The complementary and alternative medicine for endometriosis: a review of utilization and mechanism

Sai Kong, Yue-Hui Zhang, Chen-Fang Liu, Ilene Tsui, Ying Guo, Bei-Bei Ai, Feng-Juan Han, Sai Kong, Yue-Hui Zhang, Chen-Fang Liu, Ilene Tsui, Ying Guo, Bei-Bei Ai, Feng-Juan Han

Abstract

Endometriosis (EM) is one of the common gynecological conditions causing menstrual and pelvic pain and affects 10%-15% of women of reproductive age. In recent years, the complementary and alternative medical (CAM) treatment for EM has become popular due to the few adverse reactions reported. The CAM therapy for EM includes several different treatments such as herbs (herbal prescription, extract, and patent), acupuncture, microwave physiotherapy, and Chinese herb medicine enema (CHM enema). These CAM therapies are effective at relieving dysmenorrhoea, shrinking adnexal masses, and promoting pregnancy, with less unpleasant side effects when compared to hormonal and surgical treatments. In this review, we focus on the status quo of CAM on EM and try to identify therapeutic efficacy and mechanisms based on some clinical and experimental studies. We hope to provide some instructive suggestions for clinical treatment and experimental research in the future.

Figures

Figure 1
Figure 1
Pathogenesis and risk factors of endometriosis.

References

    1. Giudice LC, Kao LC. Endometriosis. The Lancet. 2004;364(9447):1789–1799.
    1. Batt RE. A History of Endometriosis. London, UK: Springer; 2011.
    1. Fauser BCJM, Diedrich K, Bouchard P, et al. Contemporary genetic technologies and female reproduction. Human Reproduction Update. 2011;17(6):829–847.
    1. Sinaii N, Cleary SD, Ballweg ML, Nieman LK, Stratton P. High rates of autoimmune and endocrine disorders, fibromyalgia, chronic fatigue syndrome and atopic diseases among women with endometriosis: a survey analysis. Human Reproduction. 2002;17(10):2715–2724.
    1. Wellbery C. Diagnosis and treatment of endometriosis. American Family Physician. 1999;60(6):1753–1762.
    1. Guo S-W, Simsa P, Kyama CM, et al. Reassessing the evidence for the link between dioxin and endometriosis: from molecular biology to clinical epidemiology. Molecular Human Reproduction. 2009;15(10):609–624.
    1. Ruhland B, Agic A, Krampe J, Diedrich K, Hornung D. Innovations in conservative endometriosis treatment: an updated review. Minerva Ginecologica. 2011;63(3):247–249.
    1. Recurrent Endometriosis: Surgical Management, Endometriosis. The Cleveland Clinic; 2010.
    1. National Center for Complementary and Alternative Medicine . .
    1. Loudon I. A brief history of homeopathy. Journal of the Royal Society of Medicine. 2006;99(12):607–610.
    1. Coulter ID, Willis EM. The rise and rise of complementary and alternative medicine: a sociological perspective. Medical Journal of Australia. 2004;180(11):587–589.
    1. Pujol LAM, Monti DA. Managing cancer pain with nonpharmacologic and complementary therapies. The Journal of the American Osteopathic Association. 2007;107(12):ES15–ES21.
    1. Barnes PM, Powell-Griner E, McFann K, Nahin RL. Complementary and alternative medicine use among adults: United States, 2002. Advance data. 2004;(343):1–19.
    1. Kellehear A. Complementary medicine: is it more acceptable in palliative care practice? Medical Journal of Australia. 2003;179(6):S46–S48.
    1. Wang DZ, Wang ZQ, Zhang ZF. Treatment of endometriosis with removing blood stasis and purgation method. Chinese Journal of Integrated Traditional and Western Medicine. 1991;11(9):524–526.
    1. Wang D, Wang Z, Yu C. Endometriosis treated by the method of resolving blood stasis to eliminate obstruction in the lower-jiao. Journal of Traditional Chinese Medicine. 1998;18(1):7–11.
    1. Li J, Zheng J, Wang D. Clinical observation on treatment of endometriosis by tonifying qi and promoting blood circulation to remove stasis and purgation principle. Chinese Journal of Integrated Traditional and Western Medicine. 1999;19(9):533–535.
    1. Zhang Z, Hu C, Tang W, et al. Therapeutic potential of Wenshen Xiaozheng Tang: a traditional chinese medicine prescription for treating endometriosis. Reproductive Sciences. 2013;20(10):1215–1223.
