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Journal of Traditional Chinese Medicine >

2024 , Vol. 44 >Issue 1: 16 - 26

DOI: https://doi.org/10.19852/j.cnki.jtcm.20231204.006

Meta-Analyses

Effectiveness and safety of acupuncture in treatment of pregnancy-related symptoms: a systematic review and Meta-analysis

  • Tingting LIU ,
  • Tongou LIU ,
  • Mingfu LIU
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  • 1 School of Traditional Chinese Medicine Clinical Medicine, Hubei University of Traditional Chinese Medicine, Wuhan 430000, China
    2 First Clinical College of Hubei University of Traditional Chinese Medicine, Wuhan 430000, China
    3 Department of Acupuncture and Tuina, Affiliated Hospital of Hubei University of Traditional Chinese Medicine, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan 430000, China

Received date: 2022-08-22

  Accepted date: 2022-11-28

  Online published: 2023-12-04

Supported by

Science and Technology Department of Hubei Province in 2023: to Investigate the Therapeutic Mechanism of Qingre Lishi Huayu Herbs on Pelvic Inflammatory Disease Based on NOTCH Signaling Pathway(2023AFD167)

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Abstract

OBJECTIVE: To systematically evaluate the efficacy and safety of acupuncture (AM) in the treatment of pregnancy-related symptoms such as acute vomiting during pregnancy.

METHODS: We comprehensively searched the available literature up to November 2021, including PubMed, Embase, Cochrane Library, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure Database, for randomized controlled trials (RCTs) on AM for the treatment of severe vomiting, insomnia, pharyngeal and pelvic pain, mood abnormalities, and dyspepsia during pregnancy.

RESULTS: Sixteen RCTs with a cumulative sample size of 1178 cases were included. Of these, 964 patients were included in the Meta-analysis. The Meta-analysis results showed that AM was more efficient than Western medicine in treating discomfort during pregnancy [odds ratio (OR) = 1.19, 95% confidence interval (CI) (1.11, 1.28), P < 0.01]. AM was better than the control group in improving the visual analog scale scores [standard mean difference (SMD) = 0.62, 95% CI(0.53, 0.71), P < 0.01]. AM was superior to the control group in improving Numerical Rating Scale (NRS) symptom scores [OR = 7.31, 95% CI(3.36, 15.94), P < 0.01]. There was no significant difference in adverse effects between the AM and sham-AM groups and the analgesic drug group [OR = 0.70, 95% CI(0.39, 1.28), P = 0.25], but the treatment and control groups had mild adverse effects with a low incidence.

CONCLUSIONS: AM is more effective than other treatments or pharmacotherapy alone in the treatment of pregnancy-related symptoms, and is relatively safe. However, the quality of the included trials was rather poor, and high-quality studies are required to confirm our findings.

Key words： acupuncture; pregnancy; nausea; vomiting; sleep initiation and maintenance disorders; low back pain; pelvic pain; mood abnormalities; Meta-analysis; systematic review

Cite this article

Tingting LIU , Tongou LIU , Mingfu LIU . Effectiveness and safety of acupuncture in treatment of pregnancy-related symptoms: a systematic review and Meta-analysis[J]. Journal of Traditional Chinese Medicine, 2024 , 44(1) : 16 -26 . DOI: 10.19852/j.cnki.jtcm.20231204.006

