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Effectiveness and safety of Chinese medicine at Shenque (CV 8) for primary Dysmenorrhea: a systematic review and meta-analysis of randomized controlled trials

Effectiveness and safety of Chinese medicine at Shenque (CV 8) for primary Dysmenorrhea: a systematic review and meta-analysis of randomized controlled trials
Effectiveness and safety of Chinese medicine at Shenque (CV 8) for primary Dysmenorrhea: a systematic review and meta-analysis of randomized controlled trials

BACKGROUND: Primary dysmenorrhea (PD) is the most common complaint associated with menstruation and affects up to three-quarters of women at some stage of their reproductive life. In Chinese medicine, navel therapy, treatment provided at Shenque (CV 8), is used as a treatment option for PD.

OBJECTIVE: To evaluate the effect of navel therapy on pain relief and quality of life in women with PD, compared with Western medicine (WM).

METHODS: China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), SinoMed and Wanfang Database, MEDLINE, the Cochrane Library, Embase, Web of Science, and the International Clinical Trial Registry of the U.S. National Institutes of Health were searched from their inceptions to April 1, 2021. Randomized controlled trials (RCTs) assessing therapeutic effects of navel therapy on PD were eligible for inclusion. RevMan 5.4 software was used for data analyses. The certainty of the evidence was assessed using the online GRADEpro tool.

RESULTS: Totally 24 RCTs involving 2,614 participants were identified. Interventions applied to acupuncture point CV 8 included: herbal patching, moxibustion or combined navel therapy (using at least 2 types of stimulation). Compared to placebo, there was a significant effect in favor of navel therapy on reducing overall menstrual symptom scores at the end of treatment [mean difference: -0.82, 95% confidence interval (CI): -1.00 to -0.64, n=90; 1 RCT]. As compared with Western medicine, navel therapy had a superior effect on pain intensity as assessed by Visual Analogue Scale at the end of treatment [standardized mean difference (SMD): -0.64, 95% CI: -1.22 to -0.06, I2=80%, n=262; 3 RCTs]; on symptom resolution rate at 3-month follow-up (risk ratio: 1.94, 95% CI: 1.47 to 2.56, n=1527, I2=38%; 13 RCTs); and on global menstrual symptoms score at the end of treatment (SMD: -0.67, 95% CI: -0.90 to -0.45, I2=63%, n=990; 12 RCTs). Subgroup analyses showed either a better or an equivalent effect comparing navel therapy with Western medicine. No major adverse events were reported. The methodological quality of included trials was poor overall.

CONCLUSIONS: Navel therapy appears to be more effective than Western medicine in decreasing menstrual pain and improving overall symptoms of PD. However, these findings need to be confirmed by well-designed clinical trials with adequate sample size (Systematic review registration at PROSPERO, No. CRD42021240350).

Shenque, meta-analysis, navel therapy, primary dysmenorrhea, quality of life, systematic review
1672-0415
Yan, Li-jiao
2ddd55cf-cc2f-49b0-9683-b8ca38e36687
Fang, Min
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Zhu, Si-Jia
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Wang, Zhi-jie
4ea33545-987a-41d7-a2c0-96f72655bd70
Hu, Xiao-yang
65904b24-3775-4b14-9532-eb703a056655
Liang, Shi-bing
2a2dd82a-23b1-437c-9c02-625dfea79fd4
Wang, Dou
b3ba3f72-72bd-4e0e-ae24-d776b203b744
Yang, Dan
61a303f8-05ea-456c-a27f-4de26a7143ad
Shen, Chen
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Robinson, Nicola
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Liu, Jian-ping
ab58e381-fd47-404c-ba28-9dfc6423002f
Yan, Li-jiao
2ddd55cf-cc2f-49b0-9683-b8ca38e36687
Fang, Min
5077dab0-80f4-4871-8bb1-5cb70455a805
Zhu, Si-Jia
0b66f33c-6e0d-4c66-a807-486677394394
Wang, Zhi-jie
4ea33545-987a-41d7-a2c0-96f72655bd70
Hu, Xiao-yang
65904b24-3775-4b14-9532-eb703a056655
Liang, Shi-bing
2a2dd82a-23b1-437c-9c02-625dfea79fd4
Wang, Dou
b3ba3f72-72bd-4e0e-ae24-d776b203b744
Yang, Dan
61a303f8-05ea-456c-a27f-4de26a7143ad
Shen, Chen
6c0a14c3-0e05-4e94-8a50-c6a7866a55b2
Robinson, Nicola
8d9e1831-747b-4d1e-aa37-51e0909484c1
Liu, Jian-ping
ab58e381-fd47-404c-ba28-9dfc6423002f

Yan, Li-jiao, Fang, Min, Zhu, Si-Jia, Wang, Zhi-jie, Hu, Xiao-yang, Liang, Shi-bing, Wang, Dou, Yang, Dan, Shen, Chen, Robinson, Nicola and Liu, Jian-ping (2022) Effectiveness and safety of Chinese medicine at Shenque (CV 8) for primary Dysmenorrhea: a systematic review and meta-analysis of randomized controlled trials. Chinese Journal of Integrated Medicine. (doi:10.1007/s11655-022-3319-z).

