针刺治疗糖尿病性周围神经病变系统评价的再评价

目的:对针刺治疗糖尿病性周围神经病变(DPN)的系统评价进行再评价,以为临床决策提供依据.方法:计算机检索中英文数据库中有关针刺治疗DPN的系统评价,检索时间至2019年7月1日,由两名研究者根据纳入、排除标准进行文献筛选,对最终纳入文献使用荟萃分析报告标准(PRISMA)、系统评价质量评价工具(AMSTAR 2)和证...     

中医药治疗缺血性视神经病变的文献质量评价

目的对中医药(中药、中成药、针刺)治疗缺血性视神经病变(ION)的相关文献进行现状分析及质量评价。方法检索4大中文数据库、3大英文数据库近10年关于中医药治疗ION的文献,并对纳入文献进行全面的评价,包括研究对象、干预措施、研究类型等,并采用相应的质量评估工具评价文献质量。结果纳入的50篇文献中,研究对象以前部缺血性视神经病变为主(46.15%);针刺治疗的文献较少(5.77%);随机对照试验占所有试验类型的65.38%,但可信度较低;所有文章均未采用隐藏序列、盲法、样本量估算;仅1篇文章报告脱落病例,但缺乏原因和意向治疗分析;多数(80.77%)文献未报告安全性评估。结论中医药治疗ION的相关文献普遍质量不高,应重点关注干预措施为针刺治疗的研究和规范严谨的多中心大样本临床试验。     

刺络放血法治疗糖尿病周围神经病变的系统评价

目的系统评价刺络放血法治疗糖尿病周围神经病变的临床疗效。方法检索中国知网(CNKI,1979～2017)、维普资讯中文期刊服务平台(1989～2018)、美国图书馆Pub Med/MEDLINE关于刺络放血法治疗糖尿病周围神经病变的相关文献,对纳入文献进行质量评价。采用Rev Man 5.2.0软件进行Meta分析。结果共纳入2项临床随机对照研究,共140例糖尿病周围神经病变患者。Meta分析结果:刺络放血疗法加基础常规治疗,与基础常规治疗比较,治疗糖尿病周围神经病变的临床疗效[OR=3.82,95%CI(1.51,9.70)],P=0.005。结论临床证据显示:在常规治疗的基础上合用刺络放血法治疗糖尿病周围神经病变的临床疗效优于单纯常规治疗组。由于纳入研究质量低且样本量小,尚需开展多中心、大样本、高质量的临床随机对照试验加以验证。     

小针刀治疗腰椎间盘突出症的系统评价

目的 对公开发表的小针刀治疗腰椎间盘突出症的文献进行Meta 分析,评价小针刀对腰椎间盘突出是否有效.方法 对中国期刊全文数据库(CNKI)、重庆维普数据库(VIP)关于小针刀治疗腰椎间盘突出症与非小针刀组治疗腰椎间盘突出症疗效的文献进行研究,将其结果进行Meta 分析.按照Cochrane系统评价方法对纳入研究的方法学质量进行评价,用Revman 4.2.8软件进行统计分析.结果 纳入文献7篇,共889例患者.其中,治疗组448例,对照组441例. 各研究基线资料具有可比性,均报道有随机方法但未提及盲法和分配隐藏,仅有两篇明确提到按时间顺序随机.Meta 分析显示两组统计学差显著异.结论 小针刀治疗腰椎间盘突出症明显优于推拿、针刺、药物等疗法,联合推拿、针刺、牵引等疗法效果更显著.但由于高质量的文献很少,样本量有限,仍需做进一步深入研究.     

