{"paper_id":"315e7ede-2408-449d-a8d6-3d7ea109d35b","body_text":"INTRODUCTION \nReview question / Objective P: Patients \nwho meet the relevant diagnostic criteria for \nendometriosis; I: The treatment group \nconsisted of various acupuncture and moxibustion \ntherapies, mainly including electroacupuncture, \nabdominal acupuncture, acupoint catgut \nembedding，warming needle moxibustion，herb-\npartition moxibustion，acupuncture，moxa stick \nmoxibustion，buccal acupuncture，midnight-noon \nebb-flo w l o w - f re q u e n c y t h e r a p y，l a s e r \nmoxibustion，ear acupuncture; C: The control \ng ro u p i s c o n t ro l l e d b y p l a c e b o，s h a m \nacupuncture，western medicine or traditional \nChinese medicine，blank; O: Clinical e fficacy \nrate，Visual Analogue Score (VAS) and adverse \nevents; S: Published clinical randomized controlled \ntrials of acupuncture and moxibustion methods for \nendometriosis. \nRationale In recent years, traditional Chinese \nacupuncture and moxibustion have been applied \nmore and more in the clinical treatment of EMs, \nand the relevant mechanism suggests that \nacupuncture and moxibustion can improve pelvic \ncirculation, relieve uterine smooth muscle spasm \nand regulate hormone levels. There are many \nmethods of acupuncture and moxibustion for the \ntreatment of endometriosis in clinical practice, \nincluding routine acupuncture, electroacupuncture, \nabdominal acupuncture, and moxibustion, etc. \nMost of them have achieved good therapeutic \neffects. However, due to the lack of direct efficacy \nand safety comparison between various \nacupuncture and moxibustion therapies, it is not \npossible to form a relatively accurate assessment \nof the differences in outcome improvement \nindicators in patients with endometriosis treated by \ndifferent acupuncture and moxibustion therapies. \nThrough the comparison of different acupuncture \nINPLASY 1\nInternational Platform of Registered Systematic Review and Meta-analysis Protocols\nINPLASYA network meta-analysis of different acupuncture \nand moxibustion methods for the treatment of \nendometriosis\nSu, Y1; Zheng, XY2; Zhu, H3; Jia, Y4; Yang, J5.\nADMINISTRATIVE INFORMATION  \nSupport -  None. \nReview Stage at time of this submission - Preliminary searches. \nConflicts of interest - None declared. \nINPLASY registration number: INPLASY202380077 \nAmendments - This protocol was registered with the International \nPlatform of Registered Systematic Review and Meta-Analysis Protocols \n(INPLASY) on 17 August 2023 and was last updated on 17 August 2023.\nCorresponding author: \nYang Su\n1310922817@qq.com\nAuthor Affiliation:                   \nChengdu University of Traditional \nChinese Medicine.\nSu et al. INPLASY protocol 202380077. doi:10.37766/inplasy2023.8.0077\nSu et al. INPLASY protocol 202380077. doi:10.37766/inplasy2023.8.0077 Downloaded from https://inplasy.com/inplasy-2023-8-0077/\nINPLASY202380077\ndoi: 10.37766/inplasy2023.8.0077 \nReceived: 17 August 2023\nPublished: 17 August 2023\n\nand moxibustion methods to provide evidence-\nbased medical evidence to treat endometriosis. \nCondition being studied Endometriosis is a \ncommon gynecological disease，which is mainly \nfeatured by pelvic abdominal pain, dysmenorrhea, \ninfertility, dyspareunia and so on. It is a chronic \ndisease due to its incompletely clear cause, \ndifficulty to cure, and the risk of su fferring \ncancer.According to incomplete estimates, the \nincidence of endometriosis in women of \nchildbearing age is about 10% to 15%, the \nincidence of endometriosis in infertile women is \nabout 20% to 50%, and the incidence of \ne n d o m e t r i o s i s i n w o m e n w i t h c l i n i c a l \nmanifestations of menstrual pelvic pain is about \n71% to 87%. At present, the main treatment \nmethods of Western medicine for endometriosis \nare drug therapy, surgical therapy, interventional \ntherapy and auxiliary therapy. At present, Western \nmedicine treatment has the characteristics of drug \ntoxicity, postoperative trauma, poor prognosis and \nhigh recurrence rate, so seeking a safe and \neffective treatment has become an urgent need for \nthe treatment of endometriosis. In recent years, \ntraditional Chinese acupuncture and moxibustion \nhas been applied more and more in the clinical \ntreatment of this disease, and the relevant \nmechanism suggests that acupuncture and \nmoxibustion can improve pelvic circulation, relieve \nuterine smooth muscle spasm and regulate \nhormone levels. There are many methods of \nacupuncture and moxibustion in clinical treatment \nof