Cho Seung-Hun, Whang Wei-Wan
Hospital of Korean Medicine, Kyung Hee University Medical Center, Seoul, Korea.
Menopause. 2009 Sep-Oct;16(5):1065-73. doi: 10.1097/gme.0b013e3181a48abd.
The aim of this study was to critically assess whether acupuncture therapy reduces vasomotor menopausal symptoms and to evaluate the adverse effects of acupuncture therapy on the basis of the results of randomized controlled trials (RCTs).
Nineteen electronic databases, including English, Korean, Japanese, and Chinese databases, were systematically searched for RCTs in which acupuncture was used to reduce vasomotor menopausal symptoms before July 2008. There were no language restrictions. The methodological quality of the eligible studies was assessed using the categories provided by the Menstrual Disorders and Subfertility Review Group.
Eleven studies, which included a total of 764 individual cases, were systematically reviewed. The methodological quality of the trials varied substantially. Six trials compared acupuncture treatment to sham or placebo acupuncture. Only one study using a nonpenetrating placebo needle found a significant difference in the severity outcomes of hot flashes between groups (mean difference, 0.48; 95% CI, 0.05-0.91). Five studies reported a reduced frequency of hot flashes within groups; however, none found a significant difference between groups. An analysis of the outcomes of the trials that compared acupuncture with hormone therapy or oryzanol for reducing vasomotor symptoms showed that acupuncture was superior. Three RCTs reported minimal acupuncture-related adverse events.
There is no evidence from RCTs that acupuncture is an effective treatment in comparison to sham acupuncture for reducing menopausal hot flashes. Some studies have shown that acupuncture therapies are better than hormone therapy for reducing vasomotor symptoms. However, the number of RCTs compared with a nonpenetrating placebo control needle or hormone therapy was too small, and the methodological quality of some of the RCTs was poor. Further evaluation of the effects of acupuncture on vasomotor menopausal symptoms based on a well-controlled placebo trial is therefore warranted.
本研究旨在严格评估针刺疗法是否能减轻血管舒缩性绝经症状，并根据随机对照试验（RCT）结果评估针刺疗法的不良反应。
系统检索了19个电子数据库，包括英文、韩文、日文和中文数据库，以查找2008年7月前使用针刺疗法减轻血管舒缩性绝经症状的RCT。无语言限制。使用月经紊乱与亚生育审查组提供的类别评估符合条件研究的方法学质量。
系统评价了11项研究，共纳入764例个体病例。试验的方法学质量差异很大。6项试验将针刺治疗与假针刺或安慰剂针刺进行了比较。只有1项使用非穿透性安慰剂针的研究发现两组潮热严重程度结果存在显著差异（平均差异为0.48；95%CI为0.05 - 0.91）。5项研究报告组内热潮频率降低；然而，均未发现组间存在显著差异。对比较针刺与激素疗法或谷维素减轻血管舒缩症状的试验结果分析表明，针刺更具优势。3项RCT报告了与针刺相关的轻微不良事件。
RCTs没有证据表明与假针刺相比，针刺是减轻绝经潮热的有效治疗方法。一些研究表明，针刺疗法在减轻血管舒缩症状方面优于激素疗法。然而，与非穿透性安慰剂对照针或激素疗法比较的RCT数量过少，且部分RCT的方法学质量较差。因此，有必要基于严格对照的安慰剂试验进一步评估针刺对血管舒缩性绝经症状的影响。
