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Abstract: Objective: To provide guidance for future randomized controlled trials (RCTs) based on a review concerning acupuncture for treating polycystic ovary syndrome (PCOS). Methods: A comprehensive literature search was conducted in October 2015 using MEDLINE, EMBASE, SCISEARCH, Cumulative Index to Nursing and Allied Health Literature, the Cochrane Menstrual Disorders and Subfertility Group trials register, Allied and Complementary Medicine (AMED), China National Knowledge Infrastructure (CNKI), and the Wanfang databases. RCTs comparing either acupuncture with no/sham/pharmacological intervention or a combination of acupuncture and conventional therapy with conventional therapy in the treatment of PCOS were included in this review. A quality evaluation was performed for each of the included studies. Results: Thirty-one RCTs were included in the review and were divided into four categories according to the type of intervention used in the comparator or control group. Menstrual frequency, hormones, anthropometrics, insulin sensitivity, blood lipids, and fertility were used as the main measurements to assess the effects of acupuncture on the patients with PCOS. Thirty trials, except for one, showed an improvement in at least one of the indicators of PCOS after acupuncture treatment. However, normalizing the methodological and reporting format remains an issue. Conclusions: Based upon this review of current clinical trials concerning acupuncture for treating PCOS, we provide guidelines for better clinical trial design in the future.

针刺治疗多囊卵巢综合征随机对照试验指南

[1]Cui, W., Li, J., Sun, W., et al., 2011. Effect of electroacupuncture on oocyte quality and pregnancy for patients with PCOS undergoing in vitro fertilization and embryo transfer. Chin. Acupunct. Mox., 31(8):687-691 (in Chinese).

[2]Cui, W., Li, J., Sun, W., et al., 2012. Effect of electroacupuncture on oocyte quality and pregnancy of patients with PCOS undergoing in vitro fertilization and embryo transfer. World J. Acupunct. Mox., 22(1):23-29.

[3]Cui, W., Li, J., Sun, W., et al., 2015. Effect of electroacupuncture on the spindle and oocyte quality in polycystic ovary syndrome. Shanghai J. Acu.-Mox., 34(2):109-112 (in Chinese).

[4]Cui, Y., Xiong, B., Zhou, Y., 2012. Effect of acupuncture on sex hormone and cytokines in treatment of polycystic ovarian pyndrome. Mil. Med. J. S. Chin., 26(6):547-549 (in Chinese).

[5]Dincer, F., Linde, K., 2003. Sham interventions in randomized clinical trials of acupuncture—a review. Complement. Ther. Med., 11(4):235-242.

[6]Ehrmann, D.A., 2005. Polycystic ovary syndrome. N. Engl. J. Med., 352(12):1223-1236.

[7]Emanuel, E.J., Miller, F.G., 2001. The ethics of placebo-controlled trials—a middle ground. N. Engl. J. Med., 345(12):915-919.

[8]Franasiak, J., Young, S.L., Williams, C.D., et al., 2012. Longitudinal anti-müllerian hormone in women with polycystic ovary syndrome: an acupuncture randomized clinical trial. Evid. Based Complement. Alternat. Med., 2012:973712.

[9]Franks, S., 1995. Polycystic ovary syndrome. N. Engl. J. Med., 333(13):853-861.

[10]He, X.J., 2014. Acupuncture in treating 55 women with polycystic ovary syndrome. Med. Inform., 27(10):294-295 (in Chinese).

[11]Jedel, E., Labrie, F., Oden, A., et al., 2011. Impact of electro-acupuncture and physical exercise on hyperandrogenism and oligo/amenorrhea in women with polycystic ovary syndrome: a randomized controlled trial. Am. J. Physiol. Endocrinol. Metab., 300(1):E37-E45.

[12]Jin, C.L., Wei, L.X., Zhao, J.P., et al., 2014. Efficacy comparison between electroacupuncture and dyne treatment of polycystic ovary syndrome. Chin. Acupunct. Mox., 34(12):1174-1178 (in Chinese).

