Différences
Ci-dessous, les différences entre deux révisions de la page.
| Les deux révisions précédentes Révision précédente Prochaine révision | Révision précédente | ||
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acupuncture:evaluation:gyneco-obstetrique:10. douleurs pelviennes et lombalgies de la grossesse [27 Nov 2022 16:10] Nguyen Johan |
acupuncture:evaluation:gyneco-obstetrique:10. douleurs pelviennes et lombalgies de la grossesse [29 Aug 2025 17:05] (Version actuelle) Nguyen Johan [1.1.1. Li 2025] |
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| ====== Douleurs pelviennes et lombalgies de la grossesse : évaluation de l'acupuncture ====== | ====== Douleurs pelviennes et lombalgies de la grossesse : évaluation de l'acupuncture ====== | ||
| ===== Systematic Reviews and Meta-Analysis===== | ===== Systematic Reviews and Meta-Analysis===== | ||
| - | | ☆☆☆ | Evidence for effectiveness and a specific effect of acupuncture | | ||
| - | | ☆☆ | Evidence for effectiveness of acupuncture | | ||
| - | | ☆ | Limited evidence for effectiveness of acupuncture | | ||
| - | | Ø | No evidence or insufficient evidence | | ||
| ==== Generic acupuncture ==== | ==== Generic acupuncture ==== | ||
| - | === Yang 2022 ☆☆ === | + | === Li 2025 === |
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| + | Li M, Xiao Z, Tan D, Tang X, Zhao D, Chen Q. Acupuncture for the treatment of pregnancy-related low back pain: A systematic review and network meta-analysis. J Back Musculoskelet Rehabil. 2025 Jun 13:10538127241301682. https://doi.org/10.1177/10538127241301682 | ||
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| + | ^Background|The effects of acupuncture are rarely studied in pregnant women. A relevant systematic review did not include comparisons with sham acupuncture (SAcu).| | ||
| + | ^Objective|To explore the effects of acupuncture, SAcu, and standard care (SC) on pregnancy-related low back pain.| | ||
| + | ^Methods|We searched five medical literature databases for articles published from inception to September 30, 2022. The primary outcome was visual analog scale (VAS) intensity after the intervention. The secondary outcomes were the overall effects of treatment, quality of life (QOL), and QOL was evaluated by the Short Form-36 Health Survey Questionnaire (SF-36). | | ||
| + | ^Results| The network meta-analysis included **eight studies and 864 patients**. Six trials were at low risk of bias and two studies had a high risk of bias due to allocation concealment and blinding. Acupuncture and SAcu were relatively more advantageous in terms of analgesic effects after intervention than SC, but there were no differences between them. In terms of overall effects in number of remissions and the SF-36, Acupuncture was found to be superior to other methods, and SAcu was better than SC. Acupuncture had the highest surface under the cumulative ranking curve, followed by SAcu and SC for all outcomes.| | ||
| + | ^Conclusions|Acupuncture performs similarly to SAcu in pain relief and is more efficient than SC. Regarding the effectiveness of treatment and QOL, acupuncture therapy was superior to SAcu and SC.| | ||
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| + | === Wang 2025 === | ||
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| + | Wang S, Zhang H, Zhang G, Jin L. Effectiveness of nonpharmacologic interventions on pregnancy-related low back pain: A network meta-analysis of randomized controlled trials. Medicine (Baltimore). 2025 Aug 22;104(34):e43969. https://doi.org/10.1097/MD.0000000000043969 | ||
| + | ^Backgound| Pregnancy-related low back pain (PLBP) is a prevalent clinical condition occurring antenatally and postnatally. Given limited evidence on conservative management, this study systematically assessed the efficacy of non-pharmacological interventions for pain relief and physical function improvement in females with PLBP.| | ||
| + | ^Methods| The Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were followed. A systematic search was performed across 12 electronic databases from inception to March 30, 2024. Eligibility screening was performed according to predefined criteria, followed by the quality assessment utilizing the Cochrane Risk of Bias Tool. Data analysis was conducted using Stata 18.0. Network meta-analysis applied the node-cut method for the consistency test, and used the surface under the cumulative ranking curve to reflect the likelihood of each non-pharmacological intervention being the best intervention.| | ||
| + | ^Results| Thirty-six randomized controlled trials were examined (N = 4511 participants). The surface under the cumulative ranking curve identified music-relaxation as the highest-ranked therapy for pain reduction (97.1%), and **manipulation-acupuncture** as the highest-ranked therapy for physical function indicators (78.3%).| | ||
