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Staff S, Yang C, Greten J, Braun V, Reissfelder C, Herrle F, Ghanad E. Manual Acupuncture for Postoperative Pain and Recovery after Abdominal Surgeries: A Systematic Review. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024. [PMID: 39388100 DOI: 10.1089/jicm.2023.0750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/15/2024]
Abstract
Introduction: Acupuncture's role in surgical and postoperative contexts is gaining traction. However, the evidence remains patchy and is often of low-grade quality, particularly in the context of postintestinal surgery. Purpose: To assess acupuncture's efficacy in pain relief and functional recovery after abdominal surgery. Methods: We searched PubMed, Cochrane, Web of Science, and Google Scholar for randomized trials using manual acupuncture as the main intervention. Outcomes included postoperative pain, analgesic use, nausea, gastrointestinal (GI) regeneration, and length of hospital stay. For risk of bias assessment Cochrane risk of bias tool 2 was employed. Registered with PROSPERO: CRD42022311718. Results: Of 700 records till May 2023, 8 trials (551 patients; 16-200/trial) were included. Due to factors such as varying experimental settings and unpublished protocols, there was high risk of bias and heterogeneity, making meta-analysis unfeasible. Safety data were documented sufficiently by two trials. However, acupuncture showed marked benefits in pain relief, less analgesic use, fewer nausea cases, and improved GI recovery. One study reported reduced hospitalization time. Conclusion: Due to the varied methodologies and potential biases in existing studies, the definitive effectiveness of acupuncture remains unclear. To confirm the potential benefits of acupuncture as suggested by the reviewed studies, it's imperative to have more standardized study protocols, well-defined interventions and controls, and objective measures of efficacy.
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Affiliation(s)
- Sophie Staff
- Medical Faculty Mannheim, Department of Surgery, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany
| | - Cui Yang
- Medical Faculty Mannheim, Department of Surgery, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany
| | - Johannes Greten
- Heidelberg School of Chinese Medicine, Heidelberg, Germany
- TCM Research Centre, Piaget Institute, Gaia, Portugal
| | - Volker Braun
- Medical Faculty Mannheim, Medical University Library, University of Heidelberg, Mannheim, Germany
| | - Christoph Reissfelder
- Medical Faculty Mannheim, Department of Surgery, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany
| | - Florian Herrle
- Medical Faculty Mannheim, Department of Surgery, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany
- Department of Surgery, Prien Hospital on Chiemsee, Prien am Chiemsee, Germany
| | - Erfan Ghanad
- Medical Faculty Mannheim, Department of Surgery, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany
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2
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Lunny C, Whitelaw S, Reid EK, Chi Y, Ferri N, Zhang JHJ, Pieper D, Kanji S, Veroniki AA, Shea B, Dourka J, Ardern C, Pham B, Bagheri E, Tricco AC. Exploring decision-makers' challenges and strategies when selecting multiple systematic reviews: insights for AI decision support tools in healthcare. BMJ Open 2024; 14:e084124. [PMID: 38969371 PMCID: PMC11227798 DOI: 10.1136/bmjopen-2024-084124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 06/24/2024] [Indexed: 07/07/2024] Open
Abstract
BACKGROUND Systematic reviews (SRs) are being published at an accelerated rate. Decision-makers may struggle with comparing and choosing between multiple SRs on the same topic. We aimed to understand how healthcare decision-makers (eg, practitioners, policymakers, researchers) use SRs to inform decision-making and to explore the potential role of a proposed artificial intelligence (AI) tool to assist in critical appraisal and choosing among SRs. METHODS We developed a survey with 21 open and closed questions. We followed a knowledge translation plan to disseminate the survey through social media and professional networks. RESULTS Our survey response rate was lower than expected (7.9% of distributed emails). Of the 684 respondents, 58.2% identified as researchers, 37.1% as practitioners, 19.2% as students and 13.5% as policymakers. Respondents frequently sought out SRs (97.1%) as a source of evidence to inform decision-making. They frequently (97.9%) found more than one SR on a given topic of interest to them. Just over half (50.8%) struggled to choose the most trustworthy SR among multiple. These difficulties related to lack of time (55.2%), or difficulties comparing due to varying methodological quality of SRs (54.2%), differences in results and conclusions (49.7%) or variation in the included studies (44.6%). Respondents compared SRs based on the relevance to their question of interest, methodological quality, and recency of the SR search. Most respondents (87.0%) were interested in an AI tool to help appraise and compare SRs. CONCLUSIONS Given the identified barriers of using SR evidence, an AI tool to facilitate comparison of the relevance of SRs, the search and methodological quality, could help users efficiently choose among SRs and make healthcare decisions.
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Affiliation(s)
- Carole Lunny
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, UBC, Toronto, Ontario, Canada
- Evidence Synthesis, Precisionheor LLC, Vancouver, British Columbia, Canada
| | - Sera Whitelaw
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Québec, Canada
| | - Emma K Reid
- Department of Pharmacy, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Yuan Chi
- Yealth Network, Beijing Health Technology Co., Ltd, Beijing, China
| | - Nicola Ferri
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Jia He Janet Zhang
- Anesthesiology, Pharmacology & Therapeutics, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Dawid Pieper
- Institute for Health Services and Health System Research, Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Neuruppin, Brandenburg, Germany
| | - Salmaan Kanji
- Department of Pharmacy, Ottawa Hospital, Ottawa, Ontario, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Areti-Angeliki Veroniki
- Li Ka Shing Knowledge Institute of St Michael's Hospital, Knowledge Translation Program, St Michael's Hospital, Toronto, Ontario, Canada
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | | | - Jasmeen Dourka
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
| | - Clare Ardern
- Department of Family Practice, The University of British Columbia-Vancouver Campus, Vancouver, British Columbia, Canada
| | - Ba Pham
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, University of Toronto, Toronto, Ontario, Canada
| | - Ebrahim Bagheri
- Department of Electrical and Computer Engineering, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Andrea C Tricco
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Knowledge Translation Program, St Michael's Hospital, Toronto, Ontario, Canada
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Rodrigues JC, de Arruda GT, de Moraes PC, Firão CB, Avila MA, Driusso P. Self-management of primary dysmenorrhea-related pain: cross-sectional study on non-pharmacological interventions. Pain Manag 2024; 14:265-272. [PMID: 39041620 PMCID: PMC11340746 DOI: 10.1080/17581869.2024.2376519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 06/25/2024] [Indexed: 07/24/2024] Open
Abstract
Aim: Different nonpharmacological strategies are adopted to decrease primary dysmenorrhea (PD)-related pain. The present study aimed to verify women's use of nonpharmacological methods for pain and compare them with evidence from the literature.Materials & methods: A two-step study was conducted, comprising an online survey with 9144 women to assess nonpharmacological strategies for relieving PD-related pain, and a literature review on PubMed of verify the evidence of nonpharmacological methods.Results: Many women reported using heat therapy (61.5%), tea (42.4%) and massage (30.9%) to alleviate menstrual pain. However, the literature on these methods is limited.Conclusion: Several nonpharmacological methods are used by women to relieve PD-related pain and studies with low bias risk are needed to prove their effectiveness.
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Affiliation(s)
- Jéssica Cordeiro Rodrigues
- Women's Health Research Laboratory, Physical Therapy Department, Universidade Federal de São Carlos (UFSCar), São Carlos, São Paulo, 13565-905, Brazil
| | - Guilherme Tavares de Arruda
- Study Group on Chronic Pain (NEDoC), Laboratory of Research on Electrophysical Agents (LAREF), Department of Physical Therapy, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, 13565-905,Brazil
| | - Pâmela Calixto de Moraes
- Women's Health Research Laboratory, Physical Therapy Department, Universidade Federal de São Carlos (UFSCar), São Carlos, São Paulo, 13565-905, Brazil
| | - Caren Beatriz Firão
- Study Group on Chronic Pain (NEDoC), Laboratory of Research on Electrophysical Agents (LAREF), Department of Physical Therapy, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, 13565-905,Brazil
| | - Mariana Arias Avila
- Study Group on Chronic Pain (NEDoC), Laboratory of Research on Electrophysical Agents (LAREF), Department of Physical Therapy, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, 13565-905,Brazil
| | - Patricia Driusso
- Women's Health Research Laboratory, Physical Therapy Department, Universidade Federal de São Carlos (UFSCar), São Carlos, São Paulo, 13565-905, Brazil
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Zhai S, Wang C, Ruan Y, Liu Y, Ma R, Fang F, Zhou Q. Wrist-ankle acupuncture for primary dysmenorrhea: a randomized controlled trial evaluating the efficacy of an analgesic strap. Front Neurol 2024; 15:1362586. [PMID: 38872824 PMCID: PMC11172147 DOI: 10.3389/fneur.2024.1362586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 05/10/2024] [Indexed: 06/15/2024] Open
Abstract
Background Drawing on the principles of wrist-ankle acupuncture (WAA), our research team has developed a portable device for WAA point compression, termed the acupressure wrist-ankle strap (AWA). The current study aims to evaluate the efficacy of the AWA in alleviating pain associated with primary dysmenorrhea. Methods A single-blind, randomized clinical trial was conducted from April 1, 2019, to December 31, 2019. 78 participants with primary dysmenorrhea were recruited from Shanghai University of Traditional Chinese Medicine. All participants were treated on the first day of menstruation for 30 min. Participants in the AWA group used the AWA, the internal side of which is equipped with a tip compression component, while participants in the non-acupressure wrist-ankle acupuncture(NAWA)group used the NAWA, with the inside tip pressing parts removed. The main outcome was the difference in visual analogue scale (VAS) score between baseline and 30 minutes after randomization. Results A total of 78 participants aged 18 to 30 years were included in the intention-to-treat analyses. The VAS scores (mean [standard deviation]) in the AWA group were significantly lower than those in the NAWA group at each time point of intervention (5 minutes: 95% CI, [-1.27 to -0.68], p < 0.001; 10 minutes: 95% CI, [-2.34 to -1.51], p < 0.001; 30 minutes: 95% CI, [-3.74 to -2.72], p < 0.001). In the AWA group, 16 participants reported "obvious relief" of dysmenorrhea pain while 23 did not; the average onset time of analgesia they reported were (21.50 ± 3.65) min, while no subjects in NAWA group reported obvious pain relief. The pain threshold (mean [standard deviation]) at SP9 of both sides in AWA group decreased significantly after intervention that in NAWA group (Left: 95% CI, [-5.02 to -1.81], p < 0.001; Right: 95% CI, [-7.67 to -4.24], p < 0.001). There was no significant change in the temperature at CV4 in either group (95% CI, [-0.63 to -0.66], p = 0.970). Conclusion This trial substantiates our hypothesis that the AWA provides immediate analgesic effects. The AWA represents an effective and safe non-invasive physical therapy option, which patients can self-administer to alleviate abdominal pain.
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Affiliation(s)
- Shujie Zhai
- Department of Rehabilitation Medicine, Eastern Hepatobiliary Surgery Hospital, Naval Medical University, Shanghai, China
- School of Traditional Chinese Medicine, Naval Medical University, Shanghai, China
| | - Chenmiao Wang
- Department of Rehabilitation Medicine, Eastern Hepatobiliary Surgery Hospital, Naval Medical University, Shanghai, China
| | - Yi Ruan
- School of Traditional Chinese Medicine, Naval Medical University, Shanghai, China
| | - Yue Liu
- Department of Acupuncture and Moxibustion, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Rui Ma
- Department of Cardiology, Eastern Hepatobiliary Surgery Hospital, Naval Medical University, Shanghai, China
| | - Fanfu Fang
- Department of Rehabilitation Medicine, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Qinghui Zhou
- School of Traditional Chinese Medicine, Naval Medical University, Shanghai, China
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5
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Barbosa-Silva J, Avila MA, de Oliveira RF, Dedicação AC, Godoy AG, Rodrigues JC, Driusso P. Prevalence, pain intensity and symptoms associated with primary dysmenorrhea: a cross-sectional study. BMC Womens Health 2024; 24:92. [PMID: 38311716 PMCID: PMC10840141 DOI: 10.1186/s12905-023-02878-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 12/31/2023] [Indexed: 02/06/2024] Open
Abstract
BACKGROUND Primary dysmenorrhea (PD) is an etiological cyclic pelvic pain related to the menstrual period; it can negatively impact women's quality of life and productivity. The aim of the present study was to estimate the prevalence of PD and analyze associated symptoms in Brazilian women. METHODS An online cross-sectional study was carried out in Brazil, with a structured questionnaire regarding dysmenorrhea and associated symptoms. PD intensity was measured with the Numerical Rating Scale for Pain and classified as mild (1-3), moderate (4-7) and severe (> 8). The association between qualitative variables was performed using Pearson's Chi-Square Test. The quantification of this association was measured using multinomial logistic regression models, with calculation of Odds Ratio and confidence interval. A significance level of 5% was considered. RESULTS A total of 10,070 women were included. Most participants classified PD intensity as moderate (40.4%, 41.9% and 49.7%) and severe (21.2%, 24.8% and 28.4%) in the previous month, 3 months and 5 years, respectively. The most common symptoms associated with PD were irritability, abdominal distension sensation, anxiety and feeling more emotional. The increased of the risk (OR > 1.0) for moderate and severe PD-related pain intensity is related to age, nulliparity and presence PD since adolescence. CONCLUSION There is a high prevalence of PD among Brazilian women, and the most common symptoms reported were irritability, abdominal distension sensation, anxiety and feeling more emotional.
