[Different moxibustion therapies for primary dysmenorrhea: a network Meta-analysis]

Area of Science:

• Integrative Medicine
• Traditional Chinese Medicine
• Gynecology

Background:

• Primary dysmenorrhea (PD) significantly impacts women's quality of life.
• Conventional treatments for PD have limitations and potential side effects.
• Moxibustion, a traditional therapy, is increasingly explored for PD management.

Purpose of the Study:

• To conduct a network meta-analysis comparing the clinical efficacy of various moxibustion therapies for primary dysmenorrhea (PD).
• To identify the most effective moxibustion techniques for improving clinical outcomes in PD patients.

Main Methods:

• Searched 8 major databases for randomized controlled trials (RCTs) on moxibustion for PD.
• Included 64 RCTs involving 5,814 patients and 11 moxibustion types.
• Utilized network meta-analysis with R and Stata software for data analysis and risk of bias assessment.

Main Results:

• Nine moxibustion therapies outperformed conventional medication in overall clinical effectiveness, with wheat-grain sized cone moxibustion being most effective (OR=8.91).
• Herb-partitioned moxibustion showed the best pain reduction (VAS score: MD=-4.19).
• Heat-sensitive moxibustion was most effective for reducing menstrual symptom scores (CMSS: MD=-11.13) and prostaglandin F2α levels (PGF2α: MD=-24.94).
• Moxibustion therapies demonstrated a lower incidence of adverse events compared to conventional Western medicine.

Conclusions:

• Wheat-grain sized cone moxibustion, herb-partitioned moxibustion, and heat-sensitive moxibustion are promising for PD treatment.
• These specific moxibustion techniques offer superior efficacy and safety compared to conventional treatments.
• Further high-quality RCTs are needed to validate these findings due to limitations in current evidence quality and quantity.