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acupuncture:evaluation:gyneco-obstetrique:10. nausees et vomissements gravidiques [28 Dec 2024 09:18] Nguyen Johan [Tableau] |
acupuncture:evaluation:gyneco-obstetrique:10. nausees et vomissements gravidiques [17 Oct 2025 13:45] (Version actuelle) Nguyen Johan [2. Clinical Practice Guidelines] |
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| ==== Special Acupuncture Techniques ==== | ==== Special Acupuncture Techniques ==== | ||
| + | === Comparison of Acupuncture techniques === | ||
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| + | == Liu 2025 == | ||
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| + | Liu H, Liao C, Deng J, Yang Y, Yang Y, Guo X, Liu C, Tang C. Efficacy of acupoint-related therapies for nausea and vomiting in pregnancy: a Bayesian network meta-analysis. Front Med (Lausanne). 2025 Sep 30;12:1589950. https://doi.org/10.3389/fmed.2025.1589950 | ||
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| + | ^Objective|Bayesian network meta-analysis was used to compare the efficacy of different acupoint-related treatments for Nausea and Vomiting of Pregnancy (NVP).| | ||
| + | ^Methods|PubMed, Embase, Cochrane Library, CNKI, Wan Fang, and VIP databases were systematically searched from the time of library construction to February 20, 2025, to include randomized controlled trials (RCTs) comparing acupoint-related treatments for the treatment of nausea and vomiting in pregnancy. Literature screening, data extraction and risk of bias assessment were performed independently by two investigators, Bayesian network Meta-analysis was performed by R4.4.1 software.| | ||
| + | ^Result|A total of **38 studies containing 1,164 patients** were included, this Bayesian network meta-analysis assessed the efficacy of various treatments for NVP across multiple outcomes. Results indicated that Acupoint Application (AA), Acupressure, Auriculotherapy Acupoint Application (ATAA), Ginger Moxibustion Acupoint Application (GMAA), and Moxibustion Acupoint Application (Mox_AA) were significantly more effective than Press Needle (PN) in improving PUQE scores. Thunder Fire Moxibustion (TFM) ranked highest in efficacy (89.1%), followed by GMAA (74.2%) and Acupressure (70.3%). Regarding overall efficacy, AA was less effective than AA_WA (OR = 0.22) and Acupuncture (OR = 0.44), but more effective than usual care (UT) (OR = 3.76), with AA_WA ranking highest (84.7%). In terms of NVP quality of life, TCM_acupuncture showed the greatest benefit (MD = 30.43), significantly outperforming AA (MD = -42.54), Mox_AA, and UT. Overall, TCM_acupuncture emerged as the most effective treatment for both symptom relief and quality of life improvement, followed by Mox_AA and ATAA, while UT was the least effective across all measures.| | ||
| + | ^Conclusion|Overall, the analyses showed that TFM may be the most effective in treating NVP, followed by GMAA and ear pressure therapy. Compared to PN, AA, auricular pressure therapy, ATAA and GMAA were more effective. AA was more effective than UT, but not as effective as AA_WA and acupuncture. In terms of quality-of-life improvement, TCM_acupuncture may be the most effective, followed by Mox_AA and ATAA, and UT was the least effective. Overall, acupuncture-based treatments, especially Thunder Fire Moxibustion and TCM acupuncture, performed better in the treatment of NVP.| | ||
| === Acupressure === | === Acupressure === | ||
