针灸治疗失眠症的随机对照试验评价

目的：对用针灸治疗失眠症的临床效果进行评价.方法：通过文献检索分析研究的方法,检索到2009年1月至2012年12月有关针灸治疗失眠症的临床对照试验相关文献共128篇,删除没有明确说明随机分配方法的RCT研究论文69篇,仅对剩余的59篇文献进行归类分析.结果：符合条件的7篇RCT共425例患者满足纳入标准,将针灸组和药物组进行对比,比值（OR）为3.25,95%的置信区间[2.50,5.05],P〈0.0001,差异显著,具有统计学意义.结论：针灸治疗失眠症可能有效,目前还不能明确针灸治疗失眠症的临床效果.     

Therapeutic effects of acupuncture for neurogenic dysphagia-a randomized controlled trial

OBJECTIVE:To evaluate the therapeutic effects and long-term efficacy of acupuncture for neurogenic dysphagia.METHODS:Subjects with neurogenic dysphagia undergoing routine swallowing management were randomized to receive either 20 sessions of true acupuncture(experimental group) or sham acupuncture(control group 1) for approximately one and a half months.A third group(control group 2) comprised of non-randomized subjects with neurogenic dysphagia who received routine care were recruited from separate wards.The outcomes were assessed by the Royal Brisbane Hospital Outcome Measure for Swallowing(RBHOMS),as well as by the consistencies of ingested food and fluid.RESULTS:A total of 87 subjects(experimental group,n= 20;control group 1,n=19;control group 2,n=48) were recruited into the trial.The average RBHOMS score showed a greater improvement in the experimental group and in control group 1 than in control group 2.The average levels of foodand fluid consistencies displayed greater improvement in the experimental group than in the two control groups.CONCLUSIONS:This study demonstrates that acupuncture may have therapeutic effects and long-term efficacy for neurogenic dysphagia.However,due to an insufficient sample size and the lack of follow-up for control group 2,multi-centre trials employing a larger sample size may be required to draw concrete conclusions.     

Effect of Tiaoshen Kaiqiao acupuncture in the treatment of ischemic post-stroke depression: a randomized controlled trial

Objective

To observe the effect of Tiaoshen Kaiqiao acupuncture in the treatment of ischemic post-stroke depression.

Clinical curative effect of electric acupuncture on acute cerebral infarction: a randomized controlled multicenter trial

ObjectiveTo examine whether electric acupuncture can improve the daily life of patients with ischemic cerebral apoplexy at acute stage.MethodsA stratified-block randomized controlled multicenter trial was designed for this study. Totally 340 patients with acute ischemic cerebral apoplexy were randomly divided into an electric acupuncture group and a control group. In the electric acupuncture group, 170 patients were treated with electric acupuncture and routine therapy, and 170 patients in the control group with routine therapy alone. Major indexes for judging curative effect were Barthel index at 3- and 6-months follow-up visits and number of re-hospitalized patients. Minor indexes for judging curative effect were change in the score for nervous dysfunction at 4 and 12 weeks follow-up visits and number of patients persisting in rehabilitation treatment with acupuncture during follow-up visit.ResultsBaseline data at the time of case selection between the two groups were similar. The odds ratio (OR) was 0.92, and the 95% confidence interval (CI) was 0.49–1.73 in disabled rate and 0.73 and 0.51–1.05 in the number of re-hospitalized patients in the electric acupuncture group at 6-month follow up visit compared with the control group. There was no difference in the score for nervous dysfunction at the end of 12-week follow-up visit between the two groups. The score for nervous dysfunction at the end of 4-week treatment in the electric acupuncture group was significantly higher than that in the control group (P<0.05). The number of patients discharged from hospital who persisted in rehabilitation treatment with acupuncture in the acupuncture group was significantly higher than that in the control group.ConclusionUsing electric acupuncture to treat patients with acute ischemic cerebral apoplexy can effectively improve the nervous dysfunction scores after 4-week treatment and their ability to deal with daily life after 6-month follow-up visit. Systematic treatment with acupuncture may also reduce the number of patients with secondary apoplexy.     

Effect of electroacupuncture on chemotherapy-induced peripheral neuropathy in patients with malignant tumor: a single-blinded,randomized controlled trial

Objective

To evaluate the effect of electroacupuncture on chemotherapy-induced peripheral neuropathy (CIPN), quality of life and immune status of patients with malignant tumors.

