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acupuncture:evaluation:gyneco-obstetrique:03. endometriose [25 Jul 2024 10:13] Nguyen Johan |
acupuncture:evaluation:gyneco-obstetrique:03. endometriose [15 Jun 2025 16:59] (Version actuelle) Nguyen Johan [2. Clinical Practice Guidelines] |
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| ==== Generic Acupuncture ==== | ==== Generic Acupuncture ==== | ||
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| + | === Chen 2024 === | ||
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| + | Chen C, Li X, Lu S, Yang J, Liu Y. Acupuncture for clinical improvement of endometriosis-related pain: a systematic review and meta-analysis. Arch Gynecol Obstet. 2024 Oct;310(4):2101-2114. https://doi.org/10.1007/s00404-024-07675-z | ||
| + | ^Backgound| Endometriosis is a common chronic gynecological condition characterized by the presence of endometrial tissue outside the uterine cavity, leading to chronic inflammation, pelvic nodules and masses, pelvic pain, and infertility. Acupuncture has been shown to improve pain associated with endometriosis by modulating abnormal levels of prostaglandins, β-endorphins, dynorphins, electrolytes, and substance P. This review aims to evaluate the clinical efficacy of acupuncture in treating endometriosis, specifically focusing on its efficacy in relieving pain associated with endometriosis.| | ||
| + | ^Methods| A comprehensive search was conducted in eight databases (PubMed, EMBASE, Cochrane, Web of Science, China National Knowledge Infrastructure (CNKI), the China Biology Medicine (CBM), Wanfang, and Weipu database) to identify randomized controlled trials (RCTs) published from database inception to December 16, 2022, which investigated the use of acupuncture for endometriosis-related pain. Two researchers independently screened articles, extracted data, and assessed methodological quality using the Cochrane Collaboration's risk of bias tool. Meta-analysis was performed using Stata statistical software.| | ||
| + | ^Results| A total of 1991 articles were identified, and ultimately, **14 studies involving 793 patients **(387 in the acupuncture group and 359 in the control group) were included. The control interventions in the included studies included placebo, traditional Chinese medicine (TCM), and Western medicine treatments. Meta-analysis results showed that compared to the control group, acupuncture treatment for pain associated with endometriosis demonstrated significant reductions in pain severity [SMD = - 1.10, 95% CI (- 1.45, - 0.75), P < 0.001], improved response rate [RR = 1.25, 95% CI (1.09, 1.44), P = 0.02], and decreased serum CA-125 levels [SMD = - 0.62, 95% CI (- 1.15, - 0.08), P = 0.024]. Furthermore, subgroup analysis revealed that electroacupuncture and auricular acupuncture were superior to the control group in reducing pain severity, while auricular acupuncture and warm needling showed greater clinical efficacy compared to the control group. However, there were no significant differences between electroacupuncture or fire needling and the control group in terms of pain relief. The findings suggest that acupuncture is effective in improving pain associated with endometriosis.| | ||
| + | ^Conclusions| In conclusion, acupuncture is effective in alleviating dysmenorrhea and pelvic pain associated with endometriosis, reducing serum CA-125 levels, decreasing the size of nodules, improving patients' quality of life, and lowering the recurrence rate. However, it should be noted that the current evidence is limited by the design and quality flaws of the original studies, as well as a lack of research specifically focusing on subtypes of acupuncture. Therefore, caution should be exercised when interpreting the results.| | ||
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| === Giese 2023 === | === Giese 2023 === | ||
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| | ⊕ positive recommendation (regardless of the level of evidence reported) \\ Ø negative recommendation (or lack of evidence) | | | ⊕ positive recommendation (regardless of the level of evidence reported) \\ Ø negative recommendation (or lack of evidence) | | ||