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| ^Conclusion|Compared to single intravenous infusion, acupoint injection and acupoint injection plus intravenous infusion can produce a better clinical efficacy with less adverse reactions. | | ^Conclusion|Compared to single intravenous infusion, acupoint injection and acupoint injection plus intravenous infusion can produce a better clinical efficacy with less adverse reactions. | | ||
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| + | ===== Overviews of systematic reviews ===== | ||
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| + | ==== Choi 2025 ==== | ||
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| + | Choi SJ, Choi S, Kim DI. Acupuncture and Herbal Medicine for Nausea and Vomiting in Pregnancy: An Overview and Quality Assessment of Systematic Reviews. Int J Womens Health. 2025 May 11;17:1343-1361. https://doi.org/10.2147/IJWH.S512247 | ||
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| + | ^Backgound|Up to 85% of pregnant women experience nausea and vomiting in pregnancy (NVP), which can impact both the pregnant woman and developing fetus. Traditional East Asian Medicine (TEAM) including acupuncture and herbal medicine has been used to treat NVP; however, its effectiveness remains under debate. This study aimed to systematically review the existing evidence from systematic reviews on the effectiveness of TEAM for NVP and to critically evaluate the quality of these reviews.| | ||
| + | ^Methods|Nine databases were searched from their inception until January 2024. Search terms included, "Hyperemesis gravidarum", "Nausea", "Vomiting", "acupuncture" and "herbal medicine". Systematic reviews (SRs) that evaluated the effect of TEAM treatment for NVP were included. We evaluated methodological quality, reporting quality, and risk of bias using the AMSTAR-2, ROBIS tool, and PRISMA guidelines.| | ||
| + | ^Results|In total, 20,121 publications were retrieved from the databases. **Twenty-five SRs met the inclusion criteria**, indicating that acupuncture and related techniques, and herbal medicines are effective in alleviating NVP. Various methods including traditional acupuncture, acupressure, acupoint injection, electroacupuncture, herbal acupoint patching, and herbal decoctions were used. Herbs like ginger and additional aromatherapies such as lemon and cardamom have also shown beneficial effects. However, there are controversies regarding the consistency of results and the quality of methodologies. Despite low risk of bias across reviews, all were deemed low or critically low in methodological quality, with none fully adhering to PRISMA guidelines.| | ||
| + | ^Conclusion|This comprehensive review underscores the potential of TEAM in managing NVP but highlights significant gaps in research quality and reporting. Future studies of higher methodological quality are essential to validate these findings and guide clinical practice.| | ||
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| Systematic reviews and guidelines for a listing of randomized control trials included: | Systematic reviews and guidelines for a listing of randomized control trials included: | ||
| - **Acudoc2**: RCT included in the GERA Database and not cited in other sources. | - **Acudoc2**: RCT included in the GERA Database and not cited in other sources. | ||
