Effects of moxibustion or acupoint therapy for the treatment of primary dysmenorrhea: a meta-analysis.

UNLABELLED: CONTEX: Primary dysmenorrhea (PD) is a common gynecological syndrome that is characterized by cramping in the lower abdomen during menstruation, particularly during puberty. Treatment for PD includes a variety of pharmacological, nonpharmacological, and surgical options. Although studies supporting use of traditional Chinese medicine (TCM) have helped in the proliferation of its comprehensive therapy, their results do not determine with certainty whether moxibustion and acupoint therapy are better for the treatment of PD than nonacupuncture-related therapy.

OBJECTIVE: The study intended to compare the effectiveness of moxibustion and acupoint therapy- such as sandwiched moxibustion, moxibustion, acupuncture, eye of floating needle, and acupoint application-with other therapeutic methods for the treatment of PD.

DESIGN: Six electronic databases-PubMed, Web of Science, the Chinese Biomedical Literature Database (CBM), the Chinese Journal Full-text Database (CNKI), the Chinese Science and Technology Journal Full-text Database (VIP), and Chinese Wanfang Data-were searched electronically, from inception to December, 2012, to find randomized, controlled trials (RCTs). Relevant references in articles used in the current study were searched manually. Literature was screened, data were extracted, and the methodological quality of the included studies was assessed. Then, meta-analyses were performed.

SETTING: All of processes of this study were conducted at Tianjin University of Traditional Chinese Medicine and School of Nursing at Tianjin Medical University.

PARTICIPANTS: The research team divided the selected RCTs into 2 groups based on the type of PD that the participants had: (1) the undifferentiated type group (UTG) and (2) the cold-damp stagnation type group (CDSTG).

OUTCOME MEASURES: The research team measured total effective rate, symptom score, and variation of peripheral blood prostaglandin F2α (PGF2α).

RESULTS: A total of 20 RCTs, involving 2134 participants, were included in the current study. Results of the metaanalysis showed that (1) the total efficacy for the 2 studied interventions was better, with a statistically significant difference from that of the control methods: degrees of freedom (df) = 14, relative risk (RR) = 1.19, 95% confidence interval (95% CI) = (1.14 - 1.24), P < .000 for the UTG, and df = 4, RR = 1.15, 95% CI (1.02 - 1.29), P = .03 for the CDSTG; (2) the studied interventions were better than the control methods, with statistically significant differences, in relieving the severity of symptoms of PD: df = 3, mean difference (MD) = 3.20, 95% CI (2.36 - 4.04), P < .000 for the UTG and df = 1, MD = 2.09, 95% CI (0.16 - 4.02), P = .03 for the CDSTG; and (3) no statistical difference existed between the intervention and control methods groups in the reduction of the level of peripheral blood PGF2α: df = 2, standardized mean difference (SMD) = 0.13, 95% CI (-0.13 - 0.39), P = .32.

CONCLUSIONS: Moxibustion and acupoint therapy can relieve pain effectively for individuals with PD, and these treatments have advantages in overall efficiency. Because of limitations on the quantity and quality of the included studies and the lack of a large, multicenter study, the research team's conclusion has yet to be substantiated.