@2024 Afarand., IRAN

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ISSN: 2252-0805    The Horizon of Medical Sciences 2017;23(4):265-271

Background
Cupping is one of the methods used in the treatment of certain diseases in Iran and in many countries of the world which is prevalent in some medical schools including Chinese medicine and traditional medicine [1, 2].
Previous Studies
… [3-9]. Cupping in Iranian traditional medicine is used for two groups of people: 1) Prevention for healthy people exposed to certain diseases. 2) Treatment of patients who need to extricate these substances due to accumulation of corpuscles in the body [2, 8]. The general conditions for doing the treatment are determined by the physical and emotional state of patient, age, habits and environmental conditions [2], and there are, of course, prohibitions on this therapeutic approach, which are strictly necessary. For example, weakness, sluggishness, anemia, exercise and heavy movement before and after cupping, sexual relationship 12 hours before and 24 hours after the cupping [1, 10], cold and dry temperaments, aging [11], severe cold or hot air, menstrual periods, stomachs full of food or completely empty, starving, inappropriate psychological state, and extreme nervous excitement, time after bathing and under two years of age and over 60 years of age are the most important preventive measures against cupping. … [12-14].
Aim(s)
According to what was said, and since the general interest in traditional therapies and especially cupping is increasing [15], the present study was conducted to determine the relationship between the amount of blood released during cupping and the patients` individual conditions, and the time of doing it.
Research type
This is a descriptive cross-sectional study
Research society, place and time
This study was conducted among men who had referred to a cupping center in Saveh City in spring of 2016.
Sampling method and number
Simple sampling was done and the number of samples was considered to be 400 in comparison with previous studies that eventually 391 subjects were studied.
Used devices&materials
At first, using medical and religious tests and articles about cupping, and with the opinion of professors and exports, a questionnaire including personal data, date of reference to day and month, and the year, age, height, weight, and the amount of blood released during the cupping in grams, was designed. It should be noted that although the measurement of liquids is usually based on their volume, since the determination of the amount of blood released during the cupping based on its volume is difficult, and there is the probability of contamination and reduction of measurement accuracy, and on the other hand, the aim of the study was to express the same criterion for all the samples, the weight criterion based in grams was used to replace the volume in milliliters. At the time of referral to the center, and after expressing the goal of the study, and obtaining informed consent, the questionnaires were completed in form of self-report. For few subjects who had problems in completing the questionnaires, the items were read by the researcher and their answers were recorded. In order to minimize errors and to make good use of the resulting information, only one center with an expert person in cupping in one season (spring) and at certain hours of the day (8-10am and 5-7pm) ware determined to maximize the similarity of execution conditions in terms of environmental factors and individual circumstances and technical issues, and to minimize the possibility of interfering with confounding variables. Also, the sex of all the studied clients were male according to the manhood of the presenter. Regarding the position of the operation, the position between the two scapulas was determined as the only studied position. The process of cupping was such that all the clients were instructed to study the panel for this purpose in order to know the minimum preparation for cupping, at the time of entering the center. Therefore, for people who were not prepared for any reason, the cupping was not carried out, or these people were not included into the study. Then, the subjects were sitting on the cupping bed in form of quadrant facing the qibla and the cupping was initially performed with a suction device and a cup of cupping in three stages and for about 2 minutes, the cupping was done slowly between the two scapula to the extent that the area become colored with subcutaneous blood pressure, but do not bruise or blemish in any way. Then, with razor no. 11, vertical surface scratches were made in equal length and in three rows and at rate of 40 and were carried out in three stages of blood sampling [13]. After the completion of blood collection, the cupping site was cleaned and dressed. After scratching and after each blood sampling, the person was asked about the change of his condition in terms of weakness, anxiety, head stiffness, and so on. To accurately measure the amount of released blood, at the beginning of each person's cupping procedure, at first, the plastic nylon was covered on a steel bowl, and after the cuts and suctions of the final blood, the nylon, containing the collected blood and the suction cup, was placed on a precision dial gauge, and its weight was observed. Then, the weight of empty nylon and the clean and unused sucking glass from the sum of that fraction and the final figure (which only contains the blood weight) was recorded on the sheet. Finally, the data of the questionnaire were entered into SPSS 16 software. Data were analyzed by descriptive statistics, Chi-square, T-test and one-way ANOVA.
Findings by Text
Participants in the study had a mean age of 35.83±12.17 years in the range of 9-76 years, mean height of 175.25±8.27 centimeter in the range of 123-199 centimeter, mean weight of 81.11±14.03 kilogram in the range of 32-130 kilogram and BMI of 26.43±4.43 kilogram per square meter in the range of 16-49. The mean of released blood during the cupping was 93.16±35.16 gram in the range of 12-220 gram. There was a significant and meaningful relationship between the mean age (p=0.001), weight (p=0.003), and BMI (p=0.007) and the mean of released blood during cupping. However, the relationship between the mean height and the mean released blood was not significant (p<0.05). There was no significant difference between the different days of the week in terms of amount of released blood during cupping (p<0.05). However, in comparison, the maximum amount of released blood was on the Monday and Tuesday i.e. the middle days of the week that was only statistically significant compared to Wednesday(p<0.05). There was no significant difference between the groups in terms of prevention and treatment (p<0.05). However, in those who had previous history of cupping, the amount of released blood was higher than those without a history (p<0.001). In terms of treatment groups, the amount of released blood was higher in those who had done cupping because of blood pressure compared to other groups, and the lowest amount of released blood was related to those who had headache and blood concentration respectively (p<0.05). Also, the mean of released blood based on age group (p<0.001) and BMI (p<0.028) had statistically significant difference (Table 1).
Main comparison to the similar studies
In a study done by Daniels et al. to determine the best time and place for maximal hemorrhage, it was concluded that the intervals and different points of body did not have a clear effect on the amount of blood from bloodstream [16]. In a study by Huber et al. using for cupping methods on 50 volunteers, it was shown that if the person who is doing cupping is professional, or if the person has 10 to 20 times the experience of doing cupping, the amount of suction resulting from cupping at multiple times will be roughly equal and repeatable [17]. … [18-22]. In terms of age group, the study was similar to other studies [1, 23]. The only place of cupping of the clients and the most common place of their previous cupping was between two scapula, which is consistent with the study by Heidari et al. [1] and it indicates the importance of this region to other areas of cupping. … [24-30].
Suggestions
It is recommended that similar studies be carried out in other centers and cities, and in both genders, and taking into account other possible variables. Consideration of appropriate time by users and, in particularly the administration should be considered. In addition, in order to further study of the causes of the increased amount of released blood during cupping, it is suggested in future studies parameters such as blood pressure, coagulation factors, type of temperament, etc. be determined.
Limitations
Performing a study in a city, in a center and one sex, as well as simultaneous study of cupping with the objectives of prevention and treatment, with a variety of diseases, from selective constraints, and the exclusivity of manpower to unify the implementation of the skin cut-out procedure in general, is a compulsory restriction of this research.
Conclusions
Individual characteristics such as age, weight, body mass index, cause of referral and history of cupping affect the amount of released blood during cupping, but the time of cupping (day and month) does not affect the amount of released blood.
Acknowledgments
The researchers are grateful for the cooperation of Dr. Seyed Ehsan Safari, Reza Tasbandi, Rasoul Asgari, Seyed Mohammad Vahid Ghazanfari, and all the participants in the study.
Conflict of interest
Non-declared
Ethical Permissions
Consent was obtained from all the participants after expressing the purpose of the research.
Funding Sources
The funding of this project has been exclusively provided by the authors.

TABLES and CHARTS

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