Acupuncture accelerates recovery after general anesthesia:a prospective randomized controlled trial

BACKGROUND: Acupuncture anesthesia was created in the 1950’s in China and continues to be used there today during most major surgeries. It is widely used in China for such complex operations as brain, heart, and abdominal surgery. It is popular in China because it is economical, practical, and beneficial to the patients. With acupuncture anesthesia there is less bleeding during surgery and there is also quicker post-operative recovery.OBJECTIVE: This randomized prospective study aims at comparing the effect of two acupoints(Yongquan, KI1 and Renzhong, DU26) with sham acupuncture and no acupuncture on the time to recovery of consciousness after general anesthesia by means of the Bispectral Index monitor(BIS).DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: This is a prospective randomized controlled study. We randomly assigned 50 patients to 5 groups during recovery from surgical anesthesia. Four groups had acupuncture on KI1(group A), DU26(groups B), both KI1 and DU26(group C), and sham points(group D), and one had no acupuncture(group E).MAIN OUTCOME MEASURES: Bispectral Index(BIS), time to spontaneous eye opening, time to tracheal extubation, and time to following commands were measured as the main outcome measures.RESULTS: Time to spontaneous eye opening differed among groups(P=0.002), as well as time to tracheal extubation(P<0.000 1) and time to following commands(P=0.000 6). BIS values differed significantly among groups both 5 and 10 min after the end of anesthesia(P<0.000 1 and P=0.000 4,respectively). BIS values of groups D and E were lower than those of the other groups and those of group C were higher. The same pattern was observed also 15 and 30 min after the end of anesthesia, although the difference among groups was not significant at these time points(P=0.164 and P=0.104, respectively).CONCLUSION: Acupuncture on DU26 and KI1 accelerates recovery of consciousness after general anesthesia. Moreover, a possible synergistic effect of DU26 and KI1 is suggested. This issue may play a role in the optimization of operating room management and raise interest about the usefulness of acupuncture on unconsciousness states of different nature.     

杵针治疗腰椎间盘突出症的多中心随机对照研究

目的比较杵针和电针治疗血瘀型腰椎间盘突出症的临床疗效差异。方法将233例血瘀型腰椎间盘突出症患者随机分成治疗组117例和对照组116例。治疗组采用杵针治疗,穴取腰阳关八阵穴、河车路命门至长强段、环跳、阳陵泉,隔天治疗1次,20 min/次,每周3次,12次为1个疗程,共观察治疗1个疗程;对照组穴取腰阳关、十七椎、环跳、阳陵泉,治疗时间和周期与治疗组相同。观察两组的临床疗效,并记录两组患者治疗前后及治疗后1个月随访时下腰痛评分(JOA评分)。结果两组腰椎间盘突出症患者治疗后,治疗组总有效率86.32%,对照组总有效率90.52%,两组比较差异无统计学意义(P>0.05),说明两组临床疗效相当。两组腰椎间盘突出症患者治疗后及1个月后随访时的JOA评分与治疗前比较均有显著性提高(P<0.01),而各时间点组间差异均无统计学意义(P>0.05)。结论杵针与电针治疗血瘀型腰椎间盘突出症临床疗效相当,但杵针无创伤、无痛苦、操作方便,患者易于接受,值得临床推广应用。     

针刺治疗青少年近视效果的系统评价

目的系统评价针刺治疗青少年近视的疗效。方法计算机检索维普数据库、中国知网、万方数据库,查找关于针刺治疗青少年近视的随机对照试验(RCT),检索时限均从1955年1月1日~2015年12月31日。主要由2位研究者先选择文献及其资料,再行Meta分析(RevMan 5.2软件)。结果共纳入6个研究,707例患者。Meta分析结果显示:针刺组治疗青少年近视的总有效率[RR=6.01,95%CI(1.29,28.07),P=0.02]优于对照组,与对照组间的差异有统计学意义。但发表偏倚较大,使该Meta分析过分夸大了治疗效应量。结论现有证据尚不能表明针刺治疗青少年近视有效,尚需开展更多研究予以验证。     

Effectiveness of ZiYin Xiehuo granules and Zishen Qinggan granules on partial precocious puberty in girls: a multicenter,randomized, single-blind,controlled trial

OBJECTIVE

To evaluate the effect of ZiYin Xiehuo granules (ZYXH) and Zishen Qinggan granules (ZSQG) on partial precocious puberty (PPP).

