Dang Gui Shao Yao San (DSS) in the treatment of primary dysmenorrhea

Abstract

Background. Painful cramps in the lower abdomen occurring during menstruation without obvious pelvic organic lesions is known as primary dysmenorrhea. DSS is a traditional Chinese herbal formula consisting of 6 herbs namely Angelica sinensis, Paeonia lacitifora, Ligusticum chuanxiong, Poria cocos, Astractylodes macrocephala and Alisma plantago-aquatica in ratio of 3:16:8:4:8:4. Objective of the study. To explore scientific research regarding the efficacy, mechanisms and safety of DSS in the treatment of PD. Material and methods. We searched for studies published in electronic databases (PubMed, Cochrane Library, CNKI) over the last years by using search strategy. We included randomized controlled trials and cohort studies that reported the use of DSS for PD. The main efficacy outcome was the relief of menstrual pain intensity quantified by validated pain scales including visual analog scale. Results. There were twenty studies (2000 participants) it resulted that DSS had an adjunct treatment effect on reducing the intensity of menstrual pain compared with placebo or no treatment group with statistically significant difference (Mean difference =2.50, 95 % CI 3.00-2.00, p < 0.001). The DSS group showed a reduced rate of recurrence. Most adverse events are mild and transient, including gastrointestinal symptoms and dizziness. DSS is used for the treatment of PD with anti-inflammatory, antispasmodic, and analgesic effects. The major components of these formula, namely those of Danggui (Angelica sinensis) and Shaoyao (Paeonia lactiflora), can regulate the synthesis of prostaglandins, improve blood flow, and modulate the nervous system, all of which will greatly relieve the pain. Conclusion. Danggui Shaoyao San formula in treatment for primary dysmenorrhea has shown itself to be a safe and effective approach with analgesia, improved quality of life, and a decreased recurrence rate.