针灸治疗慢性盆腔炎随机对照试验质量报告

目的:采用CONSORT声明和STRICTA标准评价国内针灸治疗慢性盆腔炎临床随机对照试验质量。方法:利用计算机检索与手工检索。检索CNKI、CBM、VIP和万方4个数据库,结合手工检索相关期刊,筛选出符合研究标准的文献,采用CONSORT声明和STRICTA标准进行质量评价。结果:共纳入合格文献85篇。大部分文献存在随机方法描述不清和无随机隐藏、盲法使用率低、无样本量计算、无意向治疗分析、针刺细节报道不充分、无针刺治疗医生的资历等问题。结论:针灸治疗慢性盆腔炎的临床随机对照试验质量普遍较低,影响报道的可靠性和同质可比性。为提高针灸临床随机试验可靠性和质量,应该将CONSORT声明和STRICTA标准引入针灸临床随机试验设计并严格执行。     

针刺治疗腰椎间盘突出症国内文献质量评价

目的：通过对针刺治疗腰椎间盘突出症临床随机对照试验文献的质量评价,了解针刺治疗腰椎间盘突出症的研究现状及质量。方法：检索中国期刊全文数据库中有关针刺治疗腰椎间盘突出症的临床随机对照研究,制定针刺治疗腰椎间盘突出症文献信息采集表,对纳入文献的随机方法、分配隐藏、基线可比性、诊断及疗效标准、干预措施、盲法、随访、不良反应、病例脱落及意向治疗分析等方面进行描述性分析,并根据Jadad记分评价文献质量。结果：符合纳入标准文献共33篇,涉及患者2140例。其中16篇有明确的诊断标准,21篇有明确的疗效标准,4篇文献说明随机分组方法,17篇文献进行了组间均衡性比较,2篇文献提及随访,1篇文献描述了脱落例数,2篇文献观察了不良反应,全部文献均未进行样本量估算且未实行盲法。Jadad记分结果显示,33篇文献全部为低质量研究。结论：针刺治疗腰椎间盘突出症临床随机对照研究中诊断和疗效评定等标准交叉混用,组间均衡性、随机分配和随访、失访等有关研究方案质量的评价均较低。     

针刺结合穴位注射治疗糖尿病周围神经病变52例

目的:观察针刺结合穴位注射疗法对糖尿病周围神经病变的临床疗效.方法:将糖尿病周围神经病变的患者104 例随机分为针刺结合穴位注射治疗组和对照组各52例.结果:治疗2个月后,针刺结合穴位注射治疗组的临床显效率为51.9%,总有效率为88.5%,均优于对照组(P<0.05).结论:针刺结合穴位注射治疗组治疗糖尿病周围神经病变临床效果良好.     

基于CONSORT和STRICTA评价针灸治疗肩-手综合征

目的:采用CONSORT声明和STRICTA标准评价国内针灸治疗肩-手综合征临床随机对照试验质量。方法:利用计算机检索与手工检索。检索CNKI、CBM、VIP、万方四个数据库,结合手工检索相关期刊,筛选出符合研究标准的文献,采用CONSORT声明和STRICTA标准进行质量评价。结果:共纳入合格文献152篇。大部分文献存在随机方法描述不清(36.18%)和无随机隐藏、盲法使用率低(3.29%)、无样本量计算、无意向治疗分析、针刺细节报道不充分、无针刺治疗医生的资历等问题。结论:目前针灸治疗肩-手综合征的临床随机对照试验质量普遍较低,影响报道的可靠性和同质可比性。为提高针灸临床随机试验可靠性和质量,应该将CONSORT声明和STRICTA标准引入针灸临床随机试验设计并严格执行。     

采用CONSORT和STRICTA评价针刺治疗糖尿病胃轻瘫随机对照试验报告质量

[目的]采用试验报告统一标准（CONSORT）和报告针刺临床试验中干预措施（STRICTA）标准评价针刺治疗糖尿病胃轻瘫随机对照试验的报告质量。[方法]计算机检索Cochrane图书馆临床对照试验数据库、PubMed、中国知识基础设施工程、维普等数据库。文种限制为中英文。纳入针刺治疗糖尿病胃轻瘫的随机对照试验,并采用CONSORT声明和STRICTA标准进行报告质量评价。[结果]共纳入针刺治疗糖尿病胃轻瘫随机对照研究28篇文献。根据CONSORT声明和STRICTA标准对纳入文献进行分析,无文献提及随机分配方案的隐藏、样本量的计算方法和治疗师资历。大部分研究对随机方法描述不清、盲法使用率低、未使用流程图、不良反应报道少、针刺细节报道不充分等问题。[结论]目前针刺治疗糖尿病胃轻瘫的研究报告质量普遍较低。今后应采用国际公认的CONSORT声明和STRICTA标准对针刺疗法进行规范报告。     