Efficacy of acupuncture on fibromyalgia syndrome: a Meta-analysis

ObjectiveTo comprehensively evaluate the effectiveness of acupuncture as a treatment for fibromyalgia syndrome.MethodsTwo review authors independently selected the trials for the Meta-analysis, assessed their methodological quality and extracted relevant data. A quality assessment was conducted according to the Cochrane Review Handbook 5.0. RevMan 5.0.20 software was used in the statistical analysis.ResultsA total of 523 trials were reviewed and 9 trials were selected for Meta-analysis. (a) Compared acupuncture with sham acupuncture, there was a significant difference in the visual analogue scale, but no difference in the pressure pain threshold. Additionally, and there was a difference in the fibromyalgia impact questionnaire and the multidisciplinary pain inventory after 4 weeks of treatment, but no difference after 7 weeks of therapy. There was no difference in the numerical rating scale in weeks 3, 8 and 13. (b) Acupuncture versus drugs. There were differences in the VAS after 20 days of acupuncture and moxibustion treatment comparing with the drug amitriptyline, and after 4 weeks of acupuncture and moxibustion treatment comparing with the drug fluoxetine and amitriptyline. There were also differences in the number of tender points when comparing acupuncture with amitriptyline or fluoxetine. There was no difference in total efficiency when comparing acupuncture with amitriptyline after 4 weeks of treatment, but there were differences between the two groups 45 days after treatment. There were also differences in total efficiency comparing acupuncture with fluoxetine, and when comparing 4 weeks post-treatment of acupuncture with a combination of amitriptyline, oryzanol and vitamin B. (c) A comparison of acupuncture, drugs and exercise with drugs and exercise showed PPT differences in months 3 and 6. There was no difference between the two comparison groups after follow-up visits in months 12 and 24.ConclusionsCompared with sham acupuncture, there was not enough evidence to prove the efficacy of acupuncture therapy for the treatment of fibromyalgia. Some evidence testified that the effectiveness of acupuncture therapy for fibromyalgia was superior to drugs; however, the included trials were not of high quality or had high bias risks. Acupuncture combined with drugs and exercise could increase pain thresholds in the short term, but there is a need for higher quality randomized controlled trials to further confirm this.     

头穴透刺法治疗失眠症的随机对照研究

背景：失眠已成为威胁公众身体健康的突出问题,针灸在治疗失眠方面具有疗效高和副作用小的优势。 目的：观察头穴透刺法治疗失眠症的临床疗效。 设计、场所、对象和干预措施：将符合纳入标准、源于解放军总医院针灸科门诊的70例失眠患者随机分为头穴透刺组和常规针刺组,其中脱落4例,最终头穴透刺组纳入32例,常规针刺组纳入34例。头穴透刺组给予头穴透刺法,而常规针刺组则给予一般针刺疗法。两组患者均治疗4周。 主要结局指标：比较两组临床疗效、治疗前后匹兹堡睡眠质量指数量表积分和睡眠结构各成分的变化。 结果：头穴透刺组总有效率为90.6%,优于常规针刺组的73.5%（P＜0.05）。头穴透刺法对睡眠质量、睡眠时间及睡眠效率的改善均优于常规针刺法（P＜0.05,P＜0.01）。头穴透刺法能明显增加睡眠总时间和深睡期时间,与常规针刺组相比,差异有统计学意义（P＜0.01）。 结论：头穴透刺法治疗失眠症的临床疗效优于常规针刺法,主要体现在改善睡眠质量、睡眠时间及睡眠效率等方面。     

人工流产术后即时放置三种不同宫内节育器的临床效果观察

目的 了解3种常用宫内节育器(IUD)在人工流产术后即时放置的临床效果和安全性.方法 采用前瞻、随机对照临床研究方法,对2012年1-12月来自上海市浦东医院、浦东新区人民医院、浦东新区公利医院、浦东新区光明中医院4家医院计划生育门诊的1 200例早孕(孕周＜8周)妇女,行人工流产术后即时放置IUD,用抽取内含随机数字的信封方式确定放置IUD的类型,分别为MYCu、TCu380A和宫铜200 IUD 3种.每种IUD均观察400例,随访12个月,采用WHOLTA 2.0生命表法统计3种IUD随访12个月的累计终止率.结果 1 199例完成了12个月的随访,失访1例(0.08％,1/1 200);无子宫穿孔发生.MYCu、TCu380A和宫铜200 IUD的带器妊娠率分别为0.26/百妇女年、0、0.52/百妇女年(x2=1.951,P≥0.2);脱落相关终止率分别为0.26/百妇女年、1.84/百妇女年、2.05/百妇女年(x2=5.539,P =0.066).因症取器率分别为1.26/百妇女年、7.29/百妇女年和2.76/百妇女年,3者差异有统计学意义(x2=21.625,P=0.001),与IUD使用相关的终止率分别为3.25/百妇女年、9.00/百妇女年、5.50/百妇女年,3者差异有统计学意义(x2=12.191,P=0.004);IUD异位发生率分别为1.51/百妇女年、0、0.26/百妇女年,3者差异有统计学意义(x2 =8.649,P =0.014).结论 人工流产术后即时放置MYCu、TCu380A和宫铜200的避孕效果均良好,其中MYCu IUD不易脱落、与IUD使用相关的终止率低、续用率高,但IUD异位发生率较高.     

