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The Cochrane Database of Systematic... Apr 2016Primary dysmenorrhoea is the most common form of period pain and affects up to three-quarters of women at some stage of their reproductive life. Primary dysmenorrhoea is... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Primary dysmenorrhoea is the most common form of period pain and affects up to three-quarters of women at some stage of their reproductive life. Primary dysmenorrhoea is pain in the absence of any organic cause and is characterised by cramping pain in the lower abdomen, starting within the first eight to 72 hours of menstruation.This review examines the currently available evidence supporting the use of acupuncture (stimulation of points on the body using needles) and acupressure (stimulation of points on the body using pressure) to treat primary dysmenorrhoea.
OBJECTIVES
To determine the effectiveness and safety of acupuncture and acupressure in the treatment of primary dysmenorrhoea when compared with a placebo, no treatment, or conventional medical treatment.
SEARCH METHODS
We searched the following databases: the Cochrane Menstrual Disorders and Subfertility Group Trials Register (to September 2015), Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library), MEDLINE, EMBASE, PsycINFO, CINAHL and Chinese databases including Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), VIP database and registers of ongoing trials.
SELECTION CRITERIA
We included all published and unpublished randomised controlled trials (RCTs) comparing acupuncture with sham acupuncture or placebo control, usual care, pharmacological treatment or no treatment. We included the following modes of treatment: acupuncture, electro-acupuncture, and acupressure. Participants were women of reproductive age with primary dysmenorrhoea during the majority of the menstrual cycles or for three consecutive menstrual cycles, and moderate to severe symptoms.
DATA COLLECTION AND ANALYSIS
We calculated odds ratios (ORs) for dichotomous outcomes and mean differences (MDs) or standardised mean differences (SMDs) for continuous outcomes, with 95% confidence intervals (CIs). We pooled the data where appropriate. Our primary outcomes was pain. Secondary outcomes included menstrual symptoms, quality of life, and adverse effects.
MAIN RESULTS
We included 42 RCTs (4640 women). Acupuncture or acupressure was compared with a sham/placebo group, medication, no treatment or other treatment. Many of the continuous data were not suitable for calculation of means, mainly due to evidence of skew.1. Acupuncture studies Acupuncture versus sham or placebo control (6 RCTs)Findings were inconsistent and inconclusive. However, the only study in the review that was at low risk of bias in all domains found no evidence of a difference between the groups at three, six or 12 months. The overall quality of the evidence was low. No studies reported adverse events. Acupuncture versus NSAIDs Seven studies reported visual analogue scale (VAS) pain scores, but were unsuitable for pooling due to extreme heterogeneity (I² = 94%). In all studies the scores were lower in the acupuncture group, with the mean difference varying across studies from 0.64 to 4 points on a VAS 0 - 10 scale (low-quality evidence). Four RCTs reported rates of pain relief, and found a benefit for the acupuncture group (OR 4.99, 95% CI 2.82 to 8.82, 352 women, I² = 0%, low-quality evidence). Adverse events were less common in the acupuncture group (OR 0.10, 95% CI 0.02 to 0.44, 4 RCTs, 239 women, 4 trials, I² = 15%, low-quality evidence). Acupuncture versus no treatment Data were unsuitable for analysis, but pain scores were lower in the acupuncture group in all six studies reporting this outcome. The quality of the evidence was low. No studies reported adverse events.2. Acupressure studiesNo studies of acupressure reported adverse events. Acupressure versus sham or placebo controlData were unsuitable for pooling, but two studies reported a mean benefit of one to three points on a 0 - 10 VAS pain scale. Another four studies reported data unsuitable for analysis: all found that pain scores were lower in the acupuncture group. No studies reported adverse events. The quality of the evidence was low. Acupressure versus NSAIDsOne study reported this outcome, using a 0 - 3 pain scale. The score was higher (indicating more pain) in the acupressure group (MD 0.39 points, 95% CI 0.21 to 0.57, 136 women, very low-quality evidence). Acupressure versus no treatmentThere was no clear evidence of a difference between the groups on a VAS 0 - 10 pain scale (MD -0.96 points, 95% CI -2.54 to 0.62, 2 trials, 140 women, I² = 83%, very low-quality evidence).
AUTHORS' CONCLUSIONS
There is insufficient evidence to demonstrate whether or not acupuncture or acupressure are effective in treating primary dysmenorrhoea, and for most comparisons no data were available on adverse events. The quality of the evidence was low or very low for all comparisons. The main limitations were risk of bias, poor reporting, inconsistency and risk of publication bias.