[13]Johansson, J., Stener-Victorin, E., 2013. Polycystic ovary syndrome: effect and mechanisms of acupuncture for ovulation induction. Evid. Based Complement. Alternat. Med., 2013:762615.

[14]Johansson, J., Redman, L., Veldhuis, P.P., et al., 2013. Acupuncture for ovulation induction in polycystic ovary syndrome: a randomized controlled trial. Am. J. Physiol. Endocrinol. Metab., 304(9):E934-E943.

[15]Lai, M.H., Ma, H.X., Yao, H., et al., 2010. Effect of abdominal acupuncture therapy on the endocrine and metabolism in obesity-type polycystic ovarian syndrome patients. Acupunct. Res., 35(4):298-302 (in Chinese).

[16]Lanham, M.S., Lebovic, D.I., Domino, S.E., 2006. Contemporary medical therapy for polycystic ovary syndrome. Int. J. Gynecol. Obstet., 95(3):236-241.

[17]Leonhardt, H., Hellström, M., Gull, B., et al., 2014. Ovarian morphology assessed by magnetic resonance imaging in women with and without polycystic ovary syndrome and associations with antimullerian hormone, free testosterone, and glucose disposal rate. Fertil. Steril., 101(6):1747-1756.e3.

[18]Li, B., Han, J.R., 2010. Clinical observation of acupuncture combined with Chinese herb in the treatment of PCOS. J. Clin. Acupunct. Mox., 26(1):20-21 (in Chinese).

[19]Li, C., Zhang, S.B., 2011. The effects of acupuncture in treating 30 women with PCOS. Beijing J. Tradit. Chin. Med., 30(2):128-130 (in Chinese).

[20]Li, L., Fan, Y.C., Wang, H.M., et al., 2014. Effect of clomiphene citrate tablets combined with acupuncture on ovulation failure in polycystic ovary syndrome. Hebei J. TCM, 36(8):1203-1205 (in Chinese).

[21]Li, N., 2013. Efficacy and safety evaluation of acupuncture combined with auricular point sticking therapy in the treatment of polycystic ovary syndrome. Chin. Acupunct. Mox., 33(11):961-964 (in Chinese).

[22]Li, Y.L., Lian, F., Wang, R.X., et al., 2011. Observation of clomiphene citrate resistant polycystic ovary syndrome treated by combination of acupuncture, Chinese and western medicine. Hebei J. TCM, 33(2):244-246 (in Chinese).

[23]Liang, R.W., Liu, X.X., Li, X.Y., et al., . Effect of points acupuncture and closeness combined with assisted reproductive technology on ocytes maturity of PCOS infertility patients. J. Clin. Acupunct. Mox., 29(3):17-19 (in Chinese).

[24]Liang, R.W., Liu, X.X., Li, X.Y., et al., 2013b. The effects of acupoint block, needling and assisted reproductive technique on the level of hormone in infertile patients with PCOS. West. J. Tradit. Chin. Med., 26(2):98-99 (in Chinese).

[25]Liang, Z., . Effect of acupuncture combined with Chinese herbal medicine and promoting ovulation treatment on the obese and infertile women with polycystic ovary syndrome. J. Clin. Acupunct. Mox., 31(5):12-15 (in Chinese).

[26]Liang, Z., 2015b. Effect of acupuncture combined with promoting ovulation treatment on pregnancy and ovulation rate of infecundity women with polycystic ovary syndrome of phlegm wet type. Modern J. Integr. Tradit. Chin. West. Med., 24(14):1498-1500 (in Chinese).

[27]Lin, S.H., 2014. Clinical observation of acupuncture in the treatment of PCOS. Asia-Pacific Tradit. Med., 10(20):89-90 (in Chinese).

