An Open-Labelled Randomized Comparative Efficacy Study of Unani Formulations and Hijama Bila Shart in Tashanuji Usr al-Tamth (Spasmodic Dysmenorrhea)

Objectives: To compare the efficacy of Unani formulations and Hijama Bila Shart in Tashanuji Usr al-Tamth (spasmodic dysmenorrhea). Materials and Methods: Diagnosed patients (n=40) were randomly allocated in 2 groups (A and B). Group A (n=20) received 200 mL Joshanda (decoction) of Post Amaltas (7 g), Badiyan (5 g), and Pudina Khushk (5 g) and 6 g Sufuf (Tukhm Kharpaza (5 g), Hulba (3 g), Hab ul Qilt (3 g), and Maghz Tukhm Bakayan (1 g), twice daily, 2 days before the onset of menstruation and continued for 3 days of menstrual cycle and Hijama bila Shart (dry cupping) were applied over the suprapubic region on day 1 to day 3 of the menstrual cycle in Group B (n=20) for three consecutive cycles. The primary outcome included a Verbal Rating Scale (VRS) for the severity of pain at baseline and at each follow-up. The secondary outcome included a multidimensional scoring system WaLIDD (working ability, location, intensity, days of pain, dysmenorrhea) score at baseline and post-intervention (4^th cycle). With a 5% level of significance, the data was statistically analyzed. Results: In both groups significant pain relief was noted at each follow-up from baseline. Cupping therapy was more effective than oral medication. The mean WaLIDD score of group A and group B comparison at baseline [8.85±1.23 and 8.20±1.40] and post-intervention [4.10±2.69 and 4.20±2.40] was statistically not significant (p>0.05). However, the intragroup comparison showed significant differences in both groups. No side effects of drugs were noted. Conclusion: Both groups were effective, safe and cost-effective, in pain management of Tashanuji Usr al-Tamth. However, further randomized standard controlled trials in large samples are recommended.