ABSTRACT: The present study reports results of 500 cases of dysfunctional uterine bleeding treated with combined auricular-plaster and moxibustion therapies. After treatment, 480 cases were cured, constituting 96. 0 %; l6 cases were improved, constituting 3. 2 % and 4 had no any effect, constituting 0. 8%. The total effective rate was 99. 2 %.

KEY WORDS: Dysfunctional uterine bleeding Combined auricular-plaster and moxibustion therapy

Since 1965, we have been adopting combined auricular-plaster and moxibustion therapies and principles of differentiating syndromes and typing of traditional Chinese medicine to treat 500 cases of dysfunctional uterine bleeding and have achieved a striking therapeutic effect. It is summarized as follows:

CLINICAL DATA:
All the 500 cases of dysfunctional uterine bleeding (DUB) patients were out-patents and in-patients of our hospital and confirmed by gynecological examination. The youngest was 17 years and the oldest 52 years. The shortest duration of disease was 20 days and the longest 4 years.

TREATMENT METHODS:
1. Otopoint
Main Otopoint selected were Zigong (EX-CA 1), Ovary and Pingjian (MAT 2), combined with Kidney (MASC), Liver (MASC 5) and Sympathesis (MA-AH 7 ) for qi-deficiency type DUB; with Liver (MASC 5 ), spleen (WIC) and Erzhong (MA-H 1) for blood-deficiency type; with Kidney (MASC ) and Yuanzhong (MA-AT) for kidney yang deficiency type; and with Xiajiaoduan, Shenmen and Internal Gentials (MATF ) for blood stasis type.

2. Operation
Take one grain of cleaned Vaccariae seed to place at the center of every piece of rectangular adhesive plaster 0. 5 x 0. 5 cm². Ask the patient to take a sitting position and separately fixed the adhesive plaster to the above-mentioned Otopoint areas after routine sterilization. The operator used his or her thumb and index finger to press the Vaccariae seed to stimulate the Otopoint from gentle, moderate to heavy strength gradually about 3 -- 5min for each Otopoint, causing the patient to experience soreness, numbness, distention and pain sensations. If the patient felt a warm sensation in the oppressed auricular part, the therapeutic effect would be much better. Order the patient to press his or her Otopoint one by one and 4 -- 5 times a day by himself or herself. Generally, the adhesive plaster was changed once every three days in chronic DUB patients or once every other day in acute DUB patients. Otopoint of the bilateral ears were used alternately or simultaneously according to the state of disease. Ten sessions were considered as a therapeutic course and the interval between two courses was 3 -- 5 days.

3. Acupoints for Moxibustion
Main acupoint: Shenque (CV 8 ); adjunct acupoints: (1 ) Zusanli (ST 36 ), Xuehai (SP l0) and Zhiyin (BL 67); and (2) Sanyinjiao (SP 6), Qihai (CV 6) and Dadun (LR 1).

4. Methods
Shenque (CV 8) was moxibustioned for 20 moxa-cones by placing a layer of salt wrapped in a piece of cloth, once daily; and the auxiliary acupoints were moxibustioned with. moxa sticks, about 20 minutes for each point. The two groups of acupoint were used alternately. The treatment was conducted beginning from the third day on of the menstrual onset and stopped till the fifth-seventh day of termination of menstrual period.

CRITERIA FOR EVALUATING THE THERAPEUTIC EFFECT
Cured: After treatment, all the symptoms vanished and the follow-up survey in half a year showed no relapse.

Effective: Clinical symptoms disappeared or were relieved.
Ineffective: After one course of treatment, clinical symptoms had no any improvement.

RESULTS
After treatment, of the 500 cases of DUB patients, 480 were cured, constituting 96. 0 %, 16 had improvement, constituting 3. 2% and 4 had no any improvement, constituting 0. 8%. The total effective rate was 99.2 %. In addition, various types of DUB all had a better therapeutic effect which is shown in the following Table.
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Typing                        Cases     Cure(cases %)    Improvement(cases %)  No effect(cases %)
Qi-deficiency             142           122      85.9             16        ll.3                          4    2.8
Blood-heat                 240           200      83.3             32       13.3                        8    3.3
Yang-deficiency         64              44        68.8             16       25.0                        4    6.2
Blood stasis               54              46        85.2              6        11.l                         2    3.7
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A TYPICAL CASE
Miss Rong, aged 27 years, complained of having frequent incessant dripping of blood from vigina for 4 years after marriage, accompanying with sallow complexion, emaciation, taut thready pulse, low fever, poor appetite and severe insomnia. Her hemoglobin was 6g%. It was diagnosed as dysfunctional uterine bleeding. She tried treatment with quite a few methods in some hospitals but did not achieve significant
benefit. In September of 1988, she came to our department asking for further treatment. Based on the theory of traditional Chinese medicine, it was diagnosd as metrorrhagia and metrostaxis and attributed to deficiency of both spleen qi and kidney-qi. She was treated with the aforementioned auricular-plaster and moxibustion therapies. After 3 days' treatment, she responded with good benefit; and after 10 days,' treatment, she was cured. Her hemoglobin was 13g%, her body weight increased and her complexion became ruddy. The fo1low-up survey in 6 months showed that her menstruation was normal and she was pregnant.

COMMENTS
Dysfunctional uterine bleeding is one of the common gynecopathy in clinic and is often seen in adolescent and climacteric women due to functional disorder of the ovary. In traditional Chinese medicine, it is termed as “Benglou" beng (burst out ) means massive uterine bleeding while lou means incessant dripping of blood from uterus, which often result from deficiency of kidney-qi, immediate menopause and irregular menstrual intervals. At the present, both Western and traditional Chinese medicine have no ideal treatment methods. In the light of the cause of disease, we adopt combined auricular-plaster and moxibustion therapies and principles of differentiating syndromes and typing to treat it and have achieved satisfactory resu1ts. All the four types of dysfunctional uterine bleeding have a considerably beneficial response. The ear is the place where most meridians gather together and thus has a close relation to the meridians and internal organs of the body. Auricular-plaster stimulation cou1d dredge meridians, promote circulation of qi and blood, regulate functional activities of Zangfu organs and raise the resistance of the whole body. Moxibustion Of Zusanli (ST 36), Sanyinjiao (SP 6 ), etc. may warm meridians, stop bleeding, Soothe the liver and regulate flow of qi. Salt moxibustion of Shenque (CV 8) is capable of regulating yin and yang, tonifying the liver and kidney and enriching spleen-qi and kidney-qi. In this way, Otopoint pressing and moxibustion are used in combination to produce a significant therapeutic effect probably by way of favourab1e modulation of the endocrine

by Liu Shizhong, Zhu Zhiping, etc.