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| + | ==== Collège National des Gynécologues et Obstétriciens Français (CNGOF, France), Convergences PP 2025 ⊕ ==== | ||
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| + | Fritel X, Chabbert-Buffet N, Brillac T, Bailleul A, Acapo S, Bautrant E, Calvarin E, Canis M, Chalut-Natal C, Cornillet-Bernard M, Garcia E, Lacoste C, Ponomareva A, Sabaté JM, Saracco P, Suc A, Tyson S, Fauconnier A, Levesque A. Douleurs pelviennes associées à l’Endométriose, conseils pour la pratique clinique. Un consensus formalisé d’experts par le CNGOF & Convergences PP [Clinical Practice Guidelines for Pelvic Pain Associated with Endometriosis. A Consensus-Based Approach by CNGOF & Convergences PP]. Gynecol Obstet Fertil Senol. 2025 Jun 9:S2468-7189(25)00152-7. https://doi.org/10.1016/j.gofs.2025.06.003 | ||
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| + | | 21) L’acupuncture peut être proposée dans la prise en charge complémentaire des douleurs pelviennes chroniques associées à l’endométriose.| | ||
| + | ==== Korean Society of Endometriosis (Korea) 2024 ⊕ ==== | ||
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| + | Lee HJ, Yoon SH, Lee JH, Chung YJ, Park SY, Kim SW, Hong YH, Kim SE, Kim Y, Chun S, Na YJ. Clinical evaluation and management of endometriosis: 2024 guideline for Korean patients from the Korean Society of Endometriosis. Obstet Gynecol Sci. 2024 Dec 11. https://doi.org/10.5468/ogs.24242 | ||
| + | |Experts recommend that clinicians discuss non-medical strategies, such as **acupuncture**, physiotherapy, electrotherapy, psychological interventions, dietary interventions, and Chinese medicine, to address the quality of life and psychological well-being of women with endometriotic symptoms. However, clinicians should acknowledge that no recommendations can be made for any specific non-medical intervention to reduce pain or improve quality-of-life measures in women with endometriosis, since the potential benefits and harms are unclear (grade D) | | ||
| ==== European Society of Human Reproduction and Embryology (ESHRE) 2022 Ø ==== | ==== European Society of Human Reproduction and Embryology (ESHRE) 2022 Ø ==== | ||
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| ===== Randomized Controled Trials / Essais contrôlés randomisés ===== | ===== Randomized Controled Trials / Essais contrôlés randomisés ===== | ||
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| - **Acudoc2**: RCTs identified in the Acudoc2 database but not included in the cited SRs. | - **Acudoc2**: RCTs identified in the Acudoc2 database but not included in the cited SRs. | ||
| - | - **Navarro 2021**: Navarro-Santana MJ, Sanchez-Infante J, Gómez-Chiguano GF, Cummings M, Fernández-de-Las-Peñas C, Plaza-Manzano G. Effects of manual acupuncture and electroacupuncture for lateral | + | - **Giese 2023**: Giese N, Kwon KK, Armour M. Acupuncture for endometriosis: A systematic review and meta-analysis. Integr Med Res. 2023 Dec;12(4):101003. https://doi.org/10.1016/j.imr.2023.101003 |
| + | - **Wang 2023**: Wang Y, Coyle ME, Hong M, He S, Zhang AL, Guo X, Lu C, Xue CCL, Liang X. Acupuncture and moxibustion for endometriosis: A systematic review and analysis. Complement Ther Med. 2023 Sep;76:102963. https://doi.org/10.1016/j.ctim.2023.102963 | ||
| + | - **Mira 2018**/ Mira TAA, Buen MM, Borges MG, Yela DA, Benetti-Pinto CL. Systematic review and meta-analysis of complementary treatments for women with symptomatic endometriosis. Int J Gynaecol Obstet. 2018;143(1):2-9. | ||
| + | - **Xu 2017**: Xu Y, Zhao W, Li T, Zhao Y, Bu H, Song S. Effects of acupuncture for the treatment of endometriosis-related pain: A systematic review and meta-analysis. PLoS One. 2017;12(10):. [176386]. | ||
| + | - **Lund 2017**: Lund I, Lundeberg T. Is acupuncture effective in the treatment of pain in endometriosis? J Pain Res 2016 Mar 24;9:157-65.[186541]. | ||
| ==== List ==== | ==== List ==== | ||
| - | ^ ^ RCT ^ Sources ^ | + | ^ ^ RCT ^ comparator ^ Sources ^ |
