Literature Research Of Acupuncture Treatment For Leiomyoma In Recent30Years

ObjectiveModern literatures on Leiomyoma with acupuncture and moxibustion (including combine traditional Chinese and western medicine) treatment published in resent30years were studied.(1) Assess the characteristicof the literatures, and summarize the rules, guide clinical and scientific research.(2) Evaluate the differences of efficacy and safety between acupuncture treatment and medicine therapy for Leiomyoma by Systematic review.(3) Summarize the commonly used acupuncture therapy for Leiomyoma and the rules of Acupoint selection, as to find the effective acupuncture treatment scheme in clinic.MethodsFormulate the retrieval strategy, retrieval index, retrieval tools and retrieval time, retrieve and get the citations and the full text. The literatures strictly satisfied the inclusion and exclusion criteria were included, and were metrology analysized on aspects of the published time, research areas, journal sources, research types, research units, intervention method and quality of the literatures. Based on the metrology analysis, according to the inclusion and exclusion criteria of systematic review, the clinical randomized controlled trials which observed the curative effect respectively on acupuncture treatment and the combination of acupuncture and Chinese herbology/western medicine therapy comparing with Chinese herbology/western medicine therapy on Leiomyoma, were screened. Then extracted the material of the literatures and evaluated the methodological quality. The Meta analysis was conducted using the software of RevMan5.1offered by Cochrance collaboration site. According to the metrology analysis, included the clinical curative effect reports of acupuncture treatment on Leiomyoma, the methods and rules of Acupoint selection were analysized and summarized by the software of EXCEL.Results1. Results of Bibliometric analysis:122literatures on Leiomyoma with acupuncture and moxibustion (including combine traditional Chinese and western medicine) treatment were included finally, with the overall quantity increasing year by year. The published literature number of the regions Guangzhou and Shanghai is in the lead. Researches were mainly carried out in the hospital. Reports were mainly published on the core and provincial periodicals of TCM, with the research types mainly of Preventive Measures Research and Case Presentation, only2treatment mechanism researches were published. The main intervention methods were Acupuncture and Scientific Pressure on Ear Acupiont. Curative effect evaluation index was mainly to observe the clinical curative effect, including the clinical symptoms and signs and B ultrasonic examination. There were14controlled clinical trials, but only10randomized controled trials, and more of the literatures for low quality, only one high quality literature with4points.2. Results of Systematic review:(1) There were10RCTs of comparison of acupuncture and drug treatment on Leiomyoma, with794cases of patients with Leiomyoma, including only1high quality literature.(2) Chinese medicine therapy primarily with acupuncture was adopted in treatment group, and medicaments in controlled group, in which6trails used traditional Chinese medicine, and4trails used Western medicine.(3) The total clinical effective rate was adopted as the main end outcome in all10trails, in addition improvement rate of clinical symptoms and the reduction of Leiomyoma volume in3trails, serum hormone level before and after treatmentin2trails, HGB and menstruation duration in1trail, psychological state and the changment of tongue coating and pulse condition in1trail.(4) A total of4trails were received heterogeneity test (P=0.70,12=0%), the results showed that these studies had the clinical and statistical homogeneity, and the fixed effects model was used for Meta analysis. Overall effect inspection showed significant differences between two groups in total clinical effective rate (Z=3.22, P=0.001), Acupuncture combined with Chinese medicine therapy had better total effect than Chinese medicine [OR=2.88,95%CI (1.51,5.48)].3. Rules of Acupoint selection:(1) In the clinical studies of acupuncture treatment on Leiomyoma, the acupoints which had been used involved all the meridians, but focused on Ren meridian, Spleen meridian of foot Taiyin and Stomach meridian of foot Yangming with the total frequency of129(29.59%)、88(20.18%)�'�78(17.89%) respectively. The most commonly used acupoints are Qi Hai(CV6) in Ren meridian, San Yinjiao(SP6) in Spleen meridian and Zu Sanli(ST36) in Stomach meridian.(2) As the main point, San Yinjiao (Spleen meridian,11.62%) is most commonly used, with Guan Yuan (Ren meridian,11.27%) and Zi Gong (Extra point,10.21%) as follow. As the matching acupoint, Qi Hai (Ren meridian,26.32%) is most commonly used, with San Yinjiao (Spleen meridian,9.21%) and Tai Chong (Liver meridian,8.55%) as follow.(3)22abdominal acu-points are used with33.85%of the total. The acupoints of chest, shoulder and upper arm haven’t been selected.(4)15ear acupionts were mainly used in clinic to treat Leiomyoma, in which selection frequency more than5are endocrine, subcortical, uterus, kidney and spleen. Endocrine has highest frequency of utilization, with11times (20.4%) and subcortical, uterus have the same frequency of utilization, with8times (14.8%).Conclusion(1) In the recent30years, the therapeutic effect acupuncture treating Leiomyoma caused extensive attention of the medics, related reseaches have increased. The feature of the studies has been formed on the main area, published periodicals and treatment method. These feature provids evidence for acupuncture treating Leiomyoma in clinic and research. But clinical diagnosis standard is still not unified, the specification degree of the RCTs and the quality of the literatures should be further improved.(2) We primarily consider that acupuncture combined with Chinese medicine has better effect than Chinese medicine alone on Leiomyoma. But because of the low quality of literatures and shortcoming of methodology, the credibility of the results is lower. So in the future clinical and scientific research, researchers need to improve the methodology of the study, the specification degree of literature, and to provide high quality evidence for acupuncture treating Leiomyoma in clinic and research.(3) Acupuncture therapy in the treatment of Leiomyoma relied on the result of differentiation of symptoms and signs but not the syndromes. The mainly discipline of acupoints selection focused on the acupoints from the remote and local area, while combining with subsidiary auricular points therapy. And acupuncture prescription for leiomyoma appears the situation of combination with the concentration distribution trend and disperser using points in more meridians. In the future, in the clinical treatment studies of acupuncture treatment for Leiomyoma, researchers should pay more attention to the TCM Bian Zheng of Leiomyoma, Menstrual staging, and then sum up the relevant roles of acupoint selection, in order to improve the curative effect.