Topics: Acupuncture Therapy; Adolescent; Adult; Anti-Inflammatory Agents, Non-Steroidal; Dysmenorrhea; Female; Humans; Middle Aged; Randomized Controlled Trials as Topic; Young Adult
PubMed: 27087494
DOI: 10.1002/14651858.CD007854.pub3 -
Medicine Jun 2019Auricular acupressure has been used for treating obesity, but inconsistent outcomes have been reported. Moreover, systematic reviews and meta-analyses have seldom... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Auricular acupressure has been used for treating obesity, but inconsistent outcomes have been reported. Moreover, systematic reviews and meta-analyses have seldom addressed the effects of auricular acupressure and duration of treatment in overweight/obese individuals. This study reviewed research articles on auricular acupressure for weight reduction, analyzed the related effects on obesity, and explored the relationships between weight reduction and treatment duration, as well as outcome variables.
METHODS
We searched PubMed, Cochrane Library, CINAHL, MEDLINE with Full Text, National Digital Library of Theses and Dissertation in Taiwan, and Airiti Library for articles up to July 4, 2018. Eight eligible trials were identified for qualitative synthesis, and one of them was excluded from quantitative synthesis. Inclusion criteria were as follows: intervention contained auricular acupressure, study subjects were overweight and/or obese, as defined by published authors, and the study design had 2 or more arms for comparison.
RESULTS
Pooled analysis of the 7 remaining studies revealed that auricular acupressure alone, or with diet and/or exercise, was effective for weight reduction, particularly for decreasing body weight (BW), body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), body fat mass (BFM), and body fat percentage (BFP), compared with no treatment, sham treatment, or use of surgical tape with diet and/or exercise. However, there was no effect on hip circumference. A 12-week acupressure intervention was associated with a larger effect on lowering BW and BMI compared with 4-, 6-, and 8-week interventions. The methodologic quality of trials included in the quantitative synthesis ranged from scores 2 to 6 based on the modified Jadad scale. Additionally, this meta-analysis combined studies that used different acupoints and outcomes evaluated at different timepoints, which may have been potential sources of bias.
CONCLUSION
The study results indicate that auricular acupressure is effective for weight reduction. However, further vigorous studies that use double-blind randomized controlled design are needed to verify these findings. WC, WHR, BFP, or BFM should be used as obesity-related parameters in weight reduction studies to detect changes in fat, muscle, and skeletal weight.
Topics: Acupressure; Humans; Overweight; Weight Loss
PubMed: 31261540
DOI: 10.1097/MD.0000000000016144 -
PloS One 2015To explore the commonly utilized sham acupressure procedures in existing acupressure trials, and to assess whether different types of sham interventions yield different... (Review)
Review
OBJECTIVES
To explore the commonly utilized sham acupressure procedures in existing acupressure trials, and to assess whether different types of sham interventions yield different therapeutic outcomes, and, as far as possible, to identify directions for the future development of an adequate sham acupressure method.
METHODS
Randomized controlled trials comparing true acupressure with sham interventions were included. Thirteen electronic databases were adopted to locate relevant studies from inception to July 3, 2014. Meanwhile, eight Chinese journals on complementary and alternative medicine were manually searched to locate eligible articles. In addition, eligible studies listed in the reference lists of the included papers and other related systematic reviews on acupressure were also screened to further search any potentially eligible trials. Methodological quality of the included studies was evaluated using the risk of bias assessment tool developed by the Cochrane Back Review Group. Descriptive analysis was adopted to summarize the therapeutic outcomes.
RESULTS
Sixty-six studies with 7265 participants were included. Methodological quality of the included trials was generally satisfactory. Six types of sham acupressure approaches were identified and "non-acupoint" stimulation was the most frequently utilized sham point while an acupressure device was the most commonly used approach for administering sham treatments. Acupressure therapy was a beneficial approach in managing a variety of health problems and the therapeutic effect was found to be more effective in the true acupressure groups than that in the sham comparative groups. No clear association could be identified between different sham acupressure modalities and the reported treatment outcomes.
CONCLUSIONS
A great diversity of sham acupressure controls have been used in clinical practice and research. A solid conclusion whether different sham alternatives are related to different treatment outcomes cannot be derived because of significant clinical heterogeneity among the analyzed trials. Non-acupoints are generally recommended but the definite locations should be identified with caution. For studies using single sham acupoints on hands or legs, it is suggested to apply identical acupressure devices on the same acupoint as in the active intervention without any stimulation. While for studies on pain, stimulation of sham acupoints should be avoided.
