Blinding Effect of Non-penetrating Sham Needle in the Randomized Controlled Trials of Acupuncture: A Systematic Review简

The aim of this article was to assess the clinical evidence for or against the blinding effect of non-penetrating sham needle as placebo needle. This systematic review included randomized controlled trials（RCTs） of acupuncture taking non-penetrating sham acupuncture as placebo needle. Systematic searches were conducted in 13 electronic databases up to July 2012： Medline, PubMed, the Cochrane Library, CINAHL, EMBASE, a Chinese medical database. All parallel or cross-over RCTs of acupuncture for the blinding effect of non-penetrating needle were chosen without language restrictions. Finally, totally 7 RCTs met the inclusion criteria. In conclusion, our systematic review and meta-analysis demonstrate that the non-penetrating needle is an effective instrument for placebo control in the acupuncture RCTs.     

Effectiveness of electroacupuncture for female stress urinary incontinence: a systematic review and Meta-analysis

OBJECTIVE: To evaluate the effectiveness of electroacupuncture(EA) for female stress urinary incontinence(SUI).METHODS: We searched 12 databases electronically from inception to November 2018 without language restrictions. We included randomized controlled trials(RCTs) involving women with SUI, but excluded other types of urinary incontinence or studies that were not RCTs. Two independent reviewers extracted study characteristics, with disagreements resolved by consensus. Data were pooled and ex...     

Effectiveness of bee venom acupuncture in alleviating post-stroke shoulder pain: a systematic review and meta-analysis

BACKGROUND:Shoulder pain is a common complication of stroke.Bee venom acupuncture(BVA)is increasingly used in the treatment of post-stroke shoulder pain.OBJECTIVE:To summarize and evaluate evidence on the effectiveness of BVA in relieving shoulder pain after stroke.SEARCH STRATEGY:Nine databases,namely MEDLINE,EMBASE,the Cochrane Library,the China National Knowledge Infrastructure(CNKI),the Japan Science and Technology Information Aggregator,Electronic(J-STAGE),and four Korean medical databases,namely,the National Assembly Library,the Research Information Service System,the National Discovery for Science Leaders,and OASIS,were searched from their inception through August 2014 without language restrictions.INCLUSION CRITERIA:Randomized controlled trials(RCTs)were included if BVA was used at acupoints as the sole treatment,or as an adjunct to other treatments,for shoulder pain after stroke.DATA EXTRACTION AND ANALYSIS:Two review authors independently selected trials for inclusion,assessed methodological quality and extracted data.RESULTS:A total of 138 potentially relevant articles were identifi ed,4 of which were RCTs that met our inclusion criteria.The quality of studies included was generally low,and a preponderance of positive results was demonstrated.All four trials reported favorable effects of BVA on shoulder pain after stroke.Two RCTs assessing the effects of BVA on post-stroke shoulder pain,as opposed to saline injections,were included in the meta-analysis.Pain was signifi cantly lower for BVA than for saline injections(standardized mean difference on 10-cm visual analog scale:1.46 cm,95%CI=0.30–2.62,P=0.02,n=86)CONCLUSION:This review provided evidence suggesting that BVA is effective in relieving shoulder pain after stroke.However,further studies are needed to confi rm the role of BVA in alleviating post-stroke shoulder pain.Future studies should be conducted with large samples and rigorous study designs.     

Efficacy of acupuncture therapy for post-stroke fatigue: a systematic review and Meta-analysis

OBJECTIVE: To assess the effectiveness and safety of acupuncture for post-stroke fatigue(PSF). METHODS: Eight online databases were searched to collect relevant trials of acupuncture for PSF published before April 2021. Meta-analysis was performed by using RevMan 5.4 software. The Grading of Recommendations, Assessment, Development and Evaluation system was used to assess the certainty of evidence. RESULTS: Four randomized controlled trials involving 289 PSF patients were identified and included...     

Current status of outcome reporting in randomized controlled trials of traditional Chinese medicine for mammary gland hyperplasia: A systematic reviewOA

Objective: To assess outcome indicators in clinical trials and provide a reference for establishing a core outcome set to treat hyperplasia of mammary gland(HMG) with traditional Chinese medicine(TCM).Methods: Eight online databases were searched from their inception to December 31, 2022, to assess outcomes reported in randomized controlled trials(RCTs) of HMG treated with TCM. The quality of the included studies was assessed according to the Cochrane Risk of Bias Assessment Tool. All outcomes w...     

