A multicenter randomized trial showed that 20 sessions of acupuncture over 8 weeks resulted in greater improvement in symptoms of moderate to severe chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) compared with sham therapy. Treatment effects endured over 24 weeks follow up. The findings are published in Annals of Internal Medicine.
CP/CPPS manifests discomfort or pain in the pelvic region for at least 3 of the previous 6 months without evidence of infection. Lower urinary tract symptoms, psychological issues, and sexual dysfunction may also be involved. Men with CP/CPPS may have a poor quality of life due to the many neuropsychophysiologic pathophysiology factors associated with the disorder, such as inflammation in the prostate, anxiety and stress, and dyssynergic voiding. Antibiotics, a-blockers, and anti-inflammatories are the mainstays of treatment in clinical practice, but they have limited effectiveness and are associated with adverse events with long-term use. Acupuncture has shown promise as an alternative treatment, but high-quality evidence is scarce.
Researchers from the China Academy of Chinese Medical Sciences randomly assigned 440 male participants (220 in each group) to either 8 weeks of acupuncture or sham therapy to assess the long-term efficacy of acupuncture for improving symptoms of CP/CPPS. The treatment was considered effective if participants 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.
The researchers found that compared with the sham acupuncture group, larger proportions of participants in the acupuncture group reported marked or moderate improvements in symptoms at all assessment points. No significant difference was found in changes in International Index of Erectile Function 5 score at all assessment time points or in peak and average urinary flow rates at week 8. No serious adverse events were reported in either group.
According to the researchers, these findings show long-term efficacy of acupuncture and provide high-quality evidence for clinical practice and guideline recommendations.
Reference: “Efficacy of Acupuncture for Chronic Prostatitis/Chronic Pelvic Pain Syndrome – A Randomized Trial” by Yuanjie Sun, MD, Yan Liu, MD, Baoyan Liu, MD, Kehua Zhou, MD, DPT, Zenghui Yue, MD, Wei Zhang, MD, PhD, Wenbin Fu, MD, Jun Yang, MD, Ning Li, MD, Liyun He, MD, PhD, Zhiwei Zang, MD, Tongsheng Su, MD, Jianqiao Fang, MD, PhD, Yulong Ding, MD, Zongshi Qin, MD, Hujie Song, MD, Hui Hu, MD, PhD, Hong Zhao, MD, PhD, Qian Mo, MD, PhD, Jing Zhou, MD, PhD, Jiani Wu, MD, PhD, Xiaoxu Liu, MD, PhD, Weiming Wang, MD, PhD, Ran Pang, MD, PhD, Huan Chen, MD, MSc, Xinlu Wang, MD and Zhishun Liu, MD, PhD, 17 August 2021, Annals of Internal Medicine.
Assuming neither the patients or researchers could tell the sham from the real acupuncture! How did they fool the researchers?