Rédacteurs : Johan Nguyen, Olivier Goret, Claude Pernice

Différences

Ci-dessous, les différences entre deux révisions de la page.

--- acupuncture:evaluation:gyneco-obstetrique:10. douleurs pelviennes et lombalgies de la grossesse [15 Aug 2021 17:19]
Nguyen Johan [2.1. National Institute for Health and Care Excellence (NICE, UK) 2021 Ø]
+++ acupuncture:evaluation:gyneco-obstetrique:10. douleurs pelviennes et lombalgies de la grossesse [14 Apr 2025 18:24] (Version actuelle)
Nguyen Johan [1.1.1. Li 2023]
@@ Ligne 5: / Ligne 5: @@
 ====== Douleurs pelviennes et lombalgies de la grossesse : évaluation de l'acupuncture ======
 ===== Systematic Reviews and Meta-Analysis=====
-| ☆☆☆  | Evidence for effectiveness and a specific effect of acupuncture  |
-| ☆☆   | Evidence for effectiveness of acupuncture                        |
-| ☆    | Limited evidence for effectiveness of acupuncture                |
-| Ø    | No evidence or insufficient evidence                             |
+==== Generic acupuncture ====
+=== Zhang 2024 ===
-==== Koukoulithras 2021 (ear acupuncture) Ø ====
+Zhang A, Li J, He T, Xie H, Mou X, Yeung TC, Chen S, Wang CC, Fan X, Li L. Efficacy and safety of acupuncture in treating low back and pelvic girdle pain during pregnancy: a systematic review and meta-analysis of randomized controlled trials. Acupunct Herb Med. 2024 Sep;4(3):346-357.  https://doi.org/10.1097/HM9.0000000000000093.|
+^Objectives| Low back and pelvic girdle pain (LBPGP) is common during pregnancy. Acupuncture is an effective and safe therapy for pain relief. However, further evidence is required to confirm the efficacy and safety of acupuncture in treating LBPGP during pregnancy. This study aimed to systematically review and investigate the clinical efficacy and safety of acupuncture for the treatment of pregnancy-related LBPGP.|
+^Methods| The PubMed, EMBASE, Cochrane Library, CNKI, VIP, and WanFang databases were searched from January 2000 to August 2023. Only the randomized controlled trials (RCTs) involving pregnant women between 16 and 34 weeks of gestation diagnosed with LBPGP were included in the study. A meta-analysis was conducted and pooled risk ratios (RRs) or mean differences (MDs) with 95% confidence intervals (CIs) were compared.|
+^Results| Meta-analysis included **12 RCTs involving 1,641 participants**. Eleven trials compared acupuncture alone or acupuncture combined with standard care (SC), of which three trials also used non-penetrating or placebo acupuncture as the control group. One trial compared acupuncture alone with non-penetrating acupuncture. Compared with SC, acupuncture combined with SC group significantly decreased visual analog scale score (mean difference (MD) = −2.83, 95% CI = −3.41 to −2.26, P < 0.00001), cesarean section rate (RR = 0.69, 95% CI = 0.49–0.97, P = 0.03), preterm birth rate (RR = 0.42, 95% CI = 0.27–0.65, P < 0.0001), labor duration (MD = −1.97, 95% CI = −2.73 to −1.20, P < 0.0001), and Oswestry disability index score (MD = −9.14, 95% CI = −15.68 to −2.42, P = 0.008). In addition, acupuncture combined with SC significantly improved 12-Items Short Form Health Survey of physical component summaries (SF12-PCS). No significant differences were observed in the spontaneous delivery rate, newborn weight, drowsiness, and 12-Items Short Form Health Survey of mental component summaries (SF12-MCS) between the two groups. Adverse events such as needle pain and needle bleeding were aggravated in both the SC and acupuncture treatment groups but none were associated with acupuncture during or after the treatment period.|
+^Conclusions| Meta-analysis showed that acupuncture combined with SC had better efficacy than SC alone and could be a potential therapy for LBPGP during pregnancy. The safety results imply that acupuncture caused few adverse reactions; however, more evidence is required for further confirmation.|
+=== Li 2023 ===