[28]Liu, X.X., Liu, Y.M., Li, X.Y., et al., 2012. Combination of acupuncture and medicine in regulating disorders of PCOS women. Chin. J. Med. Guid., 14(Suppl. 1):112-114 (in Chinese).

[29]MacPherson, H., Altman, D.G., Hammerschlag, R., et al., 2010. Revised standards for reporting interventions in clinical trials of acupuncture (STRICTA): extending the consort statement. PLoS Med., 7(6):e1000261.

[30]Margolin, A., Avants, S.K., Kleber, H.D., 1998. Investigating alternative medicine therapies in randomized controlled trials. JAMA, 280(18):1626-1628.

[31]Norman, R.J., Dewailly, D., Legro, R.S., et al., 2007. Polycystic ovary syndrome. Lancet, 370(9588):685-697.

[32]Pastore, L.M., Williams, C.D., Jenkins, J., et al., 2011. True and sham acupuncture produced similar frequency of ovulation and improved LH to FSH ratios in women with polycystic ovary syndrome. J. Clin. Endocrinol. Metab., 96(10):3143-3150.

[33]Qiu, Y.F., Wen, L.H., Yang, M., et al., 2015. Observations on the warm needling therapy combined the curative effect of traditional Chinese medicine for liver blood stasis type PCOS. J. North Pharm., 12(5):19-20 (in Chinese).

[34]Rashidi, B.H., Tehrani, E.S., Hamedani, N.A., et al., 2013. Effects of acupuncture on the outcome of in vitro fertilisation and intracytoplasmic sperm injection in women with polycystic ovarian syndrome. Acupunct. Med., 31(2):151-156.

[35]The Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group, 2004. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil. Steril., 81(1):19-25.

[36]Sheng, Y.H., 2015. The effects of acupuncture and HMG on the infertile women with polycystic ovary syndrome who are resistant to CC. Asia-Pacific Tradit. Med., 11(16):106-107 (in Chinese).

[37]Sherman, K.J., Hogeboom, C.J., Cherkin, D.C., et al., 2004. Description and validation of a noninvasive placebo acupuncture procedure. J. Altern. Complement. Med., 8(1):11-19.

[38]Shi, Y., Feng, H.J., Liu, H.R., et al., 2009. Observation on therapeutic effect of acupuncture combined with Chinese herbs on polycystic ovary syndrome of kidney deficiency and phlegm stasis type. Chin. Acupunct. Mox., 29(2):99-102 (in Chinese).

[39]Stefanaki, C., Bacopoulou, F., Livadas, S., et al., 2015. Impact of a mindfulness stress management program on stress, anxiety, depression and quality of life in women with polycystic ovary syndrome: a randomized controlled trial. Stress, 18(1):57-66.

[40]Stener-Victorin, E., Jedel, E., Mannerås, L., 2008. Acupuncture in polycystic ovary syndrome: current experimental and clinical evidence. J. Neuroendocrinol., 20(3):290-298.

[41]Stener-Victorin, E., Jedel, E., Janson, P.O., et al., 2009. Low-frequency electroacupuncture and physical exercise decrease high muscle sympathetic nerve activity in polycystic ovary syndrome. Am. J. Physiol. Regul. Integr. Comp. Physiol., 297(2):R387-R395.

[42]Stener-Victorin, E., Baghaei, F., Holm, G., et al., 2012. Effects of acupuncture and exercise on insulin sensitivity, adipose tissue characteristics, and markers of coagulation and fibrinolysis in women with polycystic ovary syndrome: secondary analyses of a randomized controlled trial. Fertil. Steril., 97(2):501-508.

[43]Stener-Victorin, E., Holm, G., Janson, P.O., et al., 2013. Acupuncture and physical exercise for affective symptoms and health-related quality of life in polycystic ovary syndrome: secondary analysis from a randomized controlled trial. BMC Complement. Altern. Med., 13(1):131.

