Li X, Hao X, Liu JH, Huang JP. Efficacy of non-pharmacological interventions for primary dysmenorrhoea: a systematic review and Bayesian network meta-analysis.
BMJ Evid Based Med 2024;
29:162-170. [PMID:
38242565 PMCID:
PMC11137453 DOI:
10.1136/bmjebm-2023-112434]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/10/2023] [Indexed: 01/21/2024]
Abstract
OBJECTIVES
To assess the relative benefits of various non-pharmacological interventions on treating primary dysmenorrhoea within a network meta-analysis.
STUDY DESIGN
Systematic review and Bayesian network meta-analysis.
INCLUSION CRITERIA
Randomised controlled trial involving patient with primary dysmenorrhoea and received non-pharmacological interventions.
DATA SOURCES
Four databases (Medline, Embase, Cochrane Library and Web of Science) were searched from inception to October first, 2022.
RISK-OF-BIAS ROB ASSESSMENT
RoB 2.0 assessment tools was used to assess the risk of bias in the included studies.
SYNTHESIS OF RESULTS
Conventional meta-analysis was conducted by pairwise comparison between non-pharmacological therapy and control treatment. The Bayesian network meta-analysis was conducted by the Aggregate Data Drug Information System Software based on the consistency or inconsistency model, and rank probability was used to indicate the priority of non-pharmacological therapy.
RESULTS
33 studies involving eight non-pharmacological interventions were included. With regard to conventional meta-analysis, we selected Visual Analogue Scale (VAS) as primary outcome to evaluate the pain intensity. The result showed that eight interventions (Exercise, Herb, Acupuncture, Aromatherapy, Transcutaneous Electrical Nerve Stimulation, Topical heat, Acupressure, Yoga) displayed positive effect on reduction of menstrual pain compared with placebo or no treatment. A Bayesian network meta-analysis revealed that exercise -3.20 (95% CI -4.01 to -2.34), acupuncture -2.90 (95% CI -3.97 to -2.85) and topical heat -2.97 (95% CI -4.66 to -1.29) probably resulted in a reduction in pain intensity (VAS) .
CONCLUSIONS
Non-pharmacological interventions may result in a reduction or slight reduction in pain intensity compared with no treatment or placebo. Specifically, exercise and acupuncture are considered as potentially effective non-pharmacological treatments in short-term treatment. Indeed, larger and better methodological quality research is needed.
TRIAL REGISTRATION NUMBER
CRD42022351021.
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