| + | ^Conclusion| Limited evidence indicated that music-relaxation therapy may be the most effective strategy for alleviating pain, while manipulation-acupuncture therapy may be optimal for enhancing physical function. Integrated non-pharmacological interventions demonstrated greater effectiveness compared to monotherapy in improving PLBP.| | ||
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| + | === Zhang 2024 === | ||
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| + | Zhang A, Li J, He T, Xie H, Mou X, Yeung TC, Chen S, Wang CC, Fan X, Li L. Efficacy and safety of acupuncture in treating low back and pelvic girdle pain during pregnancy: a systematic review and meta-analysis of randomized controlled trials. Acupunct Herb Med. 2024 Sep;4(3):346-357. https://doi.org/10.1097/HM9.0000000000000093.| | ||
| + | ^Objectives| Low back and pelvic girdle pain (LBPGP) is common during pregnancy. Acupuncture is an effective and safe therapy for pain relief. However, further evidence is required to confirm the efficacy and safety of acupuncture in treating LBPGP during pregnancy. This study aimed to systematically review and investigate the clinical efficacy and safety of acupuncture for the treatment of pregnancy-related LBPGP.| | ||
| + | ^Methods| The PubMed, EMBASE, Cochrane Library, CNKI, VIP, and WanFang databases were searched from January 2000 to August 2023. Only the randomized controlled trials (RCTs) involving pregnant women between 16 and 34 weeks of gestation diagnosed with LBPGP were included in the study. A meta-analysis was conducted and pooled risk ratios (RRs) or mean differences (MDs) with 95% confidence intervals (CIs) were compared.| | ||
| + | ^Results| Meta-analysis included **12 RCTs involving 1,641 participants**. Eleven trials compared acupuncture alone or acupuncture combined with standard care (SC), of which three trials also used non-penetrating or placebo acupuncture as the control group. One trial compared acupuncture alone with non-penetrating acupuncture. Compared with SC, acupuncture combined with SC group significantly decreased visual analog scale score (mean difference (MD) = −2.83, 95% CI = −3.41 to −2.26, P < 0.00001), cesarean section rate (RR = 0.69, 95% CI = 0.49–0.97, P = 0.03), preterm birth rate (RR = 0.42, 95% CI = 0.27–0.65, P < 0.0001), labor duration (MD = −1.97, 95% CI = −2.73 to −1.20, P < 0.0001), and Oswestry disability index score (MD = −9.14, 95% CI = −15.68 to −2.42, P = 0.008). In addition, acupuncture combined with SC significantly improved 12-Items Short Form Health Survey of physical component summaries (SF12-PCS). No significant differences were observed in the spontaneous delivery rate, newborn weight, drowsiness, and 12-Items Short Form Health Survey of mental component summaries (SF12-MCS) between the two groups. Adverse events such as needle pain and needle bleeding were aggravated in both the SC and acupuncture treatment groups but none were associated with acupuncture during or after the treatment period.| | ||
| + | ^Conclusions| Meta-analysis showed that acupuncture combined with SC had better efficacy than SC alone and could be a potential therapy for LBPGP during pregnancy. The safety results imply that acupuncture caused few adverse reactions; however, more evidence is required for further confirmation.| | ||
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| + | === Li 2023 === | ||
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| + | Li R, Chen L, Ren Y, Huang J, Xu Y, Lin X, Zhen R. Efficacy and safety of acupuncture for pregnancy-related low back pain: A systematic review and meta-analysis. Heliyon. 2023 Jul 25;9(8):e18439. https://doi.org/10.1016/j.heliyon.2023.e18439 | ||
| + | ^Background| Pregnancy-related low back pain (PLBP) is a common musculoskeletal disorder, affecting people's physical and psychological health. Acupuncture is widely used in clinical practice as a treatment for PLBP. This study aimed to evaluate the efficacy and safety of acupuncture or acupuncture combined with other treatments for PLBP patients.| | ||
| + | ^Methods| The Cochrane Library, PubMed, EMBASE, Web of Science, the Chinese Biological Medicine Database, China National Knowledge Infrastructure, WanFang Database, and VIP information database were searched from inception to January 31, 2022. Randomized controlled trials (RCTs) were eligible, without blinding and language restriction. Cochrane's risk of bias tool was used to assess the methodological quality. Meta-analysis was performed using RevMan 5.3.| | ||
