Hye Lin Woo, KMD,a Hae Ri Ji, KMD,e Yeon Kyoung Pak, KMD,e Hojung Lee,c Su Jeong Heo, KMD, PhD,dJin Moo Lee, KMD, PhD,b and Kyoung Sun Park, KMD, PhDb,∗
Medicine (Baltimore). 2018 Jun; 97(23): e11007.
Abstract
Background:
This systematic review aimed to evaluate the current evidence regarding the efficacy and safety of acupuncture on primary dysmenorrhea.
Methods:
Ten electronic databases were searched for relevant articles published before December 2017. This study included randomized controlled trials (RCTs) of women with primary dysmenorrhea; these RCTs compared acupuncture to no treatment, placebo, or medications, and measured menstrual pain intensity and its associated symptoms. Three independent reviewers participated in data extraction and assessment. The risk of bias in each article was assessed, and a meta-analysis was conducted according to the types of acupuncture. The results were expressed as mean difference (MD) or standardized mean difference (SMD) with 95% confidence intervals (CIs).
Results:
This review included 60 RCTs; the meta-analysis included 49 RCTs. Most studies showed a low or unclear risk of bias. We found that compared to no treatment, manual acupuncture (MA) (SMD = −1.59, 95% CI [−2.12, −1.06]) and electro-acupuncture (EA) was more effective at reducing menstrual pain, and compared to nonsteroidal anti-inflammatory drugs (NSAIDs), MA (SMD = −0.63, 95% CI [−0.88, −0.37]) and warm acupuncture (WA) (SMD = −1.12, 95% CI [−1.81, −0.43]) were more effective at reducing menstrual pain. Some studies showed that the efficacy of acupuncture was maintained after a short-term follow-up.
Conclusion:
The results of this study suggest that acupuncture might reduce menstrual pain and associated symptoms more effectively compared to no treatment or NSAIDs, and the efficacy could be maintained during a short-term follow-up period. Despite limitations due to the low quality and methodological restrictions of the included studies, acupuncture might be used as an effective and safe treatment for females with primary dysmenorrhea.
Declaration: Support provided by NIH/NCCAM grant R25 AT002879 (Suppl) and 1K23AT006392. LHR owned the acupuncture practice. The authors report no financial or commercial conflicts of interest.
Highlights
Whole Systems Traditional Chinese Medicine (WS-TCM) added to IVF may be beneficial.
WS-TCM and IVF was associated with more live births compared with acupuncture and IVF.
WS-TCM and IVF was associated with more live births compared with IVF alone.
WS-TCM is individualized and includes acupuncture and other TCM interventions.
Abstract
Patients undergoing IVF may receive either acupuncture or whole-systems traditional Chinese medicine (WS-TCM) as an adjuvant IVF treatment. WS-TCM is a complex intervention that can include acupuncture, Chinese herbal medicine, dietary, lifestyle recommendations.
In this retrospective cohort study, 1231 IVF patient records were reviewed to assess the effect of adjuvant WS-TCM on IVF outcomes compared among three groups:
IVF with no additional treatment;
IVF and elective acupuncture on day of embryo transfer; or
IVF and elective WS-TCM.
The primary outcome was live birth.
Of 1069 non-donor cycles, WS-TCM was associated with greater odds of live birth compared with IVF alone (adjusted odds ratio [AOR] 2.09; 95% confidence interval [CI] 1.36 to 3.21), or embryo transfer with acupuncture only (AOR 1.62; 95% CI 1.04 to 2.52). Of 162 donor cycles, WS-TCM was associated with increased live births compared with all groups (odds Ratio [OR] 3.72; 95% CI 1.05 to 13.24, unadjusted) or embryo transfer with acupuncture only (OR 4.09; 95% CI: 1.02 to 16.38, unadjusted).
Overall, IVF with adjuvant WS-TCM was associated with greater odds of live birth in donor and non-donor cycles. These results should be taken cautiously as more rigorous research is needed.
Efficacy of Traditional Chinese Herbal Medicine in the management of female infertility: a systematic review
Ried K1, Stuart K. Complement Ther Med. 2011 Dec;19(6):319-31. doi: 10.1016/j.ctim.2011.09.003. Epub 2011 Oct 5.
Conclusions
Review suggests that management of female infertility with Chinese Herbal Medicine can improve pregnancy rates 2-fold within a 4 month period compared with Western Medical fertility drug therapy or IVF. Assessment of the quality of the menstrual cycle, integral to TCM diagnosis, appears to be fundamental to successful treatment of female infertility.
Chinese herbal medicine for female infertility: an updated meta-analysis.
