Elements of Health Centre, Victoria, Canada.
J Sex Med. 2010 Feb;7(2 Pt 2):981-95. doi: 10.1111/j.1743-6109.2009.01582.x. Epub 2009 Nov 12.
Provoked vestibulodynia (PVD) is a distressing genital pain condition affecting 12% of women. Treatment modalities vary and although vestibulectomy has the highest efficacy rates, it is usually not a first-line option. Acupuncture has a long history in the traditional Chinese medicine (TCM) system and operates on the premise that pain results from the blockage or imbalance of important channels. The main principle of treatment is to move Qi and blood to cease genital pain.
To explore effect sizes and feasibility in a pilot study of acupuncture for women with PVD.
Eight women with PVD (mean age 30 years) underwent 10 1-hour acupuncture sessions. Specific placement of the needles depended on the woman's individual TCM diagnosis. TCM practitioners made qualitative notes on participants' feedback after each session. Main Outcome Measures. Self-reported pain (investigator-developed), pain-associated cognitions (Pain Catastrophizing Scale [PCS], Pain Vigilance and Awareness Questionnaire), and sexual response (Female Sexual Function Index) were measured before and after treatment sessions 5 and 10. Qualitative analyses of TCM practitioner notes were performed along with one in-depth case report on the experience of a participant.
A repeated measures analysis of variance revealed significant decreases in pain with manual genital stimulation and helplessness on the PCS. An examination of effect sizes also revealed strong (though nonsignificant) effects for improved ability to have intercourse and sexual desire. Qualitative analyses were overall more positive and revealed an improvement in perceived sexual health, reduced pain, and improved mental well-being in the majority of participants.
Effect sizes and qualitative analyses of practitioner-initiated interviews showed overall positive effects of acupuncture, but there were statistically significant improvements only in pain with manual genital stimulation and helplessness. These findings require replication in a larger, controlled trial before any definitive conclusions on the efficacy of acupuncture for PVD can be made.
诱发性外阴疼痛（PVD）是一种令人痛苦的生殖器疼痛疾病，影响 12%的女性。治疗方法多种多样，尽管外阴切开术的疗效最高，但通常不是首选方法。针灸在中医（TCM）系统中有悠久的历史，其运作前提是疼痛是由重要经络的阻塞或失衡引起的。治疗的主要原则是行气活血，以停止生殖器疼痛。
探索针灸治疗 PVD 女性的试点研究中的效果大小和可行性。
8 名 PVD 女性（平均年龄 30 岁）接受了 10 次 1 小时的针灸治疗。具体的针位取决于女性的个人 TCM 诊断。TCM 从业者在每次治疗后对参与者的反馈进行了定性记录。主要观察指标：治疗前和治疗后 5 次和 10 次治疗后自我报告的疼痛（研究者开发的）、与疼痛相关的认知（疼痛灾难化量表[PCS]、疼痛警觉和意识问卷）和性反应（女性性功能指数）。
重复测量方差分析显示，手动生殖器刺激时疼痛和 PCS 无助感显著降低。对效应大小的检查还显示，改善性交能力和性欲的效果较强（尽管无统计学意义）。定性分析总体上更为积极，发现大多数参与者的感知性健康得到改善，疼痛减轻，精神健康状况得到改善。
实践者发起的访谈的效果大小和定性分析显示，针灸的总体效果积极，但只有在手动生殖器刺激和无助感方面的疼痛有统计学显著改善。这些发现需要在更大的对照试验中得到复制，才能对针灸治疗 PVD 的疗效做出任何明确的结论。
