1
|
Aksoy Can A, Vefikuluçay Yilmaz D. Effect of Acupressure on Menopausal Symptoms and Quality of Life in Postmenopausal Women: A Randomized Controlled Trial. Holist Nurs Pract 2024:00004650-990000000-00034. [PMID: 39120136 DOI: 10.1097/hnp.0000000000000663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2024]
Abstract
This study was conducted as a randomized controlled experimental trial with the aim of determining the effect of acupressure on menopausal symptoms and quality of life in postmenopausal women, as well as the correlation between the two. This randomized controlled experimental study was conducted between May and November 2021 with women coming to a Menopause School in Turkey. A Descriptive Characteristics Form, the Menopause Rating Scale, and the World Health Organization Quality of Life Scale Short Form were used to collect data. The study was performed with 61 patients in an acupressure group (n = 30) and a control group (n = 31). Acupressure was performed on the acupressure group in 30-minute sessions 3 times a week for 4 weeks, a total of 12 sessions. No intervention was performed on the control group. When the groups were compared, it was seen that the menopause symptom scores of the acupressure group were lower than those of the control group, and that their quality of life scores in the bodily and psychological areas were higher (P < .05). When within group comparisons were considered, it was seen that menopause symptoms declined over time in the acupressure group, and the scores of all dimensions of quality of life increased (P < .05). It was found that acupressure applied to women during menopause may reduce menopause symptoms and may improve their quality of life.
Collapse
Affiliation(s)
- Ahu Aksoy Can
- Author Affiliations: Department of Obstetrics and Gynecology Nursing, Mersin University Faculty of Nursing, Mersin, Turkey
| | | |
Collapse
|
2
|
Chen K, Beeraka NM, Zhang X, Sinelnikov MY, Plotnikova M, Zhao C, Basavaraj V, Zhang J, Lu P. Recent Advances in Therapeutic Modalities Against Breast Cancer-Related Lymphedema: Future Epigenetic Landscape. Lymphat Res Biol 2023; 21:536-548. [PMID: 37267206 PMCID: PMC10753987 DOI: 10.1089/lrb.2022.0016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
Background: Lymphedema is a significant postsurgical complication observed in the majority of breast cancer patients. These multifactorial etiopathogenesis have a significant role in the development of novel diagnostic/prognostic biomarkers and the development of novel therapies. This review aims to ascertain the epigenetic alterations that lead to breast cancer-related lymphedema (BCRL), multiple pathobiological events, and the underlying genetic predisposing factors, signaling cascades pertinent to the lapses in effective prognosis/diagnosis, and finally to develop a suitable therapeutic regimen. Methods and Results: We have performed a literature search in public databases such as PubMed, Medline, Google Scholar, National Library of Medicine and screened several published reports. Search words such as epigenetics to induce BCRL, prognosis/diagnosis, primary lymphedema, secondary lymphedema, genetic predisposing factors for BRCL, conventional therapies, and surgery were used in these databases. This review described several epigenetic-based predisposing factors and the pathophysiological consequences of BCRL, which affect the overall quality of life, and the interplay of these events could foster the progression of lymphedema in breast cancer survivors. Prognosis/diagnostic and therapy lapses for treating BCRL are highly challenging due to genetic and anatomical variations, alteration in the lymphatic vessel contractions, and variable expression of several factors such as vascular endothelial growth factor (VEGF)-E and vascular endothelial growth factor receptor (VEGFR) in breast cancer survivors. Conclusion: We compared the efficacy of various conventional therapies for treating BCRL as a multidisciplinary approach. Further substantial research is required to decipher underlying signaling epigenetic pathways to develop chromatin-modifying therapies pertinent to the multiple etiopathogenesis to explore the correlation between the disease pathophysiology and novel therapeutic modalities to treat BCRL.
Collapse
Affiliation(s)
- Kuo Chen
- Department of Breast Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Narasimha M. Beeraka
- Raghavendra Institute of Pharmaceutical Education and Research (RIPER), Anantapuramu, Andhra Pradesh, India
- I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - Xinliang Zhang
- I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - Mikhail Y. Sinelnikov
- I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - Maria Plotnikova
- I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - Cuiping Zhao
- The 80th Army Hospital of the Chinese People's Liberation Army, Weifang, China
| | - Vijaya Basavaraj
- Department of Pathology, JSS Medical College, JSS Academy of Higher Education & Research (JSS AHER), Mysuru, Karnataka, India
| | - Jin Zhang
- I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - Pengwei Lu
- Department of Breast Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| |
Collapse
|
3
|
Choi SJ, Kim DI, Yoon SH, Choi CM, Yoo JE. Randomized, single-blind, placebo-controlled trial on Hominis placenta extract pharmacopuncture for hot flashes in peri- and post-menopausal women. Integr Med Res 2022; 11:100891. [PMID: 36338608 PMCID: PMC9634366 DOI: 10.1016/j.imr.2022.100891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 09/29/2022] [Accepted: 10/06/2022] [Indexed: 11/05/2022] Open
Abstract
Background Hominis placenta pharmacopuncture is widely used for climacteric symptoms. This study examined the efficacy and safety of pharmacopuncture with PLC (the extract of Hominis placenta) on hot flashes for perimenopausal and postmenopausal women. Methods This study was a randomized placebo-controlled single-blind trial, which recruited 128 perimenopausal and postmenopausal women, randomly assigned to receive pharmacopuncture with PLC or normal saline (NS) for eight weeks. The primary outcome was the mean changes in the hot flash score (HFS) and the secondary outcomes were the mean changes in the Menopause Rating Scale (MRS), follicle-stimulating hormone (FSH) levels, and estradiol (E2) levels from baseline to eight weeks. Missing values were imputed using the last-observation-carried-forward method. Results After treatment (week 9), the HFS decreased significantly in both groups (p = 0.000). The residual HFS was 47.09 ± 41.39% and 56.45 ± 44.92 % in the PLC and control groups, respectively (p = 0.262). One month after the treatment (week 13), the score of the PLC group was reduced, but the score increased in the control group (p = 0.077). There were no statistically significant differences in the mean changes in MRS, FSH, and E2 between the two groups. No serious adverse events related to this trial were noted. Conclusion In this study, Hominis placenta extract pharmacopuncture did not differ significantly from NS in reducing the hot flash score. While this therapy appears safe, the potential for long-term effect of PLC extract needs to be examined in a large randomized controlled trial with appropriate controls.
Collapse
Affiliation(s)
- Su-Ji Choi
- Department of Korean Obstetrics & Gynecology, College of Korean Medicine, Dong-Guk University, Korean Medicine Hospital, Goyang, Republic of Korea
| | - Dong-Il Kim
- Department of Korean Obstetrics & Gynecology, College of Korean Medicine, Dong-Guk University, Korean Medicine Hospital, Goyang, Republic of Korea,Corresponding author at: Department of Korean Obstetrics & Gynecology, College of Korean Medicine, Dong-Guk University, Korean Medicine Hospital, 27 Dongguk-ro, Ilsandong-gu, Goyang, Gyeonggi-do 10326, Republic of Korea.
| | - Sang Ho Yoon
- Department of Obstetrics and Gynecology, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
| | - Chang-Min Choi
- Department of Korean Gynecology, College of Korean Medicine, Wonkwang University, Iksan, Republic of Korea
| | - Jeong-Eun Yoo
- Laon Korean Medicine Clinic, Daejeon, Republic of Korea
| |
Collapse
|
4
|
Kouzuma N, Taguchi T, Higuchi M. Heart Rate and Autonomic Nervous System Activity Relationship During Acupuncture Associated with Postural Change and Effect on Menopausal Symptoms: A Prospective Randomized Trial. Med Acupunct 2022; 34:299-307. [PMID: 36311889 PMCID: PMC9595640 DOI: 10.1089/acu.2022.0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective The autonomic nervous system (ANS) has been assessed using heart rate variability (HRV), and HRV has been used to evaluate acupuncture. This study investigated the relationship between heart rate (HR) and ANS activity during acupuncture and postural change. Materials and Methods Subjects (48 menopausal women) were assigned randomly to acupuncture and sham groups. Japanese-style acupuncture at 7 points was performed weekly for 4 weeks. For sham treatment an acupuncture tube was pressed at the same 7 points. Measurements of HR were taken at: stage 1 (supine position before acupuncture; control); stage 2 (acupuncture for 10 minutes), and stage 3 (after standing for 10 minutes). During the experiments, the following HRV indices were obtained: high (0.15 - 0.40 Hz) frequency (HF) power and low frequency (LF) power/high frequency power ratio (LF/HF) as an index of the parasympathetic nervous system activity and sympathetic nervous system activity, respectively. Participants' menopausal symptoms were assessed using a visual analogue scale. Results Reduction in HR during needle insertion and removal was significantly lower than that of retention (P < 0.01). There was a significant positive correlation between HR reduction during insertion and removal of needles (r = 0.732; P = 0.000). HR decreased by ≥5% in 79% (19/24) of the acupuncture-treated subjects. HF was increased significantly during acupuncture, while LF/HF decreased during standing. Menopausal symptoms were alleviated significantly. Conclusions Stimulation during acupuncture-needle insertion and removal regulated ANS function, causing a decreased HR. This technique relieve patients' menopausal symptoms.
Collapse
Affiliation(s)
- Naoko Kouzuma
- Divisions of Basic Nursing, Kyushu University of Nursing and Social Welfare, Tamana, Kumamoto, Japan
| | - Taro Taguchi
- Divisions of Acupuncture and Moxibustion, and Kyushu University of Nursing and Social Welfare, Tamana, Kumamoto, Japan
| | - Makie Higuchi
- Divisions of (Professor Emeritus) Pharmacology, Kyushu University of Nursing and Social Welfare, Tamana, Kumamoto, Japan
| |
Collapse
|
5
|
Liu C, Wang Z, Guo T, Zhuang L, Gao X. Effect of acupuncture on menopausal hot flushes and serum hormone levels: a systematic review and meta-analysis. Acupunct Med 2021; 40:289-298. [PMID: 34894774 DOI: 10.1177/09645284211056655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate the efficacy/effectiveness and safety of acupuncture for the treatment of hot flushes and its impact on serum hormone levels in menopausal women. METHODS A total of 10 databases were searched from their inception to August 2018. Reference lists of reviews and included articles were also hand-searched. Randomized controlled trials (RCTs) comparing the effect of acupuncture versus sham acupuncture, or acupuncture versus hormone therapy (HT), as treatment for menopausal hot flushes were included. Outcomes included hot flush frequency, hot flush severity and serum hormone levels of estradiol (E2), luteinizing hormone (LH) and follicle-stimulating hormone (FSH). Meta-analyses were performed using Review Manager 5.3 software. RESULTS Thirteen RCTs including 1784 patients were selected, seven of which were available for meta-analysis. Compared with sham acupuncture, acupuncture significantly decreased hot flush frequency (mean difference (MD) -0.84, 95% confidence interval (CI) [-1.64, -0.05], I2 = 54%) from baseline to the end of study, but did not impact end scores of hot flush frequency (MD 0.19, 95% CI [-0.61, 0.99], I2 = 0%) or severity (MD 0.02, 95% CI [-0.13, 0.17], I2 = 0%). No differences were found between acupuncture and HT in serum levels of E2 (MD 6.56, 95% CI [-3.77, 16.89], I2 = 76%), FSH (MD 1.06, 95% CI [-1.44, 3.56], I2 = 0%) or LH (MD -3.36, 95% CI [-13.37, 6.65], I2 = 89%). CONCLUSION Acupuncture may not decrease hot flush frequency, but yet appears to have similar effects on serum hormone levels as HT, that is, increased E2 and decreased FSH and LH. Considering that no firm conclusions could be drawn due to the low quality and limited number of included trials included, further high-quality RCTs need to be conducted.