基于CONSORT-NPTs(2017)和CONSORT-STRICTA评价针刺治疗更年期抑郁症随机对照试验的报告质量研究

目的:基于CONSORT非药物随机对照试验扩展声明(2017)和CONSORT-STRICTA,评价当前国内外针刺治疗更年期抑郁症的随机对照试验的质量,为今后进行高质量临床研究提供改进依据。方法:计算机检索CNKI、CBM、VIP、WF、Pub Med、MEDLINE、Cochrane Library和Embase,查找所有相关文献,并由两位评价者根据纳入和排除标准进行筛选,最后采用CONSORT非药物随机对照试验扩展声明(2017)和CONSORT-STRICTA进行文献质量评价。结果:共纳入合格RCT试验25篇。CONSORT评价显示:文题提示为RCT为0篇(0%)、所有文章均无依从性相关阐述0篇(0%)、对样本量的估算2篇(8%)、分配隐藏4篇(16%)、随机方法 2篇(8%)、随机方法实施2篇(8%)、盲法报告3篇(12%)、统计学方法阐述较简单、缺少受试者流程图等; STRICTA条目评价发现:对治疗场所、针灸师背景、选择对照合理解释25篇文献均是零报道。结论:针灸治疗更年期抑郁症的临床研究RCT质量偏低,应根据非药物随机对照临床试验扩展声明(2017)和CONSORT-STRICTA进行严格临床实验设计,以提高研究质量,进一步证实针刺治疗更年期抑郁症的疗效。     

Acupuncture for allergic rhinitis: a systematic review and meta analysis

Objective

To analyze and review the clinical efficacy of acupuncture (including electroacupuncture) alone for allergic rhinitis (AR) and to compare its efficacy with antihistamines and Chinese patent medicine Bi Yan Kang Tablet.

Methods

The search strategy, inclusion and exclusion criteria were made according to the principle of evidence-based medicine. We performed a systematic search on China National Knowledge Infrastructure (CNKI), Wanfang Academic Journal Full-text Database (Wanfang), Chongqing VIP Database (CQVIP), Chinese Biomedical Literature Database (CBM), PubMed, Excerpta Medica Database (EMBASE), Web of Science, Cochrane Library, and Cochrane Central Register of Controlled Trials (CENTRAL) for randomized controlled trials (RCTs) of acupuncture for allergic rhinitis between January 1990 and December 2015. The quality was evaluated by Cochrane Handbook for Systematic Reviews of Interventions Version 5.1, and the meta-analysis was conducted by RevMan 5.3 version.

Results

Twenty eligible RCTs were included into the meta-analysis after selection. Compared with antihistamines, the meta-analysis showed RR=1.24>1, 95%CI[1.15, 1.33], P<0.00001, indicating that acupuncture achieved a better total effective rate for AR than antihistamines; MD = –0.93<0, 95%CI[–1.22,–0.63], P<0.00001, indicating that acupuncture is better than antihistamines in decreasing the total nasal symptom score (TNSS) in AR patients; and MD = 1.46>0, 95%CI[–10.84, 13.75], P = 0.82, indicating that there was no statistical difference between acupuncture and antihistamines in regulating immunoglobulin E (IgE) in AR patients. Compared with Bi Yan Kang Tablet, the meta-analysis has shown RR = 1.50>1, 95%CI[1.30, 1.73], P<0.00001, indicating that acupuncture achieved a better total effective rate for AR than Chinese patent medicine Bi Yan Kang Tablet.