| - | - **Hu 2024**:Hu Y, Yang Q, Hu X. The efficacy and safety of acupuncture and moxibustion for the management of nausea and vomiting in pregnant women: A systematic review and meta-analysis. Heliyon. 2024 Jan 11;10(2):e24439. https://doi.org/10.1016/j.heliyon.2024.e24439 | + | - **Hu 2024**:Hu Y, Yang Q, Hu X. The efficacy and safety of acupuncture and moxibustion for the management of nausea and vomiting in pregnant women: A systematic review and meta-analysis. Heliyon. 2024 Jan 11;10(2):e24439. https://doi.org/10.1016/j.heliyon.2024.e24439 (n=21) |
| - | - **Jin 2024**:Jin B, Han Y, Jiang Y, Zhang J, Shen W, Zhang Y. Acupuncture for nausea and vomiting during pregnancy: A systematic review and meta-analysis. Complement Ther Med. 2024 Oct;85:103079. https://doi.org/10.1016/j.ctim.2024.103079 | + | - **Jin 2024**:Jin B, Han Y, Jiang Y, Zhang J, Shen W, Zhang Y. Acupuncture for nausea and vomiting during pregnancy: A systematic review and meta-analysis. Complement Ther Med. 2024 Oct;85:103079. https://doi.org/10.1016/j.ctim.2024.103079 (n=24) |
| - | - **Tan 2023**: Tan MY, Shu SH, Liu RL, Zhao Q. The efficacy and safety of complementary and alternative medicine in the treatment of nausea and vomiting during pregnancy: A systematic review and meta-analysis. Front Public Health. 2023 Mar 9;11:1108756. https://doi.org/10.3389/fpubh.2023.1108756 | + | - **Tan 2023**: Tan MY, Shu SH, Liu RL, Zhao Q. The efficacy and safety of complementary and alternative medicine in the treatment of nausea and vomiting during pregnancy: A systematic review and meta-analysis. Front Public Health. 2023 Mar 9;11:1108756. https://doi.org/10.3389/fpubh.2023.1108756 (n=33) |
| + | - **Gong 2021**: Gong J, Gu D, Wang H, Zhang F, Shen W, Yan H, Xie J. Effect of acupressure in nausea and vomiting treatment during pregnancy: A meta-analysis. Explore (NY). 2024 Jan-Feb;20(1):17-26. https://doi.org/10.1016/j.explore.2023.06.015 | ||
| - **Lu 2021**: Lu H, Zheng C, Zhong Y, Cheng L, Zhou Y. Effectiveness of Acupuncture in the Treatment of Hyperemesis Gravidarum: A Systematic Review and Meta-Analysis. Evid Based Complement Alternat Med. 2021. [220826]. https://doi.org/10.1155/2021/2731446 | - **Lu 2021**: Lu H, Zheng C, Zhong Y, Cheng L, Zhou Y. Effectiveness of Acupuncture in the Treatment of Hyperemesis Gravidarum: A Systematic Review and Meta-Analysis. Evid Based Complement Alternat Med. 2021. [220826]. https://doi.org/10.1155/2021/2731446 | ||
| - **Matthews 2015**: Matthews A, Haas DM, O'Mathúna DP, Dowswell T. Interventions for nausea and vomiting in early pregnancy. Cochrane Database Syst Rev. 2015 Sep 8;2015(9):CD007575. https://doi.org/10.1002/14651858.cd007575.pub4 | - **Matthews 2015**: Matthews A, Haas DM, O'Mathúna DP, Dowswell T. Interventions for nausea and vomiting in early pregnancy. Cochrane Database Syst Rev. 2015 Sep 8;2015(9):CD007575. https://doi.org/10.1002/14651858.cd007575.pub4 | ||
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| ^ 2019 | Yang R. Analysis of the efficacy and safety of acupuncture in the auxiliary treatment of hyperemesis gravidarum. Health Horizon. 2019;7:92. | | | Lu 2021 | | ^ 2019 | Yang R. Analysis of the efficacy and safety of acupuncture in the auxiliary treatment of hyperemesis gravidarum. Health Horizon. 2019;7:92. | | | Lu 2021 | | ||
| ^ 2018 | Huang Shi-wei. [Therapeutic Observation of the Treatment of Hyperemesis Gravidarum Majorly with Intradermal Needle plus Acupressure]. Shanghai Journal of Acupuncture and Moxibustion. 2018;37(1):51-55. [100905]. | Acupuncture intradermique | | | | ^ 2018 | Huang Shi-wei. [Therapeutic Observation of the Treatment of Hyperemesis Gravidarum Majorly with Intradermal Needle plus Acupressure]. Shanghai Journal of Acupuncture and Moxibustion. 2018;37(1):51-55. [100905]. | Acupuncture intradermique | | | | ||