| - | ^ 2020 | Gadau M, Zhang SP, Wang FC, et al. A multi-center international study of acupuncture for lateral elbow pain—Results of a randomized controlled trial. Eur J Pain. Epub ahead of print 17 April 2020. DOI:10.1002/ejp.1574. | Navarrro 2021 | | + | | | | | | |
| - | ^ 2019 | Bostrom K, Maehlum S, Cvancarova Smastuen M, et al. Clinical comparative effectiveness of acupuncture versus manual therapy treatment of lateral epicondylitis: feasibility randomized clinical trial. Pilot Feasib Stud 2019; 5: 110 | Navarro 2021 | | + | ^ 2023 | Li PS, Peng XM, Niu XX, Xu L, Hung Yu Ng E, Wang CC, Dai JF, Lu J, Liang RN. Efficacy of acupuncture for endometriosis-associated pain: a multicenter randomized single-blind placebo-controlled trial. Fertil Steril. 2023 May;119(5):815-823. https://doi.org/10.1016/j.fertnstert.2023.01.034 | Sham | Giese 2023 | |
| - | ^ 2018 | W. Yuanli. [Clinical observation of electroacupuncture in treatment of refractory external humeral epicondylitis]. AsiaPacific Traditional Medicine, vol. 14, no. 8, pp. 165-166, 2018 | Zhou 2020 | | + | ^ 2022 | Du J, Cong H. [Therapeutic mechanism of elongated fast needling in treating endometriosis based on intestinal microorganism]. J Clin Acupunct Moxibustion. 2022;38(01):32-36. | | Wang 2023 | |
| - | | | H. Hui, “Clinical observation on the treatment of external humeral epicondylitis by hysteresis acupuncture combined with acupuncture manipulation,” Journal of New Chinese Medicine, vol. 50, no. 11, pp. 196–198, 2018 | Zhou 2020 | | + | | | Li T, Wang SY, Huang ZQ, Cai QH, Zhang S, Wang S, Tian T. [CO2 laser moxibustion for endometriosis related pelvic pain of cold coagulation and blood stasis: a randomized controlled trial]. Zhongguo Zhen Jiu. 2022 Apr 12;42(4):397-401. | | Acudoc2 | |
| - | ^ 2017 | Jeon J, Bussin E and Scott A. Temporal divergence of changes in pain and pain-free grip strength after manual acupuncture or electroacupuncture: an experimental study in people with lateral epicondylalgia. Chin Med 2017; 12: 22 | Navarro 2021 | | + | ^ 2021 | Armour M, Cave AE, Schabrun SM, Steiner GZ, Zhu X, Song J, Abbott J, Smith CA. Manual Acupuncture Plus Usual Care Versus Usual Care Alone in the Treatment of Endometriosis-Related Chronic Pelvic Pain: A Randomized Controlled Feasibility Study. J Altern Complement Med. 2021 Oct;27(10):841-849. https://doi.org/10.1089/acm.2021.0004 | | Giese 2023, Wang 2023 | |
| - | | | Liao Leshan. [Ironing combined with acupuncture therapy for 30 cases of tennis elbow]. Journal of External Th erapy of TCM, vol. 26, no. 6, pp. 10-11, 2017 | Zhou 2020 | | + | | | Chen YB, Leng J, Lin BJ, Xu MH. [Thunder-fire moxibustion combined with mifepristone for ovarian chocolate cyst dysmenorrhea with kidney deficiency and blood stasis: a randomized controlled trial]. Zhongguo Zhen Jiu. 2021 Feb 12;41(2):161-4. Chinese. https://doi.org/10.13703/j.0255-2930.20191011-0002 | | Wang 2023 | |
| - | | | Ural FG, Ozturk GT, Boluk H, et al. Ultrasonographic evaluation of acupuncture effect on common extensor tendon thickness in patients with lateral epicondylitis: a randomized controlled study. J Altern Complement Med 2017; 23(10): 819–822. | Navarro 2021 | | + | ^ 2020 | Chen LF, Jin XF, Li BW, Zhan MJ, Hu HT. [Herb-separated moxibustion on dysmenorrhea in ovarian endometriosis: a randomized controlled trial]. Zhongguo Zhen Jiu. 2020 Jul 12;40(7):717-20. Chinese. https://doi.org/10.13703/j.0255-2930.20190716-k0003 | | Wang 2023 | |
| - | | | Wong Ng EY, Fung PW, Mok KM, et al. Comparison of treatment effects on lateral epicondylitis between acupuncture and extracorporeal shockwave therapy. Asia Pac J Sports Med Arthrosc Rehabil Technol 2017; 7: 21–26. | Navarro 2021 | + | | | Ni J. Clinical study on moxibustion and auricular point pressing with beans combined with routine therapy for dysmenorrhea due to endometriosis. N Chin Med. 2020;52(12):153-156. | | Wang 2023 | |
| + | ^ 2019 | Pan Q. Use of Warm Acupuncture in Control of Dysmenorrhea in Endometriosis. Guangzhou University of Chinese Medicine; 2019. | | Wang 2023 | | ||
| + | ^ 2017 | Zhang L. Clinical Observation of Acupuncture in the Treatment of Blood Stasis Type of Ovarian Chocolate Cyst. Heilongjiang University of Chinese Medicine; 2017. | | | | ||
