Clinical Effects of Optimized Pushing–Ironing Turtle-Shell Moxibustion Combined with Balanced Cupping in Primary Dysmenorrhea

Objective: This study aims to evaluate the therapeutic efficacy of combining optimized pushing–ironing turtle-shell moxibustion with balanced cupping for primary dysmenorrhea (PD). Methods: This study is a prospective, randomized clinical trial from April to December 2024. A total of 126 PD patients were divided into three groups: Group A (balanced cupping + turtle-shell moxibustion), Group B (turtle-shell moxibustion alone), and Group C (balanced cupping alone), with complete treatment in the first 3 months. Evaluations included pain visual analog scale (VAS) scores, Chinese Menstrual Pain Symptom Scale scores, Cox Menstrual Symptom Scale (CMSS) scores, 36-Item Short Form Health Survey (SF-36) scores, serum biomarker levels, and assessments of nursing satisfaction and adverse events. Results: Of the 126 enrolled, 123 completed the study. Posttreatment, VAS scores, Chinese Menstrual Pain Symptom Scale scores, CMSS menstrual severity score, CMSS menstrual symptom duration scores, SF-36 scores, and serum biomarker levels were significantly lower in all groups, with Group A showing the most improvement ( P < 0.05). Group A's satisfaction rate was 97.56%, higher than Groups B (92.68%) and C (95.12%), but not significantly different ( P > 0.05). Adverse reaction rates were low across all groups: 2.00% in A, 1.00% in B, and 0.00% in C, with no significant differences ( P > 0.05). Conclusion: This study showed that combining optimized pushing–ironing turtle-shell moxibustion with balanced cupping is significantly more effective than either technique alone in alleviating pain, enhancing traditional Chinese medicine symptoms and quality of life, and regulating inflammation and blood flow disorders, while also maintaining high patient satisfaction and safety.