A Systematic Evaluation Of Warming Needle Moxibution In Treating Chronic Pelvic Inflammatory

ObjectiveChronic pelvic inflammatory disease is a common and high incidence in women with a long duration. The disease is more common in married women of child-bearing age, accompanied by irregular menstruation, infertility, ectopic pregnancy and so on. It has serious damage to the patients’physical and mental health, and may reduce their quality of life. In recent years, the incidence of the disease is gradually increasing for various reasons, while the western medical treatments of the disease, either drugs or surgery, are not very efficacy. Many experimenters of clinical trials reported their using of warming needle moxibustion to treat the disease, but according to evidence based medicine evaluation method, these reports are not reasonable, for their unprecise design, disunity standard of diagnosis and curative effect evaluation.Using a systematic review or a Meta analysis method to warming needle moxibustion treatment of chronic pelvic inflammatory disease by a number of independent study results in a comprehensive system, quantitative analysis and objective assessment of the overall quality of these researches, based on the evidence-based medicine method between warming needle moxibustion and non-warming needle moxibustion treatment of chronic pelvic inflammatory disease efficiency. Warming needle moxibustion treatment of chronic pelvic inflammatory disease is effective and it has great, unique advantages. This systematic review on using warming needle moxibustion in treatment of chronic pelvic inflammatory disease may provide a reliable evidence to guide doctors to make an appropriate clinical decision.MethodWith retrieval strategy, an electronic search of the major domestic and international databases, including Pub Med, the Cochrane Central Library, Web of Science and CNKI (Web), CBM, VIP and Wan Fang data was carried out.We used subject headings and keywords in combination as retrieval words. All studies we searched were published between 1991 and 2015, which are all about warming needle moxibustion in the treatment of chronic pelvic inflammatory disease of the literatures, according to the criteria inclusion and exclusion and strict screening of the literatures. We extracted the relevant datas, and organized them into an Excel form. According to their Jadad quality score table results and the bias risk evaluation of the Cochrane Library, the final quality evaluation of the collected literatures was made. We used Rev Man 5.3 software for statistical analysis and Meta analysis. Differences between warming needle moxibustion and non-warming needle moxibustion treatment of chronic pelvic inflammatory disease in the total effective rates, cure rates, symptom scores, and sign integral and recurrence rates were observed. We assessed the publication bias, and made a meta analysis of positive results of sensitivity analysis.ResultIn the study, we took strict inclusion and exclusion criteria. The final 11 collected literatures are Chinese literatures all, including 3 high quality literatures, and the remaining 8 articles were of low quality. There is only 1 piece of study has the total sample size of more than 100.4 studies reported their study on warming needle moxibustion with the control of traditional Chinese medicine,2 studied were about warming needle moxibustion with western medicine treatment to control,2 studied warming needle moxibustion with acupuncture in control,2 studied warming needle moxibustion plus Chinese traditional medicine with traditional Chinese medicine treatment. We made a Meta analysis of warming needle moxibustion treatment of chronic pelvic inflammatory disease with non-warming needle moxibustion therapy in the control group. As a result, the total effective rates and the cure rates were higher in warming needle moxibustion therapy groups than the non-warming needle moxibustion therapy groups. Differences between warming needle moxibustion and non-warming needle moxibustion treatment of chronic pelvic inflammatory disease in the symptom scores, and integral sign and recurrence rates were also different. Warming needle moxibustion therepy can reduce symptoms in patients with integral signs better, and recurrence rates were lower than control group. The difference was statistically significant. But All these studies were not implemented in blinding way, and only 1 study was implemented in concealment.ConclusionWarming needle moxibustion treatment of chronic pelvic inflammatory disease is safer, much effective and available than non-warming needle moxibustion treatment. More and more clinical evidence proves that warming needle moxibustion treatment of chronic pelvic inflammatory disease is safe, effective, the total cure rate is high and the recurrence rate is low. It is worth of more clinical usage and promotion. However, due to the lack of sufficient evidence and the literatures published were of low quality, including fewer samples, unreasonable design and other issues, the credibility of these papers is not reliable. We need to study warming needle moxibustion treatment of chronic Delvic inflammatory disease further.