Collapse
Affiliation(s)
- Chang Liu
- Traditional Chinese Medicine Hospital of Guangdong Province, Guangzhou, China
| | - Zhijie Wang
- Shanxi Province Hospital of Traditional Chinese Medicine, Taiyuan, China
| | - Ting Guo
- Clinical Medical College of Acupuncture, Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Lixing Zhuang
- Clinical Medical College of Acupuncture, Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiao Gao
- The Southern Harbin Hospital Affiliated to Heilongjiang University of Chinese Medicine, Harbin, China
| |
Collapse
|
6
|
Effect of acupuncture on menopausal hot flashes: Study protocol for a randomized controlled clinical trial. WORLD JOURNAL OF ACUPUNCTURE-MOXIBUSTION 2021. [DOI: 10.1016/j.wjam.2021.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
7
|
Efficacy Comparison of Different Acupuncture Treatments for Hot Flashes: A Systematic Review with Network Meta-Analysis. JOURNAL OF ACUPUNCTURE RESEARCH 2021. [DOI: 10.13045/jar.2020.00010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The objective of this study was to conduct a systematic review and network meta-analysis to evaluate and compare the effectiveness of various types of acupuncture for menopausal hot flashes (HF). Randomized controlled trials (RCTs) were retrieved from 8 electronic databases, and the risk of bias was evaluated for the included studies. Pairwise meta-analysis and network meta-analysis were performed using Review Manager and R software for indirect comparison and ranking, respectively. In total, 23 RCTs (2,302 patients) were eligible for systematic review, of which 10 were included in network meta-analysis. Network meta-analysis showed manual acupuncture (MA) had the highest probability of reducing HF frequency and severity, followed by sham acupuncture (SA), electroacupuncture, usual care, or no treatment; furthermore, warm acupuncture significantly improved menopause-specific quality of life compared with MA or electroacupuncture. Compared with hormone replacement therapy, acupuncture had less efficacy in reducing HF frequency but enhanced menopause-specific quality of life. There was no significant difference between MA and SA in mitigating HF. The existing evidence showed that MA could be used for alleviating menopausal HF. However, it is recommended that more high-quality RCTs should be performed.
Collapse
|
8
|
Jeon SR, Nam D, Kim TH. Dropouts in randomized clinical trials of Korean medicine interventions: a systematic review and meta-analysis. Trials 2021; 22:176. [PMID: 33648566 PMCID: PMC7923634 DOI: 10.1186/s13063-021-05114-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 02/09/2021] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND The dropout rate is an important determinant of outcomes in randomized controlled trials (RCTs) and should be carefully controlled. This study explored the current dropout rate in studies of Korean medicine (KM) interventions by systematic evaluation of RCTs conducted in the past 10 years. METHODS Three clinical trial registries (Clinical Research Information Service, ClinicalTrials.gov, and World Health Organization International Clinical Trials Registry Platform) were searched to identify RCT protocols for KM interventions, such as acupuncture, herbal medicine, moxibustion, or cupping, and studies of mixed interventions, registered in Korea from 2009 to 2019. The PubMed, Embase, and OASIS databases were searched for the full reports of these RCTs, including published journal articles and theses. Dropout rates and the reasons for dropping out were analyzed in each report. The risk of bias in each of the included studies was assessed using the Cochrane risk of bias tool. The risk difference for dropping out between the treatment and control groups was calculated with the 95% confidence interval in a random effects model. RESULTS Forty-nine published studies were included in the review. The median dropout rate was 10% in the treatment group (interquartile range 6.7%, 17.0%) and 14% in the control group (interquartile range 5.4%, 16.3%) and was highest in acupuncture studies (12%), followed by herbal medicine (10%), moxibustion (8%), and cupping (7%). Loss to follow-up was the most common reason for dropping out. The risk difference for dropping out between the intervention and control groups was estimated to be 0.01 (95% confidence interval - 0.02, 0.03) in KM intervention studies. CONCLUSIONS This review found no significant difference in the dropout rate between studies according to the type of KM intervention. We recommend allowance for a minimum dropout rate of 15% in future RCTs of KM interventions. REVIEW PROTOCOL REGISTRATION PROSPERO CRD42020141011.
Collapse
Affiliation(s)
- Sae-rom Jeon
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, 26 Kyung Heedae-ro, Dongdaemun-gu, Seoul, 02447 Republic of Korea
| | - Dongwoo Nam
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, 26 Kyung Heedae-ro, Dongdaemun-gu, Seoul, 02447 Republic of Korea
| | - Tae-Hun Kim
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, 26 Kyung Heedae-ro, Dongdaemun-gu, Seoul, 02447 Republic of Korea
- Department of Korea8n Medicine Clinical Trial Center, College of Korean Medicine, Kyung Hee University, 23 Kyung Heedae-ro, Dongdaemun-gu, Seoul, 02447 Republic of Korea
| |
Collapse
|
9
|
Waldorff FB, Bang CW, Siersma V, Brodersen J, Lund KS. Factors associated with a clinically relevant reduction in menopausal symptoms of a standardized acupuncture approach for women with bothersome menopausal symptoms. BMC Complement Med Ther 2021; 21:29. [PMID: 33441145 PMCID: PMC7805030 DOI: 10.1186/s12906-021-03208-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 01/05/2021] [Indexed: 11/24/2022] Open
Abstract
Background Little is known about factors associated with a clinically relevant reduction in menopausal symptoms through a brief acupuncture approach for women with moderate-to-severe menopausal symptoms. Methods Post hoc analysis of a randomized controlled trial where participants were allocated to early versus late standardized acupuncture. Both the early group and the late group are included in this study. The late group got an identical intervention parallel staged by 6 weeks. By means of the relative importance, the effect was evaluated for both early versus late women with a 6-week follow-up. We included four symptom subscales from the validated MenoScores Questionnaire: hot flushes, day and night sweats, general sweating, menopausal-specific sleeping problems, as well as an overall score, which is the sum of the four outcomes in the analysis. Results 67 women with moderate to severe menopausal symptoms were included of whom 52 (77.6%) experienced a clinically relevant reduction in any of the four surveyed symptom subscales or overall score. 48 (71.6%) women experienced a clinically relevant reduction in any of the vasomotor symptom subscales: hot flushes, day and night sweats, general sweating. Women with vocational education were most likely to experience improvement compared to women with higher education. Beyond education, other factors of some importance for a clinically relevant reduction were no alcohol consumption, two or more births and urinary incontinence. Conclusions Level of education was the most consistent factor associated with improvement. Beyond education, other factors of some importance were no alcohol consumption, two or more births and urinary incontinence. Trial registration This study was registered in ClinicalTrials.gov at April 21, 2016. The registration number is NCT02746497.
Collapse
Affiliation(s)
- Frans Boch Waldorff
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark. .,Department of Public Health, University of Southern Denmark, Research Unit of General Practice, Odense, Denmark.
| | - Christine Winther Bang
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Volkert Siersma
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - John Brodersen
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Primary Health Care Research Unit, Region Zealand, Sorø, Denmark
| | - Kamma Sundgaard Lund
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
10
|
Sheng RY, Yan Y, Linh Dang H. Acupuncture for hot flashes: A literature review of randomized controlled trials conducted in the last 10 years. WORLD JOURNAL OF TRADITIONAL CHINESE MEDICINE 2021. [DOI: 10.4103/wjtcm.wjtcm_27_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
11
|
Soares JM, Branco-de-Luca AC, da Fonseca AM, Carvalho-Lopes CM, Arruda-Veiga EC, Roa CL, Bagnoli VR, Baracat EC. Acupuncture ameliorated vasomotor symptoms during menopausal transition: single-blind, placebo-controlled, randomized trial to test treatment efficacy. ACTA ACUST UNITED AC 2020; 28:80-85. [PMID: 32898024 DOI: 10.1097/gme.0000000000001651] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This study aimed to evaluate the effects of acupuncture on women with vasomotor symptoms during the menopausal transition with the aid of the Kupperman-Blatt Menopausal Index. METHOD Crossover, single-blind, sham-controlled trial with 100 women randomly divided into two groups of 50 participants each: G1 and G2. During the first 24 weeks of treatment, the G1 women received acupuncture and the G2 women were given sham acupuncture. The crossover was then applied: the G1 participants were given sham acupuncture, and the G2 participants received acupuncture for 24 more weeks. RESULTS The mean score of hot flashes of the group who first experienced acupuncture (G1) was statistically higher than that of the group that started with sham acupuncture (G2, P = 0.020). Also, both groups had similar mean scores in the middle of the study (both were receiving acupuncture). During the last 6 months of the study, after crossover, the values of G2 (acupuncture) were lower than those of G1 (sham acupuncture). CONCLUSIONS Acupuncture treatment may mitigate hot flashes and other climacteric symptoms during the menopausal transition.
Collapse
Affiliation(s)
- Jose M Soares
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | | | | | | | | | | | | |
Collapse
|
12
|
Qin Y, Ruan X, Ju R, Pang J, Zhao G, Hu X. Acupuncture for menopausal symptoms in Chinese women: a systematic review. Climacteric 2020; 24:68-73. [PMID: 32729333 DOI: 10.1080/13697137.2020.1795115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Menopause-related symptoms are common problems of middle-aged women that can seriously affect their quality of life. Menopausal hormone therapy (MHT) for climacteric symptoms is the first choice recommended by the International Menopause Society and likewise by other societies and institutions covering this field. However, non-hormonal therapies can be an alternative effective option, especially for women who are not suitable for MHT. Acupuncture is one of the most important methods. With deepening experience of the use of traditional Chinese acupuncture and moxibustion in the improvement of menopause symptoms, more clinical evidence has been obtained to support the effectiveness and safety of this treatment concept that is very often used in China. This review summarizes the evidence for effective treatment of climacteric complaints by acupuncture in recent years, shares the clinical experience of the authors of this review, all of whom head or work in units with daily large numbers of outpatients, and includes, in particular, results from studies performed in the Department of Acupuncture--Moxibustion of Tsinghua University Chuiyangliu Hospital, Beijing, China. In addition, there is a summary about the safety of acupuncture treatment in traditional Chinese medicine.
Collapse
Affiliation(s)
- Y Qin
- Department of Acupuncture-Moxibustion, Tsinghua University Chuiyangliu Hospital, Beijing, China
| | - X Ruan
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.,Department of Women's Health, University Women's Hospital and Research Centre for Women's Health, University of Tuebingen, Tuebingen, Germany
| | - R Ju
- Department of Obstetrics and Gynecology, Tsinghua University Chuiyangliu Hospital, Beijing, China
| | - J Pang
- Department of Acupuncture-Moxibustion, Tsinghua University Chuiyangliu Hospital, Beijing, China
| | - G Zhao
- Department of Obstetrics and Gynecology, Tsinghua University Chuiyangliu Hospital, Beijing, China
| | - X Hu
- Department of Acupuncture-Moxibustion, Tsinghua University Chuiyangliu Hospital, Beijing, China
| |
Collapse
|
13
|
Lund KS, Siersma V, Bang CW, Brodersen J, Waldorff FB. Sustained effects of a brief and standardised acupuncture approach on menopausal symptoms: post hoc analysis of the ACOM randomised controlled trial. Acupunct Med 2020; 38:396-406. [PMID: 32517477 DOI: 10.1177/0964528420920280] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Our objective was to investigate whether the effect of a brief and standardised acupuncture approach persists after the end of the acupuncture treatment (post-treatment effect) and whether the anticipation of future acupuncture treatment affects menopausal symptoms (pre-treatment effect). METHOD This study is a post hoc analysis of data from a randomised controlled trial where women with moderate to severe menopausal symptoms were offered weekly acupuncture treatment over five consecutive weeks and randomised (1:1) to an early intervention group that received treatment immediately and a late intervention group with a 6-week delay. The acupuncture style was Western medical, administered at CV3, CV4 and bilateral LR8, SP6 and SP9. Acupuncturists were general practitioners. The effect was evaluated repeatedly during and after the interventions using scales from the validated MenoScores Questionnaire (MSQ) for hot flushes (HF), day and night sweats (DNS), general sweating (GS) and menopausal-specific sleeping problems (MSSP) with a 26-week follow-up period (corresponding to 21 or 15 weeks post-treatment for the early and late intervention groups, respectively). Multivariable linear mixed models were used to analyse the extent and duration of effects. RESULTS Seventy participants were included in the study. Four participants dropped out. Furthermore, one participant was excluded from the short- and long-term follow-up analyses after the insertion of a hormonal intrauterine device, and nine participants were excluded from the long-term follow-up analysis due to the initiation of co-interventions. For each of the four outcomes, the effect was sustained up to 21 weeks post-treatment with an effect size that was only slightly diminished. A small, but significant, pre-treatment effect was observed in the HF scale scores. The same trend, although not significant, was observed in the DNS and MSSP scale scores. No serious harms were reported. CONCLUSION This study demonstrated that the overall effect of a brief and standardised acupuncture treatment on menopause-relevant outcomes was sustained up to 21 weeks post-treatment and that there was a small pre-treatment effect.