endometriosis, including routine acupuncture, \nelectroacupuncture, abdominal acupuncture, and \nmoxibustion, etc. Most of them have achieved \ngood therapeutic effect. \nMETHODS \nS e a r c h s t r a t e g y Databases ：\nSinoMed.CNKI.Wanfang.VIP .PubMed、EMbase, \nCochrane Library、Web of science. Search dates \nrange ：from Buildng a library to 2023/05/01 \nRestrictions:language is Chinese or English. I will \ncheck again prior to the final analysis. I will seek \npublication. \nP a r t i c i p a n t o r p o p u l a t i o n I n c l u s i o n \ncritieria:Patients with EMs with clear diagnostic \ncriteria.Exclusion criteria：① Review, case report, \nsystematic review, experience summary, animal \nexperimental research articles; ②Repeated \npublications, repeated citations, or similar (same) \nmethods and results published recently by the \nsame author, only 1 most authoritative literature is \nselected; ③ The purpose of the study could not \nreflect the efficacy of acupuncture in the treatment \nof endometriosis; ④ Unable to provide complete \nand effective data; ⑤There are obvious \nmethodological errors in the literature, such as \nstatistical errors and improper random allocation. \nIntervention The intervention mainly included \nelectroacupuncture,abdominal acupuncture,catgut \nembedding，warming needle moxibustion，herb-\npartition moxibustion，moxa stick moxibustion，\nbuccal acupuncture， midnight-noon ebb-flow low \nfrequency therapy ，laser moxibustion,ear \nacupuncture.It can also be used alone or in \ncombination with multiple therapies. \nComparator The comparators were placebo，\nsham acupuncture ，western medicine or \ntraditional Chinese medicine，blank. \nStudy designs to be included Network meta-\nanalysis，systematic review of randomized \ncontrolled trials to assess the beneficial effects of \ndifferent acupuncture and moxibustion methods. \nEligibility criteria Inclusion criteria :① Study type: \nRandomized Controlled trials (RCT) involving \ndifferent acupuncture and moxibustion methods \nfor endometriosis; ③ Intervention measures: The \ntreatment group was mainly treated with \nacupuncture therapy, and the control group was \ncontrolled with placebo, sham acupuncture, drugs \nor blank. (4) Outcome measures: The primary \noutcome measures were clinical effective rate, and \nthe secondary outcome measures were visual \nanalogue score (VAS) and the occurrence of \nadverse events.1.2.2 Exclusion criteria ① Review, \ncase report, systematic review, experience \nsummary, animal experimental research articles; (2) \nRepeated publications, repeated citations, or \nsimilar (same) methods and results published \nrecently by the same author, only 1 most \nauthoritative literature is selected; ③ The purpose \nof the study could not re flect the efficacy of \nacupuncture in the treatment of endometriosis; ④ \nUnable to provide complete and effective data; (5) \nThere are obvious methodological errors in the \nliterature, such as statistical errors and improper \nrandom allocation. \nI n f o r m a t i o n s o u r c e s D a t a b a s e s：\nSinoMed.CNKI.Wanfang.VIP .PubMed、EMbase、\nCochrane Library、Web of science Contact details \nINPLASY 2Su et al. INPLASY protocol 202380077. doi:10.37766/inplasy2023.8.0077\nSu et al. INPLASY protocol 202380077. doi:10.37766/inplasy2023.8.0077 Downloaded from https://inplasy.com/inplasy-2023-8-0077/\n\nf o r f u r t h e r i n f o r m a t i o n : Y a n g S u , \n1310922817@qq.com\nCitation：Listing data sources in the references\nData use license：The information quoted is all \nreferred to.\nData availability：Data availability is not applicable \nto this article as no new data were created or \nanalyzed in this study.\nEnsure that informationdata sources are clear, \naccurate, complete, and easily accessible.\nMain outcome(s) The primary outcome was \nclinical efficacy rate. \nAdditional outcome(s) Visual Analogue Score \n(VAS) and adverse events. \nData management In this study, two researchers \nindependently conducted literature retrieval and \nscreening at all levels, carried out cross-check, \nextracted relevant data, exported the title and \nabstract of the retrieved articles, and then \nimported the data into NoteExpress software for \nliterature management, eliminated duplicate \nliteratures and excluded literatures that did not \nmeet the requirements of the articles. After \nbrowsing the title and abstract of the articles, \ndownload the full text of the article and read it \ncarefully. Using excel tables to record and \nsummarize useful data, and then summarizing the \nliterature in the next step. If