The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangdong Provincial Academy of Chinese Medical Sciences and The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou 510120, China.
China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, STEM College, RMIT University, Bundoora 3083, Australia.
Complement Ther Med. 2023 Sep;76:102963. doi: 10.1016/j.ctim.2023.102963. Epub 2023 Jul 13.
This study aimed to examine the effect of acupuncture on symptoms and health-related quality of life in patients with endometriosis.
Nine biomedical databases were searched to April 2022 to identify randomized controlled trials of acupuncture and/or moxibustion used alone or as adjunct to guideline-recommended pharmacotherapy for the treatment of endometriosis. One reviewer extracted data and another verified the data. A random effects model was used to calculate mean differences.
Fifteen trials involving 1018 patients met the inclusion criteria, but diversity in comparisons and outcome measures prevented meta-analysis. Compared to sham acupuncture, manual acupuncture was more effective at reducing dysmenorrhea VAS pain score (mean difference [MD] - 2.40, 95 % CI [- 2.80, - 2.00]; moderate certainty evidence), pelvic pain VAS score (MD - 2.65, 95 % CI [- 3.40, - 1.90]; high certainty evidence) and dyspareunia VAS scores (MD - 2.88, [- 3.83, - 1.93]), lessened the size of ovarian cyst (MD - 3.88, 95 % CI [- 7.06, - 0.70]), and improved quality of life. Compared to conventional therapy, manual acupuncture plus conventional therapy and warm needle alone resulted in greater improvements in quality of life than conventional therapy. Among the six studies that reported safety, fewer adverse events were reported in participants who received acupuncture or moxibustion.
Low to moderate certainty evidence from single studies showed that manual acupuncture may improve pain-related symptoms and quality of life; however, there is insufficient evidence on the overall effectiveness of acupuncture and moxibustion for endometriosis.
本研究旨在探讨针灸治疗子宫内膜异位症患者症状和健康相关生活质量的效果。
检索了 9 个生物医学数据库，以确定单独使用或作为指南推荐药物治疗子宫内膜异位症的辅助手段的针灸和/或艾灸的随机对照试验。一名评审员提取数据，另一名评审员验证数据。使用随机效应模型计算均值差。
15 项试验涉及 1018 名患者符合纳入标准，但由于比较和结局测量指标的多样性，无法进行荟萃分析。与假针灸相比，手动针灸在减轻痛经视觉模拟评分（平均差[MD]-2.40，95%可信区间[-2.80，-2.00]；中等确定性证据）、盆腔疼痛视觉模拟评分（MD-2.65，95%可信区间[-3.40，-1.90]；高确定性证据）和性交疼痛视觉模拟评分（MD-2.88，[-3.83，-1.93]）方面更有效，减少了卵巢囊肿的大小（MD-3.88，95%可信区间[-7.06，-0.70]），并改善了生活质量。与常规治疗相比，手动针灸联合常规治疗和温针单独治疗的生活质量改善优于常规治疗。在报告安全性的 6 项研究中，接受针灸或艾灸的参与者报告的不良事件较少。
来自单项研究的低至中等确定性证据表明，手动针灸可能改善与疼痛相关的症状和生活质量；然而，针灸和艾灸治疗子宫内膜异位症的总体效果证据不足。