[44]Tang, J.L., Zhan, S.Y., Ernst, E., 1999. Review of randomised controlled trials of traditional Chinese medicine. BMJ, 319(7203):160-161.

[45]Vincent, C., Lewith, G., 1995. Placebo controls for acupuncture studies. J. R. Soc. Med., 88(4):199-202.

[46]Wang, C.Y., 2015. The effects of acupuncture and CC on the women with polycystic ovary syndrome. Asia-Pacific Tradit. Med., 11(11):83-85 (in Chinese).

[47]Wang, H., Gu, S.J., 2013. Clinical observation of acupuncture combined with Chinese herb in the treatment of PCOS with infertility. J. Hubei Univ. Chin. Med., 15(6):57-58 (in Chinese).

[48]Wang, Y.R., Li, C.R., 2013. Acupuncture in treating polycystic ovary syndrome women. Chin. Heal. Care Nut., 23(4):2112 (in Chinese).

[49]Yang, Y.H., Hong, J.Y., Wei, D.Y., et al., 2005. Acupuncture on polycystic ovarian syndrome-induced infertility. J. Guangdong Med. Coll., 23(4):377-378 (in Chinese).

[50]Zhang, H.M., 2013. Treating 30 PCOS women with acupuncture combined with western medicine. China's Naturopathy, 21(11):60-61 (in Chinese).

[51]Zhang, Q., Gao, Z., Wang, H., et al., 2014. The effect of pre-treatment with transcutaneous electrical acupoint stimulation on the quality of recovery after ambulatory breast surgery: a prospective, randomised controlled trial. Anaesthesia, 69(8):832-839.

[52]Zhang, R., Feng, X.J., Guan, Q., et al., 2011. Increase of success rate for women undergoing embryo transfer by transcutaneous electrical acupoint stimulation: a prospective randomized placebo-controlled study. Fertil. Steril., 96(4):912-916.

[53]Zhao, Y., Hu, L.S., Wang, C.H., et al., 2007. The study of treatment with compoud acupuncture-metformin on the outcome of ovulation induction with chloramiphene in the patients with PCOS. Jiangxi Med. J., 42(12):1089-1092 (in Chinese).

[54]Zheng, Y.H., Su, N.J., Ding, T., 2012. Treatment of PCOS by acupuncture: present experimental and clinical reports. Chin. J. Integr. Tradit. West. Med., 32(10):1436-1439 (in Chinese).

[55]Zheng, Y.H., Wang, X.H., Lai, M.H., et al., 2013. Effectiveness of abdominal acupuncture for patients with obesity-type polycystic ovary syndrome: a randomized controlled trial. J. Altern. Complement. Med., 19(9):740-745.

[56]Zhou, J., Qu, F., 2009. Treating gynaecological disorders with traditional Chinese medicine: a review. Afr. J. Tradit. Complement. Altern. Med., 6(4):494-517.

[57]Introducing editorial board member:

[58]Fan QU, MD, PhD, Fellow in the Research Council for Complementary Medicine (FRCCM), an editorial board member of Journal of Zhejiang University-SCIENCE B (Biomedicine & Biotechnology), is an Associate Professor and PhD Supervisor at the Women’s Hospital, School of Medicine, Zhejiang University, China. As a Principal Investigator (PI), he has been awarded more than 10 grants in the last five years, published over 50 peer-reviewed papers and has filed 10 patents. In 2015, he was awarded the “Excellence in Integrative Medicine Research Award” by the European Society of Integrative Medicine. Dr. QU was a Work Package 10 (WP10) member in the Good Practice in Traditional Chinese Medicine (GP-TCM) Research in the Post-Genomic Era, a Coordination Action funded by the European Union’s 7th Framework Program, and is now Co-Chair of the Pharmacology and Toxicology Interest Group, Good Practice in Traditional Chinese Medicine Research Association, European Union and he also serves as Vice-President of the Acupuncture Research Committee, Zhejiang Acupuncture Association, China.