[Impact of deqi on acupoint effects in patients with primary dysmenorrhea:a systematic review of randomized controlled trials]

The effects of deqi (arrival of qi) on acupoint effects in patients with primary dysmenorrhea (PD) were evaluated.Ten literature databases,including China National Knowledge Infrastructure (CNKI),VIP Database,Wanfang Database,Chinese Biomedical Literature Database (CBM),Cochrane Library CENTRAL,MEDLINE,Embase,AMED, CINAHL Plus,PsycINFO were selected.In addition,5 registers of ongoing trials,the reference lists of included articles and grey literature website OpenGrey were added.The search time was from date of database establishment to August 2016;no restrictions were made on language or status of publication.All randomized controlled trials (RCTs) and quasi-randomized controlled trials (q-RCTs) which compared the effects of deqi and non-deqi on PD or compared the effects of different deqi elements on PD were included.The research quality was assessed according to Cochrane bias risk evaluation tool 5.1.0.The RevMan 5.3.5 was applied for quantitative analysis if insignificant clinical heterogenicity with I² ≤ 75%,otherwise the results was summarized by qualitative analysis.As a result,6 RCTs involving 645 patients were included.Because of considerable clinical heterogeneity,only qualitative analysis was performed,which indicated ① acupuncture could reduce pain and anxiety regardless of deqi,and the effects of deqi on pain relief were superior or equivalent to that of none-deqi,and the effects of deqi on anxiety relief were similar to that of none-deqi;② the more intensity of deqi and higher number of acupoints selected,the better effects on pain alleviation,symptom relief and pain duration;③ the higher rate of deqi had a better acupoint effect on alleviating anxiety,but was not on pain relief;④ deqi appeared early and propagated to affected area could lead to faster onset on pain relief;⑤ the effects on relieving pain and symptoms was better when warm sensation in deqi or qi reaching affected area.Due to the few number,low quality and potential bias of included studies,it was not sufficient to draw clear conclusion regarding the effects of deqi on PD patients.This study protocol was registered in PROSPERO (CRD42016038518).