Comparative efficacy and safety of NSAIDs-controlled acupuncture in the treatment of patients with primary dysmenorrhoea: a Bayesian network meta-analysis

J Int Med Res. 2019 Jan;47(1):19-30. doi: 10.1177/0300060518800609. Epub 2018 Nov 30.

Abstract

Background: Acupuncture and non-steroidal anti-inflammatory drugs (NSAIDs) are used frequently to treat primary dysmenorrhoea. However, it is unclear whether this treatment greatly reduces the risk of primary dysmenorrhoea.

Methods: Eight databases were searched up to January 2018. Pair-wise and network meta-analyses were conducted to synthesize data from eligible studies.

Results: Seventeen randomized controlled trials were included. The following acupuncture types showed more efficacy than NSAIDs in reducing primary dysmenorrhoea risk: traditional acupuncture (odds ratio [OR] = 6.70, 95% confidence interval [CI] 2.60-20.0), eye acupuncture (OR = 3.50, 95% CI 1.40-8.90), wrist-ankle acupuncture (OR = 6.00, 95% CI 1.30-32.0), superficial acupuncture (OR= 5.10, 95% CI 1.20-26.0), moxibustion (OR = 7.70, 95% CI 2.90-25.0), electroacupuncture (OR = 23.0, 95% CI 4.80-130), ear acupuncture (OR = 13.0, 95% CI 2.80-100) and abdominal acupuncture (OR = 5.30, 95% CI 2.10-16.0). Surface under the cumulative ranking curve values were traditional acupuncture (53.0%), eye acupuncture (22.0%), wrist-ankle acupuncture (81.5%), superficial acupuncture (50.0%), moxibustion (57.8%), electroacupuncture (99.9%), ear acupuncture (41.6%) and abdominal acupuncture (44.1%).

Conclusion: Acupuncture is more efficacious than NSAIDs in reducing primary dysmenorrhoea risk. Acupuncture, particularly electroacupuncture, can decrease the risk of primary dysmenorrhoea.

Keywords: Primary dysmenorrhoea; acupuncture; electroacupuncture; network meta-analysis; non-steroidal anti-inflammatory drugs; randomized controlled trial.

Publication types

  • Comparative Study

MeSH terms

  • Acupuncture Therapy / classification
  • Acupuncture Therapy / methods*
  • Adolescent
  • Adult
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Bayes Theorem
  • Databases, Factual
  • Dysmenorrhea / physiopathology
  • Dysmenorrhea / therapy*
  • Female
  • Humans
  • Network Meta-Analysis*
  • Patient Safety
  • Randomized Controlled Trials as Topic
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents, Non-Steroidal