硬膜外麻醉和腰硬联合阻滞在84例待产妇分娩镇痛中的临床对比研究

目的:比较硬膜外麻醉和腰硬联合阻滞在待产妇分娩镇痛中的临床效果.方法:选择168例在我院生产的健康、单胎、足月临产初产妇,按麻醉方式分为硬膜外麻醉组(EA组)和腰硬联合阻滞组(CSE组),每组各84例.比较不同时间点产妇VAS疼痛评分、镇痛起效及维持时间、下肢运动阻滞评分及第一、二、三产程时间、新生儿1 min和5 min Apgar评分、产妇不良反应情况等.结果:CSE组镇痛起效时间为(2.74±1.48) min,显著短于EA组(P＜0.05),而镇痛维持时间达到(114.56±22.74)min,显著长于EA组(P＜0.05);两组产妇第一、二和三产程时间、下肢运动阻滞评分、新生儿1 min和5 min Apgar评分差异统计学意义(P＞0.05);CSE组总不良反应率为9.52％,显著低于EA组(P＜0.05).结论:硬膜外麻醉和腰硬联合阻滞对待产妇分娩均具有良好的镇痛效果,腰硬联合阻滞镇痛起效更快、持续时间更长,对产妇及新生儿无明显副作用,综合疗效确切.     

针灸治疗早泄疗效的Meta分析

目的系统评价针灸治疗早泄的疗效。方法计算机检索Cochrane图书馆临床对照试验注册中心CCTR（2011.4）、MEDLINE（1998～2011.4）、EMbase（1998～2011.4）、中国生物医学文献数据库CBM（1998～2011.4）、中国期刊全文数据库CNKI（1998～2010.4）、万方医学数据库（1998～2010.4）,并手工检索相关文献,纳入比较针灸与其它方法治疗早泄疗效的随机对照试验（RCT）。采用RevMan5.1软件进行统计分析。结果共纳入4个RCT进行分析,合计411例早泄患者。Meta分析显示：①针灸＋中药组治疗早泄的临床有效率稍高于单纯使用中药组[RR=1.50,95%CI（0.98～2.31）],但差异无统计学意义（P=0.06）。②一研究证实,针灸组治疗早泄的有效率明显高于帕罗西汀组[RR=1.29,95%CI（1.02～1.63）,P=0.03];而另两研究发现,针灸与帕罗西汀在改善患者性功能方面无统计学差异。③一研究证实,针灸治疗早泄疗效明显高于假针灸治疗（P〈0.05）。结论针灸治疗早泄疗效确切,且针灸操作简便,容易实行,创伤小,无明显毒副作用,值得临床推广运用。但因存在纳入研究数量较少,总体质量不高,各研究疗效评定标准不一致等易致偏倚的因素,影响论证真实性,期待更多高质量的多中心临床随机对照试验进一步验证。     

针刺透穴法对糖尿病周围神经病变神经传导速度的影响：随机对照试验

糖尿病周围神经病变（diabetic peripheral neuropathy,DPN）是糖尿病最常见的慢性并发症和主要的致残因素之一。患者常表现为肢体感觉异常,伴麻木、针刺、灼热或如踏棉垫感,有时伴有痛觉过敏,后期出现肌力减弱以至肌肉萎软和瘫痪,严重影响糖尿病（diabetes mellitus,DM）患者的身心健康和生活质量。国内一项流行病学调查显示DPN占DM所有并发症的16．44％。中医将其归属于消渴病合并“痹证”、“痛证”、“痿证”范畴。目前对于DPN尚无特异性治疗方法,针刺是临床采用的手段之一,本研究探讨了针刺透穴法对DPN神经传导速度的影响。     

