Quantitative Study on the Efficacy of Acupuncture in the Treatment of Menopausal Hot Flashes and Its Comparison with Non-Hormonal Drugs

Background The efficacy of acupuncture in the treatment of menopausal hot flashes has always been controversial, which limited the use of acupuncture. This study aimed to compare the efficacy of acupuncture to that of sham acupuncture (SA), placebo pills, and non-hormonal drugs to provide the necessary quantitative information for establishing medication guidelines for menopausal hot flashes.Methods A comprehensive literature search was performed using public databases. Randomized clinical studies on acupuncture therapy for the treatment of hot flashes in menopausal women were identified. A time-course model was established to describe the efficacy characteristics of acupuncture and SA, which were compared with the efficacy of non-hormonal drugs and placebo pills reported in the literature. Results A total of 17 studies involving 1123 subjects were included. It was found that the baseline number of hot flashes was an important factor affecting the efficacy of acupuncture and SA. After correcting the baseline to eight hot flashes per day, the frequency of hot flashes decreased from baseline for traditional acupuncture (TA), electro-acupuncture (EA), TA&EA (merger analysis of TA and EA), and SA were 3.1 (95% CI: 2.8, 3.4), 3.6 (95% CI: 3.2, 4.0), 3.2 (95% CI: 2.9, 3.5), and 2.6 (95% CI: 2.2, 3.0) times/day at week 8, respectively. Compared with findings reported in the literature, we found the efficacy of EA was comparable to that of selective serotonin reuptake inhibitors/serotonin–norepinephrine reuptake inhibitors (SSRIs/SNRIs) and neuroleptic agents such as gabapentin and escitalopram. Furthermore, the efficacy of TA&EA was significantly higher than that of placebo pills (2.3, 95% CI: 1.8, 2.9). Conclusions The efficacy of TA&EA was higher than that of SA and significantly higher than that of placebo pills. The efficacy of EA was higher than that of TA, significantly higher than that of SA, and comparable to that of SSRIs/SNRIs and neuroleptic agents.