| + | | | Qiu Y 25 | Acupression 6MC + 5TR | | Gong 2021 | | ||
| | | Yu Xiao-Lei, Liu Jing, Mao Qun-Yan. [Therapeutic Observation of Acupoint injection at Different Groups of Acupoints for Hyperemesis Gravidarum]. Shanghai Journal of Acupuncture and Moxibustion. 2018;37(8):887. [189731]. | Injection au point d'acupuncture | | Acudoc2 | | | | Yu Xiao-Lei, Liu Jing, Mao Qun-Yan. [Therapeutic Observation of Acupoint injection at Different Groups of Acupoints for Hyperemesis Gravidarum]. Shanghai Journal of Acupuncture and Moxibustion. 2018;37(8):887. [189731]. | Injection au point d'acupuncture | | Acudoc2 | | ||
| | | Zhang Wan-Yu, Ding Ying, Jin Yong, Cal Shao-Ren. [Clinical Observation of Acupuncture at the Eight Confluent Points plus Acupoint Sticking for Hyperemesis Gravidarum]. Shanghai Journal of Acupuncture and Moxibustion. 2018;37(8):891. [189499]. | | | Lu 2021 | | | | Zhang Wan-Yu, Ding Ying, Jin Yong, Cal Shao-Ren. [Clinical Observation of Acupuncture at the Eight Confluent Points plus Acupoint Sticking for Hyperemesis Gravidarum]. Shanghai Journal of Acupuncture and Moxibustion. 2018;37(8):891. [189499]. | | | Lu 2021 | | ||
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| | | Shang G, Liu J, Qi B, Liu J, Li H. [Effect observation of modified sini san combined with acupuncture for pregnant vomiting patients with the pattern of liver-stomach disharmony]. Information on Traditional Chinese Medicine. 2017;34(4):113–115. | | | Hu 2024, | | | | Shang G, Liu J, Qi B, Liu J, Li H. [Effect observation of modified sini san combined with acupuncture for pregnant vomiting patients with the pattern of liver-stomach disharmony]. Information on Traditional Chinese Medicine. 2017;34(4):113–115. | | | Hu 2024, | | ||
| | | Zhong Q. Clinical observation of acupuncture and moxibustion in the treatment of hyperemesis gravidarum. Inner Mongolia Journal of Traditional Chinese Medicine. 2017;36(14):120–1. | | | Lu 2021 | | | | Zhong Q. Clinical observation of acupuncture and moxibustion in the treatment of hyperemesis gravidarum. Inner Mongolia Journal of Traditional Chinese Medicine. 2017;36(14):120–1. | | | Lu 2021 | | ||
| - | ^ 2015 | Xu Y, Huang WZ, Li QW, et al. Clinical observation of acupuncture combined with moxibustion in the treatment of hyperemesis gravidarum with spleen and stomach weakness syndrome type. Journal of Frontiers of Medicine. 2015;5(10):341–2. | | | Lu 2021 | | + | ^ 2015 | Chong Zeng | acupression 36E + 6MC | | Gong 2021 | |
| + | | | Jin Cao | acupression 12VC+6MC+4Rte | | Gong 2021 | | ||
| + | | | Shao G | acupression auriculaire | | Gong 2021 | | ||
| + | | | Xu Y, Huang WZ, Li QW, et al. Clinical observation of acupuncture combined with moxibustion in the treatment of hyperemesis gravidarum with spleen and stomach weakness syndrome type. Journal of Frontiers of Medicine. 2015;5(10):341–2. | | | Lu 2021 | | ||
| + | | | Xueying Wu | acupression 6MC +36E | | Gong 2021 | | ||
| + | | | Yazhen Zeng | acupression 20V +21V | | Gong 2021 | | ||
| + | | | Zhaoqian Zhu | acupression 36E + 6MC | | Gong 2021 | | ||