+Li R, Chen L, Ren Y, Huang J, Xu Y, Lin X, Zhen R. Efficacy and safety of acupuncture for pregnancy-related low back pain: A systematic review and meta-analysis. Heliyon. 2023 Jul 25;9(8):e18439.  https://doi.org/10.1016/j.heliyon.2023.e18439
+^Background| Pregnancy-related low back pain (PLBP) is a common musculoskeletal disorder, affecting people's physical and psychological health. Acupuncture is widely used in clinical practice as a treatment for PLBP. This study aimed to evaluate the efficacy and safety of acupuncture or acupuncture combined with other treatments for PLBP patients.|
+^Methods| The Cochrane Library, PubMed, EMBASE, Web of Science, the Chinese Biological Medicine Database, China National Knowledge Infrastructure, WanFang Database, and VIP information database were searched from inception to January 31, 2022. Randomized controlled trials (RCTs) were eligible, without blinding and language restriction. Cochrane's risk of bias tool was used to assess the methodological quality. Meta-analysis was performed using RevMan 5.3.|
+^Results| **Twelve randomized controlled trials involving 1302 patients** were included. The results showed that compared to the control group, the VAS score was significantly decreased after acupuncture treatment. In addition, no significant difference was found in the preterm delivery rate (RR = 0.38, 95%CI: 0.24 to 0.61, P = 0.97) after acupuncture treatment. Compared with other therapies, acupuncture or acupuncture plus other therapies revealed a significant increase in the effective rate (OR: 6.92, 95%CI: 2.44 to 19.67, I2 = 0%). No serious adverse events owing to acupuncture were reported.|
+^Conclusion| Acupuncture or acupuncture combined with other interventions was a safe and effective therapy for treating PLBP. However, the methodological quality of the RCTs was low. More rigorous and well-designed trials should be conducted.|
+=== Yang 2022 [retracted] ===
+  * <color #ed1c24>Retraction</color>: Acupuncture for low back and/or pelvic pain during pregnancy: a systematic review and meta-analysis of randomised controlled trials. BMJ Open. 2024 Jun 11;14(6):e056878ret. https://doi.org/10.1136/bmjopen-2021-056878ret
+  * Yang J, Wang Y, Xu J, Ou Z, Yue T, Mao Z, Lin Y, Wang T, Shen Z, Dong W. Acupuncture for low back and/or pelvic pain during pregnancy: a systematic review and meta-analysis of randomised controlled trials. BMJ Open. 2022 Nov 21;12(12):e056878.  https://doi.org/10.1136/bmjopen-2021-056878.
+^Objective| Acupuncture is emerging as a potential therapy for relieving pain, but the effectiveness of acupuncture for relieving low back and/or pelvic pain (LBPP) during the pregnancy remains controversial. This meta-analysis aims to investigate the effects of acupuncture on pain, functional status and quality of life for women with LBPP pain during the pregnancy.|
+^Method| Design: Systematic review and meta-analysis. Data sources: The PubMed, EMBASE databases, Web of Science and Cochrane Library were searched for relevant randomised controlled trials (RCTs) from inception to 15 January 2022. Eligibility criteria for selecting studies: RCTs evaluating the effects of acupuncture on LBPP during the pregnancy were included. Data extraction and synthesis: The data extraction and study quality assessment were independently performed by three reviewers. The mean differences (MDs) with 95% CIs for pooled data were calculated. We assessed the confidence in the evidence using the Grading of Recommendations Assessment, Development and Evaluation framework. Main outcomes and measures: The primary outcomes were pain, functional status and quality of life. The secondary outcomes were overall effects (a questionnaire at a post-treatment visit within a week after the last treatment to determine the number of people who received good or excellent help), analgesic consumption, Apgar scores >7 at 5 min, adverse events, gestational age at birth, induction of labour and mode of birth.|
