Systematic review of clinical trials of acupuncture-related therapies for primary dysmenorrhea

Background. Acupuncture-related therapies might be an effective intervention for primary dysmenorrhea. Objective. To evaluate the effects of acupuncture-related therapies for treating primary dysmenorrhea. Search Strategy. A specified literature search was performed of the Cochrane Library, MEDLINE, EMBASE, CNKI, and CBM databases. Selection criteria. All clinical controlled trials pertaining to acupuncture-related therapies for primary dysmenorrhea were included, and the quality of the trials was assessed. Data collection and analysis. Two independent reviewers were responsible for data extraction and assessment. The original data of each trial were analyzed with software (Revman 4.2), but a meta-analysis could not be carried out because of the heterogeneity of the trials. Main Results. Thirty randomized controlled trails (RCTs) and two controlled clinical trials (CCTs) were identified. Most of the trials were of low methodologic quality (six trials were Grade B and 26 trials were Grade C). Data analysis indicated that there were conflicting results regarding whether acupuncture-related therapies were more effective than control treatments. However, there was a small, methodologic sound trial of acupuncture which suggested that acupuncture was more effective than control groups (placebo acupuncture: WMD=-0.57 and 95% CI=-0.76-0.38; standard control: WMD=-.19 and 95% CI=-0.37-0.01; visitation control: WMD=-1.04 and 95% CI=-1.28-0.80). Conclusions. Because of low methodologic quality and small sample size, there is no convincing evidence for acupuncture in the treatment of primary dysmenorrhea. There is an urgent need for randomized, blinded, placebo-controlled trials to assess the effects of acupuncture.