Comparative Efficacy of Low-Level Laser Acupuncture and Electroacupuncture in Women With Dysmenorrhea and Autonomic Imbalance: A Pilot Randomized-Controlled Trial

TL;DR

This study compares laser acupuncture and electroacupuncture for treating menstrual pain and autonomic imbalance in women, finding both effective but laser acupuncture shows unique benefits.

Contribution

Demonstrates noninvasive low-level laser acupuncture is noninferior to electroacupuncture for dysmenorrhea and autonomic dysfunction.

Findings

LLLA and EA both significantly reduced pain and autonomic imbalance compared to sham treatment.

LLLA outperformed EA in heart rate variability metrics for participants with low LF/HF ratios.

EA showed a significant decrease in proinflammatory prostaglandin E2 levels.

Abstract

Electroacupuncture (EA) has been widely applied in treating dysmenorrhea and autonomic dysfunction. Low-level laser acupuncture (LLLA), a noninvasive acupuncture, has been used clinically, but efficacy is uncertain. This study aimed to explore the efficacy of LLLA, EA, and sham-controlled LLLA on pain, heart rate variability (HRV) activity, and symptom improvement in dysmenorrhea with autonomic imbalance.

In a randomized, controlled design, a total of 114 women with dysmenorrhea and autonomic imbalance were randomly allocated to three groups: sham LLLA, LLLA, and EA. The primary outcomes are pain (VAS), and HRV parameters, and the secondary outcomes are symptom assessment (verbal multidimensional scoring system), prostaglandin E, progesterone levels, and the SF-12 quality-of-life assessment.

Contrast to the sham acupuncture, LLLA and EA effectively reconciled the pain and sympathetic/parasympathetic tone significantly, no matter the vagus or sympathetic deviated status (low or high LF/HF group). LLLA was superior to EA in terms of SDNN, RMMSD, and PNN50 (p < 0.001) in the low LF/HF group in intergroup analysis. For all participants' analysis, the effects of LLLA and EA were similar for pain assessment (VAS) and quality of life (SF-12) (p < 0.05). In proinflammatory cytokine measurement, EA showed a significant decrease in prostaglandin E2 (PGE2) levels (p = 0.022).

This pilot study showed both LLLA and EA effectively relieve dysmenorrhea without a placebo effect, LLLA is noninferior to EA in autonomic dysfunction, and the effect is even more prominent in low LF/HF status (a relatively lower energy status). Given its noninvasiveness, LLLA could be an alternative treatment and warrants further large-scale study.

ClinicalTrials.gov identifier: NCT04178226

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