the data diverges, a \nthird researcher can make a decision. The content \nof data extraction mainly includes: 1) the subject of \nthe included study, the abstract of the literature, \nthe year of publication, the test method, the type \nof study, and the number of cases; 2) Basic \ncharacteristics of the subjects, including baseline \ndata of each group, such as age, gender, duration \nof disease, follow-up time, etc.; 3) Speci fic \nintervention measures and relevant relevant \nindicators, such as randomization, diagnostic \ncriteria, course of disease, baseline data, treatment \ntime, follow-up time, adverse reactions and other \nrecords, including outcome indicators and related \nfactors causing the risk of deviation. \nQuality assessment / Risk of bias analysis The \nliterature quality was evaluated by two researchers. \nThe risk of bias was assessed using the literature \nquality assessment tool provided by the Cochrane \nCollaboration network. The quality of the selected \nliterature was evaluated through 7 articles. Specific \narticles include random sequence generation, \nassignment concealment, double blindness of \nsubjects and researchers, blind evaluation of \nresults, loss of follow-up and withdrawal, selective \nreporting, and other sources of bias. The bias of \nthe above mentioned projects can be classi fied \ninto three levels of bias: low risk, uncertain and \nhigh risk. In addition, when the selection decisions \nof two researchers are inconsistent, it can be \nresolved by negotiation or by asking a third party \nto intervene and coordinate. \nStrategy of data synthesis When closed loops \nappear in the study, the \"ring method\" is used to \ntest for inconsistencies. The inconsistency factor \n(IF value) can be judged: when P>0.05 or its 95% \nCI starting point is 0, it indicates that the direct \nevidence and indirect evidence are in good \nagreement; When P0.05, indicating good \nagreement between direct and indirect evidence. If \nthere is inconsistency, the inconsistency model is \nfitted, and sensitivity analysis is performed to test \nthe stability of the outcome measures, and vice \nversa.\nThe primary outcome was clinical efficacy rate.\nConsidering the comprehensive factors in \nacupuncture techniques, acupuncture therapies, \nstimulation intensity and frequency, differences in \ndrug components, timing of treatment in the \noriginal studies, acupoint prescription and so \non,this analysis used a random-effects model. \nSubgroup analysis Subgroup analysis is not set \nup at this time. \nSensitivity analysis 1. Type and quality of studies, \nsuch as excluding only individual observational \nstudies or studies of low quality;\n2. Definition and measurement of study subjects, \ninterventions and outcomes, such as excluding \nonly studies with different therapeutic doses;\n3. Inclusion and exclusion criteria, such as studies \nthat exclude ethnic minorities;\n4. Data extraction method and estimation method \nof missing data, such as extracting a certain data \npoint by another method;\n5. Statistical models, such as using di fferent \nweighting methods. \nLanguage restriction Chinese or English. \nCountry(ies) involved China. \nK e y w o rd s a c u p u n c t u re ; m o x i b u s t i o n；\nendometriosis；randomized controlled trials; \nnetwork meta-analysis. \nContributions of each author \nAuthor 1 - Yang Su - Author 1 drafted the \nmanuscript.\nEmail: 1310922817@qq.com\nAuthor 2 - Xiaoyan Zheng - Author 2 rectified the \narticle(data analysis and examination).\nINPLASY 3Su et al. INPLASY protocol 202380077. doi:10.37766/inplasy2023.8.0077\nSu et al. INPLASY protocol 202380077. doi:10.37766/inplasy2023.8.0077 Downloaded from https://inplasy.com/inplasy-2023-8-0077/\n\nEmail: 378794487@qq.com\nAuthor 3 - Hao Zhu - Author 3 collected data and \nextracted the data.Meanwhile,quality assessment \nwas checked.\nEmail: 1298999534@qq.com\nAuthor 4 - Yan Jia - Author 4 checked the article's \ncontents and various datas by referring software.\nEmail: 42467762@qq.com\nAuthor 5 - Jie Yang - Author 5 Checked the writing \nof the article and the authenticity of the content of \nthe paper, the reliability of the data, the credibility \nof the conclusion, whether it conformed to the \nlegal norms, academic norms and moral norms.\nEmail: jenny_yang_jie@126.com\nINPLASY 4Su et al. INPLASY protocol 202380077. doi:10.37766/inplasy2023.8.0077\nSu et al. INPLASY protocol 202380077. doi:10.37766/inplasy2023.8.0077 Downloaded from https://inplasy.com/inplasy-2023-8-0077/","source_license":"CC0","license_restricted":false}