Record type: Article

Abstract

BACKGROUND: Primary dysmenorrhea (PD) is the most common complaint associated with menstruation and affects up to three-quarters of women at some stage of their reproductive life. In Chinese medicine, navel therapy, treatment provided at Shenque (CV 8), is used as a treatment option for PD.

OBJECTIVE: To evaluate the effect of navel therapy on pain relief and quality of life in women with PD, compared with Western medicine (WM).

METHODS: China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), SinoMed and Wanfang Database, MEDLINE, the Cochrane Library, Embase, Web of Science, and the International Clinical Trial Registry of the U.S. National Institutes of Health were searched from their inceptions to April 1, 2021. Randomized controlled trials (RCTs) assessing therapeutic effects of navel therapy on PD were eligible for inclusion. RevMan 5.4 software was used for data analyses. The certainty of the evidence was assessed using the online GRADEpro tool.

RESULTS: Totally 24 RCTs involving 2,614 participants were identified. Interventions applied to acupuncture point CV 8 included: herbal patching, moxibustion or combined navel therapy (using at least 2 types of stimulation). Compared to placebo, there was a significant effect in favor of navel therapy on reducing overall menstrual symptom scores at the end of treatment [mean difference: -0.82, 95% confidence interval (CI): -1.00 to -0.64, n=90; 1 RCT]. As compared with Western medicine, navel therapy had a superior effect on pain intensity as assessed by Visual Analogue Scale at the end of treatment [standardized mean difference (SMD): -0.64, 95% CI: -1.22 to -0.06, I2=80%, n=262; 3 RCTs]; on symptom resolution rate at 3-month follow-up (risk ratio: 1.94, 95% CI: 1.47 to 2.56, n=1527, I2=38%; 13 RCTs); and on global menstrual symptoms score at the end of treatment (SMD: -0.67, 95% CI: -0.90 to -0.45, I2=63%, n=990; 12 RCTs). Subgroup analyses showed either a better or an equivalent effect comparing navel therapy with Western medicine. No major adverse events were reported. The methodological quality of included trials was poor overall.

CONCLUSIONS: Navel therapy appears to be more effective than Western medicine in decreasing menstrual pain and improving overall symptoms of PD. However, these findings need to be confirmed by well-designed clinical trials with adequate sample size (Systematic review registration at PROSPERO, No. CRD42021240350).

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Accepted/In Press date: 9 June 2021
e-pub ahead of print date: 15 April 2022
Additional Information: Funding Information: Supported by Innovation Team and Talents Cultivation Program of National Administration of Traditional Chinese Medicine (No. ZYYCXTD-C-202006), Longitudinal Development Funding of Beijing University of Chinese Medicine (No. 2021-ZXFZJJ-016), the National Institute for Health Research (No. SPCR-143) Shanxi Provincial Health Commission Project (No. 2020050) Publisher Copyright: © 2022, The Chinese Journal of Integrated Traditional and Western Medicine Press and Springer-Verlag GmbH Germany, part of Springer Nature.
Keywords: Shenque, meta-analysis, navel therapy, primary dysmenorrhea, quality of life, systematic review

Identifiers

Local EPrints ID: 468339
URI: http://eprints.soton.ac.uk/id/eprint/468339
ISSN: 1672-0415
PURE UUID: 1b439afe-dd3e-440c-bfec-cf7358dd0fda
ORCID for Xiao-yang Hu: ORCID iD orcid.org/0000-0002-3143-7999

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Date deposited: 10 Aug 2022 18:12
Last modified: 17 Mar 2024 07:17

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Contributors

Author: Li-jiao Yan
Author: Min Fang
Author: Si-Jia Zhu
Author: Zhi-jie Wang
Author: Xiao-yang Hu ORCID iD
Author: Shi-bing Liang
Author: Dou Wang
Author: Dan Yang
Author: Chen Shen
Author: Nicola Robinson
Author: Jian-ping Liu

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