    1. Flower A, Lewith GT, Little P. Seeking an oracle: using the Delphi process to develop practice guidelines for the treatment of endometriosis with Chinese herbal medicine. Journal of Alternative and Complementary Medicine. 2007;13(9):969–976.
    1. Wang Q, Zhao H, Xiang Q, et al. Effect of Yikun Neiyi Wan on the expression of aromatase P450, COX-2, and ER related receptor in endometrial cells in vitro from patients with endometriosis. Journal of Traditional Chinese Medicine. 2009;29(4):296–300.
    1. Chen M, Zhang H, Li J, Dong G-R. Clinical observation on acupuncture combined with acupoint sticking therapy for treatment of dysmenorrhea caused by endometriosis. Chinese Acupuncture & Moxibustion. 2010;30(9):725–728.
    1. Xiang D-F, Sun Q-Z, Liang X-F. Effect of abdominal acupuncture on pain of pelvic cavity in patients with endometriosis. Chinese Acupuncture & Moxibustion. 2011;31(2):113–116.
    1. Ma MZ. Xuefu Zhuyu Decoction for treatment of 83 endometriosis patients. Shanghai Journal of Traditional Chinese Medicine. 1993;2:16–17.
    1. Zhang SY, Wang YY. Xuefu Zhuyu Decoction for treatment of 36 endometriosis patients. Chinese Journal of Ethnomedicine and Ethnopharmacy. 2011;22:p. 84.
    1. Zhang JY. Clinical observation of 79 endometriosis patients treated with Xuefu Zhuyu Decoction. Zhejiang Journal of Traditional Chinese Medicine. 2008;43(8):p. 455.
    1. Wang CF. Clinical observation of 60 endometriosis-associated dysmenorrhoea patients treated with Xuefu Zhuyu Decoction. Modern Journal of Integrated Traditional Chinese and Western Medicine. 2007;16(14):1931–1932.
    1. Gao AZ. Xuefu Zhuyu Decoction for treatment of 42 endometriosis patients. Guangming Journal of Chinese Medicine. 2012;27(4):717–718.
    1. Fang DL. Clinical observation of endometriosis patients treated with Xuefu Zhuyu Decoction. Clinical Journal of Anhui Traditional Chinese Medicine. 2003;15(4):297–298.
    1. Pan L, Zheng H. Effect of xiaochaihu soup on the expression of COX-2 and P450arom of endometriosis in rats. Journal of Medical Research. 2011;40(8):126–128.
    1. Altan ZM, Denis D, Kagan D, Grund EM, Palmer SS, Nataraja SG. A long-acting tumor necrosis factor α-binding protein demonstrates activity in both in vitro and in vivo models of endometriosis. Journal of Pharmacology and Experimental Therapeutics. 2010;334(2):460–466.
    1. Sharpe-Timms KL, Nabli H, Zimmer RL, Birt JA, Davis JW. Inflammatory cytokines differentially up-regulate human endometrial haptoglobin production in women with endometriosis. Human Reproduction. 2010;25(5):1241–1250.
    1. Scholl B, Bersinger NA, Kuhn A, Mueller MD. Correlation between symptoms of pain and peritoneal fluid inflammatory cytokine concentrations in endometriosis. Gynecological Endocrinology. 2009;25(11):701–706.
    1. Zhang WJ, Wang ZN, Zhen PE, Zheng H. The regulation of Xiaochaihu Decoction on interleukin-8 and tumor necrosis factor in endometriotic tissues. Shaanxi Journal of Traditional Chinese Medicine. 2004;5:468–470.
    1. Wang ZN, Zhang WJ, Zheng H, et al. Effects of Xiaochaihutang, a Chinese medicine, and danazol on angiogenesis in rat endometriosis model. Chinese Journal of Pathophysiology. 2004;20(5):862–865.
    1. Zheng H, Zuo L-D. Experimental study on treatment of endometriosis with xiaochaihu decoction. Chinese Journal of Integrated Traditional and Western Medicine. 2006;26(supplement 1):119–122.
    1. Zheng H, Li HY, Zuo LD. An experimental study of mechanism in treatment for endometriosis with Xiao Chai Hu Tang in rats. Labeled Immunoassays and Clinical Medicine. 2005;12(1):35–37.
    1. Zheng H, Zuo LD. Experimental study of the treatment of Xiaochaihu Tang on endometriosis rats. Shaanxi Journal of Traditional Chinese Medicine. 2006;26(9):1147–1149.