Topics: Acupressure; Acupuncture Therapy; Control Groups; Humans; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 26177378
DOI: 10.1371/journal.pone.0132989 -
Medicina (Kaunas, Lithuania) Jan 2023Background and Objectives: The purpose of this systematic review was to summarize the current evidence to examine the safety and effectiveness of auricular acupressure... (Meta-Analysis)
Meta-Analysis Review
Background and Objectives: The purpose of this systematic review was to summarize the current evidence to examine the safety and effectiveness of auricular acupressure on dry eye diseases. Materials and Methods: Twenty databases were searched from their inception until November 2022. Only randomized controlled trials (RCTs) in which auricular acupressure was used for dry eye diseases were included. The selection process, data extraction and quantitative were conducted according to the guidelines. Results: Seven RCTs met the inclusion criteria. Meta-analysis showed that compared to artificial tears, auricular acupressure had a favorable effect on prolonging tear breakup time (TBUT), improving the Schirmer I test (SIT) score and the score of symptoms (SOS) of patients with dry eye disease (p < 0.05). Furthermore, compared to the artificial tears alone, auricular acupressure plus artificial tears had a significantly greater SIT score (p < 0.001) and response rate (p = 0.006), significantly longer TBUT (p < 0.001), and significantly lower Ocular surface disease index (OSDI) (p = 0.02) and SOS (p = 0.03). However, there was no statistically significant difference between the auricular acupressure plus artificial tears group and the artificial tears group in terms of cornea fluorescein staining (CFS) (p = 0.09). Conclusions: Auricular acupressure, as a sole intervention or in combination with artificial tears, may have a beneficial effect on dry eye disease. However, more high-quality RCTs need to be included in the future to further prove the positive effects of auricular acupressure on patients with dry eye disease.
Topics: Humans; Lubricant Eye Drops; Acupressure; Randomized Controlled Trials as Topic; Dry Eye Syndromes; Tears
PubMed: 36676806
DOI: 10.3390/medicina59010177 -
Evidence-based Complementary and... 2021The treatment effects and safety of ear acupressure (EAP) for patients with allergic rhinitis (AR) have yet to be clarified. (Review)
Review
BACKGROUND
The treatment effects and safety of ear acupressure (EAP) for patients with allergic rhinitis (AR) have yet to be clarified.
OBJECTIVE
To evaluate the effects and safety of EAP in AR patients.
DESIGN
Systematic review of published studies.
METHODS
A total of 24 English and Chinese databases (PubMed, EMBASE (Excerpta Medical Database), Cochrane Central Register of Controlled Trials, CINAHL, Informit, ScienceDirect, LILACS (Latin American and Caribbean Health Sciences), ProQuest, AMED, Blackwell Synergy, PsycINFO, Panteleimon, AcuBriefs, KoreaMed, IndMed, Ingenta, mRCT, ISI Web of Knowledge, ERIC, VIP Information (http://www.cqvip.com), China National Knowledge Infrastructure (http://www.cnki.net), Cochrane Library, Chinese Cochrane Centre Controlled Trials Register Platform, and Wanfang Chinese Digital Periodical and Conference Database) were searched from their respective inceptions to August 2020 to collect randomized controlled trials of ear acupressure for allergic rhinitis. We performed literature inclusion, data extraction, and trial quality evaluations. Methodological quality was assessed according to the Cochrane Handbook. Revman5.3 was used for all analyses.
RESULTS
A total of 203 trials were identified and eleven studies involved 1094 participants aged 3-70 years. EAP was better than control group interventions in terms of effectiveness (risk ratio (RR): 0.51; 95% confidence interval (CI): 0.36-0.70; < 0.0001). EAP was superior to sham EAP in terms of improvement of the total nasal symptom score (RR: -0.50; 95% CI: -0.96-0.05; = 0.03), sneezing score (RR: -0.36; 95% CI: -0.59-0.12; = 0.003), global QoL score (RR: 0.42; 95% CI: 0.04-0.08; = 0.03), and eye symptom score (RR: -0.36; 95% CI: -0.67-0.05; = 0.02).
CONCLUSIONS
Despite the positive results, it is premature to confirm the efficacy of EAP for treating AR. More high-quality studies are needed to confirm safety and efficacy.
PubMed: 34007299
DOI: 10.1155/2021/6699749 -
Evidence-based Complementary and... 2020The efficacy of auricular acupressure in patients with hypertension and insomnia is controversial. This systematic review aims to explore the effectiveness of auricular...
OBJECTIVE
The efficacy of auricular acupressure in patients with hypertension and insomnia is controversial. This systematic review aims to explore the effectiveness of auricular acupressure in reducing blood pressure and improving sleep in this population.
