Efficacy of Acupuncture for Pelvic Pain associated with Endometriosis in Women: A protocol for systematic review and meta-analysis

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This protocol outlines a systematic review and meta-analysis to assess the effectiveness of acupuncture compared to non-penetrating needles in reducing pelvic pain associated with endometriosis.

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This protocol outlines a planned systematic review and meta-analysis designed to evaluate the efficacy of acupuncture for managing pelvic pain in women with endometriosis. The study aims to include randomized controlled trials comparing acupuncture against non-penetrating needles, focusing on primary outcomes such as pain reduction and secondary outcomes like quality of life improvements. Although the paper details specific search strategies, eligibility criteria, and statistical analysis plans, it does not present completed results or data synthesis because the review had not yet started at the time of publication. This paper is centrally about endometriosis — specifically assessing a complementary therapy for its associated pelvic pain symptoms.

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Abstract

P: pelvic pain associated with EMs; I: acupuncture; C: non-penetrating needles; O: reduce the pain level.Condition being studied: The usage of acupuncture for pelvic pain caused by endometriosis is common, although studies have not been conducted to establish its effectiveness.Hence, we will conduct a systematic review to assess the effectiveness of acupuncture in treating endometriosisrelated pelvicpain.Eligibility criteria: Study participants were eligible based on the following criteria: 1) 18-45 years old; 2) following menarche; 3) complete uterus and at least one ovary; 4) all patients had EMs INPLASY registration number: This protocol was registered with the International Platform of Registered Systematic Review and Meta-Analysis Protocols (INPLASY) on 03 March 2023
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Introduction

Review question / Objective: P: pelvic pain associated with EMs; I: acupuncture; C: non-penetrating needles; O: reduce the pain level. Condition being studied: The usage of acupuncture for pelvic pain caused by endometriosis is common, although studies have not been conducted to establish its effectiveness. Hence, we will conduct a systematic review to assess the INPLASY 1 International Platform of Registered Systematic Review and Meta-analysis Protocols INPLASY PROTOCOL Efficacy of Acupuncture for Pelvic Pain associated with Endometriosis in Women: A protocol for systematic review and meta-analysis Xu, LX1; Sun, P2; Yan, DM3; Tu, B4. To cite: Xu et al. Efficacy of Acupuncture for Pelvic Pain associated with Endometriosis in Women: A protocol for systematic review and meta- analysis. Inplasy protocol 202330006. doi: 10.37766/inplasy2023.3.0006 Received: 03 March 2023 Published: 03 March 2023 Review question / Objective: P: pelvic pain associated with EMs; I: acupuncture; C: non-penetrating needles; O: reduce the pain level. Condition being studied: The usage of acupuncture for pelvic pain caused by endometriosis is common, although studies have not been conducted to establish its e ffectiveness. Hence, we will conduct a systematic review to assess the effectiveness of acupuncture in treating endometriosis- related pelvicpain. Eligibility criteria: Study participants were eligible based on the following criteria: 1) 18-45 years old; 2) following menarche; 3) complete uterus and at least one ovary; 4) all patients had EMs INPLASY registration number: This protocol was registered with the International Platform of Registered Systematic Review and Meta-Analysis Protocols (INPLASY) on 03 March 2023 and was last updated on 03 March 2023 (registration number INPLASY202330006). Corresponding author: lingxia xu [email protected] Author Affiliation: Academician Workstation, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, China. Support: Nos.2019XZZX- LG005. Review Stage at time of this submission: The review has not yet started. Conflicts of interest: None declared. Xu et al. Inplasy protocol 202330006. doi:10.37766/inplasy2023.3.0006 Xu et al. Inplasy protocol 202330006. doi:10.37766/inplasy2023.3.0006 Downloaded from https://inplasy.com/inplasy-2023-3-0006/ effectiveness of acupuncture in treating endometriosis-related pelvicpain.

Methods

Search strategy: From the following seven databases, studies were extracted to February 2023: PubMed, EMBASE, web of science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wan Fang Database (WanFang), sinomed and Weipu Database for Chinese Technical Periodicals (VIP). We searched the international and Chinese clinical trial registration platforms up to February 2023. P a r t i c i p a n t o r p o p u l a t i o n : S t u d y participants were eligible based on the following criteria: 1) 18-45 years old; 2) following menarche; 3) complete uterus and at least one ovary; 4) all patients had EMs. Intervention: Acupuncture. Comparator: Non-penetrating needles. Study designs to be included: RCTs. Eligibility criteria: Study participants were eligible based on the following criteria: 1) 18-45 years old; 2) following menarche; 3) complete uterus and at least one ovary; 4) all patients had EMs. Information sources: PubMed, EMBASE, web of science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wan Fang Database (WanFang), sinomed and Weipu Database for Chinese Technical Periodicals (VIP). Main outcome(s): Our study aimed to determine whether acupuncture can reduce the pain level (primary outcome), improve different aspects of the quality of life by Quality-of-life scales(he SF-36) and the take-home-baby rate(secondary outcome) for patients with EMs. Quality assessment / Risk of bias analysis: An assessment of bias risk was performed b y t w o i n v e s t i g a t o r s , w i t h a n y disagreements being resolved by three investigators. Seven items were included in this study, which were evaluated using the RoB 2 tool.random sequence generation; allocation concealment; blinding of patients and doctors; blinding of outcome assessment; incomplete and missing outcome data; selective outcome data reporting, other bias. Strategy of data synthesis: The continuous data will be measured by Mean difference or Std Mean difference, 95% Confidence interval and P values. The dichotomous variables include will be estimated by Relative risk, 95% Confidence interval and P values. The chi-squared test and I2 statistic will be used to test the statistical heterogeneity. Subgroup analysis: 1)by age: patients were stratified into two groups: mean age >35 years and mean age≤35 years. 2)by the severity of endometriosis: patients were stratified into three groups: I, II, or III endometriosis. Sensitivity analysis: Sensitivity analysis will be performed by excluding studies with high risk of bias and changing the statistical model. Country(ies) involved: China. Other relevant information: Endometriosis (EMs) is a chronic disease caused by active endometrial tissue (glands and stroma) growing outside the uterus.EMs is characterized primarily by pain, and 87.7% of patients experience dysmenorrhea, 71.3% experience non-menstrual pain in the abdomen, 57.4% experience total abdominal pain, 56.2% experience pain during intercourse, 46.2% experience anal pain, and 39.5% experience painful bowel movement, which negatively in fluences their  mental and physical health, and  increases the social medical burde. Modern medicine has a good analgesic and lesion inhibition effect, but pelvic pain is prone to relapses.

Keywords

Acupuncture, Pelvic Pain, Endometriosis, systematic review, meta- analysis. INPLASY 2Xu et al. Inplasy protocol 202330006. doi:10.37766/inplasy2023.3.0006 Xu et al. Inplasy protocol 202330006. doi:10.37766/inplasy2023.3.0006 Downloaded from https://inplasy.com/inplasy-2023-3-0006/ Contributions of each author: Author 1 - LINGXIA XU. Email: [email protected] Author 2 - PENG SUN. Email: [email protected] Author 3 - dongmei yan. Email: [email protected] Author 4 - qing tu. Email: [email protected] Author 5 - bin li. Email: [email protected] INPLASY 3Xu et al. Inplasy protocol 202330006. doi:10.37766/inplasy2023.3.0006 Xu et al. Inplasy protocol 202330006. doi:10.37766/inplasy2023.3.0006 Downloaded from https://inplasy.com/inplasy-2023-3-0006/

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