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acupuncture:evaluation:gyneco-obstetrique:07. mastodynies [08 Jun 2019 06:57] (Version actuelle)
Nguyen Johan créée
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 +====== Mastodynies : évaluation de l'​acupuncture ======
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 +===== Revues systématiques et méta-analyses =====
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 +| ☆☆☆ | Preuves en faveur d’une efficacité et d’un effet spécifique de l’acupuncture |
 +| ☆☆ | Preuves en faveur d’une efficacité de l’acupuncture |
 +| ☆ |Preuves limitées en faveur d’une efficacité de l’acupuncture |
 +| Ø |Absence de preuve ou preuves insuffisantes |
 +
 +==== Hafiz 2018 ☆ ====
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 +Hafiz SP, Barnes NLP, Kirwan CC. Clinical management of idiopathic mastalgia: a systematic review. J Prim Health Care. 2018;​10(4):​312-323. ​  ​{{:​medias securises:​acupuncture:​evaluation:​gyneco-obstetrique:​hafiz-197724.pdf|[197724]}}. ​
 +^Introduction|Idiopathic mastalgia (benign breast pain of unknown origin) is often poorly managed because of its subjective nature and unclear aetiology. Mastalgia is a reason for up to 50% of breast outpatient referrals. Existing systematic reviews discuss dated treatment options that provide limited symptomatic relief. |
 +^Methods| A systematic review was conducted for aetiology and treatment of idiopathic mastalgia in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidance. Databases such as PubMed, MEDLINE, Cochrane Database and the Clinical Trial Registry were searched (February 2016). |
 +^ Results |Reassurance plus bra-fitting advice provides relief for most women. If symptoms persist, addition of topical non-steroidal anti-inflammatory drugs (NSAIDs) provides relief in 70-92% of women. There is some benefit in reducing dietary coffee and fat intake. Medical treatments have serious side-effects (often androgenic or menopausal) and should be considered only in cases resistant to simpler measures. Dopamine agonists are useful, but less effective than endocrine treatments such as Danazol or Tamoxifen. Of the Selective Oestrogen Receptor Modulator drugs, Ormeloxifene appears most effective, but is not licenced in the United Kingdom. Relaxation therapy, **acupuncture** and kinesiology may be useful but currently lack good evidence of effectiveness. |
 +^ Discussion |First-line management of breast pain should be explanation,​ reassurance and a bra-fitting advice. Subsequent drug therapy should be balanced against its side-effects;​ topical NSAIDs and Ormeloxifene show greatest benefit with least side-effects. Newer agents (Ormeloxifene) currently being used for mastalgia in India could be considered in the developed world. |
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