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Affiliation(s)
- Jordana Barbosa-Silva
- Women's Health Research Laboratory (LAMU), Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | - Mariana Arias Avila
- Laboratory of Research on Electrophysical Agents (LAREF), Physical Therapy Department, Federal University of São Carlos, São Carlos, Brazil
| | - Raissa Fernanda de Oliveira
- Women's Health Research Laboratory (LAMU), Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | - Anny Caroline Dedicação
- Women's Health Research Laboratory (LAMU), Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil.
- Multiprofessional Residency Program, Hospital Israelita Albert Einstein (HIAE), São Paulo, Brazil.
| | - Amanda Garcia Godoy
- Laboratory of Research on Electrophysical Agents (LAREF), Physical Therapy Department, Federal University of São Carlos, São Carlos, Brazil
| | - Jessica Cordeiro Rodrigues
- Women's Health Research Laboratory (LAMU), Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | - Patricia Driusso
- Women's Health Research Laboratory (LAMU), Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
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6
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Liao CC, Lin CL, Tsai FJ, Chien CH, Li JM. Acupuncture's long-term impact on depression prevention in primary dysmenorrhea: A 19-year follow-up of a Taiwan cohort with neuroimmune insights. J Affect Disord 2024; 344:48-60. [PMID: 37816484 DOI: 10.1016/j.jad.2023.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 09/05/2023] [Accepted: 10/04/2023] [Indexed: 10/12/2023]
Abstract
BACKGROUND Primary dysmenorrhea (PD) is a common gynecological condition causing depression. Acupuncture is an effective option for PD management but its effects on PD-associated depression remain unclear. METHODS A retrospective cohort study involving 35,099 propensity score-matched pairs of acupuncture users and non-users with PD was conducted using data from Taiwan's Longitudinal Generation Tracking Database 2000. Cox proportional hazard models were used to estimate depression risk, and bioinformatics analyses were performed to uncover underlying molecular mechanisms. RESULTS The risk of developing depression was reduced by 64 % in acupuncture users compared with non-acupuncture users during the 19-year follow-up period. The decrease was dose-dependent. Bioinformatics analyses identified 34 co-expressed targets for acupuncture, PD, and depression; and eight hub genes (coding for interleukin 6 and 1B, tumor necrosis factor, albumin, vascular endothelial growth factor A, C-reactive protein, prostaglandin-endoperoxide synthase 2, and brain-derived neurotrophic factor) potentially involved in the therapeutic effects of acupuncture. Several molecular pathways were found to be involved, including cytokine-cytokine receptor interaction, neuroactive ligand-receptor interaction, cyclic adenosine 3',5'-monophosphate signaling pathway, mitogen-activated protein kinase signaling pathway, serotonergic synapse, and estrogen signaling pathway. LIMITATIONS Bias in the selection of participants could have been introduced as a consequence of the retrospective nature of the study. Data were derived from a single national database, and acupuncture treatment details were unavailable. CONCLUSION Acupuncture may protect against the development of depression in patients with PD. This study provides insight into the potential molecular mechanisms underlying the therapeutic effects of acupuncture in PD management and depression prevention.
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Affiliation(s)
- Chung-Chih Liao
- Department of Post-Baccalaureate Veterinary Medicine, College of Medical and Health Science, Asia University, Taichung 41354, Taiwan; Chuyuan Chinese Medicine Clinic, Taichung 40455, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung 40459, Taiwan
| | - Fuu-Jen Tsai
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan; Department of Medical Research, China Medical University Hospital, Taichung 40402, Taiwan; Division of Medical Genetics, China Medical University Children's Hospital, Taichung 40447, Taiwan; Department of Biotechnology and Bioinformatics, Asia University, Taichung 41354, Taiwan
| | - Chi-Hsien Chien
- Department of Post-Baccalaureate Veterinary Medicine, College of Medical and Health Science, Asia University, Taichung 41354, Taiwan
| | - Jung-Miao Li
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan; Department of Chinese Medicine, China Medical University Hospital, Taichung 40447 , Taiwan.
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Fuentes-Aparicio L, Cuenca-Martínez F, Muñoz-Gómez E, Mollà-Casanova S, Aguilar-Rodríguez M, Sempere-Rubio N. Effects of therapeutic exercise in primary dysmenorrhea: an umbrella and mapping review. PAIN MEDICINE (MALDEN, MASS.) 2023; 24:1386-1395. [PMID: 37555833 DOI: 10.1093/pm/pnad104] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 07/15/2023] [Accepted: 07/19/2023] [Indexed: 08/10/2023]
Abstract
PURPOSE Primary dysmenorrhea (PD) is 1 of the most prevalent gynecologic conditions. The main aim of this umbrella review was to assess the effects of therapeutic exercise (TE) on PD. METHODS A systematic search was carried out in PubMed, Embase, SPORTDiscus, CINAHL, and PEDro (December 10, 2022). The outcome measures assessed were menstrual pain intensity, menstrual pain duration, and quality of life. Methodological quality was analyzed using the AMSTAR and ROBIS scales, and the strength of evidence was established according to the advisory committee grading criteria guidelines. RESULTS Nine systematic reviews were included. The results showed that TE, regardless of the exercise model and intensity, has a clinical effect in improving menstrual pain intensity in women with PD with moderate quality of evidence. In addition, the results showed that TE has a clinical effect in improving the duration of menstrual pain in women with PD with a limited quality of evidence. However, the results are controversial on the improvement of quality of life in women with PD with a limited quality of evidence. CONCLUSIONS TE seems an effective option to implement in women with PD to improve the intensity and duration of menstrual pain. We cannot draw robust results for quality of life due to the low number of primary studies. More research in this field can help us establish more robust conclusions, as well as to assess whether there is one exercise model or intensity of training that is more effective than others.PROSPERO number: This review was previously registered in PROSPERO (CRD42022371428).
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Affiliation(s)
| | | | - Elena Muñoz-Gómez
- Department of Physiotherapy, University of Valencia, Valencia, Spain
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Erdoğan P, Yardımcı H. Analgesic effects of LI4 acupuncture during intrauterine device insertion: a randomized controlled clinical trial. Arch Gynecol Obstet 2023; 308:1361-1368. [PMID: 37466690 DOI: 10.1007/s00404-023-07106-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 06/11/2023] [Indexed: 07/20/2023]
Abstract
PURPOSE Intrauterine device (IUD) is one the most effective contraceptive methods with reversible long-term effects. However, the major drawback of IUD use is pain perception during the insertion of the device. The aim of this study is to investigate the effects of bilateral LI4 acupuncture, administered before IUD insertion, on pain perception. METHODS This is a prospective randomized controlled study. It was held in Community Health Center in Niğde, Turkiye. Individuals enrolled in the study were randomized into the acupuncture group and non-intervention group. Acupuncture group received bilateral LI4 acupuncture prior to IUD insertion while others received no interventions. After IUD insertion, 10 cm visual analog scale (VAS) score was evaluated at 3rd minute and at 10th minute. Health care provider performing the IUD insertion and VAS evaluation was blind to randomization. RESULTS In total 72 participants were included in the study. The VAS scores were significantly lower in the acupuncture group both at 3rd minute and at 10th minute (1.93 ± 1.68; 3.81 ± 1.95; p < 0.001 and 0.53 ± 0.84; 1.64 ± 1.10; p < 0.001 respectively). Linear regression analysis showed that acupuncture was a significant predictor for lowering VAS both at 3rd minutes and 10th minutes following IUD insertion (p < 0.001). CONCLUSION This is the first randomized controlled clinical study investigating the effects of acupuncture on pain control during IUD insertion. The results demonstrated that bilateral LI4 acupuncture provides significant pain relief at both cervical and fundal components. Acupuncture prior to IUD insertion is a significant predictor of lowering overall VAS scores of individuals. TRIAL REGISTRATION NCT04963582.
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Affiliation(s)
- Pınar Erdoğan
- Midwifery Department, Niğde Ömer Halisdemir University Zübeyde Hanım School of Health, Atatürk Bulvarı, Derbent Campus Merkez, Niğde, Turkey.
| | - Harun Yardımcı
- Director of Health Services Department, Niğde Provincial Directorate of Health, Yenice mah, Süleyman Fethi Cad. Merkez, Niğde, Turkey
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Rogers SK, Galloway A, Hirsh AT, Zapolski T, Chen CX, Rand KL. Efficacy of psychological interventions for dysmenorrhea: a meta-analysis. PAIN MEDICINE (MALDEN, MASS.) 2023; 24:1086-1099. [PMID: 37154693 DOI: 10.1093/pm/pnad058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 05/01/2023] [Accepted: 05/02/2023] [Indexed: 05/10/2023]
Abstract
Dysmenorrhea is pelvic pain associated with menstruation and is one of the most common pain conditions among reproductive-age women. It is commonly treated with medications, complementary and alternative medicine, and self-management techniques. However, there is increased focus on psychological interventions which modify thoughts, beliefs, emotions, and behavioral responses to dysmenorrhea. This review examined the efficacy of psychological interventions on dysmenorrhea pain severity and interference. We conducted a systematic search of the literature using PsycINFO, PubMed, CINHAL, and Embase. A total of 22 studies were included; 21 examined within-group improvement (ie, within-group analysis) and 14 examined between-group improvement (ie, between-group analysis). Random-effects meta-analyses were conducted on pain severity and interference, with average effect sizes calculated using Hedges's g. Within-group analyses showed decreased pain severity and interference at post-treatment (g = 0.986 and 0.949, respectively) and first follow-up (g = 1.239 and 0.842, respectively). Between-group analyses showed decreased pain severity at post-treatment (g = 0.909) and decreased pain severity and interference at first follow-up (g = 0.964 and 0.884, respectively) compared to control groups. This review supports the efficacy of psychological interventions for dysmenorrhea, but conclusions are tempered by suboptimal methodological quality of the included studies and high heterogeneity across studies. Additional, rigorous research is needed to determine the clinical utility of psychological interventions for dysmenorrhea.
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Affiliation(s)
- Sarah K Rogers
- Department of Psychology, School of Science, Indiana University-Purdue University Indianapolis, Indianapolis, IN 46202, United States
| | - Amanda Galloway
- Department of Psychology, School of Science, Indiana University-Purdue University Indianapolis, Indianapolis, IN 46202, United States
| | - Adam T Hirsh
- Department of Psychology, School of Science, Indiana University-Purdue University Indianapolis, Indianapolis, IN 46202, United States
| | - Tamika Zapolski
- Department of Psychology, School of Science, Indiana University-Purdue University Indianapolis, Indianapolis, IN 46202, United States
| | - Chen X Chen
- Indiana University School of Nursing, Indianapolis, IN 46202, United States
| | - Kevin L Rand
- Department of Psychology, School of Science, Indiana University-Purdue University Indianapolis, Indianapolis, IN 46202, United States
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Correyero-León M, Llamas-Ramos R, Calvo-Rodrigo J, Alvarado-Omenat JJ, Llamas-Ramos I. Transcutaneous Tibial Nerve Stimulation for Primary Dysmenorrhea: A Protocol for a Randomized Controlled Trial. Healthcare (Basel) 2023; 11:healthcare11111633. [PMID: 37297773 DOI: 10.3390/healthcare11111633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/18/2023] [Accepted: 05/22/2023] [Indexed: 06/12/2023] Open
Abstract
Primary dysmenorrhea (PD) is a painful menstruation that can persist for the duration of a woman's fertile life. Non-steroidal anti-inflammatory drugs, hormonal therapy, physiotherapy techniques, etc., are the main treatments. The main objective of this study is to evaluate the effectiveness of transcutaneous posterior tibial nerve stimulation (TTNS) in PD patients. The study will consist of a single-blind randomized clinical trial, parallel-assigned with two arms. Women with PD (18-43 years) with regular menstrual cycles and at least 4 points in VAS will be randomly divided into experimental (TTNS) and placebo (simulated stimulation) groups during 12 treatment sessions (1 session/week) and several follow-ups: monthly during treatment and 1, 3 and 6 months after. Maximum and mean pain intensity, pain duration, pain severity, number of anti-inflammatory drugs, quality of life, sleep quality, overall improvement, treatment satisfaction and secondary effects will be measured once a month every 6 months and at 3 and 6 months. The Student's t-test for independent samples or the Mann-Whitney U test will be used. The literature shows effective physiotherapeutic techniques for PD in the short term, which do not act on causes and have limitations. The TTNS technique can be used in transcutaneous and percutaneous modalities, with similar effectiveness, but the transcutaneous causes less discomfort. TTNS modulates pain, and long-term benefits could be achieved at low cost and without patient discomfort.