Medium- and long-term efficacy of ligustrazine plus conventional medication on ischemic stroke： a systematic review and meta-analy- sis

OBJECTIVE： To evaluate the medium- to long-term efficacy of ligustrazine plus conventional medicine treating ischemic stroke. METHODS： Randomized controlled trials （RCTs） testing ligustrazine in the treatment of acute isch- emic stroke were retrieved from Cochrane Library, PubMed, Excerpta Medica Database, Chinese Medi- cal Journal Database, Chinese Biomedical Data- base, China National Knowledge Infrastructure Da- tabase, and Chinese Clinical Trial Register, and then identified by the inclusive and exclusive criteria. The quality of trials was assessed with the Co- chrane Handbook 5.1, a risk of bias assessment toot. RevMan 5.1 was used for meta-analysis.RESULTS： Three RCTs involving 643 patients were included. Compared to conventional medicine treatment alone, ligustrazine plus conventional medicine treatment showed significant difference in reduction of stroke recurrence either at the end of 1-year follow-up [RR=0.42, 95% CI （0.18, 0.94）, P〈 0.05] or 3-years observation [RR=0.48, 95% C/（0.27, 0.83）, P〈0.05]. The ligustrazine group also showed higher survival rate [RR=1.67, 95% CI （1.02, 0.2.71）, P〈0.05] and significantly better effective rate [RR= 1.28, 95% CI（1.10, 1.50）, P〈0.05] than that of the control group at the end of 1 year visit. Only one tri- al conducted safety assessment and no adverse events were reported. The methodological quality of all the trials included was generally poor. CONCLUSION： The findings provided evidence that the combination of ligustrazine and conven- tional medication was medium- and long-term ben- eficial to the patients suffering ischemic stroke. But more RCTs of high quality are needed to further prove the efficacy and safety of using ligustrazine for ischemic stroke.     

Effectiveness and safety of seven oral Chinese patent medicines as adjuvant therapy for cancer-related anemia: A systematic review and network meta-analysis of randomized controlled trialsOA

Objective: To evaluate the effectiveness and safety of seven oral Chinese patent medicines(CPMs) as adjuvant therapy for cancer-related anemia(CRA) by network meta-analysis(NMA).Methods: A literature search to obtain randomized controlled trials(RCTs) of seven oral CPMs in the adjuvant treatment of CRA was conducted in multiple databases from the inception to April 2022. The Rev Man5.3 and R 4.1.1 software were used for NMA.Results: We ultimately included 29 RCTs with 2140 patients. Traditional ...     

Xiyanping Injection in Treatment of Viral Pneumonia in Children: A Meta-analysis of Random Control Trials

Objective To evaluate the efficacy and safety of Xiyanping Injection in the treatment of viral pneumonia in children. Methods We searched several databases, including Pub Med, CNKI, VIP and Wanfang Data(January— June, 2014). The references of all selected studies were also retrieved to collect the relevantly randomized controlled trials(RCTs) on Xiyanping Injection for viral pneumonia in children. Two authors screened the literatures in accordance with the inclusive criteria, extracted the data and assessed the methodological quality of the included studies. We used Rev Man 5.2 software for meta-analysis. Results Meta-analysis on the 10 included RCTs showed that the effective rates of defervescing and vanishing of the rashes and cough in the Xiyanping Injection group were better than those in the Ribavirin Injection group. There was no significant difference between the two groups in the incidence of adverse drug reaction. Conclusion The existing research indicated that Xiyanping Injection is a secure and efficient scheme for viral pneumonia in children. Because of the poor quality of present researches, these results should be verified by strictly-designed and large-scale sample RCTs.     

Randomized Clinical Trials of Traditional Chinese Medicines for Treating Ulcerative Colitis: A Scoping Review