Collapse
Affiliation(s)
- Kamma Sundgaard Lund
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Volkert Siersma
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Christine Winther Bang
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - John Brodersen
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Primary Health Care Research Unit, Region Zealand, Koege, Denmark
| | - Frans Boch Waldorff
- The Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Copenhagen, Denmark
| |
Collapse
|
14
|
Zayas J, Ruddy KJ, Olson JE, Couch FJ, Bauer BA, Mallory MJ, Yang P, Zahrieh D, Athreya AP, Loprinzi CL, Cathcart-Rake EJ. Real-world experiences with acupuncture among breast cancer survivors: a cross-sectional survey study. Support Care Cancer 2020; 28:5833-5838. [PMID: 32253604 DOI: 10.1007/s00520-020-05442-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 03/27/2020] [Indexed: 12/17/2022]
Abstract
PURPOSE The purpose of this study was to evaluate acupuncture use among breast cancer survivors, including perceived symptom improvements and referral patterns. METHODS Breast cancer survivors who had used acupuncture for cancer- or treatment-related symptoms were identified using an ongoing prospective Mayo Clinic Breast Disease Registry (MCBDR). Additionally, Mayo Clinic electronic health records (MCEHR) were queried to identify eligible participants. All received a mailed consent form and survey including acupuncture-related questions about acupuncture referrals, delivery, and costs. Respondents were also asked to recall symptom severity before and after acupuncture treatment and time to benefit on Likert scales. RESULTS Acupuncture use was reported among 415 participants (12.3%) of the MCBDR. Among MCBDR and MCEHR eligible participants, 241 women returned surveys. A total of 193 (82.1%) participants reported a symptomatic benefit from acupuncture, and 57 (24.1% of participants) reported a "substantial benefit" or "totally resolved my symptoms" (corresponding to 4 and 5 on the 5-point Likert scale). The mean symptom severity decreased by at least 1 point of the 5-point scale for each symptom; the percentage of patients who reported an improvement in symptoms ranged from 56% (lymphedema) to 79% (headache). The majority of patients reported time to benefit as "immediate" (34%) or "after a few treatments" (40.4%). Over half of the participants self-referred for treatment; 24.1% were referred by their oncologist. Acupuncture delivery was more frequent in private offices (61.0%) than in hospital or medical settings (42.3%). Twelve participants (5.1%) reported negative side effects, such as discomfort. CONCLUSIONS Acupuncture is commonly utilized by patients for a variety of breast cancer-related symptoms. However, patients frequently self-refer for acupuncture treatments, and most acupuncture care is completed at private offices, rather than medical clinic or hospital settings.
Collapse
Affiliation(s)
- Jacqueline Zayas
- Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Medicine and the Mayo Clinic Medical Scientist Training Program, Rochester, MN, 55905, USA.
| | - Kathryn J Ruddy
- Department of Medical Oncology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Janet E Olson
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, 55905, USA
| | - Fergus J Couch
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Brent A Bauer
- Department of General Internal Medicine, Mayo Clinic, Rochester, MN, 55905, USA
| | - Molly J Mallory
- Department of General Internal Medicine, Mayo Clinic, Rochester, MN, 55905, USA
| | - Ping Yang
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, 55905, USA
| | - David Zahrieh
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, 55905, USA
| | - Arjun P Athreya
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN, 55905, USA
| | | | | |
Collapse
|
15
|
He Q, Ren Y, Wang Y, Zhang F, Zhang S. The efficacy and safety of acupuncture for perimenopause symptom compared with different sham acupuncture control groups: A protocol of systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e19366. [PMID: 32150082 PMCID: PMC7478674 DOI: 10.1097/md.0000000000019366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 01/31/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Perimenopause is a period that every woman must go through, most people are more or less affected by perimenopausal symptoms, it to affect women's health, work, life, and economy. As acupuncture treatment is more and more increasing in perimenopausal symptoms, there have also been many clinical trials about it. But the results of the trials are inconsistent. Therefore, we will conduct a systematic review and meta-analysis of the safety and efficacy of perimenopausal symptoms treated with acupuncture. METHODS The protocol followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. RCT study on different acupuncture interventions for perimenopausal symptoms will be searched in 8 databases (PubMed, EMBASE, the Cochrane Library, the web of science, CBM, CNKI, WAN FANG, and VIP). Besides, the search will also be performed on the clinical trial research platform if necessary. The primary outcome that will be extracted: the Flushes per 24 hours, the Frequency of hot flashes, the severity of hot flashes, the menopause-related symptom score, the treatment efficacy, the adverse event. Endnote software X8 will be used for study selection, STATA 13.0 and Review Manager software 5.3 will be used for analysis and synthesis. These studies selection, data extraction, and risk of bias assessment will be conducted by 2 independent reviewers. RESULTS This study will provide the results: 1. the primary and secondary outcome indicators of different acupuncture intervention measures (traditional hand acupuncture, moxibustion, ear acupuncture, laser, acupressure points) for perimenopausal symptoms. 2. The effects of different control groups (medicine control, routine care, waiting, and sham acupuncture control) on the analysis results will be reported, especially the effects of different sham acupuncture control (invasive/noninvasive) on the analysis results. CONCLUSION This systematic review and meta-analysis study hopes to provide useful evidence for better use of different types of acupuncture in treat perimenopausal symptoms and better design of control groups in related clinical trials. In addition, the research conclusion will be published in peer journals.OSF REGISTRATION NUMBER DOI 10.17605/OSF.IO/VZCKU Ethics and dissemination This conclusion of the study will be published in peer journals. The ethical approval is not required because there is no direct involvement of human.
Collapse
Affiliation(s)
- Qiujun He
- College of Basic Medicine, Chengdu University of Traditional Chinese Medicine
| | - Yajing Ren
- Chengdu University of Traditional Chinese Medicine
| | | | - Feng Zhang
- College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Sanyin Zhang
- Chengdu University of Traditional Chinese Medicine
| |
Collapse
|
16
|
Iliodromiti S, Wang W, Lumsden MA, Hunter MS, Bell R, Mishra G, Hickey M. Variation in menopausal vasomotor symptoms outcomes in clinical trials: a systematic review. BJOG 2019; 127:320-333. [PMID: 31621155 PMCID: PMC6972542 DOI: 10.1111/1471-0528.15990] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND There is substantial variation in how menopausal vasomotor symptoms are reported and measured among intervention studies. This has prevented meaningful comparisons between treatments and limited data synthesis. OBJECTIVES To review systematically the outcome reporting and measures used to assess menopausal vasomotor symptoms from randomised controlled trials of treatments. SEARCH STRATEGY We searched MEDLINE, Embase, and Cochrane Central Register of Controlled Trials from inception to May 2018. SELECTION CRITERIA Randomised controlled trials with a primary outcome of menopausal vasomotor symptoms in women and a sample size of at least 20 women per study arm. DATA COLLECTION AND ANALYSIS Data about study characteristics, primary vasomotor-related outcomes and methods of measuring them. MAIN RESULTS The search identified 5591 studies, 214 of which were included. Forty-nine different primary reported outcomes were identified for vasomotor symptoms and 16 different tools had been used to measure these outcomes. The most commonly reported outcomes were frequency (97/214), severity (116/214), and intensity (28/114) of vasomotor symptoms or a composite of these outcomes (68/214). There was little consistency in how the frequency and severity/intensity of vasomotor symptoms were defined. CONCLUSIONS There is substantial variation in how menopausal vasomotor symptoms have been reported and measured in treatment trials. Future studies should include standardised outcome measures which reflect the priorities of patients, clinicians, and researchers. This is most effectively achieved through the development of a Core Outcome Set. This systematic review is the first step towards development of a Core Outcome Set for menopausal vasomotor symptoms. TWEETABLE SUMMARY Menopausal hot flushes and night sweats have been reported in 49 different ways in clinical research. A core outcome set is urgently required.
Collapse
Affiliation(s)
- S Iliodromiti
- Women's Health Division, Blizard Institute, Queen Mary University London, London, UK.,School of Medicine, University of Glasgow, Glasgow, UK
| | - W Wang
- Department of Obstetrics, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - M A Lumsden
- School of Medicine, University of Glasgow, Glasgow, UK
| | - M S Hunter
- Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - R Bell
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - G Mishra
- Faculty of Medicine, School of Public Health, University of Queensland, Brisbane, Australia
| | - M Hickey
- Department of Obstetrics and Gynaecology, University of Melbourne and The Royal Women's Hospital, Victoria, Australia
| |
Collapse
|
17
|
Belešová R, Tóthová V. Use of evaluation tools to evaluate symptoms and changes in climacteric women in the Czech Republic and abroad. CENTRAL EUROPEAN JOURNAL OF NURSING AND MIDWIFERY 2019. [DOI: 10.15452/cejnm.2019.10.0026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
|
18
|
Johnson A, Roberts L, Elkins G. Complementary and Alternative Medicine for Menopause. J Evid Based Integr Med 2019; 24:2515690X19829380. [PMID: 30868921 PMCID: PMC6419242 DOI: 10.1177/2515690x19829380] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Menopause is associated with problematic symptoms, including hot flashes, sleep problems, mood disorders, sexual dysfunction, weight gain, and declines in cognitive functioning. Many women seek complementary and alternative medicine (CAM) for symptom management. This article critically reviews the existing literature on CAM treatments most commonly used for menopausal symptoms. Electronic searches were conducted to identify relevant, English-language literature published through March 2017. Results indicate that mind and body practices may be of benefit in reducing stress and bothersomeness of some menopausal symptoms. In particular, hypnosis is a mind-body intervention that has consistently shown to have a clinically significant effect on reducing hot flashes. Evidence is mixed in regard to the efficacy of natural products and there are some safety concerns. Health care providers should consider the evidence on CAM in providing an integrative health approach to menopausal symptom management.
Collapse
|
19
|
Choi SJ, Kim DI. To evaluate the efficacy and safety of PLC in perimenopausal or postmenopausal women with Hot Flashes: study protocol for a randomized controlled trial. Trials 2019; 20:415. [PMID: 31291984 PMCID: PMC6617856 DOI: 10.1186/s13063-019-3482-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 05/30/2019] [Indexed: 11/29/2022] Open
Abstract
Background Hot flashes are the most frequent symptoms of the menopause, with 10–20% of all postmenopausal women reporting nearly intolerable occurrences. Although pharmacopuncture with hominis placenta extract is one of the new acupuncture therapies popular in East Asian medicine with a known efficacy in treating facial flushing, there has been little research on the efficacy and safety of this extract. This study, therefore, aims to evaluate the efficacy and safety of pharmacopuncture with hominis placenta extract (PLC) compared to injections of normal saline, in perimenopausal and postmenopausal women in Korea. Methods/design This study is a randomized placebo-controlled single-blind multi-center parallel-design trial. In total, 128 perimenopausal or postmenopausal women who meet the inclusion criteria will be recruited. The treatment group will receive PLC pharmacopuncture twice a week, for a total of 18 sessions over 9 weeks. The control group will receive injections of normal saline at the same acupoints during the same period. The post-treatment follow-up assessment will occur 4 weeks after the participant has completed the treatment. Discussion We believe that this trial will provide evidence for the efficacy and safety of PLC pharmacopuncture as a treatment for hot flashes in perimenopausal and postmenopausal women. Trial registration Clinical Research Information Service (CRIS), Republic of Korea, ID: KCT0003533, Registered on 20 February 2019. Electronic supplementary material The online version of this article (10.1186/s13063-019-3482-5) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Su-Ji Choi
- Department of Obstetrics & Gynecology, College of Korean Medicine, Dongguk University Korean Medicine Hospital, 27 Dongguk-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10326, Republic of Korea
| | - Dong-Il Kim
- Department of Obstetrics & Gynecology, College of Korean Medicine, Dongguk University Korean Medicine Hospital, 27 Dongguk-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10326, Republic of Korea.
