Wei Zhang,1,# Yu Fang,1,# Minfeng Shi,2 Mingzhen Zhang,3,4 Yuangui Chen,5 and Tie Zhou1

1Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China;

2Reproductive Center, Changhai Hospital, Naval Medical University, Shanghai, China;

3Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou, China;

4WMU-Monash University BDI Alliance in Clinical & Experimental Biomedicine, Wenzhou Medical University, Wenzhou, China;

5Hongkou Branch, Changhai Hospital, Naval Medical University, Shanghai, China

Corresponding author.

Contributions: (I) Conception and design: T Zhou, Y Chen, W Zhang; (II) Administrative support: T Zhou, Y Chen; (III) Provision of study materials or patients: W Zhang, Y Fang, M Shi; (IV) Collection and assembly of data: W Zhang, Y Fang; (V) Data analysis and interpretation: W Zhang, Y Fang, M Shi, M Zhang; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.

#These authors contributed equally to this work.

Correspondence to: Tie Zhou, MD, PhD. Department of Urology, Changhai Hospital, Naval Medical University, 168 Changhai Rd, Shanghai 200433, China. Email: moc.361@eituohznew; Yuangui Chen, MD. Hongkou Branch, Changhai Hospital, Naval Medical University, 15 East Jiangwan Rd, Shanghai 200081, China. Email: moc.361@nehccodohtro.

 

 

 

Abstract

Background

The study aims to perform a meta-analysis of published trials and evaluate the efficacy of acupuncture on chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) by symptom score reduction, optimal acupuncture session, and most frequently used acupoints.

Methods

A literature search was performed for randomized controlled trials (RCTs) comparing efficacy of acupuncture with sham acupuncture or standard medication on CP/CPPS. The primary outcome was the reduction of National Institute of Health-Chronic Prostatitis Index (NIH-CPSI) total score and its subscales. The optimal acupuncture session to reach its clinical efficacy and most common compatibility rule of acupoints were also evaluated.

Results

Ten trials involving 770 participants were included. Meta-analysis showed compared with sham acupuncture, acupuncture yielded significant reduction in NIH-CPSI total score [weighted mean difference (WMD): 7.28, 95% confidence interval (95% CI): 5.69–8.86), and provided better pain relief (WMD: 3.57, 95% CI: 2.07–5.08), urinary symptoms improvement (WMD: 1.68, 95% CI: 1.13–2.22), and quality of life (QOL) (WMD: 2.38, 95% CI: 1.41–3.36). Compared with standard medication, acupuncture were more efficacious in reducing NIH-CPSI total score (WMD: 3.36, 95% CI: 1.27–5.45), also showed significant greater pain relief (WMD: 2.36, 95% CI: 1.67–3.06), marginal advantage in improving QOL (WMD: 0.98, 95% CI: 0.12–1.83) but no difference in reducing urinary symptom (WMD: −0.03, 95% CI: −1.30 to 1.24). Four acupuncture sessions were the minimum “dose” to reach clinical efficacy, and prolonged acupuncture sessions continuously improved urinary symptoms and QOL. The majority of acupoint selection strategies were based on the combination of any three acupoints from CV3, CV4, BL32, SP6, and SP9.

Conclusions

Acupuncture has promising efficacy for patients with CP/CPPS, especially category IIIB, in aspects of relieving pain and urinary symptoms and improving the QOL. Acupuncture may serve as a standard treatment option when available, and a tailored comprehensive treatment strategy for CP/CPPS is the future trend.

Keywords: Acupuncture, chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), National Institute of Health-Chronic Prostatitis Index (NIH-CPSI), acupuncture session, acupoint selection