Acupuncture and Moxibustion in the Treatment of Gynecological Perioperative Anxiety: A Systematic Review and Meta-Analysis

Xiu Wang,1,2 Qianqian Yu,3 Jun Zhu,4 Junlan Liu,2 Xuyuan Gao,2 Xiudie Wang,2 Lanlan Wang,2 Xia Xu2 1Department of Traditional Chinese Medicine, Shandong College of Traditional Chinese Medicine, Yantai City, Shandong Province, 264199, People’s Republic of China; 2College of Traditional Chinese Medicine, Anhui University of Traditional Chinese Medicine, Hefei City, Anhui Province, 230012, People’s Republic of China; 3Department of Critical Care Medicine, Qingdao University Affiliated Hospital, Qingdao City, Shandong Province, 266035, People’s Republic of China; 4Department of Traditional Chinese Medicine, Anhui College of Traditional Chinese Medicine, Wuhu, Anhui, 241005, People’s Republic of ChinaCorrespondence: Xia Xu, College of Traditional Chinese Medicine, Anhui University of Traditional Chinese Medicine, 1 Qianjiang Road, Yaohai District, Hefei City, Anhui Province, People’s Republic of China, Tel +86 15955170282, Email [email protected]: This systematic review and meta-analysis aims to investigate the effectiveness and safety of acupuncture and moxibustion in managing perioperative anxiety during gynecological surgery.Methods: Relevant studies published from the establishment of the databases to March 20, 2023, were searched in PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang, VIP, and CBM. Literature screening and data extraction were independently conducted by two investigators. The Cochrane risk-of-bias tool 2.0 was utilized to assess the risk of bias in the included studies. Data analysis was carried out using Stata 15.1 software.Results: The analysis included a total of 3254 patients from twenty studies. It was found that acupuncture and moxibustion therapy resulted in a reduction of postoperative State-Trait Anxiety Inventory (STAI-S) scores (mean difference [MD] = − 3.50, 95% confidence interval [CI] [− 6.93 to − 0.07], P = 0.046), as well as both preoperative and postoperative Visual Analogue Scale-Anxiety (VAS-anxiety) and Self-Rating Anxiety Scale (SAS) scores (pre-operation: SMD = − 1.04, 95% CI [− 1.73 to − 0.35], P = 0.003; post-operation: SMD = − 0.78, 95% CI [− 1.21 to − 0.35], P < 0.001) in comparison to the control group. Nonetheless, no significant variances were noted between the two groups with regards to preoperative and intraoperative STAI-S scores (pre-operation: MD = − 3.38, 95% CI [− 9.58 to 2.82], P = 0.286; intraoperative: MD = − 1.09, 95% CI [− 7.32 to 5.13], P = 0.730), and intraoperative VAS-anxiety and SAS scores (SMD = − 0.44, 95% CI [− 1.51 to 0.64], P = 0.427).Conclusion: During the perioperative period of gynecological surgery, acupuncture and moxibustion therapy show potential in alleviating anxiety in patients. It is noteworthy that the current level of evidence is limited by the small sample size. Therefore, further validation of these findings is necessary.Keywords: perioperative anxiety, gynecological surgery, acupuncture, systematic review, meta-analysis