| |
Collapse
|
20
|
|
21
|
The Effect of Mindfulness-Based Cognitive Therapy on Quality of life in Perimenopausal Women. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2019. [DOI: 10.5812/ijpbs.86525] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
22
|
Lund KS, Siersma V, Brodersen J, Waldorff FB. Efficacy of a standardised acupuncture approach for women with bothersome menopausal symptoms: a pragmatic randomised study in primary care (the ACOM study). BMJ Open 2019; 9:e023637. [PMID: 30782712 PMCID: PMC6501989 DOI: 10.1136/bmjopen-2018-023637] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 12/17/2018] [Accepted: 12/21/2018] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE To investigate the efficacy of a standardised brief acupuncture approach for women with moderate-to-severe menopausal symptoms. DESIGN Randomised and controlled, with 1:1 allocation to the intervention group or the control group. The assessor and the statistician were blinded. SETTING Nine Danish primary care practices. PARTICIPANTS 70 women with moderate-to-severe menopausal symptoms and nine general practitioners with accredited education in acupuncture. INTERVENTION The acupuncture style was western medical with a standardised approach in the predefined acupuncture points CV-3, CV-4, LR-8, SP-6 and SP-9. The intervention group received one treatment for five consecutive weeks. The control group was offered treatment after 6 weeks. MAIN OUTCOME MEASURES Outcomes were the differences between the randomisation groups in changes to mean scores using the scales in the MenoScores Questionnaire, measured from baseline to week 6. The primary outcome was the hot flushes scale; the secondary outcomes were the other scales in the questionnaire. All analyses were based on intention-to-treat analysis. RESULTS 36 participants received the intervention, and 34 participants were in the control group. Four participants dropped out before week 6. The acupuncture intervention significantly decreased hot flushes: Δ -1.6 (95% CI [-2.3 to -0.8]; p<0.0001), day-and-night sweats: Δ -1.2 (95% CI [-2.0 to -0.4]; p=0.0056), general sweating: Δ -0.9(95% CI [-1.6 to -0.2]; p=0.0086), menopausal-specific sleeping problems: Δ -1.8 (95% CI [-2.7 to -1.0]; p<0.0001), emotional symptoms: Δ -3.4 (95% CI [-5.3 to -1.4]; p=0.0008), physical symptoms: Δ -1.7 (95% CI [-3 to -0.4]; p=0.010) and skin and hair symptoms: Δ -1.5 (95% CI [-2.5 to -0.6]; p=0.0021) compared with the control group at the 6-week follow-up. The pattern of decrease in hot flushes, emotional symptoms, skin and hair symptoms was already apparent 3 weeks into the study. Mild potential adverse effects were reported by four participants, but no severe adverse effects were reported. CONCLUSIONS The standardised and brief acupuncture treatment produced a fast and clinically relevant reduction in moderate-to-severe menopausal symptoms during the six-week intervention. No severe adverse effects were reported. TRIAL REGISTRATION NUMBER NCT02746497; Results.
Collapse
Affiliation(s)
- Kamma Sundgaard Lund
- Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Volkert Siersma
- Research Unit for General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - John Brodersen
- Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Primary Health Care Research Unit, University of Copenhagen, Copenhagen, Denmark
| | - Frans Boch Waldorff
- The Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| |
Collapse
|
23
|
Wright CL, Aickin M. Improvement of Menopausal Symptoms with Acupuncture Not Reflected in Changes to Heart Rate Variability. Acupunct Med 2018; 29:32-9. [DOI: 10.1136/aim.2010.003053] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Hypothesis Studies indicate that menopausal symptoms are relieved by acupuncture. Additional studies have suggested that acupuncture may affect heart rate variability (HRV). This paper reports a pilot study that investigated whether menopausal symptoms responded to acupuncture, and if changes in the spectral analysis of HRV, either suppression of low frequency or augmentation of high frequency bands, corresponded with symptom report. Methods/interventions 12 healthy menopausal subjects were enrolled in this feasibility study. At baseline, subjects were experiencing moderately distressing menopausal symptoms, scoring at least 22 of a possible 44 points on the Menopausal Rating Scale. 10 traditional Chinese medicine-based, protocol acupuncture treatments were administered over a 4 week period, three times a week for 2 weeks, followed by twice a week for 2 weeks. Outcome measures Menopausal Rating Scale questionnaire, 11 menopausal symptoms were evaluated on a zero to four severity scale via self-administered daily checklist for 4 weeks. Dynamic measures of HRV (autoregressive model) were captured before, during and after acupuncture at each session. Spectral analysis of the heart rate was used to compute power in the low frequency and high frequency bands, and their ratio. Results All subjects complied fully with the protocol without any reported adverse events. While all 11 symptoms showed significant improvement, and one HRV measure changed, on average over the study period, there was essentially no support for a relationship between HRV, menopausal symptom report and acupuncture intervention.
Collapse
Affiliation(s)
- Cheryl L Wright
- School of Nursing, Oregon Health and Science University, Portland, Oregon, USA
| | - Mikel Aickin
- Department of Family and Community Medicine, University of Arizona, Tucson, Arizona, USA
| |
Collapse
|
24
|
Dawood AS, El-Sharawy MA, Nada DW, El-Sheikh MF. Premature ovarian failure of autoimmune etiology in 46XX patients: is there a hope? JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2018; 15:jcim-2017-0072. [PMID: 29794258 DOI: 10.1515/jcim-2017-0072] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Accepted: 03/21/2018] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To evaluate the efficacy of live bee stings at fertility points and acupuncture in treating symptoms and managing infertility in premature ovarian failure (POF) of autoimmune etiology. PATIENTS AND METHODS Patients with primary POF were allocated randomly into two groups: group I: subjected to acupuncture at specific fertility points and group II: subjected to live bee stings at sites of fertility points. RESULTS A total of 24 cases show significant reduction of Follicle stimulating hormone (FSH) level to normal range with gradual decline over the study duration: 13 cases in group I and 11 cases in group II. Eight cases got pregnant while the other 13 cases regained normal menses but still infertile. CONCLUSIONS Both bee sting therapy and acupuncture were effective in reduction of FSH levels with restoration of regular menstrual patterns and restoration of fertility. The bee sting therapy was superior in the pregnancy rate, while acupuncture was superior in alleviation of symptoms.
Collapse
Affiliation(s)
- Ayman Shehata Dawood
- MD of Obstetrics and Gynecology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | | | - Doaa Waseem Nada
- MD of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Mohamed Fadel El-Sheikh
- MD of Economic Entomology, Department of Plant Protection, Faculty of Agriculture, Tanta University, Tanta, Egypt
| |
Collapse
|
25
|
Acupuncture for menopausal hot flashes: clinical evidence update and its relevance to decision making. Menopause 2018; 24:980-987. [PMID: 28350757 DOI: 10.1097/gme.0000000000000850] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE There is conflicting evidence on the efficacy and effectiveness of acupuncture for menopausal hot flashes. This article synthesizes the best available evidence for when women are considering whether acupuncture might be useful for menopausal hot flashes. METHODS We searched electronic databases to identify randomized controlled trials and systematic reviews of acupuncture for menopausal hot flushes. RESULTS The overall evidence demonstrates that acupuncture is effective when compared with no treatment, but not efficacious compared with sham. Methodological challenges such as the complex nature of acupuncture treatment, the physiological effects from sham, and the significant efficacy of placebo therapy generally in treating hot flashes all impact on these considerations. CONCLUSIONS Acupuncture improves menopausal hot flashes compared with no treatment; however, not compared with sham acupuncture. This is also consistent with the evidence that a range of placebo interventions improve menopausal symptoms. As clinicians play a vital role in assisting evidence-informed decisions, we need to ensure women understand the evidence and can integrate it with personal preferences. Some women may choose acupuncture for hot flashes, a potentially disabling condition without long-term adverse health consequences. Yet, women should do so understanding the evidence, and its strengths and weaknesses, around both effective medical therapies and acupuncture. Likewise, cost to the individual and the health system needs to be considered in the context of value-based health care.
Collapse
|
26
|
Befus D, Coeytaux RR, Goldstein KM, McDuffie JR, Shepherd-Banigan M, Goode AP, Kosinski A, Van Noord MG, Adam SS, Masilamani V, Nagi A, Williams JW. Management of Menopause Symptoms with Acupuncture: An Umbrella Systematic Review and Meta-Analysis. J Altern Complement Med 2018; 24:314-323. [DOI: 10.1089/acm.2016.0408] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Deanna Befus
- Department of Family and Community Medicine, Center for Integrative Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Remy R. Coeytaux
- Department of Family and Community Medicine, Center for Integrative Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Karen M. Goldstein
- Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC
- Division of General Internal Medicine, Department of Medicine, Duke University Medical Center, Durham, NC
| | - Jennifer R. McDuffie
- Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC
- Division of General Internal Medicine, Department of Medicine, Duke University Medical Center, Durham, NC
| | - Megan Shepherd-Banigan
- Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC
| | - Adam P. Goode
- Duke Clinical Research Institute, Durham, NC
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC
| | - Andrzej Kosinski
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham NC
| | | | - Soheir S. Adam
- Department of Medicine, Duke University Medical Center, Durham, NC
| | - Varsha Masilamani
- Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC
| | - Avishek Nagi
- Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC
| | - John W. Williams
- Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC
- Division of General Internal Medicine, Department of Medicine, Duke University Medical Center, Durham, NC
| |
Collapse
|
27
|
Trajectories of response to acupuncture for menopausal vasomotor symptoms: the Acupuncture in Menopause study. Menopause 2018; 24:171-179. [PMID: 27676631 DOI: 10.1097/gme.0000000000000735] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To examine the trajectories of responses to acupuncture treatment for menopausal vasomotor symptoms (VMS) and the characteristics of women in each trajectory. METHODS Two hundred nine perimenopausal and postmenopausal women aged 45 to 60 years experiencing at least four VMS per day were recruited and randomized to receive up to 20 acupuncture treatments within 6 months or to a waitlist control group. The primary outcome was percent change from baseline in the mean daily VMS frequency. Finite mixture modeling was used to identify patterns of percent change in weekly VMS frequencies over the first 8 weeks. The Freeman-Holton test and analysis of variance were used to compare characteristics of women in different trajectories. RESULTS Analyses revealed four distinct trajectories of change in VMS frequency by week 8 in the acupuncture group. A small group of women (11.6%, n = 19) had an 85% reduction in VMS. The largest group (47%, n = 79) reported a 47% reduction in VMS frequency, 37.3% (n = 65) of the sample showed only a 9.6% reduction in VMS frequency, and a very small group (4.1%, n = 7) had a 100% increase in VMS. Among women in the waitlist control group, 79.5% reported a 10% decrease in VMS frequency at week 8. Baseline number of VMS, number of acupuncture treatments in the first 8 weeks, and traditional Chinese medicine diagnosis were significantly related to trajectory group membership in the acupuncture group. CONCLUSIONS Approximately half of the treated sample reported a decline in VMS frequency, but identifying clear predictors of clinical response to acupuncture treatment of menopausal VMS remains challenging.
Collapse
|
28
|
Yu Q. Traditional Chinese medicine: perspectives on and treatment of menopausal symptoms. Climacteric 2018; 21:93-95. [PMID: 29419312 DOI: 10.1080/13697137.2018.1434983] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
29
|
Abstract
OBJECTIVE The aim of the study was to evaluate the short and long-term effects of acupuncture on vasomotor symptoms (VMS) and quality of life-related measures. METHODS A total of 209 perimenopausal and postmenopausal women aged 45 to 60 years, experiencing four or more VMS per day, were recruited from the community and randomized to receive up to 20 acupuncture treatments within the first 6 months (acupuncture group) or the second 6 months (waitlist control group) of the 12-month study period. The primary outcome was mean daily frequency of VMS. Secondary outcomes were VMS interference with daily life, sleep quality, depressive symptoms, somatic and other symptoms, anxiety, and quality of life. RESULTS The VMS frequency declined by 36.7% at 6 months in the acupuncture group and increased by 6.0% in the control group (P < 0.001 for between-group comparison). At 12 months, the reduction from baseline in the acupuncture group was 29.4% (P < 0.001 for within-group comparison from baseline to 12 months), suggesting that the reduction was largely maintained after treatment. Statistically significant clinical improvement was observed after three acupuncture treatments, and maximal clinical effects occurred after a median of eight treatments. Persistent improvements were seen in many quality of life-related outcomes in the acupuncture group relative to the control group. CONCLUSIONS We found that a course of acupuncture treatments was associated with significant reduction in VMS, and several quality-of-life measures, compared with no acupuncture, and that clinical benefit persisted for at least 6 months beyond the end of treatment.