METHODS
We conducted an extensive database search in Cochrane Central Register of Controlled Trials, PubMed, Ovid LWW, Web of Science, Chinese Biomedical Literature Database, China Knowledge Resource Integrated Database, Wanfang Data, and China Science and Technology Journal Database on randomized controlled trials published from inception to November 2019 that compared auricular acupressure with a control or comparison group on blood pressure control and sleep improvement. Two reviewers independently conducted data screening and extraction. Study quality was evaluated using the . Meta-analyses were performed on blood pressure, Pittsburgh Sleep Quality Index (PSQI), the efficacy rate of diagnostic and therapeutic criteria for traditional Chinese medicine syndromes (DTCTCMS), and the efficacy rate of guidelines for traditional Chinese medicine (new drug) clinical research (GTCMCR) by Revman 5.3.0.
RESULTS
A total of 18 randomized controlled trials with 1685 patients were identified. Compared with a control or comparison group, pooled meta-analyses showed that auricular acupressure significantly improved systolic blood pressure (MD = -15.05, 95% CI (-18.49, -11.61), < 0.00001), diastolic blood pressure (MD = -8.41, 95% CI (-11.33, -5.48), < 0.00001), PSQI (MD = -2.37, 95% CI (-4.64, -0.10), =0.04), the efficacy rate of DTCTCMS (RR = 1.63, 95% CI (1.16, 2.28), =0.004), and the efficacy rate of GTCMCR (RR = 1.25, 95% CI (1.12, 1.38)).
CONCLUSIONS
The results demonstrated a favorable effect of auricular acupressure to reduce blood pressure and improve sleep in patients with hypertension and insomnia. Further studies to better understand the acupoints and intervention times of auricular acupressure are warranted.
PubMed: 32655667
DOI: 10.1155/2020/7279486 -
Iranian Journal of Nursing and... 2018In this study, the effects of SP6 and LI4 acupressure on the pain severity and length of labor are examined. (Review)
Review
BACKGROUND
In this study, the effects of SP6 and LI4 acupressure on the pain severity and length of labor are examined.
MATERIALS AND METHODS
This systematic review and meta-analysis study was performed on articles published in 2004-2015. The articles, published in the English and Farsi languages, related to the effects of acupressure on the SP6 and LI4 points on the length and pain severity of labor. Data were collected by searching medical databases, including PubMed, ISI, MagIran, Google Scholar, Iran Medex, SID, Irandoc, and EMBASE, for relevant material.
RESULTS
Women who received SP6 acupressure experienced less pain immediately after the intervention [-0.56, 95% confidence interval (CI): -0.77, -0.36] than women in the touch group and exhibited decrease in the length of labor (-0.99, 95% CI: -1.39, -0.39), the active phase (0.95, 95% CI: -1.30, -0.61), and the second stage of labor (-0.39, 95% CI: -0.74, -0.03). Women who received LI4 acupressure experienced less pain immediately after the intervention (-0.94, 95%, CI: -1.36, -0.53) than women in the touch group and exhibited shorter active phase (-0.91, 95%, CI: -1.18, -0.63) and second stage of labor (-0.55, 95%, CI: -0.95, -0.15) lengths.
CONCLUSIONS
The use of SP6 and LI4 acupressure shows promise as a method for managing the length and pain severity of labor, but further study is required to establish its effectiveness along with other pharmacological and nonpharmacological methods.
PubMed: 29344038
DOI: 10.4103/ijnmr.IJNMR_184_15 -
Evidence-based Complementary and... 2021We aim to provide available synthesized evidence of the efficacy and safety of auricular acupressure for cancer patients with sleep disturbance. (Review)
Review
AIM
We aim to provide available synthesized evidence of the efficacy and safety of auricular acupressure for cancer patients with sleep disturbance.
METHODS
Randomized controlled clinical trials (RCTs) were identified from PubMed, EMBASE, Web of Science, The Cochrane Library, PsycINFO, Chinese Biomedical Database, China National Knowledge Infrastructure, Chongqing VIP, and Wanfang Data, and the search date ranged from the inception of the databases to May 2021. Literature screening and data extraction were independently performed by three researchers. The Cochrane collaboration's tool for assessing the risk of bias was applied to evaluate the risk of bias of the RCTs included. The extracted data were analyzed using Rev-Man 5.4.1 software.