Conclusion

Acupuncture alone can achieve a better total effective rate for AR than antihistamines and Bi Yan Kang Tablet. It is also better than antihistamines in improving clinical symptom scores; however, whether acupuncture is better than Bi Yan Kang Tablet needs further proof. As far as current data are concerned, there was no statistical difference between acupuncture and antihistamines in improving serum IgE; further study is needed in this regard. The risk of bias due to absent randomization methods or blinding implementation decreased the evidence level of the overall conclusion.

     

Clinical analysis of acupuncture combined with tuina in treating cervical vertigo

Objective： To investigate the clinical efficacy of acupuncture combined with tuina in treating patients with cervical vertigo. Methods： According to the principle of randomization, 258 cases with cervical vertigo who met the inclusion criteria for the study were randomly divided into an observation group and a control group, with 129 cases in each. The patients in the observation group received acupuncture combined with tuina therapy, while those in the control group were just treated by the same acupuncture therapy as in the observation group. After 10-day continuous treatments, the clinical efficacies of the two groups were analyzed and compared. Results： The total effective rate of the observation group was 100%, versus 86.0% of the control group, and the difference was significant（P〈0.05）. After treatment, cervical range of motion（ROM） scores in both groups were statistically significantly different from those before treatment（all P〈0.05）; in addition, there was a statistically significant difference in inter-group comparison of ROM score（P〈0.05）. Conclusion： Compared with simple acupuncture treatment, acupuncture combined with tuina therapy has a better effect in improving the ROM of cervical vertigo patients, with higher clinical efficacy.     

Diagnosis and objective pain assessment of traditional Chinese medicine may be useful to demonstrate specific effects of acupuncture in low back pain: A prospective, randomized, controlled and single blinded pre-study

Objective： To prove specific effects of acupuncture on chronic pain. It was speculated that the potential specific effectiveness of acupuncture could be better shown in more properly designed studies. Therefore, diagnoses of both Western medicine and traditional Chinese medicine （TCM） were used as inclusion criteria to allocate acupoints more precisely to the complaints of the patients. Secondly, objectively measurable parameters of pain relief in addition to usual Visual Analogue Scale （VAS） were chosen to quantify the effects of acupuncture. Methods： The study was prospective, randomized, controlled and single-blinded. Eighteen patients with chronic back pain and TCM diagnosis of a Taiyang/Yangming syndrome received one single session of acupuncture chosen according to TCM diagnosis or acupuncture on points outside the meridian system （controls）. We evaluated pain via VAS and increased mobility via inclinometry of the back. Results： Although the sample size was small, there was a statistically significant improvement in pain and mobility in the intervention group （n=13）, but not in the control group （n=5）. The calculated sample size adequate power was lower for inclinometry than for VAS, indicating that VAS is less probable to discriminate acupuncture effects. Conclusion： Objectively measurable physical parameters such as the angle of flexion before and after acupuncture （inclinometry） may be more suitable to measure pain relief than subjective assessment by VAS in acupuncture studies. TCM diagnosis may be a helpful inclusion criterion in studies on acupuncture, so as to potentially allocate interventions better to the complaints of patients.     

Effect of warm needling therapy and acupuncture in the treatment of peripheral facial paralysis: A systematic review and meta-analysis

Objective

The goal of this study is to explore effective treatments for peripheral facial paralysis and to evaluate the clinical efficacies of warm needling therapy and acupuncture in peripheral facial paralysis.

Combined Acupuncture and Bloodletting on Chize （LU 5） and Weizhong （BL 40） for Chronic Eczema

Objective： To observe the clinical effect of combined acupuncture with bloodletting on Chize （LU 5） and Weizhong （BL 9） for chronic eczema. Methods： A total of 40 cases were randomly allocated into an observation group and a control group, 20 in each. Cases in the observation group were treated with acupuncture plus bloodletting on Chize （LU 5） and Weizhong （BL 9）, whereas cases in the control group were treated with acupuncture alone. The acupuncture was conducted once a day, bloodletting twice a week. The therapeutic efficacy was statistically analyzed after one month of consecutive treatment. Results： The recovery and total effective rates in the observation group were significantly higher than that in the control group （P〈O.05）. Conclusion： Combined acupuncture and bloodletting on Chize （LU 5） and Weizhong （BL 40） could obtain a better effect than acupuncture alone.     

