Is manual acupuncture effective in relieving symptoms among patients with chronic prostatitis/ chronic pelvic pain syndrome?
Date of publication of randomized controlled trial: September 2015
Design
Randomized controlled trial (RCT).
Participants
100 male patients (age range: 22 to 49 years) with chronic prostatitis (CP)/ chronic pelvic pain syndrome (CPPS) diagnosed according to National Institutes of Health (NIH) category IIIB. They had a history of disease refractory to drug treatment including antibiotics, alpha-blockers and anti-inflammatory agents, and felt pain or discomfort in the pelvic region for at least 3 of the past 6 months.
Intervention
Weekly manual acupuncture treatment for 6 weeks was performed. Needles insertion points were BL-33, BL-34, BL-54, CV-1, CV-4, SP-6 and SP-9. Duration of treatment lasted for 20 minutes.
Comparator
Comparison: Manual acupuncture versus sham acupuncture.
Major Outcomes
Outcome 1: The proportion of 'responders' with response which was defined as a 50% reduction in NIH Chronic Prostatitis Symptom Index (NIH-CPSI) total score, from baseline to week 8;
Outcome 2: Change in NIH-CPSI total scores from baseline to week 6;
Outcome 3: Change in NIH-CPSI total scores from baseline to week 24.
Settings
The trial was conducted in outpatient settings.
Comparison    Manual acupuncture versus sham acupuncture
Main Results
Among CP/CPPS patients in manual acupuncture group, 92% were NIH-CPSI responders as compared to 48% of sham participants. The NIH-CPSI total scores decreased from 27.00±3.50 to 10.84±1.92 at week 6 in manual acupuncture group and from 26.50±3.70 to 16.22±6.64 in sham acupuncture group. However, the decrease at week 24 in manual acupuncture group was from 27.00±3.50 to 13.6±3.37, which was more prominent than sham acupuncture group.
Comparison: Manual acupuncture versus sham acupuncture for patients with CP/ CPPS
Outcomes No. of studies (Total number of participants) Mean (SD) / No. of participants Heterogeneity test (I2) MD (95% CI) p value Overall quality of evidence*
Intervention Comparator
1 1(100) 92%/50 48%/ 50 Not applicable as there is only 1 trial Not reported <0.001 Low
Outcomes No. of studies (Total number of participants) Proportion of 'responders'/ No. of participants Heterogeneity test (I2) MD (95% CI) p value Overall quality of evidence*
Intervention Comparator
2 1(100) Week 6: 10.84(1.92)/50 Week 6: 16.22(6.64) /50 Not applicable as there is only 1 trial Not reported <0.001 Low
3 1(100) Week 24: 13.6(3.37)/50 Week 24: 20.96(8.22)/50 Not applicable as there is only 1 trial Not reported <0.001 Low
Keys: SD= standard deviation; MD: mean difference; CI: confidence intervals.
Comparison    Manual acupuncture versus sham acupuncture
Main Results
Among CP/CPPS patients in manual acupuncture group, 92% were NIH-CPSI responders as compared to 48% of sham participants. The NIH-CPSI total scores decreased from 27.00±3.50 to 10.84±1.92 at week 6 in manual acupuncture group and from 26.50±3.70 to 16.22±6.64 in sham acupuncture group. However, the decrease at week 24 in manual acupuncture group was from 27.00±3.50 to 13.6±3.37, which was more prominent than sham acupuncture group.
Comparison: Manual acupuncture versus sham acupuncture for patients with CP/ CPPS
Outcomes 1
No. of studies (Total number of participants) 1(100)
Mean (SD) / No. of participants Intervention 92%/50
Comparator 48%/ 50
MD (95% CI) Not reported
p value <0.001
Overall quality of evidence* Low
Outcomes 2 3
No. of studies (Total number of participants) 1(100) 1(100)
Proportion of 'responders'/ No. of participants Intervention Week 6: 10.84(1.92)/50 Week 24: 13.6(3.37)/50
Comparator Week 6: 16.22(6.64) /50 Week 24: 20.96(8.22)/50
MD (95% CI) Not reported Not reported
p value <0.001 <0.001
Overall quality of evidence* Low Low
Keys: SD= standard deviation; MD: mean difference; CI: confidence intervals.
Conclusion
Benefits
This study demonstrated that among male patients with CP or CPPS, manual acupuncture group showed a 92% positive response in reducing NIH-CPSI total scores by 50%, while sham acupuncture group only reduced a 48% positive response. There were decreases in NIH-CPSI total scores in both groups. However, the reduction in manual acupuncture group was more prominent than that from sham acupuncture group. For all outcomes, the overall quality of evidence is low. Further research is likely to have an important impact on our confidence in this estimate of effect.
Harms
No adverse events related to manual acupuncture or sham acupuncture was reported in any participants throughout the study.
Link to Original Article
https://www.ncbi.nlm.nih.gov/pubmed/25939517
The synopsis is based on the following article:
Sahin S, Bicer M, Eren GA, Tas S, Tugcu V, Tasci AI, et al. Acupuncture relieves symptoms in chronic prostatitis/chronic pelvic pain syndrome: a randomized, sham-controlled trial. Prostate Cancer and Prostatic Diseases. 2015 Sep;18(3):249-54.


* Interpretation of quality assessment results:
• Very low: Further research is most likely to have an important impact on our confidence in this estimate of effect.
• Low: Further research is likely to have an important impact on our confidence in this estimate of effect.
• Moderate: Further research is fairly likely to have an important impact on our confidence in this estimate of effect.
• High: Further research is unlikely to have an important impact on our confidence in this estimate of effect.
• Very high: Further research is most unlikely to have an important impact on our confidence in this estimate of effect.

Details of assessment method can be found at Chung VC, Wu XY, Ziea ET, Ng BF, Wong SY, Wu JC. Assessing internal validity of clinical evidence on effectiveness of CHinese and integrative medicine: Proposed framework for a CHinese and Integrative Medicine Evidence RAting System (CHIMERAS). European Journal of Integrative Medicine. 2015 Aug 31;7(4):332-41.