+^Results|This meta-analysis included 10 studies, reporting on a total of 1040 women. Overall, acupuncture significantly relieved pain during pregnancy (MD=1.70, 95% CI: (0.95 to 2.45), p<0.00001, I2=90%) and improved functional status (MD=12.44, 95% CI: (3.32 to 21.55), p=0.007, I2=94%) and quality of life (MD=-8.89, 95% CI: (-11.90 to -5.88), p<0.00001, I2 = 57%). There was a significant difference for overall effects (OR=0.13, 95% CI: (0.07 to 0.23), p<0.00001, I2 = 7%). However, there was no significant difference for analgesic consumption during the study period (OR=2.49, 95% CI: (0.08 to 80.25), p=0.61, I2=61%) and Apgar scores of newborns (OR=1.02, 95% CI: (0.37 to 2.83), p=0.97, I2 = 0%). Preterm birth from acupuncture during he study period was reported in two studies. Although preterm contractions were reported in two studies, all infants were in good health at birth. In terms of gestational age at birth, induction of labour and mode of birth, only one study reported the gestational age at birth (mean gestation 40 weeks). Thus, prospective randomised clinical studies or clinical follow-up studies were hence desirable to further evaluate these outcomes.|
+^Conclusions|Acupuncture significantly improved pain, functional status and quality of life in women with LBPP during the pregnancy. Additionally, acupuncture had no observable severe adverse influences on the newborns. More large-scale and well-designed RCTs are still needed to further confirm these results.|
+=== Koukoulithras 2021 (ear acupuncture) Ø ===
 Koukoulithras I Sr, Stamouli A, Kolokotsios S, Plexousakis M Sr, Mavrogiannopoulou C. The Effectiveness of Non-Pharmaceutical Interventions Upon Pregnancy-Related Low Back Pain: A Systematic Review and Meta-Analysis. Cureus. 2021;13(1).   [217965]. [[https://doi.org/10.7759/cureus.13011|doi]]
@@ Ligne 23: / Ligne 48: @@
-==== Gutke 2015 ☆☆====
+=== Gutke 2015 ☆☆===
@@ Ligne 32: / Ligne 57: @@
 ^Conclusions|The levels of evidence were strong for a positive effect of acupuncture and pelvic belts, but weak for an effect of specific exercises. Caution should prevail in choosing other interventions for pregnancy-related lumbopelvic pain.|
-==== Liddle 2015  ☆====
+=== Liddle 2015  ☆===
 Liddle SD, Pennick V. Interventions for preventing and treating low-back and pelvic pain during pregnancy.. Cochrane Database Syst Rev. 2015.   {{:medias securises:acupuncture:evaluation:gyneco-obstetrique:liddle-187873.pdf|[187873].}}
 ^Background|More than two-thirds of pregnant women experience low-back pain and almost one-fifth experience pelvic pain. The two conditions may occur separately or together (low-back and pelvic pain) and typically increase with advancing pregnancy, interfering with work, daily activities and sleep. |
@@ Ligne 41: / Ligne 66: @@
-==== Close 2014 ====
+=== Close 2014 ===
 Close C, Sinclair M, Liddle Sd, Madden E, Mccullough Je, Hughes C. A Systematic Review Investigating The Effectiveness of Complementary and Alternative Medicine (CAM) For The Management of Low Back And/Or Pelvic Pain (LBPP) In Pregnancy. J Adv Nurs. 2014;70(8):1702-16.{{:medias+securises:acupuncture:evaluation:gyneco-obstetrique:close-160458.pdf|[160458].}}
 ^ Objectifs | To evaluate and summarize the current evidence on the effectiveness of complementary and alternative medicine for the management of low back pain and/or pelvic pain in pregnancy. Background: International research demonstrates that 25-30% of women use complementary and alternative medicine to manage low back and pelvic pain in pregnancy without robust evidence demonstrating its effectiveness. |
@@ Ligne 48: / Ligne 73: @@
 ^ Conclusion | There is limited evidence supporting the use of general CAM for managing pregnancy-related low back and/or pelvic pain. However, the restricted availability of high-quality studies, combined with the very low evidence strength, makes it impossible to make evidence-based recommendations for practice. |
