Systematic Review And Meta-analysis Of The Effect Of Acupuncture On Chronic Pelvic Inflammation Disease

Objective To evaluated the efficacy and safety of acupuncture for chronic pelvic inflammatory disease(CPID)by using the method of Cochrane Systematic Review and Rev Man5.3 software,and to provided further suggestion for clinic.Methods Rigid search strategy was made according to the characteristic of every database.The randomized controlled trials(RCT)about acupuncture on CPID were retrieved.The work was completed by two researchers independently according to the inclusion and excluding criteria.The risk of bias table of included literatures was made by Cochrane handbook5.1 and make a Meta-analysis by using Rev Man5.3 including effective rate,cure rate,recurrence rate,the pelvic cavity accumulates liquid,pelvic mass,reduction pain score and adverse reaction.Results A total of 30 studies involving 2277 patients were included.All the literatures were comparison between acupuncture and drug.According to the standard of Jadad score scale,7 studies are high quality research,and the rest are low quality.the bias risk assessment tool based on the Cochrane system evaluator's Manual 5.1.0 shows 9 studies are low bias risk,12 literatures are moderate bias risk,and 9 studies are high risk.The Meta analysis results shows:(1)clinical efficiency: acupuncture combined with drug and simple acupuncture treatment was better than the drug treatment(P<0.05).it aiso shows there was no difference between acupuncture and Drug enema treatment(P>0.05).the simple acupuncture treatment was superior to western medicine and Chinese patent medicine(P<0.05),but it is the same with Decoction of traditional Chinese Medicine(P>0.05).moxibustion and combined with varies acupunctures was superior to simple acupuncture and acupoint catgut embedding therapy(P<0.05),the analysis was also carried out according to different degree of disease.the results showns it was no difference among them(P>0.05).(2)reduction pain score: acupuncture is superior to drug therapy in reducing the pain score(P<0.05).(3)cure rate: acupuncture is superior to drug therapy(P<0.05).(4)recurrence rate: The rate of recurrence rate of acupuncture group was lower than that of the drug group(P<0.05).(5)The pelvic cavity accumulates liquid: Acupuncture can effectively reduce the pelvic effusion of CPID patients and be superior to drug treatment(P<0.05).(6)pelvic mass: The curative effect of acupuncture is not better than that of drug treatment(P>0.05).(7)Symptom score: the effect of acupuncture is better than that of the drug group(P<0.05).(8)adverse reaction:The incidence of adverse reaction of acupuncture was lower than that of drug treatment(P<0.05).Conclusion According to the results of Meta analysis,acupuncture for the treatment of CPID is effective and has small side effects.It is worth popularizing in clinical practice.But there is not enough evidence to prove that it has a better effect than the decoction of Chinese herbal medicine.And the addition of drug therapy on the basis of acupuncture has not been suggested to have a better effect.At present,the most of researches is focused on the efficiency,and the pain and related signs of the patients are little observed,and the evaluation standard of the curative effect is lack of unity.It is suggested that future research can unify the evaluation criteria and evaluate the therapeutic effect of acupuncture for CPID in many ways.