Rédacteurs : Johan Nguyen, Olivier Goret, Claude Pernice

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--- acupuncture:evaluation:gyneco-obstetrique:10. douleurs pelviennes et lombalgies de la grossesse [27 Nov 2022 16:10]
Nguyen Johan
+++ 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 ====
-=== Yang 2022 ☆☆ ===
+=== Zhang 2024 ===
+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.
-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.|

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