Intervention Review

Acupuncture for dysmenorrhoea

  1. Caroline A Smith1,*,
  2. Xiaoshu Zhu2,
  3. Lin He3,
  4. Jing Song4

Editorial Group: Cochrane Menstrual Disorders and Subfertility Group

Published Online: 19 JAN 2011

Assessed as up-to-date: 12 AUG 2010

DOI: 10.1002/14651858.CD007854.pub2

Database Title

Additional Information

How to Cite

Smith CA, Zhu X, He L, Song J. Acupuncture for dysmenorrhoea. Cochrane Database of Systematic Reviews 2011, Issue 1. Art. No.: CD007854. DOI: 10.1002/14651858.CD007854.pub2.

Author Information

  1. 1

    University of Western Sydney, Centre for Complementary Medicine Research, Penrith South DC, New South Wales, Australia

  2. 2

    School of Biomedical and Health Science, University of Western Sydney, Center for Complementary Medicine Research, Sydney, New South Wales, Australia

  3. 3

    West China Hospital, Sichuan University, Books & Information Centre, Chengdu, Sichuan, China

  4. 4

    Campbelltown and Camden Hospitals, Obstetrician and Gynaecologist, Campbelltown, NSW, Australia

*Caroline A Smith, Centre for Complementary Medicine Research, University of Western Sydney, Locked Bag 1797, Penrith South DC, New South Wales, 2751, Australia. caroline.smith@uws.edu.au.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 19 JAN 2011

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. Resumen

Background

This review examined the currently available evidence supporting the use of acupuncture to treat primary dysmenorrhoea.

Objectives

To determine the efficacy and safety of acupuncture in the treatment of primary dysmenorrhoea when compared with a placebo, no treatment, or conventional medical treatment (for example oral contraceptives and non-steroidal anti-inflammatory medication (NSAIDs)).

Search methods

The following databases were searched (from inception until March 2010): the Cochrane Menstrual Disorders and Subfertillity Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), PubMed, CINAHL, PsycINFO, Chinese Biomedical Literature Database (CBM), Chinese Medical Current Content (CMCC), China National Knowledge Infrastructure (CNKI), VIP database, Dissertation Abstracts International, BIOSIS, AMED (The Allied and Complementary Medicine Database), Acubriefs, and Acubase.

Selection criteria

Inclusion criteria included all published and unpublished randomised controlled trials comparing acupuncture with placebo control, usual care, and pharmacological treatment. The following modes of treatment were included: acupuncture, electro-acupuncture, and acupressure. Participants were women of reproductive age with primary dysmenorrhoea during the majority of the menstrual cycles or for three consecutive menstrual cycles, and moderate to severe symptoms.

Data collection and analysis

Meta-analyses were performed using odds ratios (OR) for dichotomous outcomes and mean differences or standard mean differences (SMD) for continuous outcomes, with 95% confidence intervals (CI). Primary outcomes were pain relief and improved menstrual symptoms, measured by self-rating scales. Other outcomes included use of analgesics, quality of life, and absence from school or work.

Main results

Ten trials were included in the review with data reporting on 944 participants. Six trials reported on acupuncture (n = 673) and four trials (n = 271) reported on acupressure. There was an improvement in pain relief from acupuncture compared with a placebo control (OR 9.5, 95% CI 21.17 to 51.8), NSAIDs (SMD -0.70, 95% CI -1.08 to -0.32) and Chinese herbs (SMD -1.34, 95% CI -1.74 to -0.95). One trial found a reduction in pain intensity compared with usual care (MD -2.09, 95% CI -2.99, -1.19). In two trials acupuncture reduced menstrual symptoms (for example nausea, back pain) compared with medication (OR 3.25, 95% CI 1.53 to 6.86); in one trial acupuncture reduced menstrual symptoms compared with Chinese herbs (OR 7.0, 95% CI 2.22, 22.06); and in one trial acupuncture improved quality of life compared with usual care.

There was an improvement in pain relief from acupressure compared with a placebo control (SMD -0.99, 95% CI -1.48 to -0.49), and in one trial acupressure reduced menstrual symptoms compared with a placebo control (SMD -0.58, 95% CI -1.06 to -0.10). The risk of bias was low in 50% of trials.

