OBJECTIVE: To determine the comparative effects and safety of traditional Chinese medicine (TCM) interventions based on meridian theory for pain relief in patients with primary dysmenorrhea (PD). METHODS: This is a systematic review with network meta-analysis. Randomized controlled trials (RCTs) comparing meridian-based TCM interventions with waitlist, placebo, western medicine, and conventional therapies for PD pain. A SUCRA was used to estimate the probability ranking for the effects of interventions. RESULTS: 57 RCTs involving 3,903 participants and 15 interventions were included. Thirty-two RCTs were rated as low risk of bias. A network diagram was drawn with 105 pairs of comparisons. Compared with NSAIDs and waitlist, significantly better effects were found in acupressure [SMD -1.51, 95% CI -2.91 to -0.12 /SMD -2.31, 95% CI -4.61 to -0.02], warm needling [SMD -1.43, 95% CI -2.68 to -0.18 /SMD -2.23, 95% CI -4.43 to -0.03], moxibustion [SMD -1.21, 95% CI -1.85 to -0.57 / SMD -2.10, 95% CI -3.95 to -0.07], and acupuncture [SMD -1.09, 95% CI -1.62 to -0.55 / SMD -1.89, 95% CI -3.67 to -0.11]. No adverse events were detected. CONCLUSION: For PD pain, the effects of acupressure, acupuncture, warm needling, and moxibustion were superior to those of NSAIDs and waitlist. Oral contraceptive pill, electro-acupuncture, acupressure, and warm needling demonstrated higher probabilities of being better interventions. More high-quality clinical trials are needed to provide more robust evidence of this network. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42022373312.

Full text (sometimes free) may be available at these link(s):      help

• PubMed Central
• DOI
• PubMed
• PDF locator
• publisher