Ried K1.Complement Ther Med. 2015 Feb;23(1):116-28. doi: 10.1016/j.ctim.2014.12.004. Epub 2015 Jan 3.
Methods
We searched the Medline and Cochrane databases until December 2013 for randomized controlled trials and meta-analyses investigating Chinese herbal medicine therapy for female infertility and compared clinical pregnancy rates achieved with CHM versus WM drug treatment.
Results
Forty RCTs involving 4247 women with infertility were included in our systematic review. Meta-analysis suggested a 1.74 higher probability of achieving a pregnancy with CHM therapy than with WM therapy alone (risk ratio 1.74, 95%CI: 1.56-1.94; p<0.0001; odds ratio 3.14; 95%CI: 2.72-3.62; p<0.0001) in women with infertility. Trials included women with PCOS, endometriosis, anovulation, fallopian tube blockage, or unexplained infertility. Mean pregnancy rates in the CHM group were 60% compared with 33% in the WM group.
Conclusions
Our review suggests that management of female infertility with Chinese herbal medicine can improve pregnancy rates 2-fold within a 3-6 month period compared with Western medical fertility drug therapy. In addition, fertility indicators such as ovulation rates, cervical mucus score, biphasic basal body temperature, and appropriate thickness of the endometrial lining were positively influenced by CHM therapy, indicating an ameliorating physiological effect conducive for a viable pregnancy.
Jongbae J. Park, K.M.D., Ph.D.J Altern Complement Med. 2010 Feb; 16(2): 193–198.
Conclusions
The standard therapeutic package for unexplained infertility in women studied here is safe for infants and the treated women, when administered by licensed professionals. While it remains challenging to have the target population complete a 6-month treatment course, during which most patients have to pay out of pocket, the extent of successfully achieved pregnancy in those who received full treatment provides meaningful outcomes, warranting further attention. A future study that includes subsidized treatment costs, encouraging the appropriate compliance rate, is warranted.
Altern Ther Health Med. 2010 Nov-Dec;16(6):30-5. Liu H, Li H, Xu M, Chung KF, Zhang SP.
Examining Acupuncture for Trigeminal Neuralgia: A Detailed Analysis
Summary:
This review, published in Altern Ther Health Med in November-December 2010, aimed to assess acupuncture’s effectiveness in treating trigeminal neuralgia (TN). The review encompassed twelve studies examining the efficacy of acupuncture compared to carbamazepine (CBZ), a common treatment for TN. However, due to the low quality of these studies, a comprehensive meta-analysis couldn’t be conducted.
Method:
Researchers delved into English and Chinese databases to identify randomized controlled studies on acupuncture’s impact on TN. They evaluated the methodological quality of selected studies and analyzed the odds ratios (OR) between treatment and control groups to measure efficacy.
Results:
In the twelve studies reviewed, acupuncture was pitted against CBZ with 506 participants in the acupuncture group and 414 in the control group. The studies lacked strong methodological quality, making it challenging to conduct a meta-analysis. Four trials suggested acupuncture was better than CBZ, while eight found no significant difference between the treatment and control groups. Minimal adverse effects were reported in three studies that examined acupuncture.
Conclusion:
The review indicates that acupuncture could be as effective as CBZ in treating TN but with fewer reported side effects. However, due to the low quality of the studies analyzed, the evidence is not conclusive. Better-designed studies are necessary to validate acupuncture as a reliable treatment for TN.
Summary: This study, published in the Chinese Journal of Integrative Medicine in November 2017, aimed to assess acupuncture’s impact on idiopathic trigeminal neuralgia (ITN). Patients were divided into three groups: acupuncture, sham-acupuncture, and carbamazepine (a common medication for ITN). Their pain levels, medication doses, and various sensory evaluations were monitored before, immediately after, and six months post-treatment.
Method: The study included 60 ITN patients and 30 healthy individuals. Patients were randomly assigned to three groups: acupuncture (15), sham-acupuncture (15), and carbamazepine (30). Pain intensity, medication doses, temporomandibular disorder evaluations, masticatory system functionality, and sensory threshold tests were conducted at different intervals.
Results: The acupuncture group showed decreased pain intensity by the end of the study (P=0.012). In contrast, the sham-acupuncture group required increased medication doses (P<0.01). The acupuncture group sustained improvements in myofascial pain and jaw function after six months (P<0.01, P=0.023). Mechanical thresholds improved in the acupuncture group (tactile, P<0.01; vibration, P=0.027), while deep pain thresholds increased in both acupuncture and sham-acupuncture groups (P=0.013).
Conclusion: Acupuncture demonstrated potential in treating ITN by reducing pain and associated secondary myofascial discomfort. This suggests acupuncture as a viable option for managing ITN-related pain.
