Efficacy of Acupuncture for Chronic Prostatitis/Chronic Pelvic Pain Syndrome,Annals of Internal Medicine

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Efficacy of Acupuncture for Chronic Prostatitis/Chronic Pelvic Pain Syndrome
Annals of Internal Medicine ( IF 19.6 ) Pub Date : 2021-08-17 , DOI: 10.7326/m21-1814
Yuanjie Sun ₁ , Yan Liu ₂ , Baoyan Liu ₁ , Kehua Zhou ₃ , Zenghui Yue ₄ , Wei Zhang ₅ , Wenbin Fu ₆ , Jun Yang ₇ , Ning Li ₈ , Liyun He ₉ , Zhiwei Zang ₁₀ , Tongsheng Su ₁₁ , Jianqiao Fang ₁₂ , Yulong Ding ₁₃ , Zongshi Qin ₁ , Hujie Song ₁₄ , Hui Hu ₁₅ , Hong Zhao ₁₆ , Qian Mo ₁₇ , Jing Zhou ₁ , Jiani Wu ₁ , Xiaoxu Liu ₁ , Weiming Wang ₁ , Ran Pang ₁ , Huan Chen ₁ , Xinlu Wang ₁ , Zhishun Liu ₁

Affiliation

Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China (Y.S., B.L., Z.Q., J.Z., J.W., X.L., W.W., R.P., H.C., X.W., Z.L.).
Key Laboratory of Chinese Internal Medicine of Ministry of Education, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China (Y.L.).
ThedaCare Regional Medical Center - Appleton, Appleton, Wisconsin (K.Z.).
Hengyang Hospital Affiliated to Hunan University of Chinese Medicine, Hengyang, China (Z.Y.).
The First Hospital of Hunan University of Chinese Medicine, Changsha, China (W.Z.).
Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China (W.F.).
The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China (J.Y.).
West China Hospital of Sichuan University, Chengdu, China (N.L.).
China Academy of Chinese Medical Sciences, Beijing, China (L.H.).
Yantai Hospital of Traditional Chinese Medicine, Yantai, China (Z.Z.).
Shaanxi Provincial Hospital of Traditional Chinese Medicine, Xi'an, China (T.S.).
The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China (J.F.).
Beijing Fengtai Hospital of Integrated Traditional and Western Medicine, Beijing, China (Y.D.).
Xi'an TCM Brain Disease Hospital, Xi'an, China (H.S.).
Dongfang Hospital Beijing University of Chinese Medicine, Beijing, China (H.H.).
Luohu District Hospital of Traditional Chinese Medicine, Shenzhen, China (H.Z.).
Guizhou University of Traditional Chinese Medicine, Guiyang, China (Q.M.).

**Visual Abstract. Efficacy of Acupuncture in Chronic Prostatitis/Chronic Pelvic Pain Syndrome.**
High-quality evidence on the effect of acupuncture on chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is scarce. This randomized, sham-controlled trial, which was conducted at 10 tertiary hospitals in China, sought to assess the long-term efficacy of acupuncture for CP/CPPS.

Background:

Acupuncture has promising effects on chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), but high-quality evidence is scarce.

Objective:

To assess the long-term efficacy of acupuncture for CP/CPPS.

Design:

Multicenter, randomized, sham-controlled trial. (ClinicalTrials.gov: NCT03213938)

Setting:

Ten tertiary hospitals in China.

Participants:

Men with moderate to severe CP/CPPS, regardless of prior exposure to acupuncture.

Intervention:

Twenty sessions of acupuncture or sham acupuncture over 8 weeks, with 24-week follow-up after treatment.

Measurements:

The primary outcome was the proportion of responders, defined as participants who achieved a clinically important reduction of at least 6 points from baseline on the National Institutes of Health Chronic Prostatitis Symptom Index at weeks 8 and 32. Ascertainment of sustained efficacy required the between-group difference to be statistically significant at both time points.

Results:

A total of 440 men (220 in each group) were recruited. At week 8, the proportions of responders were 60.6% (95% CI, 53.7% to 67.1%) in the acupuncture group and 36.8% (CI, 30.4% to 43.7%) in the sham acupuncture group (adjusted difference, 21.6 percentage points [CI, 12.8 to 30.4 percentage points]; adjusted odds ratio, 2.6 [CI, 1.8 to 4.0]; P < 0.001). At week 32, the proportions were 61.5% (CI, 54.5% to 68.1%) in the acupuncture group and 38.3% (CI, 31.7% to 45.4%) in the sham acupuncture group (adjusted difference, 21.1 percentage points [CI, 12.2 to 30.1 percentage points]; adjusted odds ratio, 2.6 [CI, 1.7 to 3.9]; P < 0.001). Twenty (9.1%) and 14 (6.4%) adverse events were reported in the acupuncture and sham acupuncture groups, respectively. No serious adverse events were reported.

Limitation:

Sham acupuncture might have had certain physiologic effects.

Conclusion:

Compared with sham therapy, 20 sessions of acupuncture over 8 weeks resulted in greater improvement in symptoms of moderate to severe CP/CPPS, with durable effects 24 weeks after treatment.