    1. Yang JB, Piao FJ. Clinical study of the treatment of Quyikang on 30 endometriosis patients. Yunnan Journal of Traditional Chinese Medicine and Materia Medica. 2006;27(5):32–34.
    1. Yang JB, Meng QR, Chen M, et al. Effect of quyikang on VEGF of endometriosis in rats. Chinese Archives of Traditional Chinese Medicine. 2008;26(5):979–981.
    1. Wickiewicz D, Chrobak A, Gmyrek GB, et al. Diagnostic accuracy of interleukin-6 levels in peritoneal fluid for detection of endometriosis. Archives of Gynecology and Obstetrics. 2013;288(4):805–814.
    1. Yang JB, Xu C. Effects of Quyikang on IL-2 and IL-6 in peritoneal fluid of endometriosis rats. Yunnan Journal of Traditional Chinese Medicine and Materia Medica. 2007;28(10):36–39.
    1. Yang JB, Li N. QuYi Kang: its effects on ER and β-EP in rats with endometriosis. Journal of Shaanxi College of Traditional Chinese Medicine. 2008;31(1):46–50.
    1. Yang JB, Du YL. Qu Yi Kang: its effects on hemorheology of rats with endometriosis. Modern Traditional Chinese Medicine. 2009;29(1):48–49.
    1. Yang F, Wang Y, Yang SM, Yang JB. Qu Yi Kang: its effects on TXB2 and 6-Keto-PGF1αin rats with endometriosis. Shaanxi Journal of Traditional Chinese Medicin. 2011;32(11):1557–1558.
    1. Xu XY, Consg HF, Ma BZ. Clinical observation on 46 endometriosis patients treated with Yiweining. Medical Information. 2011;24:3172–3173.
    1. Ma WG, Xu XY, Tan WH, Ma BZ, et al. Empirical study of effect of YiWeiNing on expression of Fas/FasL in rat with endometriosis. Chinese Journal of Traditional Chinese Medicine and Pharmacy. 2007;22(12):879–881.
    1. Qu F, Ma WG, Yang DX, Ma BZ. The effect of YiWeiNing on the expression of relevant apoptosis gene in the rats with endometriosis. Journal of Sichuan of Traditional Chinese Medicine. 2006;12(24):9–10.
    1. Xu XY, Cong HF, Ma WG, Ma BZ. Effects of YiWeiNing recipe on expressions of cyclo-oxygenase-2mRNA in ectopic endometrium of rats with endometriosis. Journal of Sichuan of Traditional Chinese Medicine. 2011;29(7):28–30.
    1. Koike H, Egawa H, Ohtsuka T, Yamaguchi M, Ikenoue T, Mori N. Correlation between dysmenorrheic severity and prostaglandin production in women with endometriosis. Prostaglandins Leukotrienes and Essential Fatty Acids. 1992;46(2):133–137.
    1. Koike H, Ikenoue T, Mori N. Studies on prostaglandin production relating to the mechanism of dysmenorrhea in endometriosis. Nippon Naibunpi Gakkai zasshi. 1994;70(1):43–56.
    1. Wu F, Zhang HZ, Hu JC, et al. The affections of yiwei powder on uterine contraction and vasoactive substance of the rabbits with experimental endometriosis. Chinese Journal of Information on Traditional Chinese Medicine. 2003;10(9):29–30.
    1. Wu F, Chen F, Kang YP. Effects of Yiweisan on hemorheology and vasoactive substances in Rabbit with Endometriosis. Journal of Chinese Microcirculation. 2003;7(6):355–356.
    1. Pino M, Galleguillos C, Torres M, et al. Association between MMP1 and MMP9 activities and ICAM1 cleavage induced by tumor necrosis factor in stromal cell cultures from eutopic endometria of women with endometriosis. Reproduction. 2009;138(5):837–847.
    1. Zhao RH, Yang YH, Li M, Xu C, Xia WY. Influences of Huoxue Xiaoyi Fang on ICAM-1, MMP- and VEGF in rats with endometriosis. Journal of Beijing University OfTraditional Chinese Medicine. 2012;35(12):826–899.
    1. Yang YH, Zhao RH, Xu C. Effect of the herbal medicine of Huoxue Xiaoyi decoction on the rat model of recurrence of endometriosis. China Journal of Traditional Chinese Medicine and Pharmacy. 2012;27(7):1911–1913.
