Effectiveness and Safety of Acupuncture and Moxibustion for Primary Dysmenorrhea: An Overview of Systematic Reviews and Meta-Analyses

Table 5

Quality of evidence in the included studies assessed by the GRADE approach.

Outcome	Intervention vs. comparison	Included studies	Effect size	Quality of the evidence
Total effective rate	Acupuncture and moxibustion vs. indomethacin	16 SRs, 22 RCTs	OR = 3.9, 95% CI (2.56, 5.95)	⊕ ⃝ ⃝ ⃝(1).(2).(3); very low
	Acupuncture and moxibustion vs. ibuprofen	17 SRs, 29 RCTs	OR = 3.55, 95% CI (2.88, 4.39)	⊕ ⊕ ⊕ ⃝(1); moderate
	Acupuncture and moxibustion vs. Fenbid	12 SRs, 13 RCTs	OR = 7.68, 95% CI (4.98, 11.86)	⊕ ⊕ ⊕ ⃝(1); moderate
	Acupuncture and moxibustion vs. Somiton	5 SRs, 9 RCTs	OR = 2.17, 95% CI (1.56, 3.02)	⊕ ⊕ ⃝⃝(1).(3); low
VAS	Acupuncture and moxibustion vs. NSAIDs	7 SRs, 17 RCTs	MD = −1.96, 95% CI (−2.76, −1.17)	⊕ ⊕ ⃝ ⃝(1).(2); low
	Acupuncture and moxibustion vs. sham acupuncture	5 SRs, 16 RCTs	MD = −4.38, 95% CI (−6.15, −2.60)	⊕ ⊕ ⃝ ⃝(1).(2); low
	Acupuncture and moxibustion vs. no treatment	4 SRs, 11 RCTs	MD = −5.21, 95% CI (−6.32, −4.10)	⊕ ⃝ ⃝ ⃝(1).(2).(3); very low
Adverse events	Acupuncture and moxibustion vs. NSAIDs	7 SRs, 8 RCTs	OR = 0.17, 95% CI (0.03, 1.04)	⊕ ⊕ ⃝ ⃝(1).(2); low

(1) Allocation concealment or blinding inadequate; (2) I² > 50% or large heterogeneity; (3) funnel plot dissymmetry or language limitation. ⊕: +1, ⃝: −1, ⊕ ⊕ ⊕ ⊕ : High, ⊕ ⊕ ⊕ ⃝ : Moderate, ⊕ ⊕ ⃝ ⃝ : Low, and ⊕ ⃝ ⃝ ⃝ : very low.