Complementary Therapies in Medicine (Mar 2023)
Effects of acupoint application therapy combined with chinese herbal medicine on perimenopausal syndrome: A systematic review and meta-analysis of randomized controlled trails
Abstract
Background: An increasing number of women suffer from perimenopausal syndrome (PMS) and the global burden of this disease has been steadily rising. Acupoint application therapy and Chinese herbal medicine (CHM) are widely used as effective methods for treating PMS, but the efficacy was inconsistent and the evidence should be summarized by quantitively analysis. Objective: The purpose of this systematic review and meta-analysis was to evaluate the clinical efficacy and safety of the acupoint application combined with the CHM for the treatment of PMS. Methods: We searched eight databases from their inception to August 2022 to identify relevant studies. Only randomized controlled trials (RCTs) focusing on acupoint application combined with CHM for the treatment of PMS were included in this study. To assess the clinical efficacy and safety, meta-analysis was used to quantitively synthesize the effect estimates. Subgroup analysis, publication bias assessment and sensitivity analysis were also performed. We further assessed whether the included studies had reported on the purity and potency of the CHM used in their trials. Results: A total of 8 RCTs with 560 participants were included in the systematic review and meta-analysis, of which none of them included a description of an independent testing of purity or potency of the CHM product used. There were significant differences between the acupoint application combined with CHM and CHM alone in terms of Kupperman Menopausal Index (KMI) score (MD = –2.91, 95%CI: –3.91 to –1.91), total effective rate (RR = 1.22, 95% CI: 1.11–1.34), Pittsburgh Sleep Quality Interview (PSQI) score (MD = –2.86, 95% CI: –3.61 to –2.10) and reduction in the serum level of luteinizing hormone (LH) (MD = –2.52, 95% CI: –4.70 to –0.34), whereas there were no differences between the two groups regarding lowering serum level of follicle-stimulating hormone (FSH) (MD = –1.66, 95% CI: –3.98–0.67) and elevating serum level of oestradiol (E2) (MD = 2.41, 95% CI: –0.70–5.52). For the comparation between the acupoint application combined with CHM and western medicine (WM), the KMI score (MD = –6.80, 95%CI: –7.95 to –5.65) was substantially different, while the PSQI score (MD = –0.60, 95% CI: –1.88–0.68) was not substantially different. The total effective rate in the combined group (91.7%) was higher than the western medicine group (83.49%). Conclusion: Acupoint application combined with CHM may enhance the efficacy and safety of patients with PMS. However, due to the lack of description of an independent testing of purity or potency of the CHM product used in the trials, as well as blinding of participants and investigators, these results should be interpreted with caution.