    1. Fu JR, Zhen J, Wang F, Xu HY, Tian LX. Effects of neiyifang on IL-2 and TNF-αin serum and peritoneal fluid of endometriosis rats. China Journal of Traditional Chinese Medicine and Pharmacy. 2012;30(3):537–539.
    1. Chen JH, Chen LJ. Effects of Neiyi Zhitong decoction on endometrium histomorphology of endometriosis rats. Modern Medicine Journal of China. 2006;8(9):20–22.
    1. Chen LJ, Chen JH, Zhang DD, et al. Effects of Neiyi Zhitong decoction on serum CA125, PGF2αand PGE2 of endometriosis rats. Acta Chinese Medicine and Pharmacology. 2004;32(6):39–41.
    1. Zhang PH, Liu JF. Clinical observation of endometriosis patients treated with Fuzheng Huayu decoction. Journal of New Chinese Medicine. 2012;44(6):60–61.
    1. Shi SH, Li DG, Meng XX. Effect of Huazhuo Jiedu Huoxue recipe on plasma orphanin FQ and prostaglandins in the patients of endometriosis with pain. Chinese Traditional Patent Medicine. 2007;29(6):788–790.
    1. Luo JY, Cheng ML, Chen ML, et al. Clinical study on endometriosis patients treated with Yi Kun Decoction. Modern Journal of Integrated Traditional Chinese and Western Medicine. 2006;15(12):1626–1627.
    1. Lin YM, Li L, Pang GF. Effect of level of IL-6 in ascitic fluid to white rabbit of juantongyin in treating endometriosis. Journal of Liaoning University of Traditional Chinese Medicine. 2012;14(2):73–75.
    1. Fu BJ, Sun SY, Ding TT. Clinical study on Xianji Pill in treating 70 cases of dysmenorrhea in adenomyosis of blood and heat accumulation. Shanghai Journal of Traditional Chinese Medicine. 2008;42(8):53–54.
    1. Zhang ZZ, Hu CP, Tang WW, et al. Wenshen Xiaozheng Tang suppresses the growth of endometriosis with an antiangiogenic effect. Climacteric. 2013;16(6):700–708.
    1. Zhang Z, Hu C, Tang W, et al. Therapeutic potential of Wenshen Xiaozheng Tang, a traditional Chinese medicine prescription, for treating endometriosis. Reproductive Sciences. 2013;20(10):1215–1223.
    1. Bai RX. Tripterygium tincture treatment of rheumatoid arthritis and ankylosing spondylitis: a double-blind clinical observation. Chinese Journal of Orthopaedics. 1988;18(4):p. 290.
    1. Wang Y, Lin YM. Treatment of rheumatoid arthritis with Tripterygium Wilfordii polyglycoside: a clinical observation of 32 Cases. Strait Pharmaceutical Journal. 1997;9(3):101–102.
    1. Li ZX, Tan H. The clinical efficacy of myasthenia gravis treated with Tripterygium wilfordii and effect on IL-6. Chinese Journal of Integrated Traditional and Western Medicine. 2002;22(3):p. 294.
    1. Dou CR, Bai JH. Clinical observation of rheumatoid arthritis treated with Tripterygium wilfordii. Journal of Gansu College of Traditional Chinese Medicine. 1998;15(2):p. 25.
    1. Yan XH, Zhang XM, Qiu ZH. Clinical research of Tripterygium apozem treatment for IgA nephropathy with albuminuria. Fujian Journal of Traditional Chinese Medicine. 2004;35(3):11–12.
    1. Yang WJ, Zhang JQ. Treatment of endometriosis with tripterygium wilfordii polyglycoside tablets: a clinical observation of 120 cases. Jiangsu Journal of Traditional Chinese Medicine. 1997;18(9):p. 22.
    1. Chen DF. Treatment of endometriosis with tripterygium: a clinical observation. Chinese Journal of Integrated Traditional and Western Medicine. 2003;23(3):p. 170.
    1. Chen DF, Wu YF, Di W. Treatment of endometriosis with tripterygium. Shanghai Journal of Traditional Chinese Medicine. 1994;28(9):6–9.
    1. Gu JH, He JL, Wang MD. Treatment of endometriosis with tripterygium: a clinical observation of 40 cases. Journal of Traditional Chinese Medicine. 2003;10(5):301–303.
