Management of Menopause Symptoms with Acupuncture: An Umbrella Systematic Review and Meta-Analysis.

Deanna Befus, Remy R Coeytaux, Karen M Goldstein, Jennifer R McDuffie, Megan Shepherd-Banigan, Adam P Goode, Andrzej Kosinski, Megan G Van Noord, Soheir S Adam, Varsha Masilamani, Avishek Nagi, John W Williams
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Abstract

Objectives: Vasomotor symptoms (VMSs) are the most common symptoms reported during menopause. Although hormone therapy is effective for reducing VMSs, its use is restricted in some women. Many women with VMSs thus seek nonhormonal, nonpharmacologic treatment options such as acupuncture.

Design: An umbrella systematic review (SR) was conducted, supplemented by a search of published randomized controlled trials (RCTs), that assessed the effectiveness of acupuncture for VMSs, health-related quality of life (HRQOL), and adverse effects of treatment in perimenopausal or postmenopausal women. Meta-analyses were conducted using a random-effects model when data were sufficient.

Results: Three SRs and four new RCTs were identified that met eligibility criteria. Meta-analyses of this study revealed statistically significant standardized mean differences (SMDs) associated with acupuncture compared with no acupuncture at reducing VMS frequency (SMD -0.66, 95% confidence interval [CI] -1.06 to -0.26, I2 = 61.7%, 5 trials) and VMS severity (SMD -0.49, 95% CI -0.85 to -0.13, I2 = 18.1%, 4 trials) and improving HRQOL outcomes (SMD -0.93, 95% CI -1.20 to -0.67, I2 = 0.0%, 3 trials). SMDs were smaller or not statistically significant when acupuncture was compared with sham acupuncture.

Conclusions: Evidence from RCTs supports the use of acupuncture as an adjunctive or stand-alone treatment for reducing VMSs and improving HRQOL outcomes, with the caveat that observed clinical benefit associated with acupuncture may be due, in part, or in whole to nonspecific effects. The safety of acupuncture in the treatment of VMSs has not been rigorously examined, but there is no clear signal for a significant potential for harm.

针灸治疗更年期症状:一项系统综述和荟萃分析。
目的:血管舒缩症状(vms)是更年期最常见的症状。虽然激素疗法对减少VMSs有效,但在一些妇女中使用受到限制。因此,许多患有VMSs的妇女寻求非激素、非药物的治疗选择,如针灸。设计:本研究进行了一项综合系统评价(SR),并辅以已发表的随机对照试验(rct),评估针灸治疗围绝经期或绝经后妇女vms的有效性、健康相关生活质量(HRQOL)以及治疗的不良影响。当数据充足时,采用随机效应模型进行meta分析。结果:3个SRs和4个新的rct符合入选标准。本研究的荟萃分析显示,与不针灸相比,针灸在降低VMS频率(SMD -0.66, 95%可信区间[CI] -1.06至-0.26,I2 = 61.7%, 5项试验)和VMS严重程度(SMD -0.49, 95% CI -0.85至-0.13,I2 = 18.1%, 4项试验)和改善HRQOL结果(SMD -0.93, 95% CI -1.20至-0.67,I2 = 0.0%, 3项试验)方面具有统计学意义。针灸与假针灸相比,SMDs较小或无统计学意义。结论:来自随机对照试验的证据支持使用针灸作为辅助或独立治疗来减少VMSs和改善HRQOL结果,但注意到与针灸相关的临床获益可能部分或全部归因于非特异性效果。针灸治疗VMSs的安全性还没有经过严格的检验,但没有明确的信号表明有重大的潜在危害。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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