Authors' conclusions

Acupuncture may reduce period pain, however there is a need for further well-designed randomised controlled trials.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. Resumen

Acupuncture for period pain

Dysmenorrhoea, known as period pain, is commonly experienced by younger women. Symptoms may include cramping pain in the lower abdomen that may radiate to the lower back or anterior thigh, nausea, vomiting, diarrhoea, headache, fatigue, anxiety, and dizziness. The review found some evidence for the use of acupuncture in managing period pain. However, these findings should be interpreted with caution due to the small number of studies and study participants. No significant adverse effects were identified in this review.

 

Resumen

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. Resumen

Antecedentes

Acupuntura para la dismenorrea primaria

Esta revisión examinó las pruebas actualmente disponibles que apoyan el uso de la acupuntura para el tratamiento de la dismenorrea primaria.

Objetivos

Determinar la eficacia y la seguridad de la acupuntura para el tratamiento de la dismenorrea primaria comparada con un placebo, ningún tratamiento, tratamientos médicos convencionales (por ejemplo, anticonceptivos orales y antiinflamatorios no esteroides [AINEs]).

Estrategia de búsqueda

Se hicieron búsquedas en las siguientes bases de datos (desde su inicio hasta marzo 2010): en el the Registro Especializado de Ensayos Controlados del Grupo Cochrane de Trastornos Menstruales y Subfertilidad (Cochrane Menstrual Disorders and Subfertillity Group), Registro Cochrane Central de Ensayos Controlados (Cochrane Central Register of Controlled Trials, CENTRAL) (Cochrane Library), PubMed, CINAHL, PsycINFO, Chinese Biomedical Literature Database (CBM), Chinese Medical Current Content (CMCC), China National Knowledge Infrastructure (CNKI), VIP database, Dissertation Abstracts International, BIOSIS, AMED (The Allied and Complementary Medicine Database), Acubriefs, y Acubase.

Criterios de selección

Los criterios de inclusión fueron todos los ensayos controlados con asignación aleatoria publicados y no publicados que compararan acupuntura con control de placebo, atención habitual y tratamiento farmacológico. Se incluyeron las siguientes modalidades de tratamiento: acupuntura, electroacupuntura y acupresión. Las participantes eran mujeres en edad fértil con dismenorrea primaria durante la mayoría de los ciclos menstruales o por tres ciclos menstruales consecutivos y síntomas moderados a severos.

Obtención y análisis de los datos

Se realizaron metanálisis con el uso de odds ratios (OR) para los resultados dicotómicos y diferencias de medias o diferencias de medias estandarizadas (DME) para los resultados continuos, con intervalos de confianza (IC) del 95%. Las medidas de resultado primarias fueron el alivio del dolor y la mejoría de los síntomas menstruales, medidos con escalas evaluadas por las pacientes. Otras medidas de resultado incluyeron el uso de analgésicos, la calidad de vida y el absentismo escolar o laboral.

Resultados principales

Se incluyeron diez ensayos en la revisión, con datos sobre 944 participantes. Seis ensayos informaron sobre acupuntura (n = 673) y cuatro (n = 271) informaron sobre acupresión. Hubo una mejoría en el alivio del dolor con la acupuntura comparada con un control de placebo (OR 9,5; IC del 95%: 21,17 a 51,8), AINEs (DME −0,70; IC del 95%: −1,08 a −0,32) y con hierbas chinas (DME −1,34; IC del 95%: −1,74 a −0,95). En dos ensayos la acupuntura redujo los síntomas menstruales (por ejemplo náuseas, dolor lumbar) en comparación con la medicación (OR 3,25; IC del 95%: 1,53 a 6,86); en un ensayo la acupuntura redujo los síntomas menstruales comparada con las hierbas chinas (OR 7,0; IC del 95%: 2,22; 22.06); y en otro, la acupuntura mejoró la calidad de vida en comparación con la atención habitual.

Hubo una mejoría en el alivio del dolor con la acupresión comparada con un control de placebo (DME −0,99; IC del 95%: −1,48 a −0,49), y en un ensayo la acupresión redujo los síntomas menstruales en comparación con un control de placebo (DME −0,58; IC del 95%: −1,06 a −0,10). El riesgo de sesgo era bajo en el 50% de los ensayos.

Conclusiones de los autores

La acupuntura puede reducir el dolor menstrual, pero se necesitan más ensayos controlados con asignación aleatoria bien diseñados.

Traducción

Traducción realizada por el Centro Cochrane Iberoamericano

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