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Affiliation(s)
| | - Rocío Llamas-Ramos
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, Universidad de Salamanca, Avda, Donantes de Sangre s/n, 37007 Salamanca, Spain
| | | | | | - Inés Llamas-Ramos
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, Universidad de Salamanca, Avda, Donantes de Sangre s/n, 37007 Salamanca, Spain
- University Hospital of Salamanca, P.° de San Vicente, 182, 37007 Salamanca, Spain
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Gray LJ, Durand H. Experiences of dysmenorrhea and its treatment among allistic and autistic menstruators: a thematic analysis. BMC Womens Health 2023; 23:288. [PMID: 37231369 DOI: 10.1186/s12905-023-02370-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 04/17/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Dysmenorrhea (i.e., period pain) is common and debilitating. Autistic people are known to experience pain differently, yet little is known about the menstrual pain experiences of autistic menstruators relative to non-autistic peers. This study aimed to explore the experience of period pain and treatment uptake for period pain among allistic and autistic populations. METHODS This study used a qualitative design and opportunity sampling approach. Thirty-seven participants (of whom 17 were autistic) were interviewed via video-conferencing software using a semi-structured topic guide. Transcriptions of interviews were analysed using Braun and Clarke's Reflexive Thematic Analysis. Data were initially analysed together for common themes. Autistic menstruators' data was subsequently analysed separately to elucidate the unique experiences of this group. RESULTS A total of six themes were constructed from the data. Initial analysis determined three themes related to experiences of period pain and treatment uptake in both allistic and autistic menstruators. Social perception of menstruation was discussed, highlighting the normalisation of pain, the taboo nature, and gendered experience of menstruation, contributing to untreated menstrual pain. Issues within menstrual healthcare were also shared, including experiences of ineffective treatment, dismissive interactions, and insufficient menstrual education. Impaired functionality was repeatedly highlighted, with menstruators detailing significant limitations to their usual functioning due to menstrual pain and ineffective treatment. Three further themes were constructed from separate analysis of data from autistic menstruators. Autistic menstruators discussed the impact of menstruation on their sensory experiences and needs, with many identifying overstimulation during menstruation. Social exclusion was discussed as a factor contributing to the experience of menstrual pain and poor treatment uptake. The final theme identified pain communication differences between autistic and allistic menstruators resulting in reports of ineffective treatment and challenges in healthcare interactions. CONCLUSIONS Communication differences, sensory aspects, and social factors contributed to the experience of period pain and treatment uptake for autistic menstruators. The perception of menstruation within society was highlighted by allistic and autistic menstruators as influential to their pain experience and engagement with treatment. Functionality was significantly impacted by pain for this sample. The study highlights societal and healthcare factors that could be improved to ensure accessibility of support and treatment for menstrual issues.
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Affiliation(s)
- Lauren J Gray
- Division of Psychology, Faculty of Natural Sciences, University of Stirling, Stirling, Scotland
- Department of Psychology, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland
| | - Hannah Durand
- Division of Psychology, Faculty of Natural Sciences, University of Stirling, Stirling, Scotland.
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Amzajerdi A, Keshavarz M, Ghorbali E, Pezaro S, Sarvi F. The effect of vitamin D on the severity of dysmenorrhea and menstrual blood loss: a randomized clinical trial. BMC Womens Health 2023; 23:138. [PMID: 36973702 PMCID: PMC10045437 DOI: 10.1186/s12905-023-02284-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/15/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Primary dysmenorrhea is considered as one of the women's main problems during reproductive age. The present study aimed to investigate the effect of vitamin D on the severity of dysmenorrhea and menstrual blood loss. METHODS This double-blind, randomized, placebo-controlled trial, was performed on 84 single female college students between 18 and 25 years old who living in dormitories. Students with primary dysmenorrhea and vitamin D deficiency were divided into experimental (n = 42) and control (n = 42) groups. Five days before the putative beginning of their next menstrual cycle, the experimental group received 300,000 IU vitamin D (50,000 IU, two tablets every 8 h), and the control group received a placebo (oral paraffin). The effects of the supplement on the severity of dysmenorrhea and menstrual blood loss were evaluated one cycle before and during two successive cycles. Using the visual analog scale (VAS), verbal multidimensional scoring system (VMS), and pictorial blood assessment chart (PBLAC) questionnaires. Fisher's exact, Chi-square, independent sample t-test and repeated measurements were used. RESULTS In total, 78 of the 84 students completed the study (39 students per group). The intervention resulted in a significant reduction in the mean scores of both the VAS and VMS in the experimental group, in the first and second menstrual cycles (p < 0.001, p < 0.001, respectively), but not in the means score of PBLAC. Mefenamic acid consumption at the first and second menstruation period, in the experimental group was lower than the control group (p = 0.009, p < 0.001, respectively). CONCLUSIONS The results indicate that vitamin D supplementation could decrease the severity of primary dysmenorrhea and the need to consume pain-relief medications. Contrariwise vitamin D supplementation had no significant effect on menstrual blood loss. TRIAL REGISTRATION This trial was registered in the Iranian Registry of Clinical Trials with code IRCT201305212324N on 18/1/2014. URL of registry: https://en.irct.ir/trial/1964 .
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Affiliation(s)
- Azam Amzajerdi
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Keshavarz
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Reproductive Sciences and Technology Research Center, Department of Midwifery and Reproductive Health, Iran University of Medical Sciences, Rashid Yasemi St., Valiasr St, Tehran, 1996713883, Iran.
| | - Elham Ghorbali
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Sally Pezaro
- Centre for Healthcare Research, Coventry University, Coventry, UK
- The University of Notre Dame, Fremantle, Australia
| | - Fatemeh Sarvi
- Department of Public Health, School of Health, Larestan University of Medical Sciences, Shiraz, Fars, Iran
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Lin KYH, Chang YC, Lu WC, Kotha P, Chen YH, Tu CH. Analgesic Efficacy of Acupuncture on Chronic Pelvic Pain: A Systemic Review and Meta-Analysis Study. Healthcare (Basel) 2023; 11:830. [PMID: 36981487 PMCID: PMC10048458 DOI: 10.3390/healthcare11060830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/07/2023] [Accepted: 03/09/2023] [Indexed: 03/14/2023] Open
Abstract
Chronic pelvic pain (CPP) is the pain occurred in the pelvic region longer than six months. The monotherapy of medicine may not adequate for the pain management of CPP and multidisciplinary approaches have been more recommended. The aim of this study is to evaluate the pain management efficacy of acupuncture compared with a control group on CPP. The articles of randomized controlled trial on CPP in PubMed and Embase databases were screened between January 2011 and September 2022 without language restriction to evaluate the treatment efficacy of acupuncture. The visual analogue scale/numerical rating scale (VAS/NRS) and total pain scores of National Institutes of Health-chronic prostatitis symptom index (NIH-CPSI) were served as outcome variables. Post-intervention mean scores were extracted and pooled for meta-analysis. Seventeen studies including 1455 patients were selected for meta-analysis. Both total pain scores of NIH-CPSI and VAS/NAS data revealed significant lower pain level in the acupuncture group than in the control group. Moreover, monotherapy with acupuncture revealed a significantly lower pain level than in the control group in both total pain scores of NIH-CPSI and VAS/NRS. These results indicated that acupuncture may have beneficial effects on pain management for CPP, even when administrated as a monotherapy.
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Affiliation(s)
- Kent Yu-Hsien Lin
- Department of Gynecology, Ryde Hospital, Northern Sydney Local Health District, Sydney 2122, Australia
| | - Yi-Chuan Chang
- Graduate Institute of Acupuncture Science, China Medical University, Taichung 404333, Taiwan
- Department of Chinese Medicine, China Medical University Beigang Hospital, Yunlin 651012, Taiwan
| | - Wen-Chi Lu
- Graduate Institute of Acupuncture Science, China Medical University, Taichung 404333, Taiwan
| | - Peddanna Kotha
- Graduate Institute of Acupuncture Science, China Medical University, Taichung 404333, Taiwan
| | - Yi-Hung Chen
- International Master Program in Acupuncture, China Medical University, Taichung 404333, Taiwan
- Traditional Chinese Medicine Research Center, China Medical University, Taichung 404333, Taiwan
- Department of Photonics and Communication Engineering, Asia University, Taichung 41354, Taiwan
| | - Cheng-Hao Tu
- Graduate Institute of Acupuncture Science, China Medical University, Taichung 404333, Taiwan
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Ghosh S, Ravindra RK, Modak A, Maiti S, Nath A, Koley M, Saha S. Efficacy of individualized homeopathic medicines in primary dysmenorrhea: a double-blind, randomized, placebo-controlled, clinical trial. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2023; 20:258-267. [PMID: 34085495 DOI: 10.1515/jcim-2020-0512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 05/25/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Homeopathic treatment is claimed to be beneficial for primary dysmenorrhoea (PD); still, systematic research evidences remain compromised. This study was undertaken to examine the efficacy of individualized homeopathic medicines (IH) against placebo in the treatment of PD. METHODS A double-blind, randomized, placebo-controlled trial was conducted at the gynecology outpatient department of Mahesh Bhattacharyya Homoeopathic Medical College and Hospital, West Bengal, India. Patients were randomized to receive either IH (n=64) or identical-looking placebo (n=64). Primary and secondary outcome measures were 0-10 numeric rating scales (NRS) measuring intensity of pain of dysmenorrhea and verbal multidimensional scoring system (VMSS) respectively; all measured at baseline, and every month, up to 3 months. Group differences and effect sizes (Cohen's d) were calculated on intention-to-treat (ITT) sample. RESULTS Groups were comparable at baseline (all p>0.05). Attrition rate was 10.9% (IH: 7, placebo: 7). Differences between groups in both pain NRS and VMSS favoured IH over placebo at all time points (all p<0.001, unpaired t-tests and two-ways repeated measures analysis of variance) with medium to large effect sizes. Natrum muriaticum and Pulsatilla nigricans (n=20 each; 15.6%) were the most frequently prescribed medicines. No harms, serious adverse events and intercurrent illnesses were recorded in either of the groups. CONCLUSIONS Homeopathic medicines acted significantly better than placebo in the treatment of PD. Independent replication is warranted. Trial registration: CTRI/2018/10/016013.
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Affiliation(s)
- Shubhamoy Ghosh
- Dept. of Pathology & Microbiology, Mahesh Bhattacharyya Homeopathic Medical College and Hospital, Howrah, West Bengal, India
| | - Rai Khushboo Ravindra
- Dept. of Repertory , Mahesh Bhattacharyya Homeopathic Medical College and Hospital, Howrah, West Bengal, India
| | - Amila Modak
- Dept. of Obstetrics & Gynecology, Mahesh Bhattacharyya Homeopathic Medical College and Hospital, Howrah, West Bengal, India
| | - Shukdeb Maiti
- Dept. of Repertory , Mahesh Bhattacharyya Homeopathic Medical College and Hospital, Howrah, West Bengal, India
| | - Arunava Nath
- Dept. of Forensic Medicine & Toxicology, Pratap Chandra Memorial Homoeopathic Hospital and College, Kolkata, West Bengal, India
| | - Munmun Koley
- Dept. of Organon of Medicine and Homoeopathic Philosophy, State National Homoeopathic Medical College and Hospital, Lucknow, Uttar Pradesh, India
| | - Subhranil Saha
- Dept. of Repertory, D. N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, India
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15
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Auricular Acupressure Effect on Autonomic Responses Evoked by a Cold Pressor Test in Healthy Volunteers: A Pilot Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:5703760. [PMID: 36561603 PMCID: PMC9767713 DOI: 10.1155/2022/5703760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/29/2021] [Accepted: 12/02/2022] [Indexed: 12/15/2022]
Abstract
Objective This pilot study was conducted to investigate changes in the pulse rate and blood pressure in healthy volunteers after applying auricular acupressure at the "heart acupoint." Methods A total of 120 healthy volunteers with hemodynamic indexes within normal limits were randomly allocated into 4 groups to receive auricular acupressure treatment either at the heart acupoint of the left or the right, or in both ears, and one control group without applying auricular acupressure. Results Before the application of auricular acupressure, there were no statistical differences in pulse rate and blood pressure increments among the four groups during the first cold pressor test. In groups in which auricular pressure was applied, the pulse rate was significantly reduced after the application of auricular acupressure in three groups; however, no statistically significant difference was detected among the groups. Changes in blood pressure were not statistically significant in or among the different groups after applying auricular acupressure. The average recorded pulse rate values during the second cold pressor test (after auricular acupressure) were significantly lower compared to the corresponding values taken during the first cold pressor test (before auricular acupressure) (p < 0.05); however, pulse rate increments during the two cold pressor tests (with and without auricular acupressure) were similar (p > 0.05). Conclusions These findings suggest that auricular acupressure could be used as an adjunctive nonpharmacological method for reducing the pulse rate.
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Notonegoro C, Simadibrata C, Kresnawan T. Comparison of Therapeutic Effects Between Electroacupuncture and Thread-Embedded Acupuncture in Obese Patients Undergoing a Dietary Intervention. Med Acupunct 2022; 34:380-390. [PMID: 36644421 PMCID: PMC9805856 DOI: 10.1089/acu.2022.0009] [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: 01/18/2023] Open
Abstract
Objective Obesity is an epidemic with an increasing prevalence in developing countries. The condition affects almost all physiologic functions of the body and is a significant threat to public health. Treatment of obesity is often difficult and expensive. Pharmacologic therapy has many side-effects. Acupuncture, a nonpharmacologic therapy, has shown promising results for treating obesity. Electroacupuncture (EA) and thread-embedded acupuncture (TEA) can be used. The aim of this study was to analyze the therapeutic effects of EA and TEA, using polydioxanone (PDO), on weight loss, waist circumference, and plasma-leptin concentrations in obese patients undergoing a dietary intervention. Materials and Methods This single-blinded, randomized clinical trial randomized 34 subjects into 2 groups: EA and TEA. In the EA group, EA was administered 3 times per week for 4 weeks (a total of 12 sessions). In the TEA group, EA was administered only once. Body weight and waist circumference were measured at baseline, and on days 3, 7, 14, 21, and 28 (end) of the trial. Plasma-leptin concentrations were measured at the beginning and end of the trial. Results There was a significant decrease in body weight and waist circumference in the groups before and after treatment (P < 0.001), and a significant decrease in plasma-leptin concentrations in the EA (P = 0.012) and TEA groups (P = 0.001). There were no significant differences between the groups in weight loss (P = 0.621), waist circumference (P = 0.545), and plasma-leptin concentration (P = 0.784). Conclusions EA and PDO TEA are equally effective for reducing body weight, waist circumference, and plasma-leptin concentrations in obese patients undergoing dietary interventions. However, TEA is more time-efficient than EA.
