Should acupuncture become a complementary therapy in the treatment of uterine fibroid: a systematic review and meta-analysis of randomized controlled trials

Yuehan Ren; Junning Zhang; Weizhen Wu; Yi Yuan; Jiale Wang; Yi Tang; Yan Liao; Xinmin Liu

doi:10.3389/fmed.2023.1268220

Should acupuncture become a complementary therapy in the treatment of uterine fibroid: a systematic review and meta-analysis of randomized controlled trials

Front Med (Lausanne). 2023 Dec 13:10:1268220. doi: 10.3389/fmed.2023.1268220. eCollection 2023.

Authors

Yuehan Ren^#^{1

2}, Junning Zhang^#^{2

3}, Weizhen Wu², Yi Yuan², Jiale Wang², Yi Tang², Yan Liao², Xinmin Liu¹

Affiliations

¹ Department of Gynaecology, China Academy of Chinese Medicine Sciences Guang'anmen Hospital, Beijing, China.
² Graduate School, Beijing University of Chinese Medicine, Beijing, China.
³ Department of Oncology of Integrative Chinese and Western Medicine, China-Japan Friendship Hospital, Beijing, China.

^# Contributed equally.

Abstract

Background: Uterine fibroids (UFs) are the most common benign tumors in women of reproductive age. The most effective treatment is myomectomy, but there is no long-term or low-invasive treatment option exists. Acupuncture can be used to treat UFs in a variety of ways. However, there is no meta-analytic synthesis including valid data that explored the efficacy of acupuncture for UFs.

Objective: To assess the efficacy and safety of acupuncture for treating UFs.

Methods: The PRISMA 2020 checklist was used. We identified and extracted the trials through may 2023 from six databases. The quality of the trials was assessed using the risk of bias (2.0). Meta-analysis was performed using RevMan 5.4 software, and it was synthesized using the random-effects model if the included studies were in high heterogeneity. Subgroup and sensitivity analysis were used if necessary.

Results: A total of 1,035 trials were identified, of which 11 were included in the review and meta-analysis. In terms of acupuncture scheme design and fibroid-related symptoms, the trials are highly heterogeneous. All 11 trials have reported acupuncture types, with traditional acupuncture and electroacupuncture being the more representative subgroups. A qualitative review of existing evidence shows that acupuncture has no serious adverse reaction on UFs. Meta-analysis shows that acupuncture can effectively reduce the volume of UFs (MD - 3.89, 95% CI - 5.23 to - 2.56, P < 0.00001) or uterine volume (MD - 16.22, 95% CI - 19.89 To - 12.55, p < 0.00001), reduce the score of fibroid symptoms (MD - 3.03, 95% CI - 3.45 to - 2.60, p < 0.00001), improve the treatment efficiency (RR: 0.19, 95% CI: 0.13 to 0.25, p < 0.00001), and likely do not affect the estrogen level.

Keywords: acupuncture; complementary therapy; meta-analysis; systematic review; uterine fibroid.

Publication types

Systematic Review

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study is funded by Science and Technology Innovation Project of the Chinese Academy of Traditional Chinese Medicine (ref no: C12021A02404). The funding body is not involved in the study design and conduct, data collection, management, analysis, and interpretation.