References

1. Wu H, Sun W, Chen H, et al. Health-related quality of life in different trimesters during pregnancy. Health Qual Life Outcomes 2021; 19: 182.
2. Pontius E, Vieth JT. Complications in early pregnancy. Emerg Med Clin North Am 2019; 37: 219-37.
3. Matthews A, Haas M, O'Mathúna DP, Dowswell T. Interventions for nausea and vomiting in early pregnancy. Cochrane Database Syst Rev 2015; 2015: Cd007575.
4. Lee NM, Saha S. Nausea and vomiting of pregnancy. Gastroenterol Clin North Am 2011; 40: 309-34.
5. Bustos M, Venkataramanan R, Caritis S. Nausea and vomiting of pregnancy - What's new? Auton Neurosci 2017; 202: 62-72.
6. Jennifer R, Niebyl MD. Nausea and Vomiting in Pregnancy. N Engl J Med 2010; 363: 1544-50.
7. Siminerio LL, Bodnar LM, Venkataramanan R, Caritis SN. Ondansetron use in pregnancy. Obstet Gynecol 2016; 127: 873-7.
8. Liddle SD, Pennick V. Interventions for preventing and treating low-back and pelvic pain during pregnancy. Cochrane Database Syst Rev 2015; 1-116.
9. Novaes SF, Antonieta KKS, Maria HBDL. Low back pain during gestation. Rev Lat Am Enfermagem 2006; 14: 620-4.
10. Sedov ID, Anderson NJ, Dhillon AK, Tomfohr-Madsen LM. Insomnia symptoms during pregnancy: a Meta-analysis. J Sleep Res 2020; 1-10.
11. Hashmi AM, Bhatia SK, Bhatia SK, Khawaja I S. Insomnia during pregnancy: diagnosis and rational interventions. Pak J Med Sci 1969; 1030-7.
12. Li R, Zhang J, Zhou R, et al. Sleep disturbances during pregnancy are associated with cesarean delivery and preterm birth. J Matern Fetal Neonatal Med 2016; 30: 733-8.
13. Sedov ID, Tomfohr-Madsen LM. Trajectories of insomnia symptoms and associations with mood and anxiety from early pregnancy to the postpartum. Behav Sleep Med 2020; 19: 395-406.
14. Wisner KL, Sit KY, McShea MC, et al. Onset timing, thoughts of self-harm, and diagnoses in postpartum women with screen-positive depression findings. JAMA Psychiatry 2013; 490-8.
15. Mariam KA, Srinivasan K. Antenatal psychological distress and postnatal depression: a prospective study from an urban clinic. Asian J Psychiatr 2009; 2: 71-3.
16. Mu?oz-Ortego J, Solans-Domènech M, Carrion C, en representación del ABE Working Group. Medical indications for acupuncture: systematic review. Med Clin (Barc) 2016; 147: 250-6.
17. Riedel M, Kuschel B. Medikament?se systemtherapie in der schwangerschaft. Hautarzt 2020; 71: 313-3.
18. Johnson-Davis KL, Doyle K. Therapeutic drug monitoring in pregnant patients. Ther Drug Monit 2020; 42: 172-80.
19. Schaefer C. Arzneimitteltherapiesicherheit in der schwangerschaft - eine besondere Herausforderung. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2018; 61: 1129-38.
20. Huang JG. Research progress of acupuncture and moxibustion in the treatment of insomnia. Guang Ming Zhong Yi 2021; 36: 923-27+32.
21. Wu XD, Yuan JY, Zhao NQ, Liu QG, Dong GF, Wang X. Investigation and analysis on the current situation of clinical practice guidelines for acupuncture and moxibustion at home and abroad. Zhong Guo zhen jiu 2021; 41: 923-7.
22. Wang HF, Wang WH. Global centennial acupuncture research and acupuncture internationalization analysis based on SCI database. Zhong Guo Zheng Jiu 2021; 41: 1410-4.
23. Ye X. Overview of the development of acupuncture in the Netherlands. Zhong Guo Zheng Jiu 1999; 1: 51-2.
24. Yamashita H, Tsukayama H, Tanno Y, Nishijo K. Adverse events related to acupuncture. JAMA 1998; 280: 1563-4.
25. Liang RF, Wu X. Current status and prospects of acupuncture and moxibustion development abroad. Zhong Guo Zheng Jiu 2006; 26: 79-82.
26. Zhang YM, Li YP. Cochrane collaboration and cochrane library. Beijing: Science Press, 2002: 105.
27. Smith CA, Collins CT, Levett KM, et al. Acupuncture or acupressure for pain management during labour. Cochrane Database Syst Rev 2020; 2: 1-116.
28. Foroughinia S, Hessami K, Asadi N, et al. Effect of acupuncture on pregnancy-related insomnia and melatonin: a single-blinded, randomized, placebo-controlled trial. Nat Sci Sleep 2020; 12: 271-8.
29. Carlsson CP, Axemo P, Bodin A, et al. Manual acupuncture reduces hyperemesis gravidarum a placebo-controlled, randomized, single-blind, crossover study. J Pain Symptom Manage 2000; 20: 273-9.
30. Zhao YL. Observation on curative effect of Baotai Heyun decoction combined with acupuncture in treating hyperemesis pregnancy. Sichuan Zhong Yi 2017; 35: 169-70.
31. Gan YL, Ye WL, Zhang LX. Clinical study on acupoint moxibustion combined with ear point pressing beans in treating hyperemesis pregnancy. Xin Zhong Yi 2021; 53: 152-5.