Collapse
|
30
|
Cai GY, Chen QW, Lin LH, Yao ZY. Gua Sha therapy for treating perimenopausal syndrome: Protocol for a systematic review. Eur J Integr Med 2018. [DOI: 10.1016/j.eujim.2017.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
31
|
Traditional acupuncture for menopausal hot flashes: A systematic review and meta-analysis of randomized controlled trials. Eur J Integr Med 2018. [DOI: 10.1016/j.eujim.2017.12.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
32
|
Ee CC, Thuraisingam S, Pirotta MV, French SD, Xue CC, Teede HJ. Expectancy after the first treatment and response to acupuncture for menopausal hot flashes. PLoS One 2017; 12:e0186966. [PMID: 29077767 PMCID: PMC5659680 DOI: 10.1371/journal.pone.0186966] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 10/11/2017] [Indexed: 12/02/2022] Open
Abstract
Background Evidence on the impact of expectancy on acupuncture treatment response is conflicting. Objectives This secondary analysis of a randomized sham-controlled trial on acupuncture for menopausal hot flashes investigated whether treatment expectancy score was associated with hot flash score at end-of-treatment. Secondary analyses investigated whether there were associations between other pre-specified factors and hot flash score. Study design Women experiencing moderately-severe hot flashes were randomized to receive 10 sessions of real or sham acupuncture over eight weeks. Hot flash score was collected using a seven-day hot flash diary, and expectancy using the modified Credibility and Expectancy Questionnaire immediately after the first treatment. Linear mixed-effects models with random intercepts were used to identify associations between expectancy score and hot flash score at end-of-treatment. Regression was also used to identify associations between pre-specified factors of interest and hot flash score. Because there was no difference between real and sham acupuncture for the primary outcome of hot flash score, both arms were combined in the analysis. Results 285 women returned the Credibility and Expectancy Questionnaire, and 283 women completed both expectancy measures. We found no evidence for an association between expectancy and hot flash score at end-of-treatment for individual cases in either acupuncture or sham group. Hot flash scores at end-of-treatment were 8.1 (95%CI, 3.0 to 13.2; P = 0.002) points lower in regular smokers compared to those who had never smoked, equivalent to four fewer moderate hot flashes a day. Conclusion In our study of acupuncture for menopausal hot flashes, higher expectancy after the first treatment did not predict better treatment outcomes. Future research may focus on other determinants of outcomes in acupuncture such as therapist attention. The relationship between smoking and hot flashes is poorly understood and needs further exploration.
Collapse
Affiliation(s)
- Carolyn C. Ee
- National Institute of Complementary Medicine, Western Sydney University, Sydney, New South Wales, Australia
- Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia
- * E-mail:
| | - Sharmala Thuraisingam
- Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia
| | - Marie V. Pirotta
- Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia
| | - Simon D. French
- School of Rehabilitation Therapy, Queens University, Kingston, Ontario, Canada
- Department of Chiropractic, Faculty of Science and Engineering, Macquarie University, New South Wales, Australia
| | - Charlie C. Xue
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
| | - Helena J. Teede
- Monash Centre for Health Research and Implementation: a partnership between Monash Health and the School of Public Health, Monash University, Melbourne, Victoria, Australia
| |
Collapse
|
33
|
Li W, Luo Y, Fu W, Lei R. Acupuncture May Improve Quality of Life in Menopausal Women: A Meta-Analysis of Randomized Controlled Trials. Complement Med Res 2017; 25:183-190. [PMID: 29020676 DOI: 10.1159/000479630] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE This analysis aims to identify, on the basis of the results of randomized controlled trials (RCTs), whether acupuncture therapy can alleviate menopausal symptoms and promote health-related quality of life. METHODS We included RCTs that directly compared any type of acupuncture with sham acupuncture in treating menopause-related symptoms and which were published from January 1, 2010 to December 31, 2016 in 6 electronic databases. Two authors performed this work independently; 'risk-of-bias' assessment and data extraction were also independently performed by these 2 review authors. The outcomes are presented as scores of the menopause rating scale (MRS), which represents the self-assessment of patients. RESULTS Six studies were included. Our analysis found that acupuncture can reduce the MRS score in menopausal women by the end of the treating period (2-3 months, on average) and even in the follow-up period (1-3 months), not only in the total score but also in each subscale score. But the grade of evidence is very low. CONCLUSIONS Both the total score and the subgroup analysis strongly indicated that acupuncture can alleviate menopause-related symptoms. However, the evidence is not very strong. Thus, further studies about the efficiency of acupuncture on menopausal symptoms based on well-designed trials are needed.
Collapse
|
34
|
Wu X, Zhang W, Qin Y, Liu X, Wang Z. Effect of acupuncture and its influence on cerebral activity in perimenopausal insomniacs: study protocol for a randomized controlled trial. Trials 2017; 18:377. [PMID: 28806907 PMCID: PMC5557519 DOI: 10.1186/s13063-017-2072-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Accepted: 06/28/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Perimenopausal insomnia is one of the core symptoms of the menopausal transition. Acupuncture is considered to exert a positive effect on restoring the normal sleep-wake cycle. However, there is little intuitive evidence besides evaluation using clinical effectiveness scales. We therefore designed this study, aiming to use more intuitive and reliable detection techniques such as functional magnetic resonance imaging before and after applying acupuncture to provide neuroimaging evidence, as well as to verify the effectiveness with other curative effect indicators. METHODS/DESIGN This study is a randomized, assessor-statistician-blinded, positive medicine controlled trial involving 40 participants. A total of 40 eligible patients with perimenopausal insomnia will be randomly assigned to two groups in a 1:1 ratio as an intervention group using acupuncture and a control group taking estazolam. Participants in the intervention group will receive six acupuncture treatment sessions per week for 4 consecutive weeks, for a total of 24 sessions during the study. Meanwhile, the medicine control group will be prescribed estazolam 1-2 mg/day to be taken 30 minutes before sleep for 4 weeks. The primary outcome is the Pittsburgh Sleep Quality Index. Secondary outcomes are the micro-movement sensitive mattress-type sleep monitoring system, the Hamilton Depression Scale, and the Hamilton Anxiety Scale. All outcomes will be evaluated before and after treatment. The safety of interventions will be assessed at every visit. DISCUSSION The results of this trial, which will be available in 2018, will investigate the impact of acupuncture treating perimenopausal insomnia from assessment of the sleep architecture, hormone level, and emotional-circuit neurological function, and will uncover the effective mechanism of acupuncture regulating the emotional center integrated effect. TRIAL REGISTRATION Chinese Clinical Trials Register, ChCTR-IPC-16007832 . Registered on 26 January 2016.
Collapse
Affiliation(s)
- Xiao Wu
- Chengdu University of Traditional Chinese Medicine, 37 Shi’er Qiao Road, Jinniu District, Chengdu, Sichuan 610072 People’s Republic of China
- Traditional Chinese Medicine Hospital Affiliated to Southwest Medical University, 16 Chunhui Road, Longmatan District, Luzhou, Sichuan 646000 People’s Republic of China
| | - Wei Zhang
- Sichuan Integrative Medicine Hospital, 51 4th section of Renmin South Road, Wuhou District, Chengdu, Sichuan 610041 People’s Republic of China
| | - Yuanyuan Qin
- Chengdu University of Traditional Chinese Medicine, 37 Shi’er Qiao Road, Jinniu District, Chengdu, Sichuan 610072 People’s Republic of China
| | - Xuguang Liu
- Chengdu University of Traditional Chinese Medicine, 37 Shi’er Qiao Road, Jinniu District, Chengdu, Sichuan 610072 People’s Republic of China
| | - Zhengyan Wang
- Sichuan Integrative Medicine Hospital, 51 4th section of Renmin South Road, Wuhou District, Chengdu, Sichuan 610041 People’s Republic of China
| |
Collapse
|
35
|
Lin J, Li XL, Song H, Li Q, Wang MY, Qiu XM, Li DJ, Wang L. A general description for Chinese medicine in treating premature ovarian failure. Chin J Integr Med 2017; 23:91-97. [PMID: 28265850 DOI: 10.1007/s11655-016-2642-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Indexed: 12/11/2022]
Abstract
Premature ovarian failure (POF) is a kind of gynecological disease that causes amenorrhea, infertility, menopause and urogenital symptoms. Currently hormone replacement therapy (HRT) is the most popular choice for women with POF to get rid of menopausal syndrome. However, as the popularization of Chinese herbs made Chinese medicine (CM) shine new lights, physicians are able to treat POF with both meno-herbs and integrated therapy. HRT has its own indications and contraindications. For example, unexplained vaginal bleeding, acute liver damage, liver dysfunction, vascular embolization, and breast cancer are all contraindications of HRT, and CM is taken by more physicians as an adjuvant therapy. This review, including a range of common Chinese herbs and formulations according to the existing literature, provides a general description of CM treating POF from the aspects of mechanisms and clinical application. It also highlights acupuncture as a unique physiotherapy for POF. Although the validity of CM has been supported by the evidence of many preclinical trials, clinical trials and meta-analysis, the adverse events with CM therapy still exist and no guarantee has been made for its safety. This review concludes the updated information for CM treating POF contributing to further studies.
Collapse
Affiliation(s)
- Jing Lin
- Laboratory for Reproductive Immunology, Hospital and Institute of Obstetrics and Gynecology, Institutes of Biomedical Sciences (IBS), Fudan University Shanghai Medical College, Shanghai, 200032, China
| | - Xue-Lian Li
- Laboratory for Reproductive Immunology, Hospital and Institute of Obstetrics and Gynecology, Institutes of Biomedical Sciences (IBS), Fudan University Shanghai Medical College, Shanghai, 200032, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, 200011, China
| | - Hui Song
- Laboratory for Reproductive Immunology, Hospital and Institute of Obstetrics and Gynecology, Institutes of Biomedical Sciences (IBS), Fudan University Shanghai Medical College, Shanghai, 200032, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, 200011, China
| | - Qian Li
- Laboratory for Reproductive Immunology, Hospital and Institute of Obstetrics and Gynecology, Institutes of Biomedical Sciences (IBS), Fudan University Shanghai Medical College, Shanghai, 200032, China
| | - Ming-Yan Wang
- Laboratory for Reproductive Immunology, Hospital and Institute of Obstetrics and Gynecology, Institutes of Biomedical Sciences (IBS), Fudan University Shanghai Medical College, Shanghai, 200032, China
| | - Xue-Min Qiu
- Laboratory for Reproductive Immunology, Hospital and Institute of Obstetrics and Gynecology, Institutes of Biomedical Sciences (IBS), Fudan University Shanghai Medical College, Shanghai, 200032, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, 200011, China
- The Academy of Integrative Medicine of Fudan University, Shanghai, 200032, China
| | - Da-Jin Li
- Laboratory for Reproductive Immunology, Hospital and Institute of Obstetrics and Gynecology, Institutes of Biomedical Sciences (IBS), Fudan University Shanghai Medical College, Shanghai, 200032, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, 200011, China
- The Academy of Integrative Medicine of Fudan University, Shanghai, 200032, China
| | - Ling Wang
- Laboratory for Reproductive Immunology, Hospital and Institute of Obstetrics and Gynecology, Institutes of Biomedical Sciences (IBS), Fudan University Shanghai Medical College, Shanghai, 200032, China.
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, 200011, China.
