Acupuncture for primary dysmenorrhoea: a systematic review

Abstract

Background The effectiveness of acupuncture in primary dysmenorrhoea is not fully understood.Objectives To assess the effectiveness of acupuncture for the symptomatic treatment of primary dysmenorrhoea from randomised controlled trials (RCTs).Search strategy Nineteen electronic databases, including English, Korean, Japanese and Chinese databases, were systematically searched for RCTs investigating acupuncture for primary dysmenorrhoea up to July 2008 with no language restrictions.Selection criteria All RCTs that evaluated the effects of acupuncture compared with controls were included. Studies that assessed the effect of moxibustion or body acupressure were excluded.Data collection and analysis The study abstraction and quality assessment of all studies were undertaken following the detailed descriptions of these categories as described in the Cochrane Handbook for Systematic Reviews of Interventions.Main results Twenty-seven RCTs were systematically reviewed. Only nine of the 27 trials clearly described their methods of randomisation and none of the trials stated the methods of allocation concealment. Compared with pharmacological treatment or herbal medicine, acupuncture was associated with a significant reduction in pain. Three studies reported reduced pain within groups from baseline; however, two RCTs did not find a significant difference between acupuncture and sham acupuncture.Author's conclusions The review found promising evidence in the form of RCTs for the use of acupuncture in the treatment of primary dysmenorrhoea compared with pharmacological treatment or herbal medicine. However, the results were limited by methodological flaws. The evidence for the effectiveness of acupuncture for the treatment of primary dysmenorrhoea is not convincing compared with sham acupuncture. Further rigorous nonpenetrating placebo-controlled RCTs are warranted.

Efficacy and Safety of Needle Acupuncture for Treating Gynecologic and Obstetric Disorders: An Overview

“…The full texts of the remaining 114 articles were assessed, of which 17 were included. These were eight SRs [10][11][12][13][14][15][16][17] and nine RCTs [18][19][20][21][22][23][24][25][26][27] (Fig. 1).…”

“…The remaining SRs did not provide lists of excluded studies and did not assess publication bias. 13,14,16 The characteristics of the included SRs are shown in Table 1.…”

“…[13][14][15] Four studies compared acupuncture against standard therapy (nonsteroidal anti-inflammatory drugs 14,15 With respect to the percentage of women experiencing pain relief as a dichotomous outcome, five comparisons found that acupuncture was better than pharmacologic therapy, but another five comparisons did not find any differences. [13][14][15] Two studies evaluated the use of acupuncture applying heat. One of the studies found that acupuncture was superior to treatment with NSAIDs (RR = 1.39, 95% CI: 1.09-1.76), but the other did not find any differences.…”

“…One of the studies found that acupuncture was superior to treatment with NSAIDs (RR = 1.39, 95% CI: 1.09-1.76), but the other did not find any differences. 14 Four studies compared verum acupuncture to sham acupuncture, and all reported a reduction in pain in both study groups. One study with 48 women included in the three SRs, [13][14][15] found that acupuncture was associated with greater pain reduction (90.9% versus 36.4%; p < 0.05).…”

“…In contrast, the remaining three studies found no differences between the groups. 14,15 Quality of life was assessed in two trials. 15 One identified an improvement among women treated with acupuncture, compared with usual care in the areas of body pain, mental health, vitality, social function, and emotions.…”