氢氯噻嗪治疗儿童夜尿症的随机对照研究

目的：探讨氢氯噻嗪治疗夜尿症的有效性。方法：前瞻性纳入2010年1月～2010年9月我院夜尿症患儿100例,实际纳入病例95例,将其分为实验组（47例）和对照组（48例）。实验组服用氢氯噻嗪,对照组服用安慰剂。评估夜尿症的缓解情况及药物不良反应,并比较两组间的差异。结果：所有纳入患者均对药物有较好的耐受性。氢氯噻嗪和安慰剂均能明显缓解夜尿症的发生（57.4%vs 33.3%）,差异具有统计学意义（P=0.018）,但氢氯噻嗪降低夜尿症频率缓解程度50%以上者较安慰剂效果更明显（48.1%vs 12.5%）,差异具有统计学意义（P=0.018）。结论：氢氯噻嗪能安全而有效地缓解儿童夜尿症,但是在以后的研究和临床中其临床效果仍有待于进一步证实。     

Effect of Taijiquan practice versus wellness education on knee proprioception in patients with knee osteoarthritis: a randomized controlled trial

Objective

To determine the effects of Taijiquan practice on knee proprioception in patients with knee osteoarthritis (OA).

0.125％罗哌卡因不同时间间隔硬膜外规律间断注射分娩镇痛的效果

目的 探讨不同时间间隔硬膜外规律间断注射0.125％罗哌卡因在分娩镇痛的临床效果.方法 有分娩镇痛要求的初产妇60例,随机分为45 min组（A组）、60 min组（B组）和75 min组（C组）.分别规律间隔45、60、75 min注射0.125％罗哌卡因6 ml,均无背景持续输注剂量.记录VAS、爆发痛、罗哌卡因用量、阻滞平面及不良反应发生率.结果 与镇痛前相比,3组产妇在实施分娩镇痛后VAS均降低（P＜0.05）,但3组间VAS比较差异无统计学意义（P＞0.05）.与A组相比,B组和C组罗哌卡因用量减少（P＜0.05）,而B组与C组间比较差异无统计学意义（P＞0.05）;3组最高感觉阻滞平面＜T8例数差异无统计学意义,但爆发痛次数以C组产妇最多.结论 硬膜外规律以6 ml/45min、6 ml/60min和6 ml/75min间断输注0.125％罗哌卡因均可有效用于分娩镇痛,如按“全程无痛、最小药物用量”的原则,则6 ml/60 min较好.     

左乙拉西坦治疗成人癫(疒间)临床疗效和安全性的随机对照试验

目的 评价左乙拉西坦治疗成人癫(痌)的临床疗效和安全性.方法 采用随机、双盲、双模拟、阳性药物平行对照试验设计方案,将纳入研究的120例癫(痌)受试者随机分为试验组和对照组,每组各60例.试验组给予左乙拉西坦片+丙戊酸钠缓释模拟片治疗;对照组给予丙戊酸钠缓释片+左乙拉西坦模拟片治疗.两组疗程均为26周,治疗结束后随访3个月.评定两组受试者在治疗后(治疗结束后1～3 d)及随访3个月时的总有效率、癫(痌)每周发作频率、癫(痌)发作持续时间、生活质量(QOLIE-31评分量表)及药物相关的不良反应.结果 治疗前,两组受试者的癫(痌)每周发作频率、癫(痌)发作持续时间和QOLIE-31评分比较差异均无统计学意义.治疗后及随访3个月时,试验组受试者的总有效率为95.0％(57/60)和91.7％(55/60),均分别高于对照组[71.7％(43/60),63.3％(38/60);P＜0.01].治疗后及随访3个月时,两组受试者的癫(痌)每周发作频率、癫(痌)发作持续时间和QOLIE-31评分与同组治疗前相比差异均有统计学意义(P＜0.01),两组间差异也有统计学意义(P＜0.01).治疗后两组受试者的不良反应差异无统计学意义.结论 左乙拉西坦治疗成人癫(痌)的临床疗效优于丙戊酸钠缓释片,不良反应轻微,可作为临床治疗成人癫(痌)的首选药物.     

Heyan Kuntai capsule versus dehydroepiandrosterone in treating Chinese patients with infertility caused by diminished ovarian reserve: a multicenter,randomized controlled trial

Objective

To evaluate the clinical efficacy and safety of Heyan Kuntai capsule (HYKT) in treating women with infertility caused by diminished ovarian reserve (DOR).