improving blood flow in
uterine arteries with reduction of PI and RI values and A/B
ratio compared with GB39. It may be one of the mechanisms
of SP6 for relieving dysmenorrhea. This finding reaffirms the
theory in Chinese medicine that acupoints located in differ-
ent parts (meridians) of the body have different clinical ef-
ficacies on different diseases. This study partly shows the
specificity of SP6.
On the other hand, in terms of anatomy, SP6 is located at
the medial aspect of the calf where the saphenous nerve is
superficial and the tibial nerve is deep. The saphenous nerve
derives from the L4 nerve while the tibial nerve derives from
L5–S1 nerves. Therefore, SP6 is controlled by L4–S1 nerves.
GB39 is located at the lateral aspect of calf, opposite to SP6,
and is controlled by the lateral cutaneous nerve of calf, deep
peroneal nerve, and tibial nerve, which derive from the L5
nerve, L4–S1 nerves, and L5–S1 nerves. Thus, the L4–S1
nerves govern GB39. Therefore, both SP6 and GB39 are
controlled by the L4–S1 nerves but they belong to the Spleen
meridian and Gallbladder meridian, respectively. The sig-
nificant differences of clinical efficacy of these two acupoints
in relieving menstrual pain, reducing the values of PI, RI,
and A/B ratio observed in our study, suggest that the
specificity of SP6 may be related to traditional acupuncture
meridians.
Table 6. Comparison of Differential Values
in Menstrual Pain, and PI, RI, A/B of Uterine Arterial
Flow from Baseline to Values After Treatment
in SP6 and GB39 Groups
SP6 treatment GB39 control
group (n ¼ 30) group (n ¼ 30)
Differential value Differential value p-Value
Pain scores 3.03  2.36 0.00  0.29 0.000
PI 0.57  0.42 0.10  0.58 0.000
RI 0.06  0.08 0.03  0.15 0.007
A/B 0.90  0.87 0.23  1.02 0.008
Finally, we would like to mention a few comments about
the design and limitations of this study. First, one potential
limitation was that as a pilot study, no power analysis was
provided in this study, which lowered the statistical power
of the study to a certain degree. Second, menstrual pain was
assessed according to the dysmenorrhea score criteria in the
Clinical Study Guideline for Treatment of Dysmenorrhea
with New Developed Chinese Medicine of China, which is
mainly used in China and not widely accepted, compared
to the visual analog scale value. Third, no nonmeridian
point control treatment was done in this pilot study;
therefore, there was not enough evidence to support the
specificity of acupoint, even though an unrelated point
GB39 was taken as control. Fourth, since the previous ex-
perience of acupuncture treatment was not an excluding
factor for trial participation, some patients may know the
effect of SP6 for menstrual disorders, so although we told
patients that they are going to be treated with different
acupoints, their knowledge might interfere with them being
completely blinded to treatment. We propose that in future
trials, patients with a history of acupuncture treatment and
those who know the effects of acupoints should be ex-
cluded.
Since acupoint specificity is not yet a completely answered
question, there is a need to learn much more about it. This
study is a pilot study and it is not conclusive for point
specificity. Further randomized clinical trial studies with
larger sample sizes are needed to provide more reliable ev-
idence. Future studies may focus on comparing SP6 with
another nearby nonmeridian point for relieving dysmenor-
rhea.
Conclusions
In summary, this study suggests that needling at SP6 is
effective for improving the uterine arterial flow of patients
with primary dysmenorrhea so it can relieve menstrual pain,
while GB39 does not have these effects. These different ef-
fects of SP6 and GB39 preliminarily show that the specificity
of SP6 might be more related to traditional acupuncture
meridians rather than other factors such as its innervations
and anatomical location.

Mean  standard deviation is given for each parameter. Acknowledgments

Differential value ¼ baseline value – final value.
p values are for between-group comparisons using t-test.
PI, pulsatility index; RI, resistance index; A/B, ratio of systolic
peak and diastolic peak.
We thank all the women who participated in this study.
This study is funded by the China National Basic Research
Program (program 973, grant 2006CB504503).
1078
Disclosure Statement
No competing financial interests exist.
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Address correspondence to:
Jiang Zhu, MD
School of Acupuncture and Moxibustion
Beijing University of Chinese Medicine
NO 11 Bei San Huan Dong Lu
Chaoyang District, Beijing
China
E-mail: jzhjzh@263.net