RESULTS
Nine trials involving 688 participants met the inclusion criteria and were included in the qualitative analysis; 6 trials involving 485 participants were included in the meta-analysis. Synthesized results showed that auricular acupressure had a significant effect on reducing the total Pittsburgh Sleep Quality Index (PSQI) score (MD = -3.88, 95% CI (-5.24, -2.53), < 0.00001), and the scores of five PSQI components, sleep latency (MD = -0.53, 95% CI (-0.73, -0.32), < 0.00001), subjective sleep quality (MD = -0.79, 95% CI (-1.05, -0.53), < 0.00001), sleep duration (MD = -0.50, 95% CI (-0.69, -0.31), < 0.0001), daytime dysfunction (MD = -0.53, 95% CI (-0.77, -0.29), < 0.0001), and sleep disturbances (MD = -0.54, 95% CI (-0.60, -0.49), < 0.00001), were also obviously decreased after the intervention of auricular acupressure. Shenmen and heart were the most commonly selected auricular acupoints, the main intervention durations ranged from 10 to 42 days, and the pressing times of auricular acupoints were 1-6 times a day, 1-5 min each time. One trial reported slight and transient pain caused by auricular acupressure, while the remaining 8 trials did not report obvious side effects.
CONCLUSION
Auricular acupressure can significantly improve the sleep quality of cancer patients with sleep disturbance, with no obvious side effects. Rigorously designed clinical trials are necessary for the further support of the clinical application.
PubMed: 34691214
DOI: 10.1155/2021/3996101 -
Iranian Journal of Nursing and... 2020Numerous studies have been conducted on the effect of acupressure on labor pain, some of which have reported conflicting results. Thus, the present study was performed... (Review)
Review
BACKGROUND
Numerous studies have been conducted on the effect of acupressure on labor pain, some of which have reported conflicting results. Thus, the present study was performed to critically review the previous studies related to the effect of acupressure administered during labor for relieving labor pain.
MATERIALS AND METHODS
In this study, databases of the Cochrane Central Register of the Controlled Trials, PubMed/MEDLINE, Scopus, and Web of Science were searched from their establishment until November 5, 2019. All the Randomized Controlled Trials (RCTs) that had compared the use of acupressure with either placebo or nonintervention for relieving the labor pain were included in the study. Meta-analysis was performed using the Comprehensive Meta-Analysis (CMA) software Version 2. The random-effects model was used for pooling the effect sizes across the included studies. The value <0.05 was considered as statistically significant.
RESULTS
Totally, 5853 primary papers were identified in the search, which were narrowed down to 22 studies. The results of meta-analysis showed that the acupressure decreased the labor pain in the intervention group vs. control (-1.67 [-2.29 to -1.05], z = -5.25, < 0. 001) (Q-value = 788.98, < 0.001, I-squared = 96.83). No publication bias was found in the included studies (Egger's regression intercept = -1.02, = 0.76).
CONCLUSIONS
Although the findings of this meta-analysis showed that the acupressure significantly reduced the labor pain during the active phase of labor compared to the nonintervention or placebo; considering that the quality of the included studies was generally moderate, rigorous RCTs with better design and higher quality are needed to obtain definitive conclusions.
PubMed: 33747833
DOI: 10.4103/ijnmr.IJNMR_257_19 -
Women and Birth : Journal of the... Feb 2024There is no international standard for advanced midwifery scope of practice. (Review)
Review
PROBLEM
There is no international standard for advanced midwifery scope of practice.
BACKGROUND
Globally, there is variance in how scope of midwifery practice is determined and regulated, with no consensus on extended or advanced scope. This can lead to under-utilised staff potential, un-met consumer need, and loss of professional skill.
AIMS
The aim of this scoping review was to synthesise and map what is reported in the international literature on the advanced scope of midwifery practice.
METHODS
A systematic scoping review methodology was adopted utilising Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). A full search was conducted of databases including MEDLINE, CINAHL, Scopus, Google. Publications from 2019 to August 2022 that met criteria were included. Reported skills were mapped to the International Confederation of Midwives (ICM) competencies of pre-conception, antenatal, labour and birth, postnatal plus globally identified areas for midwifery investment.
FINDINGS
28 articles met inclusion criteria. Reported skills included abortion care (n = 6), prescribing (n = 7), ultrasound (n = 2), advanced practice skills (n = 7), midwifery-led skills, primary health, post-graduate education, HIV/AIDS testing, advocacy, and acupressure (all n = 1).
DISCUSSION
This review presents a synopsis of publications describing what has been defined as advanced midwifery scope of practice in international contexts.
CONCLUSION
Establishing evidence of midwives working to the peak of professional scope is important to continue to develop professional capacity and support contemporary practice, regulation, governance, and policy while improving consumer access to equitable care. Findings aid service development, provision, and professional planning.
Topics: Female; Humans; Pregnancy; Midwifery; Professional Role
PubMed: 37845089
DOI: 10.1016/j.wombi.2023.10.001