Complementary and Alternative Medicine for Threatened Miscarriage: Advantages and Risks

Table 3

Commonly used acupuncture treatments for threatened miscarriage.

Approaches	Acupoints	Intervention	Comparison	Study design	Efficacy rate	Outcomes	Adverse events	References
Pragmatic acupuncture	LU7, LI11, HT7, LR2, LR3, GB30, GB34, GB41, SP1, SP4, ST36, ST37, KI6, KI9, KI21, KI27, BL20, BL23, BL57, BL62, PC6, TE4, TE5, TE6, CV4, GV4, GV20, EX-HN 3	Needles, moxibustion, and self-care advice. Weekly visits until 12 completed weeks of gestation	Touch intervention and medical self-care advice	A mixed methods study involving a RCT and semistructured interviews	Pregnancy loss: 16.7% vs. 23.8%; pregnancy complication: 11.1% vs. 14.2%	It causes reduced bleeding, cramping, and back pain.	Not reported	[92]
Acupoint sticking	CV 8	Dingtai decoction (Panax ginseng 30 g, Radix Angelicae Sinensis 10 g, Radix Paeoniae Alba 15 g, Cortex Eucommiae 15 g, Rehmannia glutinosa Libosch 15 g, Rhizoma Atractylodis Macrocephalae 10 g, Pericarpium Citri Reticulatae 5 g, Radix Glycyrrhizae Preparata 20 g, Radix Scutellariae 15 g, Semen Cuscutae 15 g, Herba Taxilli 15 g, Radix Dipsaci 15 g, Artemisia Argyi 15 g, Amomum Villosum 3 g), PO, BID, with the herbal residue placed on CV 8 for 6 h for 5 days until vaginal bleeding stops; combined with comparators	hCG, 3000 IU, IM, QD, 3 days; after vaginal bleeding stops, reduce to 3000 IU, IM, QOD; vitamin E, 50 mg, PO, BID; Folic acid, 0.4 mg, PO, QD, 0.4 mg, PO, QD	RCT	93.3%	The combination is beneficial for improving the symptoms of threatened miscarriage.	Not reported	[103]
Acupoint sticking	CV 8	CHM (Colla Corii Asini 1 g, Folium Artemisiae Argyi 1 g, Cortex Eucommiae 1 g, Fructus Psoraleae 1 g) placed at CV 8 for 4–6 h per day	Progesterone, 20 mg, IM, QD; hCG, 2000 IU, IM, QD, 14–28 days	RCT	94.83%	Acupoint sticking has a significant effect on early threatened miscarriage.	Not reported	[104]
Acupoint sticking	CV 8	CHM (Semen Cuscutae 10 g, Radix Dipsaci 10 g, Colla Corii Asini 6 g, Ramie root 10 g, Cortex Eucommiae 10 g) placed on CV 8 for 4–6 h per day and combined with comparator	Progesterone, 40 mg, IM, QD, until symptoms disappear, and change to 20 mg, IM, QD, 7 days	RCT	90.0%	The combination can shorten the treatment time, increase serum P level, improve luteal function, prevent subsequent miscarriage, and increase the successful pregnancy rate.	Not reported	[105]
Acupoint sticking	CV 8	CHM (Cortex Eucommiae 10 g, Ramie root 10 g, Radix Dipsaci 10 g, Semen Cuscutae 10 g, Colla Corii Asini 6 g) placed on CV 8 for 6 h per day and combined with comparator	Progesterone, 20 mg, IM, QD, 7 days	RCT	89.2%	The combination increased the efficacy rate and improved the clinical symptoms of threatened miscarriage.	Not reported	[106]
Acupoint sticking	BL 23, GV4	CHM (Semen Cuscutae 10 g, Radix Dipsaci 10 g, Colla Corii Asini 6 g, Ramie root 10 g, Cortex Eucommiae 10 g) placed on the acupoints for 4 h per day, combined with Bushen Jianpi decoction, PO, BID, and comparator	Progesterone, 20 mg, IM, QD	RCT	93.94%	The combination can improve threatened miscarriage by inhibiting the secretion of INF-γ, promoting the secretion of IL-10, correcting the pathological shift of Th1/Th2 cytokine balance, and increasing the secretion of hCG and P.	Not reported	[107]
Auricular acupuncture	TF5, AT4, CO10, CO15, CO12, AH6a, CO18	The auricular points were changed every 3 days, for 3 weeks of intervention, and combined with dydrogesterone as comparator	Dydrogesterone, 10 mg, PO, BID, until 12 gestational weeks	Prospective study	80.0%	The combination can promote hematoma absorption and regulate immune factors by reducing Th, Th/Ts, and serum CA125 level.	Not reported	[110]
Acupoint injection	ST 36	hCG 1000 IU, injected at ST36 and massaged for 3–5 min, alternating on both sides, QOD, 7–10 days, or until a week after symptoms disappear	hCG 1000 IU, IM, QOD, 7–10 days, or until a week after symptoms disappear	RCT	91.38–91.7%	It increased the levels of hCG, E2, and P; decreased the miscarriage rate and treatment time; reduced the amount of conventional medication; and promoted the development of the fetal sac.	Not reported	[113–115]
Acupoint catgut embedding	BL 17, BL 18, BL 23, BL 20, BL 21, SP 10, SP 8, KI 7	Embedding once every two weeks, 6 times, combined with comparator	Progesterone, 40 mg, IM, QD	RCT	Successful pregnancy rate: 96.0%; spontaneous abortion rate: 16.7%	Embedding reduced the spontaneous abortion rate, improved the successful pregnancy rate, and regulated hormone levels in patients after IVF-ET.	Miscarriage, and premature birth	[117]
Moxibustion	ST 36, PC 6, GV4	Moxibustion was performed at a distance of 3-4 cm from the patient’s acupoints to make the patient feel moderate heat, 20–30 min, QD. Combined with dydrogesterone, PO, first dose is 40 mg followed by 10 mg, Q8H, until the symptoms disappear	Progesterone, 40 mg, IM, QD, 14 days	RCT	Successful pregnancy rate: 87.5%	The combinations can increase hCG and P, improve symptoms, and increase the successful pregnancy rate.	Not reported	[118, 119]

RCT: randomized control trial; CHM: Chinese herbal medicine; hCG: human chorionic gonadotropin; E2: estradiol; P: progesterone; QOD: quaque omni die; Q8H: quaque 8 hours; QD: quaque die; BID: bis in die; PO: per os; IM: intramuscular; IVF-ET: in vitro fertilization-embryo transfer. Bushen Jianpi decoction composition: Radix Codonopsis 18 g, Radix Astragali Preparata 18 g, Herba Taxilli 15 g, Semen Cuscutae 15 g, Cortex Eucommiae 15 g, Radix Dipsaci 15 g, Radix Paeoniae Alba 15 g, Rhizoma Atractylodis Macrocephalae 12 g, Radix Scutellariae 12 g, Cyperus rotundus 12 g, Radix Glycyrrhizae Preparata 6 g.