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Affiliation(s)
- Cindy Notonegoro
- Department of Medical Acupuncture, Dr. Cipto Mangunkusumo Hospital, Central Jakarta, DKI Jakarta, Indonesia
- Medical Acupuncture Specialist Program, Faculty of Medicine Universitas Indonesia, Jakarta, Daerah Istimewa Jakarta, Indonesia
| | - Christina Simadibrata
- Department of Medical Acupuncture, Dr. Cipto Mangunkusumo Hospital, Central Jakarta, DKI Jakarta, Indonesia
- Medical Acupuncture Specialist Program, Faculty of Medicine Universitas Indonesia, Jakarta, Daerah Istimewa Jakarta, Indonesia
| | - Triyani Kresnawan
- Department of Nutrition and Food Production, Dr. Cipto Mangunkusumo Hospital, Central Jakarta, DKI Jakarta, Indonesia
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Dong X, Yang J, Wei W, Chen L, Su M, Li A, Guo X, Liu L, Li S, Yu S, Zeng F. Efficacy and cerebral mechanism of acupuncture and moxibustion for treating primary dysmenorrhea: study protocol for a randomized controlled clinical trial. Trials 2022; 23:964. [DOI: 10.1186/s13063-022-06675-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 08/20/2022] [Indexed: 11/29/2022] Open
Abstract
Abstract
Background
Acupuncture or moxibustion has been proven to be effective for patients with primary dysmenorrhea (PDM). However, the respective advantages and potential central mechanism of acupuncture and moxibustion are worthy of investigating to promote their further application.
Methods
In this randomized controlled neuroimaging trial, 72 patients with PDM will be randomly assigned to three groups: acupuncture treatment group, moxibustion treatment group, and waiting list group. The acupuncture treatment group and moxibustion treatment group will receive acupuncture or moxibustion, respectively, for a total of 3 sessions over 3 consecutive menstrual cycles, and the waiting list group will not take acupuncture or moxibustion during these 3 menstrual cycles. The COX Menstrual Symptom Scale (CMSS), visual analog scale (VAS), and Pain Catastrophizing Scale (PCS) will be used to evaluate the clinical efficacy. The Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS), and 36-Item Short Form Health Survey (SF-36) will be used to assess the mental state and quality of life at baseline and at the end of treatment. Functional magnetic resonance imaging (fMRI) will be performed for detecting the cerebral activity changes at baseline and at the end of the treatment. The clinical data and imaging data will be analyzed among the groups. Correlation analysis will be conducted to investigate the relationship between brain functional changes and symptom improvement.
Discussion
The application of the randomized controlled neuroimaging trial will provide objective and valid evidence about how acupuncture and moxibustion treatment relieve menstrual pain. The results of this study would be useful to confirm the potential similarities and differences between acupuncture and moxibustion in clinical efficacy and central mechanism for patients with PDM.
Trial registration
Chinese Clinical Trial Registry ChiCTR2100043732. Registered on 27 February 2021
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18
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FAN X, DU X, PAN L, SONG X, LIU J, ZHANG J, CHEN H, GAO Y, ZHANG M, SHI X, SHE Y. An infrared thermographic analysis of the sensitization acupoints of women with primary dysmenorrhea. J TRADIT CHIN MED 2022; 42:825-832. [PMID: 36083492 PMCID: PMC9924691 DOI: 10.19852/j.cnki.jtcm.20220707.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
OBJECTIVE To explore the sensitization acupoints of women with primary dysmenorrhea (PD) by comparing infrared radiation temperatures between acupoints and non-acupoints. METHODS We tested 10 acupoints of every woman with PD and healthy subjects on premenstrual, menstrual, and postmenstrual days using an infrared imaging device. The primary outcome was the absolute value of body surface temperature difference (AVTD) between the left and right sides of the same testing point. RESULTS A total of 58 PD patients and 57 healthy volunteers completed the test from May 2016 to May 2017. Compared with the healthy group, we observed a significant reduction and increase in the AVTD in Taichong (LR3) and Sanyinjiao (SP6), respectively, during menstrual days in the PD group (= 0.01; = 0.04); while during postmenstrual days, all AVTDs of Shuiquan (KI5), Diji (SP8), and Xuehai (SP10) were diminished in the PD group (= 0.01; = 0.03; = 0.01, respectively). No significant differences in AVTD were detected at any other points or testing times. CONCLUSIONS Compared with the healthy group, the AVTDs of Taichong (LR3), Sanyinjiao (SP6), Shuiquan (KI5), Diji (SP8), and Xuehai (SP10) at menstruation-relevant points of PD patients were sensitized, providing a reference for the selection of acupoints in the treatment of PD.
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Affiliation(s)
- Xisheng FAN
- 1 Graduate School, Hebei University of Chinese Medicine, Shijiazhuang 050091, China
| | - Xiaoyi DU
- 2 Depeartment of TCM Pediatric, Shijiazhuang Maternity and Child Healthcare Hospital, Shijiazhuang 050051, China
- Dr. DU Xiaoyi, Depeartment of TCM Pediatric, Shijiazhuang Maternity and Child Healthcare Hospital, Shijiazhuang 050051, China. Telephone: +86-311-89926278
| | - Lijia PAN
- 3 Department of Experimental Acupuncture, School of Acupuncture-Moxibustion and Tuina, Hebei University of Chinese Medicine, Shijiazhuang 050200, China
- 6 Hebei International Joint Research Center for Dominant Diseases in Chinese Medicine and Acupuncture
| | - Xiaodan SONG
- 1 Graduate School, Hebei University of Chinese Medicine, Shijiazhuang 050091, China
| | - Jun LIU
- 4 Department of Rehabilitation, School of Acupuncture-Moxibustion and Tuina, Hebei University of Chinese Medicine, Shijiazhuang 050200, China
- 6 Hebei International Joint Research Center for Dominant Diseases in Chinese Medicine and Acupuncture
| | - Juncha ZHANG
- 6 Hebei International Joint Research Center for Dominant Diseases in Chinese Medicine and Acupuncture
| | - Hao CHEN
- 1 Graduate School, Hebei University of Chinese Medicine, Shijiazhuang 050091, China
| | - Yayu GAO
- 1 Graduate School, Hebei University of Chinese Medicine, Shijiazhuang 050091, China
| | - Mingjian ZHANG
- 1 Graduate School, Hebei University of Chinese Medicine, Shijiazhuang 050091, China
| | - Xuliang SHI
- 5 Department of Basic Teaching and Research of Acupuncture, School of Acupuncture-Moxibustion and Tuina, Hebei University of Chinese Medicine, Shijiazhuang 050200, China
- 6 Hebei International Joint Research Center for Dominant Diseases in Chinese Medicine and Acupuncture
| | - Yanfen SHE
- 3 Department of Experimental Acupuncture, School of Acupuncture-Moxibustion and Tuina, Hebei University of Chinese Medicine, Shijiazhuang 050200, China
- 6 Hebei International Joint Research Center for Dominant Diseases in Chinese Medicine and Acupuncture
- Prof. She Yanfen, Department of Experimental Acupuncture, School of Acupuncture-Moxibustion and Tuina, Hebei University of Chinese Medicine, Shijiazhuang 050200, China.
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19
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Harada T, Taniguchi F, Kitajima M, Kitawaki J, Koga K, Momoeda M, Mori T, Murakami T, Narahara H, Osuga Y, Yamaguchi K. Clinical practice guidelines for endometriosis in Japan (The 3rd edition). J Obstet Gynaecol Res 2022; 48:2993-3044. [PMID: 36164759 PMCID: PMC10087749 DOI: 10.1111/jog.15416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 08/11/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Tasuku Harada
- Department Obstetrics and Gynecology, Tottori University
| | | | | | - Jo Kitawaki
- Department Obstetrics and Gynecology, Kyoto Prefectural University of Medicine
| | - Kaori Koga
- Department Obstetrics and Gynecology, The University of Tokyo
| | - Mikio Momoeda
- Department Obstetrics and Gynecology, Aiiku Hospital
| | - Taisuke Mori
- Department Obstetrics and Gynecology, Kyoto Prefectural University of Medicine
| | - Takashi Murakami
- Department Obstetrics and Gynecology, Shiga University of Medical Science
| | | | - Yutaka Osuga
- Department Obstetrics and Gynecology, The University of Tokyo
| | - Ken Yamaguchi
- Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine
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20
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Robinson CL, Berger A, Sottosanti E, Li M, Kaneb A, Keefe J, Kim E, Kaye A, Viswanath O, Urits I. Acupuncture as Part of Multimodal Analgesia for Chronic Pain. Orthop Rev (Pavia) 2022; 14:38321. [PMID: 36168395 PMCID: PMC9502036 DOI: 10.52965/001c.38321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/05/2024] Open
Abstract
Background Chronic pain is a multifactorial condition that is afflicting populations worldwide causing an increasing economic, physical, mental, and emotional burden. Treatments range from medications to interventional procedures to complementary and alternative medicine (CAM), such as acupuncture. This review aims to discuss the use of acupuncture in the treatment of chronic pain, proposed mechanisms, indications, and efficacy for various chronic pain conditions. Results Evidence is varied on the efficacy and quality of data on the use of acupuncture in the treatment of chronic pain. Recent studies have demonstrated promising results in the support of acupuncture for the use in the treatment of cancer, neck, and back pain, functional dyspepsia, and various chronic abdominal pain syndromes. Conclusion Acupuncture, deemed well-tolerated and safe to use, has been increasingly studied and is regarded as effective in clinical practice, but its efficacy is limited by the lack of well-conducted, high-quality clinical trials, lower quality evidence, and conflicting study results. Additionally, the exact analgesic mechanism of acupuncture remains to be fully elucidated. Increasing evidence supports the role of acupuncture as therapy in the treatment of cancer, neck, and back pain and functional dyspepsia. Further rigorous studies are needed to fully assess the use of acupuncture in various chronic pain conditions, determine its indications, and optimal treatment schedule. Overall, future studies could benefit from better designed experimental studies, larger groups, and more objectives ways to measure pain reduction and symptom improvement.
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Zhu D, Xiao Y, Zhong G, Wei X, Wu J, Chen R, Jiao L. A Bibliometric Analysis of Acupuncture Therapy in the Treatment of Primary Dysmenorrhea from 2001 to 2021. J Pain Res 2022; 15:3043-3057. [PMID: 36193164 PMCID: PMC9526442 DOI: 10.2147/jpr.s384757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 09/20/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Daocheng Zhu
- Department of Acupuncture and Moxibustion, The Affiliated Hospital of Jiangxi University of Chinese Medicine, Nanchang City, People’s Republic of China
| | - Yuanyi Xiao
- School of Acupuncture and Massage, Jiangxi University of Chinese Medicine, Nanchang City, People’s Republic of China
| | - Genping Zhong
- Department of Acupuncture and Moxibustion, The Affiliated Hospital of Jiangxi University of Chinese Medicine, Nanchang City, People’s Republic of China
| | - Xu Wei
- Department of Acupuncture and Moxibustion, The Affiliated Hospital of Jiangxi University of Chinese Medicine, Nanchang City, People’s Republic of China
| | - Jiajia Wu
- Department of Acupuncture and Moxibustion, The Affiliated Hospital of Jiangxi University of Chinese Medicine, Nanchang City, People’s Republic of China
| | - Rixin Chen
- Department of Acupuncture and Moxibustion, The Affiliated Hospital of Jiangxi University of Chinese Medicine, Nanchang City, People’s Republic of China
| | - Lin Jiao
- Department of Acupuncture and Moxibustion, The Affiliated Hospital of Jiangxi University of Chinese Medicine, Nanchang City, People’s Republic of China
- Correspondence: Lin Jiao; Rixin Chen, The Affiliated Hospital of Jiangxi University of Chinese Medicine, Nanchang City, Jiangxi Province, People’s Republic of China, Email ;
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22
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Park J, Lim YC, Hwang DS, Ha IH, Lee YS. Analysis of Healthcare Utilization for Primary Dysmenorrhea in Korea: A Retrospective, Cross-Sectional Study. Int J Womens Health 2022; 14:1015-1027. [PMID: 35959202 PMCID: PMC9359788 DOI: 10.2147/ijwh.s366386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 07/23/2022] [Indexed: 11/28/2022] Open
Abstract
Purpose This study is a retrospective, cross-sectional study aiming to present basic data on the treatment modalities and cost of care for primary dysmenorrhea (PD) by analyzing healthcare utilization and patient distributions using the 2010 to 2018 Health Insurance Review and Assessment Service (HIRA) data. Patients and Methods We used the HIRA-National Patient Sample (NPS) data to analyze medical service utilization for PD (ICD-10 code: N94.4, N94.6) in Western medicine (WM) or Korean medicine (KM) care between January 2010 and December 2018. Results There were 41,139 patients diagnosed with PD who utilized Western medicine (WM) or Korean medicine (KM) care at least once during the study period. The number of claims and patients steadily rose over the years from 7430 claims for 3989 patients in 2010 to 11,523 claims for 6226 patients in 2018. The predominant age group was 15 to 24 years. Regarding the frequency of service categories for PD in the claims, consultation was the most common and costly service category in WM (72,120 cases, 47.89%; 631,912 USD, 69.74%), while injection and analogous treatments was the most common and costly service category in KM (97,157 cases, 72.41%; 314,696 USD, 55.86%). Regarding the drug prescriptions, nonsteroidal anti-inflammatory drugs (NSAIDs) (26,617 cases, 40.47%) were the most frequently prescribed drug for PD in pharmacies and hospitals. Conclusion The result shows an annual increase in healthcare utilization for PD with the fastest rate in individuals aged 15 to 24 years. This study provides data on the current utilization of WM and KM care for PD for policymakers. Furthermore, we analyzed the frequency and cost of common treatment modalities in WM and KM, which would be useful data for clinicians and researchers.