    1. Xiao YH, Chen DP, Yan JH, Yokoyama Y. Mechanism of action of Tripterygium Wilfordii polyglycoside on experimental endometriosis. European Journal of Gynaecological Oncology. 2002;23(1):63–67.
    1. Partadiredja G, Sutarman, Yahya TN, Nuryana CT, Susilowati R. Curcumin alters motor coordination but not total number of Purkinje cells in the cerebellum of adolescent male Wistar rats. Journal of Integrative Medicine. 2013;11(1):32–38.
    1. Chen R, Liu H, JiangG R, Li X, Qu YF. Effect of traditional Chinese medicine (Daqiqi Tang) on expresstions of VEGF and MMP-9 in endometriosis rats. Reproduction & Contraception. 2010;30(10):659–663.
    1. Hang QS, Fang Y, Wang L, Chen R. Effect of Da Qiqi decoction on expression of P450 and COX-2 in endometriosis of rats. Journal of Third Military Medical University. 2012;34(21):2167–2171.
    1. Zhang Y, Cao H, Hu Y-Y, Wang H, Zhang C-J. Inhibitory effect of curcumin on angiogenesis in ectopic endometrium of rats with experimental endometriosis. International Journal of Molecular Medicine. 2011;27(1):87–94.
    1. Kim K-H, Lee EN, Park JK, et al. Curcumin attenuates TNF-α-induced expression of intercellular adhesion molecule-1, vascular cell adhesion molecule-1 and proinflammatory cytokines in human endometriotic stromal cells. Phytotherapy Research. 2012;26(7):1037–1047.
    1. Jana S, Rudra DS, Paul S, Snehasikta S. Curcumin delays endometriosis development by inhibiting MMP-2 activity. Indian Journal of Biochemistry & Biophysics. 2012;49(5):342–348.
    1. Jana S, Paul S, Swarnakar S. Curcumin as anti-endometriotic agent: implication of MMP-3 and intrinsic apoptotic pathway. Biochemical Pharmacology. 2012;83(6):797–804.
    1. Swarnakar S, Paul S. Curcumin arrests endometriosis by downregulation of matrix metalloproteinase-9 activity. Indian Journal of Biochemistry and Biophysics. 2009;46(1):59–65.
    1. Chen R, Chen JL, Fang Y. Effect of curcuma on expressions in endometriosis rats. Chinese Traditional Patent Medicine. 2011;33(7):1145–1148.
    1. Cheng W, Chen LZ, Yang SS. Puerarin suppresses proliferation of endometriotic stromal cells partly via the MAPK signaling pathway induced by 17β-estradiol-BSA. PLoS ONE. 2012;7(9)e45529
    1. Wang D, Liu Y, Han J, et al. Puerarin suppresses invasion and vascularization of endometriosis tissue stimulated by 17β-estradiol. PLoS ONE. 2011;6(9)e25011
    1. Chen Y, Chen C, Shi S, et al. Endometriotic implants regress in rat models treated with puerarin by decreasing estradiol level. Reproductive Sciences. 2011;18(9):886–891.
    1. Ding DF, Li XF, Xu H, et al. Mechanism of resveratrol on the promotion of induced pluripotent stem cells. Journal of Integrative Medicine. 2013;11(6):389–396.
    1. Maia H, Jr, Haddad C, Pinheiro N, Casoy J. Advantages of the association of resveratrol with oral contraceptives for management of endometriosis-related pain. International Journal of Women's Health. 2012;4:543–549.
    1. Bruner-Tran KL, Osteen KG, Taylor HS, Sokalska A, Haines K, Duleba AJ. Resveratrol inhibits development of experimental endometriosis in vivo and reduces endometrial stromal cell invasiveness in vitro. Biology of Reproduction. 2011;84(1):106–112.
    1. Ergenoglu AM, Yeniel AO, Erbas O, et al. Regression of endometrial implants by resveratrol in an experimentally induced endometriosis model in Rats. Reproductive Sciences. 2013;20(10):1230–1236.
    1. Rudzitis-Auth J, Menger MD, Laschke MW. Resveratrol is a potent inhibitor of vascularization and cell proliferation in experimental endometriosis. Human Reproduction. 2013;28(5):1339–1347.
    1. Wang CC, Xu H, Man GC, et al. Prodrug of green tea epigallocatechin-3-gallate (Pro-EGCG) as a potent anti-angiogenesis agent for endometriosis in mice. Angiogenesis. 2013;16(1):59–69.