-==== Pennick 2013 ☆☆====
+=== Pennick 2013 ☆☆===
@@ Ligne 59: / Ligne 84: @@
-==== Richards 2012 ====
+=== Richards 2012 ===
 Richards E, Van Kessel G, Virgara R, Harris P. Does Antenatal Physical Therapy for Pregnant Women with Low Back Pain or Pelvic Pain Improve Functional Outcomes? A Systematic Review. Acta Obstet Gynecol Scand. 2012;91(9):1038-45.  (eng).  [166575]
@@ Ligne 68: / Ligne 93: @@
-==== Ee 2008 ☆ ====
+=== Ee 2008 ☆ ===
@@ Ligne 79: / Ligne 104: @@
 ^ Conclusion  | We conclude that **limited evidence supports acupuncture use in treating pregnancy-related pelvic and back pain.**.|
-==== Pennick 2007 ☆====
+=== Pennick 2007 ☆===
@@ Ligne 90: / Ligne 115: @@
 ^Authors' conclusions| All but one study had moderate to high potential for bias, so results must be viewed cautiously. Adding pregnancy-specific exercises, physiotherapy or acupuncture to usual prenatal care appears to relieve back or pelvic pain more than usual prenatal care alone, although the effects are small. We do not know if they actually prevent pain from starting in the first place. Water gymnastics appear to help women stay at work. Acupuncture shows better results compared to physiotherapy. |
-==== Young 2001 ====
+=== Young 2001 ===
@@ Ligne 113: / Ligne 138: @@
-Management of pelvic girdle pain in pregnancy. National Institute for Health and Care Excellence (NICE). 2021:116p.   [216712]. [[https://www.nice.org.uk/guidance/gid-ng10096/documents/evidence-review-12|URL]]
+NICE guideline NG201 : Antenatal care [U] Management of pelvic girdle pain in pregnancy. National Institute for Health and Care Excellence (NICE). 2021:115P.   [219371]. [[https://www.nice.org.uk/guidance/ng201/chapter/Recommendations#interventions-for-common-problems-during-pregnancy|URL]]
+| The committee agreed that the evidence for acupuncture to treat pelvic girdle pain was mixed, of poor quality and therefore not adequate enough to justify a recommendation that would have a substantial resource impact. \\ The committee discussed the evidence on acupuncture that showed some improvements on pain intensity, and on women’s experience and satisfaction. They agreed that the resources needed to implement a recommendation for acupuncture in the NHS are not currently adequate (for example, there may not be enough trained practitioners) and that it is therefore likely that such a recommendation would entail a substantial cost.. The committee felt that because the evidence was mixed regarding the benefits and harms of acupuncture, and the quality of the evidence was poor, they could not justify a recommendation that would have a substantial resource impact.|
-|Acupuncture. Although there was some evidence that acupuncture is associated with some improvements on pain intensity, the critical outcome for this review, and on women’s experience and satisfaction, the committee agreed that the evidence was mixed regarding its benefits and harms and that the resources needed to implement a recommendation for acupuncture in the NHS are not currently adequate (for example, there are not enough trained practitioners) and that it is therefore likely that such a recommendation would entail a substantial cost without the strength of evidence underlying it to justify implementation.\\ The committee noted that no relevant published economic evaluations had been identified for 2 this topic. They also deemed that the evidence presented in the clinical review was not of 3 sufficient quality to allow for recommendations on acupuncture or manual therapy. These 4 treatments are not routinely offered by the NHS, and the committee acknowledged there 5 would be a significant resource impact were they to make such recommendations |
 ==== World Health Organization (WHO) 2021 ⊕ ====

Différences

Recherche

Imprimer/exporter

Traduire