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Affiliation(s)
- Jinhun Park
- Department of Internal Medicine, Jaseng Hospital of Korean Medicine, Seoul, Republic of Korea
| | - Yu-Cheol Lim
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Deok-Sang Hwang
- Department of OB & GY in Korean Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - In-Hyuk Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
- Correspondence: In-Hyuk Ha; Ye-Seul Lee, Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 2F, 540 Gangnam-daero, Gangnam-gu, Seoul, 06110, Republic of Korea, Tel +82-2-2222-2740, Fax +82-2-2222-2737, Email ;
| | - Ye-Seul Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
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Abstract
Studies show that between 41% and 91.5% of young women, school-aged and university-aged, are affected by dysmenorrhea. Primary dysmenorrhea, which is caused by the production of prostaglandins, is defined as cramping pain in the lower abdomen and/or pelvis occurring just before or during menstruation, in the absence of other diseases such as endometriosis, and typically lasting 1-3 days and with a negative physical examination. Secondary dysmenorrhea presents with similar signs and symptoms but is a result of underlying pelvic pathology, for example endometriosis or uterine fibroids. Dysmenorrhea most typically presents as abdominal cramping; however, it can also present with headaches, nausea, vomiting or other generalized symptoms. The diagnosis is mainly clinical, but other tests such as a pelvic examination, a pregnancy test and STI screening may be helpful in ruling out other sources of pain. Although the mainstay of treatment for dysmenorrhea is NSAIDs and hormonal therapy, lifestyle changes and complementary/alternative medicine can also be helpful approaches. Lifestyle changes include aerobic exercise and stretching, while complementary alternative medicine include peppermint, cinnamon, ginger and other herbs and supplements. Finally, endometriosis must be considered as a potential cause for secondary dysmenorrhea and would warrant a prompt referral to gynecology.
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Affiliation(s)
- Gail Gutman
- Division of Adolescent Medicine, Cohen Children's Medical Center, Northwell Health, 410 Lakeville Road, Suite 108, New Hyde Park, New York, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA.
| | - Ariel Tassy Nunez
- Division of Adolescent Medicine, Cohen Children's Medical Center, Northwell Health, 410 Lakeville Road, Suite 108, New Hyde Park, New York, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Martin Fisher
- Division of Adolescent Medicine, Cohen Children's Medical Center, Northwell Health, 410 Lakeville Road, Suite 108, New Hyde Park, New York, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
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Lin JG, Kotha P, Chen YH. Understandings of acupuncture application and mechanisms. Am J Transl Res 2022; 14:1469-1481. [PMID: 35422904 PMCID: PMC8991130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 11/18/2021] [Indexed: 06/14/2023]
Abstract
Acupuncture involves the stimulation of acupoints, which are located at specific sites of the human body, by insertion of fine metal needles, followed by manipulation. Acupuncture has been proven to be an effective treatment in pain relief. Available evidence showed that acupuncture alleviates acute pain in conditions such as postoperative pain, acute back pain, labour pain, primary dysmenorrhea, tension-type headaches and migraines. In addition, acupuncture relieves chronic pain, for example, low back pain (LBP), knee osteoarthritis (KOA), headache, shoulder pain, and neck pain. For other diseases like insomnia, drug addiction and stroke, more high-quality randomized control trials (RCTs) are needed to confirm the efficacy of acupuncture, although there are particular difficulties surrounding adequate blinding and control group designs. Recent biomedical technology unveils the mechanisms of acupuncture. Studies have found that adenosine triphosphate (ATP) and transient receptor potential vanilloid (TRPV) channels are involved in the stimulation of acupuncture at the acupoint area. In the central nervous system (CNS), neurotransmissions including opioids, serotonin, norepinephrine, orexin and endocannabinoid are modulated by acupuncture to induce analgesia. Moreover, acupuncture reduces cyclooxygenase-2 (COX-2) and prostaglandin E2 (PGE2) levels on the peripheral level by acting on the hypothalamic-pituitary-adrenal (HPA) axis, mediating peripheral opioid release. Acupuncture helps to treat insomnia by inhibiting sympathetic activity and down-regulating the HPA axis. Additionally, acupuncture reduces the effects of positive and negative reinforcements by modulating dopamine release in the nucleus accumbens. Recently, i-needles have been developed to allow for the analysis of metagenomics, meta-transcriptomics, and host-microbiome relationships following acupuncture, while skin implantable microsensors or needle-shaped microsensors are feasible for monitoring real-time microenvironmental changes in acupoints and even target organs. These studies may further accelerate the understanding of acupuncture's action mechanism.
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Affiliation(s)
- Jaung-Geng Lin
- School of Chinese Medicine, China Medical UniversityTaichung 40402, Taiwan
- Chinese Medicine Research Center, China Medical UniversityTaichung 40402, Taiwan
- Department of Healthcare Administration, Asia UniversityTaichung 41354, Taiwan
- School of Chinese Medicine, Tzu Chi UniversityHualien 970, Taiwan
| | - Peddanna Kotha
- Graduate Institute of Acupuncture Science, China Medical UniversityTaichung 40402, Taiwan
| | - Yi-Hung Chen
- Chinese Medicine Research Center, China Medical UniversityTaichung 40402, Taiwan
- Graduate Institute of Acupuncture Science, China Medical UniversityTaichung 40402, Taiwan
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Guy M, Foucher C, Juhel C, Rigaudier F, Mayeux G, Levesque A. Transcutaneous electrical neurostimulation relieves primary dysmenorrhea: A randomized, double-blind clinical study versus placebo. Prog Urol 2022; 32:487-497. [DOI: 10.1016/j.purol.2022.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/11/2022] [Accepted: 01/31/2022] [Indexed: 11/26/2022]
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Xuan Y, Zhang H, Liu D, Huang Y, Li L, Cao Q, Fu Y. The efficacy and safety of simple-needling for the treatment of primary dysmenorrhea compared with ibuprofen: A systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e28919. [PMID: 35363216 PMCID: PMC9281921 DOI: 10.1097/md.0000000000028919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 02/01/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Needling and ibuprofen are often used clinically to treat primary dysmenorrhea (PD). However, the difference between the efficacy and safety of the treatment of PD is not clear. This study evaluates the efficacy and safety of simple-needling for PD patients through a comparison with ibuprofen. METHODS A comprehensive search of 7 electronic databases and relevant medical journals, from the establishment of the publication to December 2020. The Cochrane risk of bias tool was used to evaluate the methodological quality of randomized clinical trials (RCTs) that met the inclusion criteria, and a meta-analysis was performed with the Review Manager version (RevMan version 5.3). RESULTS Twenty three RCTs were included. The meta-analysis reported that simple-needling groups had better than ibuprofen groups on cure rate (relative risk = 2.29, 95% CI [1.96, 2.68], P < .00001) and total effective rate (relative risk = 1.24, 95% CI [1.19, 1.29], P < .00001) and VAS score (MD = -1.24, 95% CI [-1.92, -0.55], P = .0004). Seven studies reported adverse events, of which 4 studies had mild adverse events. CONCLUSION Simple-needling is superior to ibuprofen treatment in terms of clinical efficacy and improvement of pain symptoms. A small number of studies reported whether simple-needling produced adverse events, so there is not enough evidence to support the safety of simple-needling in the treatment of PD. PROSPERO REGISTRATION NUMBER CRD42021233403.
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Affiliation(s)
- Yichen Xuan
- Nanchang Medical College, Nanchang, China
- Science and Technology College of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Haifeng Zhang
- Department of Tuina, The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Duanyong Liu
- Science and Technology College of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Yiyong Huang
- Nanchang Medical College, Nanchang, China
- Science and Technology College of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Linhui Li
- Department of Acupuncture, The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Qianan Cao
- Graduate School of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Yong Fu
- Department of Acupuncture, The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
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Acupuncture Alleviates Menstrual Pain in Rat Model via Suppressing Eotaxin/CCR3 Axis to Weak EOS-MC Activation. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:4571981. [PMID: 35069759 PMCID: PMC8776494 DOI: 10.1155/2022/4571981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 01/04/2022] [Indexed: 11/17/2022]
Abstract
Introduction Emerging data show that chemokine-mediated inflammation is involved in the occurrence and maintenance of pain. Recent evidence suggests that eotaxin levels rise when dysmenorrhea happens. The purpose of this study is to investigate whether eotaxin/CC chemokine receptor 3 (CCR3) axis, a key regulatory pathway for eosinophils (EOS) recruitment, is involved in acupuncture analgesia for dysmenorrhea. Methods After the cold congealing dysmenorrhea (CCD) rat model prepared, animals received perpendicular needling (PN) and transverse needling (TN) at SP6, respectively, for 20 min. The CCR3 agonist CCL11 was administered 30 min prior to acupuncture. Pain behavior was assessed via a writhing response. The uterine contraction test was detected by an electrophysiological method. Eotaxin, histamine (HIS), and interleukin-6 (IL-6) levels were evaluated by ELISA. The expression of CCR3 and histamine H1 receptor (H1R) was analyzed by RT-qPCR and Western blot. The expression of EOS, mast cells (MCs), eosinophil peroxidase (EPO), and eosinophil cationic protein (ECP) was assessed by hematoxylin-eosin staining (HE), Toluidine Blue staining (TB), and immunohistochemistry, respectively. Results Acupuncture prominently attenuated the menstrual pain in CCD rats, particularly TN technique. Electrophysiological recording data showed that the increased uterine contractility was ameliorated by acupuncture. In addition, TN decreased the release of eotaxin, HIS, IL-6, and the expression of CCR3 and H1R. HE, TB staining, and immunohistochemistry experiments showed that the increased expression of EOS, MCs, EPO, and ECP in uterine tissues was reversed by TN. Furthermore, we found that the effects of TN against CCD-induced menstrual pain, increased ECP expression, and HIS level were abolished by CCL11. Conclusion TN alleviated menstrual pain by improving the uterine inflammatory environment via suppressing eotaxin/CCR3 axis to weak EOS-MC activation in CCD rats. The study findings support the acupuncture as a promising approach for dysmenorrhea, meanwhile, indicating the importance of performing appropriate needling technique.
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Beltrán-Dussán EH. ¿Qué es la medicina alternativa, complementaria e integrativa? REVISTA DE LA FACULTAD DE MEDICINA 2021. [DOI: 10.15446/revfacmed.v70n4.91413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
El concepto de medicina alternativa fue creado por la medicina occidental para identificar prácticas médicas diferentes a la medicina convencional, tales como la medicina tradicional china y acupuntura, homeopatía, terapia neural, medicina osteopática y quiropráctica, medicina ayurveda y la medicina tradicional indígena, que también tienen fundamentos filosóficos, científicos y terapéuticos. Desafortunadamente, con el tiempo se estableció la creencia de que la medicina alternativa comprende todas las prácticas médicas que no son parte de la medicina convencional, lo que ha causado muchas inexactitudes y controversias.
La medicina surgió como necesidad de auto preservación del ser humano y que considera a la salud como bienestar completo y a la enfermedad, como pérdida de esta condición. A lo largo de su evolución han emergido diversas racionalidades y algunas de ellas se han convertido en sistemas médicos. La medicina convencional se estructuró en Occidente, fundamentada en racionalidades médicas existentes para la época y enfocada en modificar la enfermedad, lo que resultó en marcadas diferencias conceptuales con sistemas de tratamiento ya existentes que se centraban en el individuo y en modificar los procesos de la enfermedad.
Todos los sistemas médicos han generado un impacto en diversos campos sociales. Asimismo, han surgido tendencias y estrategias de integración de la medicina convencional con otros sistemas médicos comoLa electroacupuntura de Voll, la homotoxicología, el balance polar electromagnético, la antroposofía, la sintergética y la biofotónica. Actualmente se considera que el objetivo de la medicina es integrar y complementar conocimientos de diferentes racionalidades médicas dentro del concepto de una sola medicina. Teniendo en cuenta lo anterior, el objetivo del presente artículo es clarificar los conceptos de las diferentes formas de medicina, plantear algunas definiciones al respecto, y proponer una definición de medicina alternativa, complementaria e integrativa.