    1. Xu H, Becker CM, Lui WT, et al. Green tea epigallocatechin-3-gallate inhibits angiogenesis and suppresses vascular endothelial growth factor C/vascular endothelial growth factor receptor 2 expression and signaling in experimental endometriosis in vivo. Fertility and Sterility. 2011;96(4):1021–1028.
    1. Xu H, Lui WT, Chu CY, Ng PS, Wang CC, Rogers MS. Anti-angiogenic effects of green tea catechin on an experimental endometriosis mouse model. Human Reproduction. 2009;24(3):608–618.
    1. Laschke MW, Schwender C, Scheuer C, Vollmar B, Menger MD. Epigallocatechin-3-gallate inhibits estrogen-induced activation of endometrial cells in vitro and causes regression of endometriotic lesions in vivo. Human Reproduction. 2008;23(10):2308–2318.
    1. Long JR, Li Z. Ginsenoside Rg3 in combination with surgery in patients with stage III-IV endometriosis: a clinical control trial. Chinese Remedies & Clinics. 2012;12(6):720–724.
    1. Song ZY, Li Z, Zhi MC, Jiang YH. The observation of inhibition effect of Ginsenoside Rg3 on endometriosis rats model. Chinese Remedies & Clinics. 2006;6(4):255–256.
    1. Li Z, Zhi MC, Li XL, et al. Control study of Ginsenosides and Gestrinone on the treatment of endometriosis rats. Chinese Journal of Obstetrics and Gynecology. 2007;42(6):417–418.
    1. Song ZY, Fu K, Hu LY, et al. The inflnence of ginsenoside Rg3 on ID-1 and NRP-1 gene expression in endometriotic tissues. Chinese Remedies & Clinics. 2011;11(7):768–772.
    1. Du LJ, Yao YH, Fu K, et al. Effect of Ginsenoside Rg3 on expression of ID-1 gene in the endometriosis tissue. Chinese Remedies & Clinics. 2010;10(6):655–656.
    1. Wang X, Fang J, Wang HJ, et al. The efficacy of Artemisinin on treatment of endometriosis rats. Guangdong Medical Journal. 2011;32(2):163–167.
    1. Zhang X, Wang X, Wang H-J, Yang Q, Qie M-R. Inhibition effect and mechanisms of quercetin on surgically induced endometriosis. Journal of Sichuan University. 2009;40(2):228–244.
    1. Liu YL, Wang JL, Xiao DM, et al. Treatment of endometriosis with guizhi fuling capsule: a clinical observation of 48 cases. Shandong Medical Journal. 2010;50(39):78–79.
    1. Ji X, Gao J, Cai X, et al. Immunological regulation of Chinese herb Guizhi Fuling Capsule on rat endometriosis model. Journal of Ethnopharmacology. 2011;134(3):624–629.
    1. Liu HZ, Qiao FY, Chen SH, et al. Effects of guizhifuling extracture on immune function in experimental rats with endometriosis. Herald of Medicine. 2005;17:566–568.
    1. Huang ZH. The clinical application of Sanjie Zhentong capsules after laparoscopic surgery in the pelvic endometriosis. Chinese Journal of Integrated Traditional and Western Medicine. 2007;8:p. 748.
    1. Ren YL, Hu SH, Zhang HJ. Treatment efficacy and follow-up survey on 112 endometriosis patients treated with Sanjie Zhentong capsule. Journal of Chinese Practical Diagnosis and Therapy. 2005;19(4):p. 279.
    1. Zhang HQ, Ma DH, Song JM, et al. Clinical observation on 50 endometriosis cases treated with Yiweikang Granules. Journal of Traditional Chinese Medicine. 2011;52(1):27–30.
    1. Zhang HQ, Zhao SP, Liu YJ, et al. Clinical and experimental study on Yiweikang for endometriosis. Modern Medicine Journal of China. 2009;11(7):13–18.
    1. Cheng L, Li XB. Clinical observation of Dahuang Zhechong Wan on the treatment of endometriosis. Guangdong Medical Journal. 1999;20(7):565–566.
    1. Zhao F, Li Y, Ding HL, et al. Effects of Dahuang Zhechong Wan on the sex-hormone endometriosis rats. Traditional Chinese Medicine Research. 2008;21(9):14–16.
    1. Yang CB, Chen Y, Jin HM, et al. Effects of Xiang Leng Wan on dysmenorrhea and serum CA125 of patients with endometriosis. China Journal of Chinese Materia Medica. 2008;33(5):567–569.
