Short-term Outcomes of Acupuncture Interventions on Uterine Adenomyosis: A Systematic Review and Meta-analysis

The purpose of this systematic review is to evaluate for evidence of the association of acupuncture with relieving the symptoms of adenomyosis. We searched ten electronic databases and included randomized controlled trials (RCTs) in women with adenomyosis. The methodological quality was moderate evidence level by Cochrane risk-of-bias criteria. The results were analyzed by Review Manager 5.3 and expressed as standardized mean differences (SMD) or mean differences (MD). Eleven RCTs (942 subjects) were included in this meta-analysis. Analysis with no heterogeneity showed that acupuncture group obtained a significant better effect (95% CI, -0.48 to -0.10; I 2 = 0%) on reducing the size of the uterus and was superior in the shrink of carbohydrate antigen 125 (CA125) level (95% CI, -1.13 to -0.44; I 2 = 0%) than that in pharmacological medicine alone group. Moreover, acupuncture was significantly associated with improving patients’ dysmenorrheal symptoms after 3-month menstrual cycles treatment (95% CI, -1.25 to -0.13). The adverse events, especially the incidence of hot flashes, were less reported in acupuncture group compared to pharmacological medicine alone group (Odds Ratio, OR, 0.17; 95% CI, 0.08 to 0.35; I 2 = 0%). Acupuncture therapy is a promising avenue for the development of alternatives to surgery and medicine in the treatment of adenomyosis. However, further rigorous trials are needed to confirm the claims of our results.