Zongshi Qin1,2, Jiani Wu1, Chang Xu3, Zhishun Liu1. 1. Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China. 2. School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China. 3. Chinese Evidence-Based Medicine Center and Chinese Cochrane Center, West China Hospital, Sichuan University, Chengdu 610041, China.
Abstract
BACKGROUND: The benefits of acupuncture on chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) have been well established according to previous studies. However, uncertainty exists regarding the dose-response relationship between acupuncture sessions and acupuncture effects for CP/CPPS. The objective of this study is to explore the association between the acupuncture sessions and its effects based on previously published data. METHODS: A non-linear meta-regression approach with restricted cubic spline (RCS) was used to investigate the dose-response relationship between acupuncture sessions and its effects on the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI). PubMed, EMBASE, and Cochrane CENTRAL were searched up to May 20, 2018. Randomized controlled trials (RCTs) and case series studies (CSSs) reported the treatment sessions of acupuncture for CP/CPPS with at least two categories were eligible for inclusion. RESULTS: Ten studies involving 329 participants were included, the results showed a J-shaped dose-response association between acupuncture sessions and NIH-CPSI score (range 0 to 43, with higher score indicating greater CP/CPPS symptoms). Overall, more acupuncture sessions received for CP/CPPS patients is associated with increased symptom relieving. After 6 acupuncture sessions, the NIH-CPSI decreased from 26.1 (95% CI: 25.3-27.0) to 18.5 (95% CI: 11.6-25.4), with a between-session difference of -7.6 (95% CI: -14.6 to -0.7). Considering the 95%CI, both robust-error meta-regression modeling [MD: -8.3 (95% CI: -10.4 to -6.3)] and sensitivity analysis without CSSs [MD: -8.1 (95% CI: -9.5 to -6.7)] demonstrated that 18 acupuncture sessions could reach a clinically meaningful improvement regarding NIH-CPSI score. CONCLUSIONS: There appear to be dose-response relationship between acupuncture sessions and CP/CPPS outcome. Prolonged acupuncture sessions were associated with less NIH-CPSI score. According to current evidence, six acupuncture sessions might be the minimal required 'dose' to reach its clinical effects.
BACKGROUND: The benefits of acupuncture on chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) have been well established according to previous studies. However, uncertainty exists regarding the dose-response relationship between acupuncture sessions and acupuncture effects for CP/CPPS. The objective of this study is to explore the association between the acupuncture sessions and its effects based on previously published data. METHODS: A non-linear meta-regression approach with restricted cubic spline (RCS) was used to investigate the dose-response relationship between acupuncture sessions and its effects on the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI). PubMed, EMBASE, and Cochrane CENTRAL were searched up to May 20, 2018. Randomized controlled trials (RCTs) and case series studies (CSSs) reported the treatment sessions of acupuncture for CP/CPPS with at least two categories were eligible for inclusion. RESULTS: Ten studies involving 329 participants were included, the results showed a J-shaped dose-response association between acupuncture sessions and NIH-CPSI score (range 0 to 43, with higher score indicating greater CP/CPPS symptoms). Overall, more acupuncture sessions received for CP/CPPS patients is associated with increased symptom relieving. After 6 acupuncture sessions, the NIH-CPSI decreased from 26.1 (95% CI: 25.3-27.0) to 18.5 (95% CI: 11.6-25.4), with a between-session difference of -7.6 (95% CI: -14.6 to -0.7). Considering the 95%CI, both robust-error meta-regression modeling [MD: -8.3 (95% CI: -10.4 to -6.3)] and sensitivity analysis without CSSs [MD: -8.1 (95% CI: -9.5 to -6.7)] demonstrated that 18 acupuncture sessions could reach a clinically meaningful improvement regarding NIH-CPSI score. CONCLUSIONS: There appear to be dose-response relationship between acupuncture sessions and CP/CPPS outcome. Prolonged acupuncture sessions were associated with less NIH-CPSI score. According to current evidence, six acupuncture sessions might be the minimal required 'dose' to reach its clinical effects.
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