| + | | | Zhang P, Liang X, Fan Y. Clinical observation of endometriosis treated with isolated herbal moxibustion based on the effect of tonifying yang on the Du meridian. Asia-Pac Tradit Med. 2017;13(05):121-123. | | Wang 2023 | | ||
| + | ^ 2016 | de Sousa TR, de Souza BC, Zomkowisk K, da Rosa PC, Sperandio FF. The effect of acupuncture on pain, dyspareunia, and quality of life in Brazilian women with endometriosis: a randomized clinical trial. Complement Ther Clin Pract. 2016;25:114-121. https://doi.org/10.1016/j.ctcp.2016.09.006 | Sham | Giese 2023, Wang 2023, Mira 2018 | | ||
| + | | | Tian LY, Cheng ZX, Cheng XM, Nie T. [Clinical observation of modified gexia zhuoyu decocion combined with Ren and Du meridian acupoint selection in treating endometriosis]. Clin J Trad Chin Med. 2016;(5): 670–672. | | Xu 2017 | | ||
| + | ^ 2015 | Gao CY. The clinical observation of dysmenorrhea treated by acupuncture and moxibustion combining with blood-letting puncture based on the theory of collateral disease. M Sc. Thesis, Heilongjiang University of Chinese Medicine. 2015: 16–26. | | Xu 2017 | | ||
| + | | | Zhang XX, Li W. [Efficacy on endometriosis treated with electroacupuncture]. Zhongguo Zhen Jiu. 2015; 35 (4): 323–326. | | Xu 2017 | | ||
| + | ^ 2014 | Chen GX. [Clinical study on the treatment of endometriosis dysmenorrhea with catgut implantation at acupoints]. Doctoral Dissertation, Guangzhou University of Chinese Medicine. 2014: 16–20. | | Xu 2017 | | ||
| + | | | Zhang XY, Zhang CY. [Efficacy observation on the combination of acupuncture and Chinese medication in prevention of the recurrence of endometriosis after laparoscopic surgery]. Zhongguo Zhen Jiu. 2014 Feb;34(2):139-44. | | Wang 2023 | | ||
| + | ^ 2013 | Wu JX, Qian XP, Long YF, Chen F. [The clinical observation of acupuncture combining with Shugan Xiaozheng Decocionin treating endometriosis dysmenorrhea]. J Emerg Tradit Chin Med. 2013; (11):1947–1948. | | Xu 2017 | | ||
| + | ^ 2012 | Chen L, Lin Y, Yuan L, Huang H. Abdominal acupuncture in treating 70 cases of endometriosis dysmenorrhea. Int J Clin Acupunct. 2012;21:100-102. | | Wang 2023 | | ||
| + | ^ 2011 | Xiang DF, Sun QZ, Liang XF. [Effect of abdominal acupuncture on pain of pelvic cavity in patients with endometriosis]. Zhongguo Zhen Jiu. 2011; 31 (2): 113–116. | | Xu 2017 | | ||
| + | ^ 2010 | Chen M, Zhang H, Li J, Dong GR. [Clinical observation on acupuncture combined with acupoint sticking therapy for treatment of dysmenorrhea caused by endometriosis]. Zhongguo Zhen Jiu. 2010; 30 (9):725–728 | | Xu 2017 | | ||
| + | | | Rubi-Klein K, Kucera-Sliutz E, Nissel H, Bijak M, Stockenhuber D, Fink M, Wolkenstein E. Is acupuncture in addition to conventional medicine effective as pain treatment for endometriosis? A randomised controlled cross-over trial. Eur J Obstet Gynecol Reprod Biol. 2010 Nov;153(1):90-3. https://doi.org/10.1016/j.ejogrb.2010.06.023 | Sham | Giese 2023, Wang 2023, Mira 2018, Lund 2016 | | ||
| + | ^ 2009 | Yuan H. Clinical Studies on Using Moxibustion as A Complementary Therapy in Moderate to Severe Endometriosis after Conservative Surgery. Guangzhou University of Chinese Medicine; 2009. | | Wang 2023 | | ||
| + | ^ 2008 | Wayne PM, Kerr CE, Schnyer RN, Legedza AT, Savetsky-German J, Shields MH, Buring JE, Davis RB, Conboy LA, Highfield E, Parton B, Thomas P, Laufer MR. Japanese-style acupuncture for endometriosis-related pelvic pain in adolescents and young women: results of a randomized sham-controlled trial. J Pediatr Adolesc Gynecol. 2008 Oct;21(5):247-57. https://doi.org/10.1016/j.jpag.2007.07.008 | | Giese 2023, Wang 2023, Mira 2018, Xu 2017, Lund 2016 | | ||
| + | ^ 2006 | Sun YZ, Chen HL. [Controlled study on Shu-Mu point combination for treatment of endometriosis]. Zhongguo Zhen Jiu. 2006 Dec;26(12):863-5 | | Wang 2023, Xu 2017 | | ||
| + | ^ 2002 | Xiang D, Situ Y, Liang X, Cheng L, Zhang G. Ear acupuncture therapy for 37 cases of dysmenorrhea due to endometriosis. J Tradit Chin Med. 2002 Dec;22(4):282-5. PMID: 16579094. | | Giese 2023 | | ||
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