32. Xu Yh, W Z, Li QW, Xie YQ. Observation on the clinical effect of acupuncture combined with moxibustion on the treatment of dysfunction of pregnancy with weak spleen and stomach. Yi Yao Qian Yan 2015; 5: 341-2.
33. Elden H, Fagevik-Olsen M, Ostgaard HC, Stener-Victorin E, Hagberg H. Acupuncture as an adjunct to standard treatment for pelvic girdle pain in pregnant women: randomised double-blinded controlled trial comparing acupuncture with non-penetrating sham acupuncture. BJOG 2008; 115: 1655-68.
34. Silva JBGD, JA Cordeiro, LK JR. Acupuncture for insomnia in pregnancy-a prospective, quasi-randomised, controlled study. Acupunct Med 2005; 23: 47-51.
35. Silva JBGD, JA Cordeiro, LK JR. Acupuncture for low back pain in pregnancy-a prospective, quasi-randomised, controlled study. Acta Obstet Gynecol Scand 2004; 2: 60-7.
36. Silva JBGD. Acupuncture for mild to moderate emotional complaints in pregnancy-a prospective, quasi-randomised, controlled study. Acupunct Med 2007; 25: 65-71.
37. Kvorning N, Holmberg C, Grennert L, ?berg A, ?keson J. Acupuncture relieves pelvic and low-back pain in late pregnancy. Acta Obstet Gynecol Scand 2004; 83: 246-50.
38. Xie HY. Observation on therapeutic effect of acupuncture on malignant obstruction of pregnancy. Shanghai Zhen Jiu Za Zhi 2013; 32: 734-5.
39. Zhong Q. Clinical observation of acupuncture and moxibustion in the treatment of hyperemesis pregnancy. Neimenggu Zhong Yi Yao 2017; 36: 120-1.
40. Jia YZ. Study on the efficacy and safety of acupuncture and moxibustion for relieving pain in the lower back and pelvis of women in the middle and late stages of pregnancy. Zhong Guo Fu You Bao Jian 2015; 30: 6386-8.
41. Luo BZ, Huang WY. Observation on therapeutic effect of acupuncture and moxibustion on relieving pain in the back and pelvis in middle and late pregnancy. Neimenggu Zhong Yi Yao 2019; 38: 96-7.
42. Jiang X. Analysis of clinical curative effect of acupuncture and moxibustion on 35 cases of pregnancy insomnia. Shi Jie Shui Mian Yi Xue Za Zhi 2021; 8: 241-2.
43. Long Y, Huang X, Chen Y, Tang H, Zhou J, Ning YF. Effect of acupuncture on the pain of lower back and pelvis in middle and late pregnancy women. Zhong Guo Fu You Bao Jian 2014; 29: 1772-4.
44. Xiao ZS, Zou JH. A preliminary study on Zhang Xichun 's thought of regulating menstruation. Sichuan Zhong Yi 2022; 40: 16-7.
45. Tan Y. Gynecology of Chinese medicine. 10th edition. Beijing: China Chinese Medicine Publishing House: 2016; 353.
46. Nan W. Clinical study on the treatment of polycystic ovary syndrome by tonifying the kidney, removing blood stasis and dispelling phlegm. Zhong Guo Xian Dai Yao Li Xue 2008; 25: 167-70.
47. Evsen N, Gulsen E. Incidence of pregnancy-related discomforts and management approaches to relieve them among pregnant women. J Clin Nurs 2013; 23: 1736-50.
48. Martina Z, Lynette L. Walters Walters. Symptoms during normal pregnancy: a prospective controlled study. Aust N Z J Obstet Gynaecol 1999; 39: 401-10.
49. Sapra KJ, Joseph KS, Galea S, Bates LM, Buck Louis GM, Ananth CV. Signs and symptoms of early pregnancy loss: a systematic review. Reprod Sci 2017; 24: 502-13.
50. Novaes FS, Shimo AKK. Low back pain during gestation. Rev Latino-am Enfermagem 2006; 14: 620-4.
51. Vermani E, Mittal R, Weeks A. Pelvic girdle pain and low back pain in pregnancy: a review. Pain Pract 2010; 10: 60-71.
52. Silva JBGD. Acupuncture for mild to moderate emotional complaints in pregnancy-a prospective, quasi-randomised, controlled study. Acupunct Med 2007; 25: 65-71.
53. Valeria B, Fee B, Andrea P, et al. Interventions for sleep problems during pregnancy: a systematic review. Sleep Med Rev 2020; 50: 101234.
54. Zhong WJ. Application value of acupuncture and moxibustion in women during pregnancy and after delivery. Zhong Yi Yao Lin Chuang Za Zhi 2006; 18: 232-3.
55. Wu JY, Hu Y, Zhu Y, Yin P, Litscher G, Shifen X. Systematic review of adverse effects: a further step towards modernization of acupuncture in China. Evid Based Complement Alternat Med 2015; 2015: 1-19.
56. Tony YC, Mark CL. Acupuncture. Mayo Clin Proc 2013; 88: 1141-6.
57. Zhao JS. Conceptual history of acupuncture-moxibustion-historical writing and reconstruction foundation of acupuncture-moxibustion theory. Zhong Guo Zhen Jiu 2021; 41: 834-7.
58. Sun JF, Wang Z, Cheng LM. Fang JL. Advances in clinical research of acupuncture and moxibustion in the treatment of insomnia. Shi Jie Zhong Yi Yao 2021; 17: 1475-80.
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