| ^ 2014 | Jin LH, Hu DX. Clinical observation on filiform needling combined with symptomatic and supportive therapy for 20 cases of intractable hyperemesis gravidarum. J Tradit Chin Med. 2014;55(11):939–941. https://doi.org/10.13288/j.11-2166/r.2014.11.011. | | | Hu 2024, Jin 2024, Lu 2021 | | ^ 2014 | Jin LH, Hu DX. Clinical observation on filiform needling combined with symptomatic and supportive therapy for 20 cases of intractable hyperemesis gravidarum. J Tradit Chin Med. 2014;55(11):939–941. https://doi.org/10.13288/j.11-2166/r.2014.11.011. | | | Hu 2024, Jin 2024, Lu 2021 | | ||
| | | Saberi F, Sadat Z, Abedzadeh-Kalahroudi M, Taebi M. Effect of ginger on relieving nausea and vomiting in pregnancy: a randomized, placebo-controlled trial. Nurs Midwifery Stud. 2014 Apr;3(1):e11841. doi: 10.17795/nmsjournal11841. Epub 2014 Apr 17. https://doi.org/10.17795/nmsjournal11841 | acupression 6MC | gingembre | Matthews 2015 | | | | Saberi F, Sadat Z, Abedzadeh-Kalahroudi M, Taebi M. Effect of ginger on relieving nausea and vomiting in pregnancy: a randomized, placebo-controlled trial. Nurs Midwifery Stud. 2014 Apr;3(1):e11841. doi: 10.17795/nmsjournal11841. Epub 2014 Apr 17. https://doi.org/10.17795/nmsjournal11841 | acupression 6MC | gingembre | Matthews 2015 | | ||
| - | ^ 2013 | Ma JZ, Meng LP. [Observations on the therapeutic effect of applying the method of matching acupoints to treat 30 cases of hyperemesis gravidarum]. J Sichuan Tradit Chin Med. 2013;31(11):134–135. | | | Hu 2024, Jin 2024, Lu 2021 | | + | ^ 2013 | Agham | acupression 6MC | sham | Gong 2021 | |
| + | | | Jin Ruifen | acupression 36E + 6MC | | Gong 2021 | | ||
| + | | | Ma JZ, Meng LP. [Observations on the therapeutic effect of applying the method of matching acupoints to treat 30 cases of hyperemesis gravidarum]. J Sichuan Tradit Chin Med. 2013;31(11):134–135. | | | Hu 2024, Jin 2024, Lu 2021 | | ||
| + | | | Sabeiri | | | Gong 2021 | | ||
| | | Xie H. [Therapeutic observation on acupuncture for hyperemesis gravidarum]. Shanghai Journal of Acupuncture and Moxibustion. 2013;32(9):734–735. | | | Hu 2024, Tang 2023 | | | | Xie H. [Therapeutic observation on acupuncture for hyperemesis gravidarum]. Shanghai Journal of Acupuncture and Moxibustion. 2013;32(9):734–735. | | | Hu 2024, Tang 2023 | | ||
| + | | | Ye Chunmei | Acupression shenmen auriculaire | | Gong 2021 | | ||
| | | Zhang X. [Therapeutic effect of acupuncture combined with psychological counseling in treating 31 cases of hyperemesis gravidarum]. Hunan J Tradit Chin Med. 2013;29(6):74–75. https://doi.org/10.16808/j.cnki.issn1003-7705.2013.06.040. | | | Jin 2024, Lu 2021 | | | | Zhang X. [Therapeutic effect of acupuncture combined with psychological counseling in treating 31 cases of hyperemesis gravidarum]. Hunan J Tradit Chin Med. 2013;29(6):74–75. https://doi.org/10.16808/j.cnki.issn1003-7705.2013.06.040. | | | Jin 2024, Lu 2021 | | ||
| ^ 2012 | Lu X. [The effect of citicoline combined with moxibustion in the treatment of hyperemesis gravidarum]. Zhejiang JITCWM. 2012;22(10):806–807. | | | Hu 2024, | | ^ 2012 | Lu X. [The effect of citicoline combined with moxibustion in the treatment of hyperemesis gravidarum]. Zhejiang JITCWM. 2012;22(10):806–807. | | | Hu 2024, | | ||
| - | | | Naeimi Rad M, Lamyian M, Heshmat R, Jaafarabadi MA, Yazdani S. A randomized clinical trial of the efficacy of KID21 point (Youmen) acupressure on nausea and vomiting of pregnancy. Iran Red Crescent Med J. 2012;14:697–701. | | | Tang 2023 | | + | | | Naeimi Rad M, Lamyian M, Heshmat R, Jaafarabadi MA, Yazdani S. A randomized clinical trial of the efficacy of KID21 point (Youmen) acupressure on nausea and vomiting of pregnancy. Iran Red Crescent Med J. 2012;14:697–701. | acupression 21Rn | sham | Tang 2023, Gong 2021 | |
