AUTHOR=Chen Shu-Cheng , Ruan Jia-Yin , Zhang Bohan , Pang Lok-Yi , Zhong Linda , Lin Shuang-Lan , Wong Ka-Po , Ouyang Hui-Xi , Yeung Wing-Fai , Fu Qin-Wei , Chen Bo-Qian 

TITLE=Traditional Chinese medicine interventions based on meridian theory for pain relief in patients with primary dysmenorrhea: a systematic review and network meta-analysis

JOURNAL=Frontiers in Medicine

VOLUME=Volume 11 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1453609

DOI=10.3389/fmed.2024.1453609

ISSN=2296-858X

ABSTRACT=Objective: To determine the comparative effects and safety of traditional Chinese medicine (TCM) interventions based on meridian theory for pain relief in patients with primary dysmenorrhea (PD). Methods: This is a systematic review with network meta-analysis. Randomized controlled trials (RCTs) comparing meridian-based TCM interventions with waitlist, placebo, western medicine, and conventional therapies for PD pain. A SUCRA was used to estimate the probability ranking for the effects of interventions. Results: 57 RCTs involving 3903 participants and 15interventions were included. Thirty-two RCTs were rated as low risk of bias. A network diagram was drawn with 105 pairs of comparisons. Compared with NSAIDs and waitlist, significantly better effects were found in acupressure (SMD=-1.51, 95%CI [-2.91, -0.12]/SMD=-2.31, 95%CI [-4.61, -0.02]), warm needling (SMD=-1.43, 95%CI [-2.68, -0.18]/SMD=-2.23, 95%CI [-4.43, -0.03]), moxibustion(SMD=-1.21, 95%CI [-1.85, -0.57]/SMD=-2.10, 95%CI [-3.95, -0.07]), and acupuncture (SMD=-1.09, 95%CI [-1.62, -0.55]/SMD=-1.89, 95%CI [-3.67, -0.11]). No adverse events were detected.For PD pain, the effects of acupressure, acupuncture, warm needling, and moxibustion were superior to those of NSAIDs and waitlist. Oral contraceptive pill, electroacupuncture, acupressure, and warm needling demonstrated higher probabilities of being better interventions. More high-quality clinical trials are needed to provide more robust evidence of this network.