| + | ^Results| **Twelve randomized controlled trials involving 1302 patients** were included. The results showed that compared to the control group, the VAS score was significantly decreased after acupuncture treatment. In addition, no significant difference was found in the preterm delivery rate (RR = 0.38, 95%CI: 0.24 to 0.61, P = 0.97) after acupuncture treatment. Compared with other therapies, acupuncture or acupuncture plus other therapies revealed a significant increase in the effective rate (OR: 6.92, 95%CI: 2.44 to 19.67, I2 = 0%). No serious adverse events owing to acupuncture were reported.| | ||
| + | ^Conclusion| Acupuncture or acupuncture combined with other interventions was a safe and effective therapy for treating PLBP. However, the methodological quality of the RCTs was low. More rigorous and well-designed trials should be conducted.| | ||
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| + | === Yang 2022 [retracted] === | ||
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| + | * <color #ed1c24>Retraction</color>: Acupuncture for low back and/or pelvic pain during pregnancy: a systematic review and meta-analysis of randomised controlled trials. BMJ Open. 2024 Jun 11;14(6):e056878ret. https://doi.org/10.1136/bmjopen-2021-056878ret | ||
| + | * Yang J, Wang Y, Xu J, Ou Z, Yue T, Mao Z, Lin Y, Wang T, Shen Z, Dong W. Acupuncture for low back and/or pelvic pain during pregnancy: a systematic review and meta-analysis of randomised controlled trials. BMJ Open. 2022 Nov 21;12(12):e056878. https://doi.org/10.1136/bmjopen-2021-056878. | ||
| - | Yang J, Wang Y, Xu J, Ou Z, Yue T, Mao Z, Lin Y, Wang T, Shen Z, Dong W. Acupuncture for low back and/or pelvic pain during pregnancy: a systematic review and meta-analysis of randomised controlled trials. BMJ Open. 2022 Nov 21;12(12):e056878. https://doi.org/10.1136/bmjopen-2021-056878. | ||
| ^Objective| Acupuncture is emerging as a potential therapy for relieving pain, but the effectiveness of acupuncture for relieving low back and/or pelvic pain (LBPP) during the pregnancy remains controversial. This meta-analysis aims to investigate the effects of acupuncture on pain, functional status and quality of life for women with LBPP pain during the pregnancy.| | ^Objective| Acupuncture is emerging as a potential therapy for relieving pain, but the effectiveness of acupuncture for relieving low back and/or pelvic pain (LBPP) during the pregnancy remains controversial. This meta-analysis aims to investigate the effects of acupuncture on pain, functional status and quality of life for women with LBPP pain during the pregnancy.| | ||
| ^Method| Design: Systematic review and meta-analysis. Data sources: The PubMed, EMBASE databases, Web of Science and Cochrane Library were searched for relevant randomised controlled trials (RCTs) from inception to 15 January 2022. Eligibility criteria for selecting studies: RCTs evaluating the effects of acupuncture on LBPP during the pregnancy were included. Data extraction and synthesis: The data extraction and study quality assessment were independently performed by three reviewers. The mean differences (MDs) with 95% CIs for pooled data were calculated. We assessed the confidence in the evidence using the Grading of Recommendations Assessment, Development and Evaluation framework. Main outcomes and measures: The primary outcomes were pain, functional status and quality of life. The secondary outcomes were overall effects (a questionnaire at a post-treatment visit within a week after the last treatment to determine the number of people who received good or excellent help), analgesic consumption, Apgar scores >7 at 5 min, adverse events, gestational age at birth, induction of labour and mode of birth.| | ^Method| Design: Systematic review and meta-analysis. Data sources: The PubMed, EMBASE databases, Web of Science and Cochrane Library were searched for relevant randomised controlled trials (RCTs) from inception to 15 January 2022. Eligibility criteria for selecting studies: RCTs evaluating the effects of acupuncture on LBPP during the pregnancy were included. Data extraction and synthesis: The data extraction and study quality assessment were independently performed by three reviewers. The mean differences (MDs) with 95% CIs for pooled data were calculated. We assessed the confidence in the evidence using the Grading of Recommendations Assessment, Development and Evaluation framework. Main outcomes and measures: The primary outcomes were pain, functional status and quality of life. The secondary outcomes were overall effects (a questionnaire at a post-treatment visit within a week after the last treatment to determine the number of people who received good or excellent help), analgesic consumption, Apgar scores >7 at 5 min, adverse events, gestational age at birth, induction of labour and mode of birth.| | ||