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Acupuncture for Primary Dysmenorrhea: A Potential Mechanism from an Anti-Inflammatory Perspective. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:1907009. [PMID: 34899943 PMCID: PMC8664518 DOI: 10.1155/2021/1907009] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/07/2021] [Accepted: 11/26/2021] [Indexed: 12/17/2022]
Abstract
The low adverse effects of acupuncture for primary dysmenorrhea (PD), known as one of the most commonly reported gynecological debilitating conditions affecting women's overall health, have been thus far confirmed. Moreover, it has been increasingly recognized that inflammation is involved in such menstrual cramps, and recent studies have further shown that the anti-inflammatory effects of acupuncture are helpful in its control. This review portrays the role of inflammation in PD pathophysiology, provides evidence from clinical and animal studies on acupuncture for inflammation-induced visceral pain, and reflects on acupuncture-related therapies for dysmenorrhea with regard to their anti-inflammatory characteristics. Further research accordingly needs to be carried out to clarify the effects of acupuncture on proinflammatory factors in PD, particularly chemokines and leukocytes. Future studies on this condition from an anti-inflammatory perspective should be also performed in line with the notion of emphasizing stimulation modes to optimize the clinical modalities of acupuncture. Additionally, the effects and mechanism of more convenient self-healing approaches such as TENS/TEAS for PD should be investigated.
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Abstract
PURPOSE OF REVIEW To review the current literature focusing on pain management and experiences during abortion care. RECENT FINDINGS Analgesic options in abortion care address pain associated with the procedure, osmotic dilator insertion, and cervical preparation. The paracervical block (PCB) is effective for pain control in first and second trimester abortions. Lower volume PCBs demonstrate non inferiority with osmotic dilator placement compared with higher volume PCBs with lower potential for toxicity. Self-administered vaginal lidocaine gel is noninferior to PCB in first trimester abortions. Preoperative oral narcotics and sedation do not reduce pain in first trimester abortions; however, the latter may reduce anxiety. For second trimester abortions, narcotics or gabapentin do not improve postoperative pain, yet up to half of patients will use narcotics if offered. Nonpharmacological methods have shown success in pain management. Music and doula support do not improve pain; however, patients would recommend these modalities, indicating some benefit that went unmeasured. Auricular acupuncture and transcutaneous electrical nerve stimulation (TENS) reduce pain and anxiety during first trimester abortions. SUMMARY Several modalities reduce pain during abortion care; however, pain alone does not reflect patient satisfaction. Development of multidimensional measures for pain control assessment has the potential to capture the patient's overall experience.
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Peng SL, Yang HC, Lee YC, Chen CM, Chen YY, Tu CH. Analgesia Effect of Verum and Sham Acupuncture Treatments in Primary Dysmenorrhea: A MRI Pilot Study. J Pers Med 2021; 11:1244. [PMID: 34945716 PMCID: PMC8706482 DOI: 10.3390/jpm11121244] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/19/2021] [Accepted: 11/22/2021] [Indexed: 11/17/2022] Open
Abstract
Acupuncture is an alternative treatment for primary dysmenorrhea (PDM). However, mechanisms by which acupuncture exerts its analgesic properties are still unclear. This study aimed to explore the cerebral blood flow (CBF) response to verum and sham acupuncture treatments, and further investigate whether pre-treatment CBF is capable of assessing symptom changes after interventions. A total of 11 PDM patients in the verum group and 12 patients in the sham group participated in this study. Pain rating index (PRI), CBF, and gonadal hormone levels were acquired before and after 8-week treatments. Both verum and sham acupuncture treatments exert its analgesic effect on PDM after intervention as PRI reduced (p < 0.05). Blood gonadal levels were not significantly different after acupuncture in both groups (all p > 0.05). In the verum group, intervention-related decreases in CBF were observed in the right dorsal anterior cingulate cortex. In the sham group, regions identified as showing reductions in CBF after acupuncture included the left ventromedial prefrontal cortex, left caudate, and left insula. Patients with higher baseline CBF in the left precuneus and right hippocampus were accompanied with worse treatment response to acupuncture intervention. Mechanisms of verum and sham acupuncture treatments are dissimilar as manifested by different brain responses.
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Affiliation(s)
- Shin-Lei Peng
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung 404332, Taiwan;
| | - Hui-Chieh Yang
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung 404332, Taiwan;
| | - Yu-Chen Lee
- Department of Acupuncture, China Medical University Hospital, Taichung 404333, Taiwan;
| | - Chun-Ming Chen
- Department of Medical Imaging, China Medical University Hospital, Taichung 404333, Taiwan;
| | - Ying-Yu Chen
- Department of Chinese Medicine Gynecology, China Medical University Hospital, Taichung 404333, Taiwan;
| | - Cheng-Hao Tu
- Graduate Institute of Acupuncture Science, China Medical University, Taichung 404332, Taiwan
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Acupuncture Treatment Associated with Functional Connectivity Changes in Primary Dysmenorrhea: A Resting State fMRI Study. J Clin Med 2021; 10:jcm10204731. [PMID: 34682857 PMCID: PMC8537009 DOI: 10.3390/jcm10204731] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/08/2021] [Accepted: 10/13/2021] [Indexed: 11/22/2022] Open
Abstract
Primary dysmenorrhea (PDM) is the most commonly encountered gynecological problem in reproductive-age women. Acupuncture has been suggested as an effective treatment of PDM that may modulate descending pain modulation systems. In the present study, we used resting-state functional magnetic resonance imaging to investigate possible changes in descending pain modulation systems after acupuncture treatment in women with PDM. Thirty-four right-handed adult women with PDM participated in this randomized, single-blinded, sham-controlled study. Each patient was randomly allocated to an 8-week verum or sham acupuncture intervention on the bilateral Sanyinjiao (SP6). Resting-state functional magnetic resonance imaging was conducted before, during, and after the intervention to measure the spontaneous activity in brain. After the 8-week intervention, both verum and sham groups reported decreased menstrual pain. However, the cessation of decreased functional connectivity (FC) between periaqueductal gray matter and the regions associated with affective pain modulation and attention-related pain modulation were found in the verum but not in the sham group after the 8-week intervention. More decreased FC has been found in the region associated with non-specific effects of acupuncture intervention after the early stage of acupuncture intervention. These results indicated that verum acupuncture may intercept the altered FC in descending pain modulation systems in PDM.
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Affiliation(s)
- Menghan Li
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China.,National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Shuhe Wang
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xuan Gao
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
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Yuan M, Wang X, Yan X, Ding H, Yi J, Xia H, Yu X. Effects of heat-sensitive moxibustion combined with naprapathy and warming needle moxibustion combined with naprapathy in patients with periarthritis of shoulder. Am J Transl Res 2021; 13:7804-7811. [PMID: 34377257 PMCID: PMC8340244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 04/03/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To evaluate the effects of heat-sensitive moxibustion (HSM) combined with naprapathy and warming needle moxibustion (WNM) combined with naprapathy on shoulder function and serum levels of calcitonin gene-related peptide (CGRP), substance P (SP), tumor necrosis factor-α (TNF-α) and interleukin-2 (IL-2) in patients with periarthritis of shoulder (POS). METHODS From July 2017 to July 2020, sixty patients with POS admitted to our hospital were selected as the study subjects, and divided into HSM group (n=29) receiving HSM combined with naprapathy and WNM group receiving WNM combined with naprapathy (n=31). The changes in shoulder function, degrees of pain and serum levels of CGRP, SP, TNF-α and IL-2 were compared between the two groups. RESULTS After treatment, the scores of myodynamia, pain, range of motion (ROM) of shoulder joint and activities of daily living (ADLs) were improved in both groups (P<0.05), and the scores in HSM group were remarkably higher than those in WNM group (P<0.05). Visual analogue scale (VAS) scores after 3 courses of treatment were lower than those after 1 and 2 courses of treatment respectively (P<0.05), and the VAS scores in HSM group were markedly lower than those in WNM group after 1, 2, and 3 courses of treatment (P<0.05). After treatment, the serum levels of CGRP, SP, TNF-α and IL-2 were decreased in both groups (P<0.05), and the levels in HSM group were noticeably lower than those in WNM group (P<0.05). CONCLUSION HSM combined with naprapathy is superior to WNM combined with naprapathy in inhibition of inflammatory factors of pain and serum inflammatory factors, alleviating the pain and promoting the restoration of shoulder function in patients with POS.
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Affiliation(s)
- Minghua Yuan
- Rehabilitation Department, Yichun People's Hospital Yichun 336000, Jiangxi, China
| | - Xiaoyuan Wang
- Rehabilitation Department, Yichun People's Hospital Yichun 336000, Jiangxi, China
| | - Xiaoyan Yan
- Rehabilitation Department, Yichun People's Hospital Yichun 336000, Jiangxi, China
| | - Hong Ding
- Rehabilitation Department, Yichun People's Hospital Yichun 336000, Jiangxi, China
| | - Jing Yi
- Rehabilitation Department, Yichun People's Hospital Yichun 336000, Jiangxi, China
| | - Hongmei Xia
- Rehabilitation Department, Yichun People's Hospital Yichun 336000, Jiangxi, China
| | - Xueqin Yu
- Rehabilitation Department, Yichun People's Hospital Yichun 336000, Jiangxi, China
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Analgesic effects and hemodynamic mechanisms of perpendicular and transverse needling at Sanyinjiao (SP 6) in patients with primary dysmenorrhea: A randomized controlled trial. JOURNAL OF TRADITIONAL CHINESE MEDICAL SCIENCES 2021. [DOI: 10.1016/j.jtcms.2021.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Reyna Villasmil E, Mejia-Montilla J, Reyna-Villasmil N, Torres-Cepeda D, Fernández-Ramírez A. Acupuntura en el control de los síntomas de la menopausia. REPERTORIO DE MEDICINA Y CIRUGÍA 2021. [DOI: 10.31260/repertmedcir.01217372.1037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objetivo: establecer la efectividad de la acupuntura en el control de los síntomas de la menopausia. Materiales y métodos: se seleccionaron menopaúsicas sanas entre 48 y 57 años que presentaban síntomas relacionados con la menopausia que no recibían terapia hormonal. El tratamiento consistió en 24 sesiones de acupuntura y se evaluó la intensidad de los síntomas con el puntaje del índice de Kupperman antes de iniciar y a las 4 y 8 semanas después de iniciadas las sesiones de acupuntura. Resultados: en 50 menopáusicas con edad promedio de 53,4 +/- 3,2 años después de 4 y 8 semanas de tratamiento no se observaron diferencias estadísticamente significativas en la intensidad de calorones, sudoración, trastorno del sueño, depresión, vértigo, cefalea, artralgia, palpitaciones, debilidad y síntomas vaginales (p = ns). El valor promedio de índice de Kupperman inicial fue de 30,6 +/- 4,7 puntos, el cual aumentó a 32,1 +/- 5,6 puntos a las cuatro semanas para luego alcanzar un valor de 31,1 +/- 4,8 puntos a las 8 semanas. No se demostraron diferencias significativas en los valores promedio de la escala a las 4 (p = 0,150) y 8 semanas (p = 0,596). Conclusión: la acupuntura no es efectiva para controlar los síntomas causados por la menopausia, por lo que no es una alternativa de la terapia de reemplazo hormonal.
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Romero-Morales C, Bravo-Aguilar M, Abuín-Porras V, Almazán-Polo J, Calvo-Lobo C, Martínez-Jiménez EM, López-López D, Navarro-Flores E. Current advances and novel research on minimal invasive techniques for musculoskeletal disorders. Dis Mon 2021; 67:101210. [PMID: 34099238 DOI: 10.1016/j.disamonth.2021.101210] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The present review summarized the current advances and novel research on minimal invasive techniques for musculoskeletal disorders. Different invasive approaches were proposed in the physical therapy field for the management of musculoskeletal disorders, such as ultrasound-guided percutaneous needle electrolysis, dry needling, acupuncture and other invasive therapy techniques, discussing about their worldwide status, safety and interventional ultrasound imaging. Indeed, dry needling may be one of the most useful and studies invasive physical therapy applications in musculoskeletal disorders of different body regions, such as back, upper limb, shoulder, arm, hand, pelvis, lower limb, neck, head, or temporomandibular joint, and multiple soreness location disorders, such as fibromyalgia. In addition, the assessment and treatment by acupuncture or electro-acupuncture was considered and detailed for different conditions such as plantar fasciitis, osteoarthritis, spasticity, myofascial pain syndrome, osteoporosis and rheumatoid arthritis. As an increasing technique in physical therapy, the use of ultrasound-guided percutaneous needle electrolysis was discussed in injuries of the musculoskeletal system and entrapment neuropathies. Also, ultrasound-guided percutaneous neuromodulation was established as a rising technique combined with ultrasound evaluation of the peripheral nerve system with different clinical applications which need further studies to detail their effectiveness in different musculoskeletal conditions. Thus, invasive physical therapy may be considered as a promising approach with different novel applications in several musculoskeletal disorders and a rising use in the physiotherapy field.
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Affiliation(s)
- Carlos Romero-Morales
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain.
| | - María Bravo-Aguilar
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain.
| | - Vanesa Abuín-Porras
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain.
| | - Jaime Almazán-Polo
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain.
| | - César Calvo-Lobo
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain.
| | - Eva María Martínez-Jiménez
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain.
| | - Daniel López-López
- Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, 15403 Ferrol, Spain.
| | - Emmanuel Navarro-Flores
- Frailty and Cognitive Impairment Research Group (FROG), University of Valencia, 46010 Valencia, Spain.