    1. Tang YJ, Chen Y, Yu HY. Effects of Xiangleng pill on cytokine in endometriosis model rat. China Journal of Chinese Materia Medica. 2005;30(14):1108–1110.
    1. National Certification Commission for Acupuncture and Oriental Medicine .
    1. NIH Consensus Development Program. Acupuncture—consensus development conference statement. National Institutes of Health, July 2007.
    1. US National Center for Complementary and Alternative Medicine. Acupuncture. Original, 2006.
    1. Zeng R, Hong W. Clinical study of 40 cases with warm acupuncture treating endometriosis. China Journal of Chinese Medicine. 2010;25(147):342–343.
    1. Chen LN, Lin Y. The treatment of 70 endometriosis patients of dysmenorrhoea with abdominal acupuncture. Shandong Journal of Traditional Chinese Medicine. 2011;30(6):403–405.
    1. Liu YY, Ai Y, Xi YF, et al. Efficacy of different methods of acupuncture in the treatment of endometriosis-associated dysmenorrhoea. Hubei Journal of Traditional Chinese Medicine. 2009;3(7):53–54.
    1. Huo GM, Li SP, Zhou S, et al. Experimental study of the acupuncture intervention role on peritoneal fluid TNF-alpha of endometriosis rat. Hubei Journal of Traditional Chinese Medicine. 2006;28(7):8–9.
    1. Chiu J-H. How does moxibustion possibly work? Evidence-Based Complementary and Alternative Medicine. 2013;2013:8 pages.198584
    1. She C, Xiong J. Acupuncture treatment on 20 endometriosis patients. Shanghai Journal of Acupuncture and Moxibustion. 2012;31(3):178–179.
    1. Wang HM, Feng SY. Study of Cake-separated moxibustion on serum IL-6 levels in endometriosis patients. Journal of Fujian College of Traditional Chinese Medicine. 2003;13(4):21–23.
    1. Wang HM, Chen P, Feng SY, et al. Study of Cake-separated moxibustion on serum PGE2 levels in endometriosis rats. Chinese Journal of Traditional Medical Science and Technology. 2004;11(6):p. 361.
    1. Wang HM, Chen P, Feng SY, et al. Study of Cake-separated moxibustion on serum 6-keto-PGF1α levels in endometriosis rats. Shanghai Journal of Acupuncture and Moxibustion. 2004;23(10):39–40.
    1. Chen Q, Yue GP, Zhang WM. Clinical observation of acupuncture treatment on 27 endometriosis patients. Chinese Acupuncture & Moxibustion. 1996;2:25–27.
    1. Mu LJ. Effect observation of 42 endometriosis patients treated with the treatment of acupuncture. Chinese Materia Medica. 2012;19(12):80–82.
    1. Lin HY, Xu BS, et al. Effect of acupoint injection with alarelin on SP expression and analgesia in rats of endometriosis model. Suzhou University Journal of Medical Science. 2009;29(4):636–642.
    1. Sun QF. Treatment of 25 Ovarian chocolate cysts with Xiaoqiaotang and acupoint injection. Hunan Journal of Traditional Chinese Medicine. 2012;21(5):62–63.
    1. Hui XL, Zhang Y, Dong RJ. The treatment of 38 endometriosis patients with Acupuncture and Chinese medicine. Journal of Shaanxi College of Traditional Chinese Medicine. 2009;32(3):45–46.
    1. Si CQ. The treatment of 58 endometriosis patients with Acupuncture and Chinese medicine. Hebei Journal of Traditional Chinese Medicine. 2012;34(5):678–679.
    1. Zhang L. Clinical observation of Acupuncture and Herbs treatment for endometriosis. China Medical Herald. 2007;4(16):p. 136.
    1. Si CQ. Treatment of Acupuncture and Herbs for 58 endometriosis patients. Hebei Journal of Traditional Chinese Medicine. 2012;34(5):678–679.
    1. Fu Y, Xia T. Clinical observation of Acupuncture and Herbs treatment for endometriosis. Shanghai Journal of Acupuncture and Moxibustion. 2005;24(3):3–5.
    1. Chen Y-F, Zhang C-Y, Zhang X-Y, et al. Effects of acupuncture combined with medicine on expression of matrix metalloproteinase-2 in the rat of endometriosis. Chinese Acupuncture & Moxibustion. 2008;28(9):675–680.