- The Academy of Integrative Medicine of Fudan University, Shanghai, 200032, China.
| |
Collapse
|
36
|
Nonhormonal management of menopause-associated vasomotor symptoms: 2015 position statement of The North American Menopause Society. Menopause 2016; 22:1155-72; quiz 1173-4. [PMID: 26382310 DOI: 10.1097/gme.0000000000000546] [Citation(s) in RCA: 204] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To update and expand The North American Menopause Society's evidence-based position on nonhormonal management of menopause-associated vasomotor symptoms (VMS), previously a portion of the position statement on the management of VMS. METHODS NAMS enlisted clinical and research experts in the field and a reference librarian to identify and review available evidence. Five different electronic search engines were used to cull relevant literature. Using the literature, experts created a document for final approval by the NAMS Board of Trustees. RESULTS Nonhormonal management of VMS is an important consideration when hormone therapy is not an option, either because of medical contraindications or a woman's personal choice. Nonhormonal therapies include lifestyle changes, mind-body techniques, dietary management and supplements, prescription therapies, and others. The costs, time, and effort involved as well as adverse effects, lack of long-term studies, and potential interactions with medications all need to be carefully weighed against potential effectiveness during decision making. CONCLUSIONS Clinicians need to be well informed about the level of evidence available for the wide array of nonhormonal management options currently available to midlife women to help prevent underuse of effective therapies or use of inappropriate or ineffective therapies. Recommended: Cognitive-behavioral therapy and, to a lesser extent, clinical hypnosis have been shown to be effective in reducing VMS. Paroxetine salt is the only nonhormonal medication approved by the US Food and Drug Administration for the management of VMS, although other selective serotonin reuptake/norepinephrine reuptake inhibitors, gabapentinoids, and clonidine show evidence of efficacy. Recommend with caution: Some therapies that may be beneficial for alleviating VMS are weight loss, mindfulness-based stress reduction, the S-equol derivatives of soy isoflavones, and stellate ganglion block, but additional studies of these therapies are warranted. Do not recommend at this time: There are negative, insufficient, or inconclusive data suggesting the following should not be recommended as proven therapies for managing VMS: cooling techniques, avoidance of triggers, exercise, yoga, paced respiration, relaxation, over-the-counter supplements and herbal therapies, acupuncture, calibration of neural oscillations, and chiropractic interventions. Incorporating the available evidence into clinical practice will help ensure that women receive evidence-based recommendations along with appropriate cautions for appropriate and timely management of VMS.
Collapse
|
37
|
Eisenhardt S, Fleckenstein J. Traditional Chinese medicine valuably augments therapeutic options in the treatment of climacteric syndrome. Arch Gynecol Obstet 2016; 294:193-200. [PMID: 27040419 DOI: 10.1007/s00404-016-4078-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 03/14/2016] [Indexed: 12/21/2022]
Abstract
Climacteric syndrome refers to recurring symptoms such as hot flashes, chills, headache, irritability and depression. This is usually experienced by menopausal women and can be related to a hormonal reorganization in the hypothalamic-pituitary-gonadal axis. In Traditional Chinese Medicine, originating 1000s of years ago, above-mentioned symptoms can be interpreted on the basis of the philosophic diagnostic concepts, such as the imbalance of Yin and Yang, the Zang-Fu and Basic substances (e.g. Qi, Blood and Essence). These concepts postulate balance and harmonization as the principle aim of a treatment. In this context, it is not astounding that one of the most prominent ancient textbooks dating back to 500-200 BC, Huang di Neijing: The Yellow Emperor's Classic of Internal Medicine gives already first instructions for diagnosis and therapy of climacteric symptoms. For therapy, traditional Chinese medicine comprises five treatment principles: Chinese herbal medicine, TuiNa (a Chinese form of manual therapy), nutrition, activity (e.g. QiGong) and acupuncture (being the most widespread form of treatment used in Europe). This review provides an easy access to the concepts of traditional Chinese medicine particularly regarding to climacteric syndrome and also focuses on current scientific evidence.
Collapse
Affiliation(s)
- Sarah Eisenhardt
- Department of TCM/Acupuncture, Institute of Complementary Medicine (IKOM), University Bern, Personalhaus 4 Inselspital, 3010, Bern, Switzerland.,University Hospital of Psychiatry, Bern, Switzerland
| | - Johannes Fleckenstein
- Department of TCM/Acupuncture, Institute of Complementary Medicine (IKOM), University Bern, Personalhaus 4 Inselspital, 3010, Bern, Switzerland. .,Department of Sports Medicine, Institute of Sports Sciences, Goethe-University Frankfurt, Frankfurt, Germany.
| |
Collapse
|
38
|
Lesi G, Razzini G, Musti MA, Stivanello E, Petrucci C, Benedetti B, Rondini E, Ligabue MB, Scaltriti L, Botti A, Artioli F, Mancuso P, Cardini F, Pandolfi P. Acupuncture As an Integrative Approach for the Treatment of Hot Flashes in Women With Breast Cancer: A Prospective Multicenter Randomized Controlled Trial (AcCliMaT). J Clin Oncol 2016; 34:1795-802. [PMID: 27022113 DOI: 10.1200/jco.2015.63.2893] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To determine the effectiveness of acupuncture for the management of hot flashes in women with breast cancer. PATIENTS AND METHODS We conducted a pragmatic, randomized controlled trial comparing acupuncture plus enhanced self-care versus enhanced self-care alone. A total of 190 women with breast cancer were randomly assigned. Random assignment was performed with stratification for hormonal therapy; the allocation ratio was 1:1. Both groups received a booklet with information about climacteric syndrome and its management to be followed for at least 12 weeks. In addition, the acupuncture group received 10 traditional acupuncture treatment sessions involving needling of predefined acupoints. The primary outcome was hot flash score at the end of treatment (week 12), calculated as the frequency multiplied by the average severity of hot flashes. The secondary outcomes were climacteric symptoms and quality of life, measured by the Greene Climacteric and Menopause Quality of Life scales. Health outcomes were measured for up to 6 months after treatment. Expectation and satisfaction of treatment effect and safety were also evaluated. We used intention-to-treat analyses. RESULTS Of the participants, 105 were randomly assigned to enhanced self-care and 85 to acupuncture plus enhanced self-care. Acupuncture plus enhanced self-care was associated with a significantly lower hot flash score than enhanced self-care at the end of treatment (P < .001) and at 3- and 6-month post-treatment follow-up visits (P = .0028 and .001, respectively). Acupuncture was also associated with fewer climacteric symptoms and higher quality of life in the vasomotor, physical, and psychosocial dimensions (P < .05). CONCLUSION Acupuncture in association with enhanced self-care is an effective integrative intervention for managing hot flashes and improving quality of life in women with breast cancer.
Collapse
Affiliation(s)
- Grazia Lesi
- Grazia Lesi, Muriel Assunta Musti, Elisa Stivanello, Chiara Petrucci, Pamela Mancuso, and Paolo Pandolfi, Bologna Local Health Authority; Francesco Cardini, Health and Social Agency of Emilia-Romagna Region, Bologna; Giorgia Razzini, Benedetta Benedetti, and Fabrizio Artioli, Civil Hospital, Carpi; Ermanno Rondini, Istituti di Ricovero e Cura a Carattere Scientifico-Arcispedale S. Maria Nuova di Reggio Emilia, Reggio Emilia; Maria Bernadette Ligabue, Civil Hospital, Coreggio; Laura Scaltriti, Civil Hospital, Guastalla; and Alberto Botti, Hospital of Piacenza, Piacenza, Italy
| | - Giorgia Razzini
- Grazia Lesi, Muriel Assunta Musti, Elisa Stivanello, Chiara Petrucci, Pamela Mancuso, and Paolo Pandolfi, Bologna Local Health Authority; Francesco Cardini, Health and Social Agency of Emilia-Romagna Region, Bologna; Giorgia Razzini, Benedetta Benedetti, and Fabrizio Artioli, Civil Hospital, Carpi; Ermanno Rondini, Istituti di Ricovero e Cura a Carattere Scientifico-Arcispedale S. Maria Nuova di Reggio Emilia, Reggio Emilia; Maria Bernadette Ligabue, Civil Hospital, Coreggio; Laura Scaltriti, Civil Hospital, Guastalla; and Alberto Botti, Hospital of Piacenza, Piacenza, Italy.
| | - Muriel Assunta Musti
- Grazia Lesi, Muriel Assunta Musti, Elisa Stivanello, Chiara Petrucci, Pamela Mancuso, and Paolo Pandolfi, Bologna Local Health Authority; Francesco Cardini, Health and Social Agency of Emilia-Romagna Region, Bologna; Giorgia Razzini, Benedetta Benedetti, and Fabrizio Artioli, Civil Hospital, Carpi; Ermanno Rondini, Istituti di Ricovero e Cura a Carattere Scientifico-Arcispedale S. Maria Nuova di Reggio Emilia, Reggio Emilia; Maria Bernadette Ligabue, Civil Hospital, Coreggio; Laura Scaltriti, Civil Hospital, Guastalla; and Alberto Botti, Hospital of Piacenza, Piacenza, Italy
| | - Elisa Stivanello
- Grazia Lesi, Muriel Assunta Musti, Elisa Stivanello, Chiara Petrucci, Pamela Mancuso, and Paolo Pandolfi, Bologna Local Health Authority; Francesco Cardini, Health and Social Agency of Emilia-Romagna Region, Bologna; Giorgia Razzini, Benedetta Benedetti, and Fabrizio Artioli, Civil Hospital, Carpi; Ermanno Rondini, Istituti di Ricovero e Cura a Carattere Scientifico-Arcispedale S. Maria Nuova di Reggio Emilia, Reggio Emilia; Maria Bernadette Ligabue, Civil Hospital, Coreggio; Laura Scaltriti, Civil Hospital, Guastalla; and Alberto Botti, Hospital of Piacenza, Piacenza, Italy
| | - Chiara Petrucci
- Grazia Lesi, Muriel Assunta Musti, Elisa Stivanello, Chiara Petrucci, Pamela Mancuso, and Paolo Pandolfi, Bologna Local Health Authority; Francesco Cardini, Health and Social Agency of Emilia-Romagna Region, Bologna; Giorgia Razzini, Benedetta Benedetti, and Fabrizio Artioli, Civil Hospital, Carpi; Ermanno Rondini, Istituti di Ricovero e Cura a Carattere Scientifico-Arcispedale S. Maria Nuova di Reggio Emilia, Reggio Emilia; Maria Bernadette Ligabue, Civil Hospital, Coreggio; Laura Scaltriti, Civil Hospital, Guastalla; and Alberto Botti, Hospital of Piacenza, Piacenza, Italy
| | - Benedetta Benedetti
- Grazia Lesi, Muriel Assunta Musti, Elisa Stivanello, Chiara Petrucci, Pamela Mancuso, and Paolo Pandolfi, Bologna Local Health Authority; Francesco Cardini, Health and Social Agency of Emilia-Romagna Region, Bologna; Giorgia Razzini, Benedetta Benedetti, and Fabrizio Artioli, Civil Hospital, Carpi; Ermanno Rondini, Istituti di Ricovero e Cura a Carattere Scientifico-Arcispedale S. Maria Nuova di Reggio Emilia, Reggio Emilia; Maria Bernadette Ligabue, Civil Hospital, Coreggio; Laura Scaltriti, Civil Hospital, Guastalla; and Alberto Botti, Hospital of Piacenza, Piacenza, Italy
| | - Ermanno Rondini
- Grazia Lesi, Muriel Assunta Musti, Elisa Stivanello, Chiara Petrucci, Pamela Mancuso, and Paolo Pandolfi, Bologna Local Health Authority; Francesco Cardini, Health and Social Agency of Emilia-Romagna Region, Bologna; Giorgia Razzini, Benedetta Benedetti, and Fabrizio Artioli, Civil Hospital, Carpi; Ermanno Rondini, Istituti di Ricovero e Cura a Carattere Scientifico-Arcispedale S. Maria Nuova di Reggio Emilia, Reggio Emilia; Maria Bernadette Ligabue, Civil Hospital, Coreggio; Laura Scaltriti, Civil Hospital, Guastalla; and Alberto Botti, Hospital of Piacenza, Piacenza, Italy
