A meta-analysis of the clinical efficacy of the combination of acupuncture and Chinese medicine in the treatment of haemorrhoids

Abstract

At present, surgical resection is the main method of the treatment of haemorrhoids, but is easy to recur after surgery. Recently, it is reported that acupuncture has a beneficial influence on haemorrhoids. Thus, whether acupuncture is effective in the treatment of haemorrhoids is the key in this meta-analysis. To evaluate the clinical efficacy of the treatment of combination of acupuncture and Chinese medicine in haemorrhoids by meta-analysis, which provide a scientific, effective and feasible evidence for clinical decision-making and practice. A systematic review and meta-analysis of randomized clinical trials (RCTs). A meta-analysis was performed by using Review Manager 5.3. All RCTs about combination of acupuncture and Chinese medicine versus Chinese medicine alone were selected and assessed for inclusion. The effective rate (ER), recurrence rate(RR), Symptom score before and after treatment (perianal edema, hemafecia, perianal pain, pruritus ani, prolapse of haemorrhoids) were the outcomes analyzed in this meta-analysis. 11 RCTs and 976 patients were included. The methodological quality of most included trials was low to moderate. In this meta-analysis, the clinical efficacy of combination of acupuncture and Chinese medicine was more effective than only Chinese medicine used in haemorrhoids. The effective rate [OR=5.24,95%CI(3.72,7.40), P<0.0000I], recurrence rate [OR=0.29, 95%CI(0.11, 0.73), P=0.009], perianal edema [WMD=-0.74,95%CI-0.90 to -0.59, P<0.00001], hemafecia[WMD=-0.78,95%CI-0.89 to -0.67. P<0.00001], perianal pain[WMD=-0.72,95%CI-0.94 to -0.50, P<0.00001], pruritus ani[WMD=-0.75,95%CI-0.92 to -0.58, P<0.00001] and prolapse of haemorrhoids[WMD=-0.43,95%CI-0.84 to -0.02, P=0.04] were shown in this meta-analysis.(OR:odds ratio; CI:confidence interval; WMD:weighted mean difference). There was about 96% of the clinical efficiency in the treatment of acupuncture plus Chinese medicine in haemorrhoids and 89% of that used in Chinese medicine alone, which indicates clearly that 7% higher efficiency in the experimental group compared with the control group. The treatment of combination of acupuncture and Chinese medicine in haemorrhoids is more useful than Chinese medicine alone applied in piles, which is shown in 91% of clinical effects in average.