    1. Hua XB, Li RC, Zhou HL, et al. Development of rat acupuncture points map. Experimental Animals and Animal Experiments. 1991;1:1–5.
    1. Jin Y-B, Sun Z-L, Jin H-F. Randomized controlled study on ear-electroacupuncture treatment of endometriosis-induced dysmenorrhea in patients. Acupuncture Research. 2009;34(3):188–192.
    1. Xiang DF, Si TY, Deng SG. Affect of ear acupoint area electro-acupuncture on the endorphins and uterine activity in endometriosis model animals. Forum on Traditional Chinese Medicine. 2005;20(4):46–47.
    1. Li SP, Liu C, Huo GM. Effects of galvano-acupuncture Guanyuan and Diji on β-Endorphin and Dynorphin in endometriosis rats. Shaanxi Journal of Traditional Chinese Medicine. 2009;25(3):49–50.
    1. Wang HM, Wang Q. The experimental research of compound dragon's blood and agent of acupoint sticking therapy endometriosis. Chinese Journal of Traditional Medical Science and Technology. 2008;15(2):83–84.
    1. Duan YH, Duan YH, Li YH. The efficacy of auricular acupuncture treatment of primary dysmenorrhea and its impact on serum PGE-2. Zhejiang Journal of Traditional Chinese Medicine. 2007;42(3):168–170.
    1. Zhou SY. Treatment of 64 endometriosis patients with enema. Guide of China Medicine. 2012;10(4):226–229.
    1. Wu HY. Treatment of 33 endometriosis patients with infertility through Enema therapy. China Modern Doctor. 2009;47(13):p. 77.
    1. Zhang L, Zhu PQ. Treatment of endometriosis through enema with Qingyitang. Journal of Sichuan of Traditional Chinese Medicine. 2007;25(12):84–885.
    1. Lei XP, Ye ZP, Li R. Introduction of microwave treatment principle. Progress in Physiological Sciences. 2002;33(3):p. 286.
    1. Sharma B, Preston J, Ray C. Microwave endometrial ablation for menorrhagia: outcome at 2 years—experience of a district general hospital. Journal of Obstetrics and Gynaecology. 2004;24(8):916–919.
    1. Kanaoka Y, Hirai K, Ishiko O. Successful microwave endometrial ablation in a uterus enlarged by adenomyosis. Osaka City Medical Journal. 2004;50(1):47–51.
    1. Tang MB, Zhang SM, Ding YJ, et al. Clinical applied research on rectal uterine endometriosis treatment with microwave combined with traditional Chinese medicine. Journal of Practical Traditional Chinese Internal Medicine. 2012;26(7):p. 66.
    1. Xu K, He JC. The treatment of 324 tubal infertility patients with Chinese Herbs combining enema microwave therapy. Chinese Community Doctors. 2007;23(24):p. 36.
    1. Sun YH, Sun YQ. Observation of 106 endometriosis patients treated with ZiniTuxie XiaozhengJian combining microwave physiotherapy. Information on Traditional Chinese Medicine. 2008;25(4):41–42.
    1. Wu XH, Zhang CL. The treatment for 49 endometriosis patients with Chinese herbal enema and Chinese medicine. Guangming Journal of Chinese Medicine. 2011;26(12):p. 2467.
    1. Chen HH. Clinical observation of traditional Chinese combining western medicine treatment for 45 endometriosis patients. Journal of Beijing University of Traditional Chinese Medicine. 2007;30(9):p. 643.
    1. Li WL, Song XJ. Integrated traditional Chinese medicine treatment for 68 endometriosis patients. Modern Traditional Chinese Medicine. 2009;29(3):p. 19.
    1. Yang J. Enema treatment for 50 endometriosis patients. Shaanxi Journal of Traditional Chinese Medicine. 2005;26(10):p. 1007.
    1. Yu BJ, Zhao YH. Clinical observation of endometriosis patients treated with Chinese medicine. Chinese Journal of Misdiagnostics. 2009;9(9):p. 2055.
    1. Meissner K, Böhling B, Schweizer-Arau A. Long-term effects of traditional chinese medicine and hypnotherapy in patients with severe endometriosis—a retrospective evaluation. Forschende Komplementarmedizin. 2010;17(6):314–320.
    1. Hawkins RS, Hart AD. The use of thermal biofeedback in the treatment of pain associated with endometriosis: preliminary findings. Applied Psychophysiology Biofeedback. 2003;28(4):279–289.

Source: PubMed

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