| | - Maria Bernadette Ligabue
- Grazia Lesi, Muriel Assunta Musti, Elisa Stivanello, Chiara Petrucci, Pamela Mancuso, and Paolo Pandolfi, Bologna Local Health Authority; Francesco Cardini, Health and Social Agency of Emilia-Romagna Region, Bologna; Giorgia Razzini, Benedetta Benedetti, and Fabrizio Artioli, Civil Hospital, Carpi; Ermanno Rondini, Istituti di Ricovero e Cura a Carattere Scientifico-Arcispedale S. Maria Nuova di Reggio Emilia, Reggio Emilia; Maria Bernadette Ligabue, Civil Hospital, Coreggio; Laura Scaltriti, Civil Hospital, Guastalla; and Alberto Botti, Hospital of Piacenza, Piacenza, Italy
| | - Laura Scaltriti
- Grazia Lesi, Muriel Assunta Musti, Elisa Stivanello, Chiara Petrucci, Pamela Mancuso, and Paolo Pandolfi, Bologna Local Health Authority; Francesco Cardini, Health and Social Agency of Emilia-Romagna Region, Bologna; Giorgia Razzini, Benedetta Benedetti, and Fabrizio Artioli, Civil Hospital, Carpi; Ermanno Rondini, Istituti di Ricovero e Cura a Carattere Scientifico-Arcispedale S. Maria Nuova di Reggio Emilia, Reggio Emilia; Maria Bernadette Ligabue, Civil Hospital, Coreggio; Laura Scaltriti, Civil Hospital, Guastalla; and Alberto Botti, Hospital of Piacenza, Piacenza, Italy
| | - Alberto Botti
- Grazia Lesi, Muriel Assunta Musti, Elisa Stivanello, Chiara Petrucci, Pamela Mancuso, and Paolo Pandolfi, Bologna Local Health Authority; Francesco Cardini, Health and Social Agency of Emilia-Romagna Region, Bologna; Giorgia Razzini, Benedetta Benedetti, and Fabrizio Artioli, Civil Hospital, Carpi; Ermanno Rondini, Istituti di Ricovero e Cura a Carattere Scientifico-Arcispedale S. Maria Nuova di Reggio Emilia, Reggio Emilia; Maria Bernadette Ligabue, Civil Hospital, Coreggio; Laura Scaltriti, Civil Hospital, Guastalla; and Alberto Botti, Hospital of Piacenza, Piacenza, Italy
| | - Fabrizio Artioli
- Grazia Lesi, Muriel Assunta Musti, Elisa Stivanello, Chiara Petrucci, Pamela Mancuso, and Paolo Pandolfi, Bologna Local Health Authority; Francesco Cardini, Health and Social Agency of Emilia-Romagna Region, Bologna; Giorgia Razzini, Benedetta Benedetti, and Fabrizio Artioli, Civil Hospital, Carpi; Ermanno Rondini, Istituti di Ricovero e Cura a Carattere Scientifico-Arcispedale S. Maria Nuova di Reggio Emilia, Reggio Emilia; Maria Bernadette Ligabue, Civil Hospital, Coreggio; Laura Scaltriti, Civil Hospital, Guastalla; and Alberto Botti, Hospital of Piacenza, Piacenza, Italy
| | - Pamela Mancuso
- Grazia Lesi, Muriel Assunta Musti, Elisa Stivanello, Chiara Petrucci, Pamela Mancuso, and Paolo Pandolfi, Bologna Local Health Authority; Francesco Cardini, Health and Social Agency of Emilia-Romagna Region, Bologna; Giorgia Razzini, Benedetta Benedetti, and Fabrizio Artioli, Civil Hospital, Carpi; Ermanno Rondini, Istituti di Ricovero e Cura a Carattere Scientifico-Arcispedale S. Maria Nuova di Reggio Emilia, Reggio Emilia; Maria Bernadette Ligabue, Civil Hospital, Coreggio; Laura Scaltriti, Civil Hospital, Guastalla; and Alberto Botti, Hospital of Piacenza, Piacenza, Italy
| | - Francesco Cardini
- Grazia Lesi, Muriel Assunta Musti, Elisa Stivanello, Chiara Petrucci, Pamela Mancuso, and Paolo Pandolfi, Bologna Local Health Authority; Francesco Cardini, Health and Social Agency of Emilia-Romagna Region, Bologna; Giorgia Razzini, Benedetta Benedetti, and Fabrizio Artioli, Civil Hospital, Carpi; Ermanno Rondini, Istituti di Ricovero e Cura a Carattere Scientifico-Arcispedale S. Maria Nuova di Reggio Emilia, Reggio Emilia; Maria Bernadette Ligabue, Civil Hospital, Coreggio; Laura Scaltriti, Civil Hospital, Guastalla; and Alberto Botti, Hospital of Piacenza, Piacenza, Italy
| | - Paolo Pandolfi
- Grazia Lesi, Muriel Assunta Musti, Elisa Stivanello, Chiara Petrucci, Pamela Mancuso, and Paolo Pandolfi, Bologna Local Health Authority; Francesco Cardini, Health and Social Agency of Emilia-Romagna Region, Bologna; Giorgia Razzini, Benedetta Benedetti, and Fabrizio Artioli, Civil Hospital, Carpi; Ermanno Rondini, Istituti di Ricovero e Cura a Carattere Scientifico-Arcispedale S. Maria Nuova di Reggio Emilia, Reggio Emilia; Maria Bernadette Ligabue, Civil Hospital, Coreggio; Laura Scaltriti, Civil Hospital, Guastalla; and Alberto Botti, Hospital of Piacenza, Piacenza, Italy
| |
Collapse
|
39
|
Akupunktur in der endokrinologischen Gynäkologie. GYNAKOLOGISCHE ENDOKRINOLOGIE 2015. [DOI: 10.1007/s10304-015-0004-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
40
|
Kim MY, Choi SD, Ryu A. Is complementary and alternative therapy effective for women in the climacteric period? J Menopausal Med 2015; 21:28-35. [PMID: 26046035 PMCID: PMC4452811 DOI: 10.6118/jmm.2015.21.1.28] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 02/11/2015] [Accepted: 02/25/2015] [Indexed: 12/26/2022] Open
Abstract
Vasomotor symptoms start about 2 years prior to menopause in women who are approaching menopause, and early menopause symptoms appear including emotional disturbance and anxiety, followed by physical changes such as vaginal dryness, urinary incontinence and skin wrinkles. As time progresses, osteoporosis, cardiovascular diseases, and dementia occur consecutively. Hormone therapy is primarily considered for the relief of menopause symptoms in postmenopausal women. However, as hormone replacement has emerged as a therapy that increases the potential risk of thrombosis, cerebral infarction and breast cancer, complementary and alternative medicine has drawn much attention. This study aimed to examine the types and effects of evidence-based complementary and alternative therapies that are currently used.
Collapse
Affiliation(s)
- Mi Young Kim
- Department of Obstetrics and Gynecology, College of Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Seung Do Choi
- Department of Obstetrics and Gynecology, College of Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Aeli Ryu
- Department of Obstetrics and Gynecology, College of Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| |
Collapse
|
41
|
Javdan B, Cassileth B. Acupuncture Research at Memorial Sloan Kettering Cancer Center. J Acupunct Meridian Stud 2015; 8:115-21. [PMID: 26100064 DOI: 10.1016/j.jams.2015.03.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Revised: 03/17/2015] [Accepted: 03/23/2015] [Indexed: 11/16/2022] Open
Abstract
Acupuncture may help treat specific cancer-related symptoms. Here, we summarize our clinical trials that sought to determine acupuncture's role in managing cancer-related symptoms. Trials have been conducted to determine acupuncture's ability to mitigate cancer-related symptoms including dyspnea, fatigue, xerostomia, lymphedema, hot flashes, postoperative ileus, pain and dysfunction after neck dissection, and postthoracotomy pain. Published studies indicate that acupuncture versus placebo acupuncture failed to reduce cancer-related dyspnea. Both true and sham acupuncture alleviated fatigue slightly, but no significant differences between groups emerged. Compared with sham acupuncture, our research showed that acupuncture significantly improved saliva production in patients with xerostomia and significantly reduced lymphedema patients' arm circumference in a pilot study. However, acupuncture failed to significantly reduce hot flashes and was no more successful than sham acupuncture in reducing postoperative ileus. Significant reductions in pain and dysfunction occurred in cancer patients after neck dissection. In a feasibility study, acupuncture was found to be acceptable to lung cancer patients and did not interfere with standard postoperative care. In summary, acupuncture is a potential candidate for the treatment of some important cancer-related symptoms. Large clinical trials and research to investigate mechanistic pathways are warranted.
Collapse
Affiliation(s)
- Bahar Javdan
- Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Barrie Cassileth
- Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, USA.
| |
Collapse
|
42
|
Effects of acupuncture on menopause-related symptoms and quality of life in women in natural menopause. Menopause 2015; 22:234-44. [DOI: 10.1097/gme.0000000000000260] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
|
43
|
Ganesan P, Ko HM, Kim IS, Choi DK. Recent trends of nano bioactive compounds from ginseng for its possible preventive role in chronic disease models. RSC Adv 2015. [DOI: 10.1039/c5ra20559j] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Bioactive nano ginseng has roles in various diseases.
Collapse
Affiliation(s)
- Palanivel Ganesan
- Nanotechnology Research Center and Department of Applied Life Science
- College of Biomedical and Health Science
- Konkuk University
- Chungju 380-701
- Republic of Korea
| | - Hyun-Myung Ko
- Department of Biotechnology
- College of Biomedical and Health Science
- Konkuk University
- Chungju 380-701
- Republic of Korea
| | - In-Su Kim
- Department of Biotechnology
- College of Biomedical and Health Science
- Konkuk University
- Chungju 380-701
- Republic of Korea
| | - Dong-Kug Choi
- Nanotechnology Research Center and Department of Applied Life Science
- College of Biomedical and Health Science
- Konkuk University
- Chungju 380-701
- Republic of Korea
| |
Collapse
|
44
|
Taylor-Swanson L, Thomas A, Ismail R, Schnall JG, Cray L, Mitchell ES, Woods NF. Effects of traditional Chinese medicine on symptom clusters during the menopausal transition. Climacteric 2014; 18:142-56. [DOI: 10.3109/13697137.2014.937687] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
45
|
Liu Z, Wang Y, Xu H, Wu J, He L, Jiang JY, Yan S, Du R, Liu B. Efficacy of electroacupuncture for symptoms of menopausal transition: study protocol for a randomized controlled trial. Trials 2014; 15:242. [PMID: 24950841 PMCID: PMC4075980 DOI: 10.1186/1745-6215-15-242] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Accepted: 06/12/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous studies have shown that acupuncture can alleviate postmenopausal symptoms, such as hot flashes, but few studies have assessed symptoms during the menopausal transition (MT) period. Thus, the effect of acupuncture upon MT symptoms is unclear. We designed a large-scale trial aimed at evaluating the efficacy of electroacupuncture for MT symptoms compared with sham electroacupuncture and at observing the safety of electroacupuncture. METHODS/DESIGN In this multicenter randomized controlled trial, 360 women will be randomized to either an electroacupuncture group or a sham electroacupuncture group. During the 8-week-long treatment, a menopause rating scale, average 24-hour hot flash score, Menopause-Specific Quality of Life Questionnaire score, and level of female hormones will be observed. Follow-ups at the 20th and 32nd week will be made. DISCUSSION Though there is no completely inert placebo acupuncture and blinding is difficult in acupuncture trials, the placebo effect of EA can still be partially excluded in this study. For the placebo control, we use non-points and a tailor-made sham needle. This needle is different from a retractable needle, which is usually used for sham acupuncture. The needle in this trial is more simply constructed and more acceptable to Chinese people. We expect to evaluate the efficacy of electroacupuncture for MT symptoms and clarify its effect on these symptoms. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01849172 (Date of registration: 05/05/2013).
