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acupuncture:evaluation:gyneco-obstetrique:03. endometriose [25 Jul 2024 11:26] Nguyen Johan [Tableau] |
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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| ^ 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 | | ^ 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 | | ||
| ^ 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 | | ^ 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 | | ||
| + | | | 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 | | ||
| ^ 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 | | ^ 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 | | ||
| | | 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 | | | | 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 | | ||
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| ^ 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 | | ^ 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 | | ^ 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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