Therapeutic efficacy observation on point-toward-point acupuncture combined with herbs iontophoresis for knee osteoarthritis

Objective： To observe the clinical efficacy of point-toward-point acupuncture combined with herbs iontophoresis in treating knee osteoarthritis. Methods： A total of 100 patients were randomly divided into a treatment group and a control group, 50 cases in each. Patients in the treatment group received point-toward-point acupuncture with long needle combined with herbs iontophoresis treatment; while those in the control group were only treated by point-toward-point acupuncture with long needle. Clinical efficacies of the two groups were compared after treatment. Results： The total effective rate was 92.0% in the treatment group, versus 82.0% in the control group, and the difference was statistically significant （P〈O.05）. Conclusion： The point-toward-point acupuncture with long needle combined with herbs iontophoresis treatment for knee osteoarthritis has a significant effect.     

Therapeutic efficacy observation on integrative acupuncture therapy for chronic urticaria

Objective: To observe the clinical effect of comprehensive acupuncture therapy for chronic urticaria. Methods: A total of 70 patients with chronic urticaria were treated with acupuncture, bloodletting after pricking and cupping [on Shenque (CV 8)]. The changes of signs and symptoms were observed before and after treatment. The therapeutic efficacy was then assessed according to the change rate of clinical symptoms scoring. Results: After treatment, 11 of the 70 cases got basic recovery, 21 cases got marked effectiveness, 27 cases got improvement and 11 cases got no effect. The total effective rate was 84.3%. There was statistical significance in symptoms score between before and after treatment (P<0.01). Conclusion: Combining acupuncture, bloodletting after pricking and cupping on Shenque (CV 8) is effective for chronic urticaria.     

针刺治疗慢性疲劳综合征临床观察(英文)

目的:观察针刺治疗慢性疲劳综合征(Chronic Fatigue Syndrome,CFS)患者的临床疗效及对其焦虑状态的影响。方法:将90例符合纳入标准的患者随机分为2组,治疗组45例,采用针刺治疗;对照组45例,采用药物治疗。采用焦虑自评量表(Self-ratingAnxietyScale,SAS)对两组患者治疗前后的焦虑状态进行评价。结果:两组患者治疗后SAS评分较同组治疗前均有降低(P<0.01)。两组治疗后SAS评分比较,差异无统计学意义(P>0.05)。结论:针刺和药物治疗均能改善CFS患者的焦虑症状。     

针刺配合雷火灸治疗颈型颈椎病临床研究

目的：观察针刺配合雷火灸治疗颈型颈椎病的临床疗效。方法：将符合纳入标准的60例颈型颈椎病患者随机分为治疗组和对照组,每组30例。治疗组采用针刺配合雷火灸治疗;对照组采用单纯针刺治疗。观察治疗前后症状、体征积分及视觉模拟量表（Visual Analogue Scale,VAS）评分的变化。结果：治疗组在提高临床疗效、降低VAS评分,改善临床症状、体征积分方面均优于对照组（P〈0.01 或P〈0.05）。差异均有统计学意义。结论：针刺配合雷火灸能明显减轻颈型颈椎病患者的疼痛症状,改善颈椎功能。     

Clinical Observation on Deep Acupuncture at Huantiao （GB 30） for Patients with Chronic Prostatitis

Objective: To observe the clinical efficacy of deep acupuncture mainly at Huantiao (GB 30) for patients with chronic prostatitis. Methods: Forty-two cases of patients with chronic prostatitis were treated with deep acupuncture at Huantiao (GB 30) combined with adjunct acupoints on the base of syndrome differentiation. Ten times treatment was a course, and effects were evaluated after two courses. Results: Among all the 42 cases, 29 cases were cured, 9 cases were improved and 4 cases were invalid, and the total effective rate was 90.5%. Conclusion: It has good effect of deep acupuncture at Huantiao (GB 30) as major acupoint combined with adjunct acupoints on the base of syndrome differentiation for patients with chronic prostatitis.