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Yu L, Liu S, Zheng C, Liu W, Wang H, Liang F, Lu W, Xu S, Wang W. Manual acupuncture versus sham acupuncture and usual care for the prevention of primary dysmenorrhea (PD): study protocol for a randomized controlled trial. Trials 2020; 21:818. [PMID: 32993752 PMCID: PMC7525957 DOI: 10.1186/s13063-020-04720-5] [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: 02/06/2020] [Accepted: 09/02/2020] [Indexed: 11/10/2022] Open
Abstract
Background Primary dysmenorrhea (PD) is a leading cause of dysmenorrhea among adolescent girls. Manual acupuncture may be considered as an effective treatment for PD, but high-quality evidence remains limited. This trial aims to evaluate the efficacy and safety of acupuncture for the prevention of PD as compared with sham acupuncture and usual care. Methods/design This is a three-arm, randomized, controlled clinical trial in which the patients, assessors, and statisticians will be blinded. A total of 300 acupuncture-naive patients who were diagnosed as PD will be randomly allocated to the verum acupuncture, sham acupuncture, or usual care groups in a 2:2:1 ratio. Patients in the verum acupuncture group will receive manual acupuncture at specific acupuncture points with penetrating needling, while those in the sham acupuncture group will receive non-penetrating needling at non-acupuncture points. They will be given five sessions over a menstrual cycle for 3 menstrual cycles. Patients in the usual care group will receive health education and informed to receive manual acupuncture for free after waiting for 7 menstrual cycles. The primary outcome will be the change from baseline in the Cox Menstrual Symptom Scale Score (CMSS). The secondary outcomes will be the changes in Massachusetts General Hospital Acupuncture Sensation Scale (MASS), visual analog scale (VAS), Short-Form McGill Pain Questionnaire 2 (SF-MPQ-2), Pittsburgh Sleep Quality Index (PSQI), Beck Anxiety Inventory (BAI), Beck Depression Inventory II (BDI- II), Acupuncture Expectancy Scale (AES), 60-item NEO Personality Inventory-Short Form (NEO-FFI), and acute medication intake. The adverse events will be recorded at every visit. The analyses will be performed base on a full analysis set (FAS) and a per-protocol set (PPS). Discussion This study may provide high-quality evidence regarding the efficacy and safety of manual acupuncture for PD. In addition, the results of this study will help to identify the efficacy of acupuncture due to the specific effects of acupuncture or placebo effects of acupuncture ritual. Trial registration Clinical Trials.gov NCT02783534. Registered on 26 May 2016
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Affiliation(s)
- Lingling Yu
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Shiqin Liu
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Cuihong Zheng
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Wenhua Liu
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Hua Wang
- Acupuncture and Moxibustion Institution, College of Acupuncture and Moxibustion, Hubei University of Chinese Medicine/Hubei Provincial Collaborative Innovation Center of Preventive Treatment by Acupuncture and Moxibustion, 1 Tanhualin Road, Wuhan, 430030, Hubei, China
| | - Fengxia Liang
- Acupuncture and Moxibustion Institution, College of Acupuncture and Moxibustion, Hubei University of Chinese Medicine/Hubei Provincial Collaborative Innovation Center of Preventive Treatment by Acupuncture and Moxibustion, 1 Tanhualin Road, Wuhan, 430030, Hubei, China
| | - Wei Lu
- Acupuncture and Moxibustion Institution, College of Acupuncture and Moxibustion, Hubei University of Chinese Medicine/Hubei Provincial Collaborative Innovation Center of Preventive Treatment by Acupuncture and Moxibustion, 1 Tanhualin Road, Wuhan, 430030, Hubei, China
| | - Shabei Xu
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, Hubei, China.
| | - Wei Wang
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, Hubei, China.
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Zhou X, Xiong J, Chi Z, Hua F, Lu L, Chen J, Tang G, Zhu S, Zhong Z, Guo H. Acupuncture with or without moxibustion for primary dysmenorrhea: A protocol for a systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e22395. [PMID: 32957421 PMCID: PMC7505375 DOI: 10.1097/md.0000000000022395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Primary dysmenorrhea (PD) occurs during menstrual cramps, and there is currently no pathological evidence. This disease severely affects the daily lives of young women. Acupuncture (ACU) and moxibustion are an excellent way to relieve the pain of patients with PD. And it has been widely utilizing. However, the effectiveness and safety of ACU and moxibustion in treating patients with PD are not confirmed by a high-quality meta-analysis. This work aims to evaluate ACU's efficacy and safety with or without moxibustion in the management of PD. METHODS We will make a comprehensive retrieval in 9 databases as following: Embase; Cochrane Library; PubMed; Chinese databases SinoMed (previously called the Chinese Biomedical Database); Chinese National Knowledge Infrastructure; Chinese Scientific Journals Database; Wanfang Data. The time is limited from the construction of the library to August 2020. No restrictions about language and status. Our 2 authors will perform the selection of studies, the extraction of data, and the quality assessment with the risk of bias tool independently. We will use NoteExpressV3.2.0 and Excel2010 software to extract data. The content will be saved in electronic form. We will use the bias risk tool provided by the Cochrane Collaboration to evaluate the quality of the literature using RevMan 5.4 software. The primary outcome is the pain degree evaluation, including visual analog scale, numerical rating scale, Cox retrospective symptom scale, or any other scale used to evaluate the level of pain.Furthermore, the response rate involved an overall reduction in symptoms. The adverse effects and quality of life will be assessed as secondary outcomes. The risk ratio for dichotomous data and mean differences with a 95% confidence interval for continuous data will be adopted to express the effect and safety of ACU with or without moxibustion for PD. RESULTS The results of our study expect to provide high-quality, evidence-based recommendations on further treatment for clinicians. TRIAL REGISTRATION NUMBER INPLASY202080006. CONCLUSION This study will provide scientific evidence of PD Systematic review.
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Affiliation(s)
- Xingchen Zhou
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine
| | - Jun Xiong
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine
| | - Zhenhai Chi
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine
| | - Fanghui Hua
- Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Lunbin Lu
- Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Jun Chen
- Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Genhua Tang
- Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Siyuan Zhu
- Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Zhiying Zhong
- Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Han Guo
- Jiangxi University of Traditional Chinese Medicine, Nanchang, China
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Effectiveness and Safety of Acupuncture and Moxibustion for Primary Dysmenorrhea: An Overview of Systematic Reviews and Meta-Analyses. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:8306165. [PMID: 32419829 PMCID: PMC7206866 DOI: 10.1155/2020/8306165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 02/28/2020] [Accepted: 03/30/2020] [Indexed: 01/08/2023]
Abstract
Background Acupuncture and moxibustion have been accepted as treatment options for primary dysmenorrhea (PD). So far, several systematic reviews (SRs) and meta-analyses (MAs) have reported on the efficacy and safety of acupuncture and moxibustion in treating PD. Objectives The aim of this study was to critically summarize the evidence from relevant SRs and MAs reporting on the efficacy and safety of acupuncture and moxibustion in treatment of PD. Materials and Methods Seven electronic databases, including Cochrane Database of Systematic Reviews, EMBASE, PubMed, SinoMed, China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodical Database (VIP), and Wanfang database, were systematically searched. SRs or MAs about acupuncture for PD published up to May 2019 were included in the analysis. More than two authors independently assessed the quality of the evidence by AMSTAR2, PRISMA, PRISMA-A, and GRADE approach. Results A total of 28 SRs and MAs, 281 original studies, reporting on 26,459 female patients were analyzed. The majority of the SRs were of moderate reporting quality and poor methodological quality. Moderate-quality evidence suggested that acupuncture and moxibustion were more effective compared to indomethacin or Fenbid in treating PD. Low-quality evidence suggested that, compared to NSAIDs, acupuncture and moxibustion could relieve pain with less adverse effects. Conclusion Acupuncture and moxibustion seem to be effective and safe approaches in treatment of PD; yet, the methodological quality of most of the studies and the quality of evidence were low. Thus, additional studies are required to further confirm these results.
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Zhai SJ, Ruan Y, Liu Y, Lin Z, Xia C, Fang FF, Zhou QH. Time-effective analgesic effect of acupressure ankle strip pressing wrist and ankle acupuncture point on primary dysmenorrhea: Study protocol clinical trial (SPIRIT compliant). Medicine (Baltimore) 2020; 99:e19496. [PMID: 32195949 PMCID: PMC7220230 DOI: 10.1097/md.0000000000019496] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Dysmenorrhea seriously affects the ability of women to perform normal social activities and decreases their quality of life. Primary dysmenorrhea can be effectively treated with acupuncture. Based on the wrist-ankle acupuncture (WAA) theory, we designed a portable WAA point compression treatment strap that treats diseases by automatically applying pressure to acupuncture points. The proposed study aims to evaluate the immediate analgesic effect of the acupressure wrist-ankle strap in patients with primary dysmenorrhea. METHODS The study will be a randomized controlled trial conducted from May 1, 2019 to May 30, 2020 that includes 78 students from Shanghai University of Traditional Chinese Medicine who have primary dysmenorrhea and meet the eligibility criteria. Participants will be randomly divided into 2 groups in a 1:1 allocation ratio. The intervention group will use the acupressure wrist-ankle strap equipped with tip compression component parts on the internal side; the control group will use the nonacupressure wrist-ankle strap with the tip compression parts removed. All participants will be treated for 30 minutes on the 1st day of menstruation. The primary outcome is the pain intensity score measured by the visual analog scale. The secondary outcomes are the onset time of analgesia, the pain threshold at Yinlingquan (SP 9), skin temperature at Guanyuan (CV 4), and expectations and satisfaction of patients as investigated via the expectation and treatment credibility scale. DISCUSSION This trial will be the 1st study to evaluate the analgesic effect of the acupressure wrist-ankle strap in patients with primary dysmenorrhea. The quality of this study is ensured by the randomization, nonacupressure control, and blinded design. The results may provide evidence for a potential alternative treatment for primary dysmenorrhea and evidence-based proof of the analgesic effect of WAA.
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Affiliation(s)
- Shu-jie Zhai
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine
- School of Traditional Chinese Medicine, Naval Medical University, Shanghai, China
| | - Yi Ruan
- School of Traditional Chinese Medicine, Naval Medical University, Shanghai, China
| | - Yue Liu
- School of Traditional Chinese Medicine, Naval Medical University, Shanghai, China
| | - Zhen Lin
- Department of Health Statistics, Naval Medical University
| | - Chen Xia
- School of Traditional Chinese Medicine, Naval Medical University, Shanghai, China
| | - Fan-fu Fang
- Department of Rehabilitation Medicine, Changhai Hospital, Shanghai, China
| | - Qing-hui Zhou
- School of Traditional Chinese Medicine, Naval Medical University, Shanghai, China
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Zhong YM, Luo XC, Chen Y, Lai DL, Lu WT, Shang YN, Zhang LL, Zhou HY. Acupuncture versus sham acupuncture for simple obesity: a systematic review and meta-analysis. Postgrad Med J 2020; 96:221-227. [PMID: 32015189 PMCID: PMC7146934 DOI: 10.1136/postgradmedj-2019-137221] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 12/08/2019] [Accepted: 12/20/2019] [Indexed: 12/13/2022]
Abstract
Obesity is a growing chronic health problem worldwide. Studies about acupuncture for obesity treatment are many. But there are some doubts about the effectiveness of acupuncture versus sham acupuncture in treating obesity due to its lack of medical evidence. Therefore, the aim of this study is to assess the efficacy of acupuncture for obesity treatment and provide clinic evidence. Four English databases (PubMed, EMBASE, Web of Science and Cochrane Central Register of Controlled Trials) and four Chinese databases (China National Knowledge Infrastructure, Chinese BioMedical Database, Chinese Scientific Journal Database and Wan-Fang Data) were searched from their receptions to August 2019. Randomized controlled trials (RCTs) using the comparison between acupuncture and sham acupuncture to treat simple obesity were included. The primary outcome of body mass index (BMI) would be used to measure the effect of acupuncture on obesity. According to the trial data extraction form based on the Cochrane Handbook, two reviewers separately extracted the data. Risk of bias of the RCTs was assessed by the Cochrane Risk of Bias Tool. The study included 8 RCTs with 403 patients. When compared with sham acupuncture, acupuncture showed obviously effect in BMI reduction (MD=1.0kg/m2, 95% CI=0.6 to 1.4, P<0.001). There was also significant reduction in body weight (MD=1.85kg, 95%CI=0.82 to 2.88, p<0.001), WC (MD=0.97cm, 95%CI=0.24 to 1.71, p=0.01) and body fat mass percentage (MD=1.01, 95%CI=0.25 to 1.77, p<0.05). However, WHR (MD=0.01, 95%CI=0 to 0.03, p>0.05) was not statistically and significantly different between the acupuncture and control groups. Adverse effects were reported in 3 studies. The review suggests that acupuncture is an effective therapy for simple obesity rather than a placebo effect. This potential benefit needs to be further evaluated by longer-term and more rigorous RCTs.
