J Midwifery Womens Health. 2018 Jul;63(4):470-482. doi: 10.1111/jmwh.12729. Epub 2018 Jun 14.
Primary dysmenorrhea is a prevalent condition causing quality of life (QOL) reduction for many women, resulting from pain as well as parallel social and psychological distress. Yoga reduces pain and sympathetic reactivity, thus promoting QOL. This article reports a systematic review of the evidence for the effectiveness of yoga as a QOL improvement method for women with primary dysmenorrhea.
The PRISMA guidelines were used in preparation of this review. Ovid MEDLINE, PsycINFO, CINAHL, Scopus, PubMed, ScienceDirect, Cochrane Database of Systematic Reviews (CDSR), and Cochrane Central Register of Controlled Trials (CENTRAL) were screened through January 2017 using the keywords yoga, meditation, menstrual cycle, dysmenorrhea, pelvic pain, and prostaglandins. English-language randomized controlled trials (RCTs) and quasi-experimental studies regarding yoga, primary dysmenorrhea, and QOL were eligible; all yoga styles were included. Two independent reviewers rated the methodological quality of each study selected for review using the Downs and Black checklist; possible scores ranged from 0 to 32. Ratings were established through consensus.
The search yielded a total of 378 articles, of which 14 (age range 13-45 years, N = 1409) met the criteria for final review: 8 RCTs and 6 quasi-experimental studies. Downs and Black ratings were predominantly moderate in quality with moderate risk of bias, ranging from 15 to 23 (RCTs) and 10 to 17 (quasi-experimental studies). Statistically significant improvements along most QOL domains, including physical pain, sleep, concentration, negative feelings, social relationships, work capacity, and overall QOL, were identified after a yoga intervention. Results indicate preliminary evidence for yoga as a safe and effective QOL improvement method for women with primary dysmenorrhea.
Practitioners may consider yoga for management of primary dysmenorrhea. However, future research using larger RCTs of high methodological quality is needed to ascertain the magnitude of yoga's clinical significance.
原发性痛经是一种常见病症，可导致许多女性生活质量（QOL）下降，其原因不仅有疼痛，还有与之相关的社会和心理困扰。瑜伽可减轻疼痛和交感神经反应，从而提高 QOL。本文对瑜伽作为原发性痛经女性 QOL 改善方法的有效性进行了系统评价。
本文按照 PRISMA 指南进行准备。通过关键词“yoga、meditation、menstrual cycle、dysmenorrhea、pelvic pain、prostaglandins”，于 2017 年 1 月前在 Ovid MEDLINE、PsycINFO、CINAHL、Scopus、PubMed、ScienceDirect、Cochrane 系统评价数据库（CDSR）和 Cochrane 对照试验中心注册库（CENTRAL）进行检索，纳入关于瑜伽、原发性痛经和 QOL 的英语随机对照试验（RCT）和准实验研究。所有瑜伽类型均纳入研究。两名独立的综述作者使用 Downs 和 Black 清单对纳入研究进行方法学质量评价；可能的评分范围为 0 至 32 分。评分通过共识建立。
共检索到 378 篇文章，其中 14 篇（年龄 13-45 岁，N=1409）符合最终评价标准：8 项 RCT 和 6 项准实验研究。Downs 和 Black 评分主要为中等质量，存在中度偏倚风险，范围为 15-23 分（RCT）和 10-17 分（准实验研究）。瑜伽干预后，大多数 QOL 领域（包括身体疼痛、睡眠、注意力、负面情绪、社会关系、工作能力和整体 QOL）均有显著改善。
从业者可考虑将瑜伽用于原发性痛经的管理。然而，为确定瑜伽的临床意义，仍需要开展使用更大样本量和更高质量 RCT 的研究。