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | - Baoyan Liu
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No,5, Beixiange Street, 100053 Beijing, Xicheng District, China.
| |
Collapse
|
46
|
Pirotta M, Ee C, Teede H, Chondros P, French S, Myers S, Xue C. Acupuncture for menopausal vasomotor symptoms: study protocol for a randomised controlled trial. Trials 2014; 15:224. [PMID: 24925094 PMCID: PMC4066294 DOI: 10.1186/1745-6215-15-224] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 05/30/2014] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Hot flushes and night sweats (vasomotor symptoms) are common menopausal symptoms, often causing distress, sleep deprivation and reduced quality of life. Although hormone replacement therapy is an effective treatment, there are concerns about serious adverse events. Non-hormonal pharmacological therapies are less effective and can also cause adverse effects. Complementary therapies, including acupuncture, are commonly used for menopausal vasomotor symptoms. While the evidence for the effectiveness of acupuncture in treating vasomotor symptoms is inconclusive, acupuncture has a low risk of adverse effects, and two small studies suggest it may be more effective than non-insertive sham acupuncture. Our objective is to assess the efficacy of needle acupuncture in improving hot flush severity and frequency in menopausal women. Our current study design is informed by methods tested in a pilot study. METHODS/DESIGN This is a stratified, parallel, randomised sham-controlled trial with equal allocation of participants to two trial groups. We are recruiting 360 menopausal women experiencing a minimum average of seven moderate hot flushes a day over a seven-day period and who meet diagnostic criteria for the Traditional Chinese Medicine diagnosis of Kidney Yin deficiency. Exclusion criteria include breast cancer, surgical menopause, and current hormone replacement therapy use. Eligible women are randomised to receive either true needle acupuncture or sham acupuncture with non-insertive (blunt) needles for ten treatments over eight weeks. Participants are blinded to treatment allocation. Interventions are provided by Chinese medicine acupuncturists who have received specific training on trial procedures. The primary outcome measure is hot flush score, assessed using the validated Hot Flush Diary. Secondary outcome measures include health-related quality of life, anxiety and depression symptoms, credibility of the sham treatment, expectancy and beliefs about acupuncture, and adverse events. Participants will be analysed in the groups in which they were randomised using an intention-to-treat analysis strategy. DISCUSSION Results from this trial will significantly add to the current body of evidence on the role of acupuncture for vasomotor symptoms. If found to be effective and safe, acupuncture will be a valuable additional treatment option for women who experience menopausal vasomotor symptoms. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12611000393954 11/02/2009.
Collapse
Affiliation(s)
- Marie Pirotta
- Department of General Practice, University of Melbourne, Australia 200 Berkeley St, Carlton, Victoria 3053, Australia
| | - Carolyn Ee
- Department of General Practice, University of Melbourne, Australia 200 Berkeley St, Carlton, Victoria 3053, Australia
| | - Helena Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Australia Diabetes and Vascular Medicine Unit, Monash Health, Wellington Rd, Clayton VIC 3800, Australia
| | - Patty Chondros
- Department of General Practice, University of Melbourne, Australia 200 Berkeley St, Carlton, Victoria 3053, Australia
| | - Simon French
- Canada and Faculty of Health Sciences, School of Rehabilitation Therapy, Queen’s University, Ontario, 99 University Ave, Kingston, ON K7L 3N6, Canada
| | - Stephen Myers
- NatMed-Research Unit, Division of Research, Southern Cross University, Military Road, East Lismore NSW 2480, Australia
| | - Charlie Xue
- School of Health Sciences, RMIT University, 124 Little La Trobe St, Melbourne VIC 3000, Australia
| |
Collapse
|
47
|
Li Y, Zheng H, Zheng Q, Zhao L, Qin E, Wang Y, Zeng Q, Zheng H, Zhao Y, Sun W, Zhang X, Liu Z, Liu B. Use acupuncture to relieve perimenopausal syndrome: study protocol of a randomized controlled trial. Trials 2014; 15:198. [PMID: 24886348 PMCID: PMC4055374 DOI: 10.1186/1745-6215-15-198] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Accepted: 05/15/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Whether acupuncture is effective for relieving perimenopausal syndrome has been controversial recently. In this article, we report the protocol of a randomized controlled trial using acupuncture to treat perimenopausal syndrome, aiming to answer this controversy. DESIGN A multicenter randomized controlled trial with two parallel arms is underway in China. Two hundred and six women with perimenopausal syndrome will be randomly assigned to a treatment group using acupuncture plus auricular acupressure (AA group) and a control group using Climen (Bayer Healthcare Company Limited, Guangzhou, China), a 28-day sequential hormone replacement therapy, in a 1:1 ratio. Participants in the AA group will receive three acupuncture sessions per week in the first 4 weeks and two sessions per week in the following 8 weeks, for a total of 28 sessions over 12 weeks. Auricular points will be plastered by Semen Vaccariae twice per week for a consecutive 12 weeks, with both ears used alternately. The Climen control group is prescribed a tablet containing estradiol valerate 2 mg/day for the first 11 days, and a tablet containing estradiol valerate 2 mg/day plus cyroterone acetate 1 mg/day for the following 10 days. The total treatment period of the control group is three cycles. The post-treatment follow-up period will last 24 weeks. The primary outcome is the Menopause Rating Scale (MRS) assessed at baseline and 4, 12, 16, 24 and 36 weeks after randomization. The secondary outcomes are Menopause-Specific Quality of Life, average hot flash score during 24 hours, serum estradiol, follicle-stimulating hormone and luteinizing hormone level. The first two secondary outcomes are measured at the same point as the MRS. Other secondary outcomes are measured at baseline and 12, 24 weeks after randomization. DISCUSSION The results of this trial, which will be available in 2015, will clarify whether acupuncture is effective to relieve perimenopausal syndrome. TRIAL REGISTRATION ClinicalTrials.gov NCT01933204 (registered 9 August 2013).
Collapse
Affiliation(s)
- Ying Li
- Chengdu University of Traditional Chinese Medicine, 37 Shi’er Qiao Road, Jinniu District, Chengdu, Sichuan 610075, PR China
| | - Hui Zheng
- Chengdu University of Traditional Chinese Medicine, 37 Shi’er Qiao Road, Jinniu District, Chengdu, Sichuan 610075, PR China
| | - Qianhua Zheng
- Chengdu University of Traditional Chinese Medicine, 37 Shi’er Qiao Road, Jinniu District, Chengdu, Sichuan 610075, PR China
| | - Ling Zhao
- Chengdu University of Traditional Chinese Medicine, 37 Shi’er Qiao Road, Jinniu District, Chengdu, Sichuan 610075, PR China
| | - Erqi Qin
- Chengdu University of Traditional Chinese Medicine, 37 Shi’er Qiao Road, Jinniu District, Chengdu, Sichuan 610075, PR China
| | - Yu Wang
- Chengdu University of Traditional Chinese Medicine, 37 Shi’er Qiao Road, Jinniu District, Chengdu, Sichuan 610075, PR China
- General Hospital of Chengdu Military Region of the Chinese People’s Liberation Army, 270 Tianhui Road, Rongdu Avenue, Chengdu, Sichuan 610083, PR China
| | - Qian Zeng
- First Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, 39 Shi’er Qiao Road, Jinniu District, Chengdu, Sichuan 610072, PR China
| | - Huabin Zheng
- First Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, 39 Shi’er Qiao Road, Jinniu District, Chengdu, Sichuan 610072, PR China
| | - Yu Zhao
- Chengdu Integrated TCM & Western Medicine Hospital, 18 North Wanxiang Road, Gaoxin District, Chengdu, Sichuan 610016, PR China
| | - Wei Sun
- Chengdu University of Traditional Chinese Medicine, 37 Shi’er Qiao Road, Jinniu District, Chengdu, Sichuan 610075, PR China
| | - Xiaoxia Zhang
- Chengdu University of Traditional Chinese Medicine, 37 Shi’er Qiao Road, Jinniu District, Chengdu, Sichuan 610075, PR China
| | - Zhishun Liu
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, No. 5 BeiXianGe Street, XiCheng District, Beijing 100053, PR China
| | - Baoyan Liu
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, No. 5 BeiXianGe Street, XiCheng District, Beijing 100053, PR China
| |
Collapse
|
48
|
Baccetti S, Da Frè M, Becorpi A, Faedda M, Guerrera A, Monechi MV, Munizzi RM, Parazzini F. Acupuncture and traditional Chinese medicine for hot flushes in menopause: a randomized trial. J Altern Complement Med 2014; 20:550-7. [PMID: 24827469 DOI: 10.1089/acm.2012.0499] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To evaluate the effect of acupuncture on hot flushes and other menopause-related symptoms used in an integrated system, including such therapeutic techniques as diet therapy and Tuina self-massage. DESIGN Randomized trial. SETTING Outpatient center. PARTICIPANTS One hundred women in spontaneous menopause with at least three episodes of hot flushes daily were randomly allocated to two treatment groups (50 per group): Women in group A were given diet, self-massage training, and treatment with acupuncture, and women in group B (the control group) were given the same diet and self-massage training, but treatment with acupuncture started 6 weeks after they were enrolled into the study. INTERVENTION Acupuncture treatments were scheduled twice weekly for 6 consecutive weeks. OUTCOME MEASURES Mean change in frequency and/or intensity in menopause-related symptoms were estimated by questionnaire after treatment at week 4. RESULTS Treatment with acupuncture significantly reduced the occurrence of hot flushes and sudden sweating (p<.001). Other symptoms (sleep disorders, tightness in the chest, irritability, bone pain, feeling depressed) significantly improved. CONCLUSIONS Acupuncture in an integrated system that includes therapeutic techniques such as diet therapy and Tuina self-massage can be used to treat hot flushes and selected symptoms in postmenopausal women.
Collapse
Affiliation(s)
- Sonia Baccetti
- 1 Referring Center for Complementary Medicine , Tuscany Region, San Donnino, Campi Bisenzio, Italy
| | | | | | | | | | | | | | | |
Collapse
|
49
|
Chen Y, Fang Y, Yang J, Wang F, Wang Y, Yang L. Effect of acupuncture on premature ovarian failure: a pilot study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2014; 2014:718675. [PMID: 24711856 PMCID: PMC3966340 DOI: 10.1155/2014/718675] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Accepted: 02/05/2014] [Indexed: 11/29/2022]
Abstract
To investigate the effect of acupuncture on women with premature ovarian failure (POF), prospective consecutive case series study was applied. 31 women with POF were included; all patients were treated with acupuncture once every other day, three times a week for three months. Acupoints, GV 20, GV 24, GB 13, CV 3, CV 4, BL 23, BL 32, ST 25, ST 28, ST 29, ST 36, SP 6, KI 3, and LR 3, were selected. Serums FSH, E2, and LH level, Self-Rating Anxiety Scale (SAS), and Kupperman score were measured at baseline and at the end of treatment; the menstrual cycle was recorded during one-month follow-up. Compared with baseline, patients' serums FSH and LH were decreased, E2 was increased, and SAS score and Kupperman score were decreased. Four patients resumed menstrual cycle after treatment and two resumed during follow-up. No serious adverse events were found in all patients. The results indicate that acupuncture may decrease serums FSH and LH level, raise serum E2 level, relieve anxiety, reduce mental stress, and improve the menopausal symptoms.
Collapse
Affiliation(s)
- Yingru Chen
- Institute of Acupuncture and Moxibustion of China Academy of Chinese Medical Sciences, No. 16 Dong Zhi Men Nei Nan Xiao Jie, Dongcheng District, Beijing 100700, China
| | - Yigong Fang
- Institute of Acupuncture and Moxibustion of China Academy of Chinese Medical Sciences, No. 16 Dong Zhi Men Nei Nan Xiao Jie, Dongcheng District, Beijing 100700, China
| | - Jinsheng Yang
- Institute of Acupuncture and Moxibustion of China Academy of Chinese Medical Sciences, No. 16 Dong Zhi Men Nei Nan Xiao Jie, Dongcheng District, Beijing 100700, China
| | - Fei Wang
- Institute of Acupuncture and Moxibustion of the Hospital Affiliated to Tianjin University of Traditional Chinese Medicine, No. 314 An Shan Xi Dao, Nankai District, Tianjin, 300193, China
| | - Yingying Wang
- Institute of Acupuncture and Moxibustion of China Academy of Chinese Medical Sciences, No. 16 Dong Zhi Men Nei Nan Xiao Jie, Dongcheng District, Beijing 100700, China
| | - Li Yang
- Institute of Acupuncture and Moxibustion of China Academy of Chinese Medical Sciences, No. 16 Dong Zhi Men Nei Nan Xiao Jie, Dongcheng District, Beijing 100700, China
| |
Collapse
|
50
|
Effects of acupuncture and Chinese herbal medicine (Zhi Mu 14) on hot flushes and quality of life in postmenopausal women. Menopause 2014; 21:15-24. [DOI: 10.1097/gme.0b013e31829374e8] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
|