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Affiliation(s)
- Yu-Mei Zhong
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiao-Chao Luo
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yang Chen
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - De-Li Lai
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,The Affiliated Hospital, School of Medicine, UESTC, Chengdu Women's and Children's Central Hospital, Chengdu, China
| | - Wen-Ting Lu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ya-Nan Shang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Lin-Lin Zhang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Hai-Yan Zhou
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Wu X, Gan L, Zhang Y, Chen B, Luo J, Yan J, Chen G. Moxibustion for primary dysmenorrhea: Protocol for a systematic review of randomized controlled trials. Medicine (Baltimore) 2020; 99:e18547. [PMID: 31895793 PMCID: PMC6946293 DOI: 10.1097/md.0000000000018547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Primary dysmenorrhea (PD) is one of the most common gynecological complaint among menstruating females. Acupuncture has been employed to relieve the pain-based symptoms and to avoid the side effects of conventional medication, especially, moxibustion has confirmed as an effective, convenient, and safe treatment for various types of menstrual pain. The purpose of this study is to systematically assess the effect and safety of moxibustion for treating PD. METHODS AND ANALYSIS The following databases will be searched from their inception to December 2019: PubMed, Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, Wan-Fang Databases, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Citation Information by National Institute of Informatics, Chinese Scientific Journal Database. Two reviewers will search these databases, select data and evaluate the quality of studies separately. The methodological quality will be measured by the Cochrane risk of bias tool. The primary outcome is the pain degree evaluation including visual analog scale, numerical visual scale, verbal rating scale, Cox retrospective symptom scale, or any other scale used to evaluate the level of pain. And the response rate involved overall reduction in symptoms. The adverse effects, quality of life will be assessed as secondary outcomes. Risk ratio for dichotomous data and mean differences with a 95% confidence interval for continuous data will be adopted to express the effect and safety of moxibustion for PD. TRIAL REGISTRATION NUMBER PROSPERO CRD42019130141.
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Paley CA, Johnson MI. Acupuncture for the Relief of Chronic Pain: A Synthesis of Systematic Reviews. MEDICINA (KAUNAS, LITHUANIA) 2019; 56:E6. [PMID: 31878346 PMCID: PMC7023333 DOI: 10.3390/medicina56010006] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 11/23/2019] [Accepted: 12/06/2019] [Indexed: 02/06/2023]
Abstract
Background and Objectives: It is estimated that 28 million people in the UK live with chronic pain. A biopsychosocial approach to chronic pain is recommended which combines pharmacological interventions with behavioural and non-pharmacological treatments. Acupuncture represents one of a number of non-pharmacological interventions for pain. In the current climate of difficult commissioning decisions and constantly changing national guidance, the quest for strong supporting evidence has never been more important. Although hundreds of systematic reviews (SRs) and meta-analyses have been conducted, most have been inconclusive, and this has created uncertainty in clinical policy and practice. There is a need to bring all the evidence together for different pain conditions. The aim of this review is to synthesise SRs of RCTs evaluating the clinical efficacy of acupuncture to alleviate chronic pain and to consider the quality and adequacy of the evidence, including RCT design. Materials and Methods: Electronic databases were searched for English language SRs and meta-analyses on acupuncture for chronic pain. The SRs were scrutinised for methodology, risk of bias and judgement of efficacy. Results: A total of 177 reviews of acupuncture from 1989 to 2019 met our eligibility criteria. The majority of SRs found that RCTs of acupuncture had methodological shortcomings, including inadequate statistical power with a high risk of bias. Heterogeneity between RCTs was such that meta-analysis was often inappropriate. Conclusions: The large quantity of RCTs on acupuncture for chronic pain contained within systematic reviews provide evidence that is conflicting and inconclusive, due in part to recurring methodological shortcomings of RCTs. We suggest that an enriched enrolment with randomised withdrawal design may overcome some of these methodological shortcomings. It is essential that the quality of evidence is improved so that healthcare providers and commissioners can make informed choices on the interventions which can legitimately be provided to patients living with chronic pain.
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Affiliation(s)
- Carole A. Paley
- Research and Development Dept, Airedale National Health Service (NHS) Foundation Trust, Skipton Road, Steeton, Keighley BD20 6TD, UK
- Centre for Pain Research, School of Clinical and Applied Sciences, Leeds Beckett University, City Campus, Leeds LS1 3HE, UK;
| | - Mark I. Johnson
- Centre for Pain Research, School of Clinical and Applied Sciences, Leeds Beckett University, City Campus, Leeds LS1 3HE, UK;
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Wang H, Cao Y, Jin X, Yan M, Wang J, Li R, Ji L. Effect of an Acupuncture Technique of Penetrating through Zhibian (BL54) to Shuidao (ST28) with Long Needle for Pain Relief in Patients with Primary Dysmenorrhea: A Randomized Controlled Trial. Pain Res Manag 2019; 2019:7978180. [PMID: 31929849 PMCID: PMC6935824 DOI: 10.1155/2019/7978180] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 11/16/2019] [Indexed: 12/13/2022]
Abstract
Background Primary dysmenorrhea (PD) is the commonest gynecological disorder in young women of reproductive age, and there is not always satisfactory relief of pain treated by common medications. Therefore, acupuncture has been used as an alternative therapy to relieve the symptoms of PD. In clinical practice, a penetrating method of acupuncture with long needle has been shown to be particularly effective for improving primary dysmenorrhea. This study was conducted to evaluate the effectiveness of this technique for pain relief in patients with primary dysmenorrhea as compared with a conventional pain medication. Methods The present study is a perspective, randomized, ibuprofen-controlled trial. Sixty-two eligible participants were randomly assigned in a 1 : 1 ratio to receive either acupuncture treatment or ibuprofen administration. The treatment lasted for three menstrual cycles for both groups. The primary outcome was the intensity of menstrual pain measured by using the visual analogue scale at the completion of treatment. Secondary outcomes included the severity of symptoms associated with menstrual pain, responder rate, and safety of acupuncture treatment. The clinical outcomes were measured on each menstrual cycle at baseline, treatment course (3 cycles), and follow-up period. Results Sixty-four patients of primary dysmenorrhea were recruited, and 62 subjects were included in the final analysis. At trial completion, acupuncture was shown to be associated with a significantly lower pain intensity and decreased symptom severity of primary dysmenorrhea as compared with ibuprofen (p < 0.05). A significantly higher responder rate was found in the acupuncture group as compared with the control group (p < 0.05). No serious adverse events were reported by patients in either group. Conclusions The penetrating method of acupuncture with long needle may be an effective and safe therapy for pain relief in patients with primary dysmenorrhea. This trial was registered with the Chinese Clinical Trial Registry (ChiCTR-IOR-17012621).
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Affiliation(s)
- Haijun Wang
- Shanxi University of Traditional Chinese Medicine, Jinzhong, Shanxi, China
| | - Yuxia Cao
- The Third Teaching Hospital of Shanxi University of Traditional Chinese Medicine, Taiyuan, Shanxi, China
| | - Xiaofei Jin
- Shanxi University of Traditional Chinese Medicine, Jinzhong, Shanxi, China
| | - Min Yan
- Shanxi University of Traditional Chinese Medicine, Jinzhong, Shanxi, China
| | - Jianchao Wang
- The Third Teaching Hospital of Shanxi University of Traditional Chinese Medicine, Taiyuan, Shanxi, China
| | - Rangqian Li
- The Third Teaching Hospital of Shanxi University of Traditional Chinese Medicine, Taiyuan, Shanxi, China
| | - Laixi Ji
- Shanxi University of Traditional Chinese Medicine, Jinzhong, Shanxi, China
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Zhong YM, Lai DL, Chen Y, Luo XC, Lu WT, Shang YN, Zhang LL, Zhou HY. Acupuncture vs sham acupuncture for simple obesity: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2019; 98:e17562. [PMID: 31626121 PMCID: PMC6824781 DOI: 10.1097/md.0000000000017562] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 09/19/2019] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Obesity is a growing chronic health problem worldwide. Studies about acupuncture for obesity treatment are many. But there are some doubts about the effectiveness of acupuncture vs sham acupuncture in treating obesity due to its lack of an evidence-based medical proof. Therefore, the aim of this study is to assess the efficacy of acupuncture for obesity treatment and provide clinic evidence. METHODS This protocol was based on the previous reporting items for systematic review and meta-analysis agreements. Four English databases (PubMed, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials) and 4 Chinese databases (China National Knowledge Infrastructure, Chinese BioMedical Database, Chinese Scientific Journal Database, Wan-Fang Data) will be searched from their receptions to August 2019. Randomized controlled trials (RCTs) using acupuncture compared sham acupuncture (or no treatment) to treat simple obesity will be included. The primary outcome of body mass index (BMI) and body weight (BW) will be used to measure the effect of acupuncture on obesity. According to the trial data extraction form based on the Cochrane Handbook, 2 reviewers will separately extract the data. Risk of bias of the RCTs will be assessed by the Cochrane Risk of Bias Tool. Publication bias will be assessed with funnel plots. RESULTS This study will be to evaluate whether acupuncture is an effective intervention for simple obesity when compared with sham acupuncture. CONCLUSION The conclusion of this study will help clinicians provide effective treatment options for obese patients. ETHICS AND DISSEMINATION Ethical approval is not required for systematic review and meta- analysis. The results of this review will be disseminated in a peer-review journal. PROSPERO REGISTRATION NUMBER PROSPERO CRD42019129825.
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Affiliation(s)
- Yu-Mei Zhong
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
| | - De-Li Lai
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
- The Affiliated Hospital, School of Medicine, UESTC, Chengdu Women's and Children's Central Hospital, Chengdu, China
| | - Yang Chen
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
| | - Xiao-Chao Luo
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
| | - Wen-Ting Lu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
| | - Ya-Nan Shang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
| | - Lin-Lin Zhang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
| | - Hai-Yan Zhou
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
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Xu L, Xie T, Shen T, Zhang T. Effect of Chinese herbal medicine on primary dysmenorrhea: A protocol for a systematic review and meta-analysis. Medicine (Baltimore) 2019; 98:e17191. [PMID: 31567963 PMCID: PMC6756727 DOI: 10.1097/md.0000000000017191] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 08/22/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Primary dysmenorrhea (PD), the most common gynecological diseases, seriously affects women's life and work; however, without more effective treatment. Chinese herbal medicine (CHM) has been widely used for relieving dysmenorrheic pain in patients with PD. To assess the effectiveness and safety of CHM in patients with PD, a systematic review and meta-analysis of current published evidence regarding CHM as treatment for PD would be conducted in this study. METHODS Literatures related to CHM for PD from the establishment of the database to June 2019 will be retrieved from the following databases: MEDLINE, EMBACE, Wed of Science and Cochrane Central Register of Controlled Trials, Chinese Biomedical Literature Database, Chinese National Knowledge Infrastructure, and Wanfang Database. There are no language restrictions for retrieving literature. Eligible randomized clinical trials (RCTs) evaluating the effectiveness and safety of CHM in PD patients will be put in the study including outcomes of pain intensity, clinical effectiveness rate, quality of life, and adverse events. By scanning the titles, abstracts and full texts, 2 reviewers will independently select studies, extract data, and assess the quality of study. Meta-analysis of RCTs will be conducted using Review Manager 5.1 software. The results will be presented as risk ratio for dichotomous data, and standardized or weighted mean difference for continuous data. RESULT This study will provide high-quality available evidence for the treatment of PD with CHM based on pain, clinical efficacy, quality of life, and adverse events. CONCLUSION The systematic review willto evaluate the efficacy of CHM in treating PD and provide evidence for clinicians. PROSPERO REGISTRATION NUMBER CRD42019121185.
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Affiliation(s)
- Lu Xu
- School of Basic Medical Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan
| | - Tian Xie
- Shenzhen Hospital of Guangzhou University of Chinese Medicine, Shenzhen, Guangdong, China
| | - Tao Shen
- School of Basic Medical Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan
| | - Tianfeng Zhang
- Shenzhen Hospital of Guangzhou University of Chinese Medicine, Shenzhen, Guangdong, China
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Influence of the Intensity, Components, and Spreading of the Deqi Sensation on the Analgesic Effect of SP6 Needling in Primary Dysmenorrhea Patients: A Secondary Analysis of a Randomised Controlled Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 2019:6462576. [PMID: 31223331 PMCID: PMC6541943 DOI: 10.1155/2019/6462576] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 03/18/2019] [Accepted: 04/11/2019] [Indexed: 12/15/2022]
Abstract
Although deqi, the phenomenon whereby excitation of Qi in the meridians occurs with needling, is critical to the practice of acupuncture and its efficacy, it is poorly understood. So we investigate the influence of the deqi sensation on the analgesic effects of acupuncture in patients who were enrolled in a randomised controlled trial for the treatment of patients with primary dysmenorrhea, a painful and common condition, and cold and dampness stagnation. Two groups were assessed: a deqi group (undergoing deep needling with thick needles and manipulation, n=17) and a non-deqi group (undergoing shallow needling with thin needles and no manipulation, n=51). The Sanyinjiao (SP6) was needled for 30 min in both groups. Pain scores at baseline, upon needle removal, and at 10, 20, and 30 min after needle removal were evaluated by the Visual Analogue Scale for pain. The deqi sensation was evaluated by the Acupuncture Deqi Clinical Assessment Scale. Patients who experienced a genuine deqi sensation (n=39) were selected for further analysis. Compared with patients in the non-deqi group who experienced deqi (n=25), patients who self-reported deqi in the deqi group (n=14) felt a stronger deqi sensation, experienced soreness and fullness more frequently, felt a greater intensity of soreness, fullness, electric sensation, spreading, and radiating, and experienced larger spreading distances. In those who experienced the deqi sensation in the deqi group, the intensity of the sensation, as well as their degree of soreness and fullness, was negatively correlated with pain reduction. In patients who experienced the deqi sensation in the non-deqi group, deqi intensity was positively correlated with pain reduction, while soreness was negatively correlated with pain reduction. The distance of spreading was not correlated with pain reduction in either group. We found, in SP6 needling of patients with primary dysmenorrhea with cold and dampness stagnation, that a moderate deqi response predicted a prolonged analgesic effect better than a strong deqi response.
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