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Treating primary dysmenorrhoea with acupuncture: a narrative review of the relationship between acupuncture ‘dose’ and menstrual pain outcomes
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    Re: “Treating primary dysmenorrhoea with acupuncture: a narrative review of the relationship between acupuncture ‘dose’ and menstrual pain outcomes”
    • Chunhong Zhang, botanic physician First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, 300193 Tianjin, China.
    • Other Contributors:
      • Hai Lu, -
      • Ruya Sheng, -

    Acknowledgments
    This work was supported by State Chinese Medicine Administration Bureau (Specific Scientific Research of Chinese Medicine Industry, no. 201407001-6B).

    Disclosure Statement
    No competing financial interests exist.

    Authors’ contributions
    HL drafted, CZ modified and RS translated the manuscript. All authors read and approved the final version accepted for publication.

    Dear Editor,
    We read the above named paper by Armour and Smith with great interest. In order to guide clinical practice, this article provided evidence of a dose-effect relationship in treating primary dysmenorrhoea by acupuncture. However, we still have some concerns about this paper.
    The authors planned to exam the relationship between menstrual outcomes and dose components including neurophysiological dose (number of needles, retention time and mode of stimulation), cumulative dose (total number and frequency of treatments), needle location and treatment timing, but did not reach a clear conclusion [1]. Because dose-effect relationships are important, we would like to express our opinions about acupuncture‘dose’. In 1972, academician Shi Xuemin described a theory of "acupuncture manipulation quantitative arts", which is concerned with studying and determining the best dose of acupuncture for treatment. It includes four aspects: (1) the applied force; (2) the direction of applied force; (3) the optimal duration of reinforcing-reducing...

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    Conflict of Interest:
    None declared.