| | | Yan L, Liu RR, Ji FS, et al. [Observations on the efficacy of acupuncture therapy in the treatment of hyperemesis gravidarum]. Mod J Integr Tradit Chin West Med. 2012;21(29):3246–3304. | | | Jin 2024, Lu 2021 | | | | Yan L, Liu RR, Ji FS, et al. [Observations on the efficacy of acupuncture therapy in the treatment of hyperemesis gravidarum]. Mod J Integr Tradit Chin West Med. 2012;21(29):3246–3304. | | | Jin 2024, Lu 2021 | | ||
| | | Zhou Y. [Gastric Tocolysis Soup Combined with Acupuncture Therapy Hyperemesis Gravidarum Incoordination between the Liver and Stomach Syndrome Clinical Observation] [Master’s Degree]. Hunan University of Chinese Medicine; 2012. | | | Hu 2024, | | | | Zhou Y. [Gastric Tocolysis Soup Combined with Acupuncture Therapy Hyperemesis Gravidarum Incoordination between the Liver and Stomach Syndrome Clinical Observation] [Master’s Degree]. Hunan University of Chinese Medicine; 2012. | | | Hu 2024, | | ||
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| ^ 2008 | Can Gürkan O, Arslan H. Effect of acupressure on nausea and vomiting during pregnancy. Complement Ther Clin Pract. 2008 Feb;14(1):46-52. https://doi.org/10.1016/j.ctcp.2007.07.002 | | | Acudoc2 | | ^ 2008 | Can Gürkan O, Arslan H. Effect of acupressure on nausea and vomiting during pregnancy. Complement Ther Clin Pract. 2008 Feb;14(1):46-52. https://doi.org/10.1016/j.ctcp.2007.07.002 | | | Acudoc2 | | ||
| | | Chen J, Ning WX. Transcutaneous electro acupuncture stimulation in treatment of 18 cases of hyperemesis gravidarum. Chin J Tradit Med Sci Technol. 2008;15:231–2. | | | Tang 2023 | | | | Chen J, Ning WX. Transcutaneous electro acupuncture stimulation in treatment of 18 cases of hyperemesis gravidarum. Chin J Tradit Med Sci Technol. 2008;15:231–2. | | | Tang 2023 | | ||
| - | | | Puangsricharern A, Mahasukhon S. Effectiveness of auricular acupressure in the treatment of nausea and vomiting in early pregnancy. J Med Assoc Thai. 2008;91(11):1633-8. https://thaiscience.info/Journals/Article/JMAT/10402675.pdf | acupression auriculaire | | Tang 2023 | | + | | | Puangsricharern A, Mahasukhon S. Effectiveness of auricular acupressure in the treatment of nausea and vomiting in early pregnancy. J Med Assoc Thai. 2008;91(11):1633-8. https://thaiscience.info/Journals/Article/JMAT/10402675.pdf | acupression auriculaire | | Tang 2023, Gong 2021 | |
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| - | ^ 1994 | Belluomini J, Litt RC, Lee KA, Katz M. Acupressure for nausea and vomiting of pregnancy: a randomized, blinded study. Obstet Gynecol. 1994 Aug;84(2):245-8. | acupression 6MC | sham | Matthews 2015 | | + | ^ 1994 | Belluomini J, Litt RC, Lee KA, Katz M. Acupressure for nausea and vomiting of pregnancy: a randomized, blinded study. Obstet Gynecol. 1994 Aug;84(2):245-8. | acupression 6MC | sham | Gong 2021, Matthews 2015 | |
| ^ 1989 | Hyde E. Acupressure therapy for morning sickness: a controlled clinical trial. J Nurse Midwifery. 1989;34:171–8. | acupression | placebo | Tang 2023 | | ^ 1989 | Hyde E. Acupressure therapy for morning sickness: a controlled clinical trial. J Nurse Midwifery. 1989;34:171–8. | acupression | placebo | Tang 2023 | | ||
| | | Root DT. P6 acupressure reduces morning sickness. J R Soc Med. 1989;82:635. | | placebo | Tang 2023 | | | | Root DT. P6 acupressure reduces morning sickness. J R Soc Med. 1989;82:635. | | placebo | Tang 2023 | | ||
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