Objective: Traditional Chinese medicines (TCMs) are efficacious against ulcerative colitis (UC). In recent years, the number of randomized clinical trials (RCTs) of TCM has increased. Thus, it is very important to summarize the basic characteristics, quality, and types of TCM interventions in published RCTs. This scoping review was performed to systematically identify and describe the current situations about RCTs of TCMs for treating UC. Hope to express the focus and specifics of nowadays research in TCM interventions in RCTs and evaluate their common disadvantages exposed to help advance in TCM researching. Materials and Methods: Ascoping review was conducted according to the PRISMA extension for scoping reviews. We searched two English databases and four Chinese databases from the date of establishment of each database to January 2020. Data from RCTs focusing on any TCM treatment for patients with UC were extracted and evaluated. Selection and characterization were performed by two independent reviewers using predefined forms. All discrepancies were resolved by consensus discussion with a third reviewer. Microsoft Excel 2010 was used to extract the following data from the included studies: (1) basic information of the included studies including research ID, article title, publication language, journal, year of publication, and funding information; (2) patient information including gender, age, disease course, disease stage, severity, sample size; and (3) information on intervention measures, types of intervention measures, drug dosage forms, and treatment courses. Results: The search identified 2225 RCTs published between 1987 and 2020. These studies covered 36 provinces in China. The time frame of the RCTs was <28 days in approximately one-third of the RCTs (647, 29.08%). Only one RCT was published in English. Nearly three-quarters of RCTs (1665, 74.83%) did not report the severity of the disease. Three types of interventions were included in the RCTs: pharmacotherapy (2028, 91.15%), nonpharmacotherapy (57, 2.56%), and a combination of the two (140, 6.29%). The administration modes of the intervention groups were evaluated. Drug therapy involved 12 types of TCM dosage forms, which were decoctions, troches, powders, capsules, granules, pills, suppositories, ointments, injections, gels, oral liquids, and substitute tea according to the frequency of use. Nondrug intervention measures involved 10 treatment options, namely, acupuncture, moxibustion, hemospasia, auricular point, acupoint catgut embedding, acupoint injection, scrapping, tuina, acupoint application, and five?tone therapy according to the frequency of use. Most studies included in this review were low in quality. This underscores the need for improvement in the quality of trial methodology in TCM RCTs.     

Incorporating Chinese Medicine Principles into Acupuncture Clinical Trial Design: Case Studies

The unique characteristics of Chinese medicine theories play a critical role in guilding clinical practice. Thus, clinical research in Chinese medicine, either acupuncture or Chinese herbal medicine needs to reflect the nature of clinical practice. However, the concepts of individualized diagnosis and treatment present problems in employing existing trial methodology and designing trials that fully comply with the gold standard of randomized controlled trials and adhere to Chinese medicine pr…     

英文摘要

Acupuncture and Moxibustion Treating Sprained Ankle
ZHAO Xia,DU Yuan- hao,XlONG Jun,LI Bo
Abstract： Objective： To evaluate the quality of randomized controlled trials （RCTs） on acupuncture and moxibustion for sprained ankle and carries on the method to study the quality evaluation to all randomized controlled trials. Methods： The literatures between 1979-2008 were searched by means of electronic retrieval. Type and methodology, general condition,diagnosis of diseases and enrolled and excluded criteria,assessment of sample content, treatment condition,     

Comparative efficacy of traditional Chinese herbal injection for chronic renal failure: A systematic review and network meta-analysis of randomized controlled trialsOA

Objective: To conduct a systematic review and network meta-analysis(NMA) for the comparison of the efficacy and safety of Chinese herbal injection(CHI) combined with Western medicine(WM) and WM monotherapy for chronic renal failure(CRF).Methods: Eight databases were searched from inception to August 30, 2022. Randomized controlled trials(RCTs) regarding the comparison of CHI-WM combination therapy and WM monotherapy were included. Literature search, risk-of-bias assessment, and data extraction w...     

Acupoint Herbal Patching with or without ConventionalTreatment for Stable Chronic Obstructive PulmonaryDisease: a Systematic Review of RandomizedControlled Trials

Objective: To evaluate the effectiveness and safety of AHP with or without CT for people with COPD at stable stage. Methods: We searched randomized controlled trials comparing AHP (with or without CT) with no intervention, placebo, or CT from six databases. Two authors selected studies, extracted data and evaluated risk of bias of included trials. RevMan 5.2 software was used to analysis data. Results: Twenty one RCTs (2327 participants) were included. AHP of non-sanfu applied on no fixed dates with CT significantly decreased the mean frequency of acute exacerbation of COPD (times per year) (MD: ?1.24; 95% CI: ?2.02 to ?0.46; 2 trials), and improved the lung function parameters and quality of life. The AHP with CT showed no better effect in 6-minute walking distance (6MWD) and hospitalization. In addition, AHP applied at sanfu (specific dates based on lunar calendar) with CT had significant effect for 6MWD. One trial reported skin irritation and found no significant difference between two groups. Another trial reported two patients had eyes discomfort, which was inferred as the adverse effects of seretide. Conclusion: AHP used as adjunct to CT, appears to be effective than CT alone in patients with stable COPD. However, further large, rigorously designed trials are warranted to confirm these potential effects.     

Evidence base of randomized controlled trials and guideline recommendations of patent Traditional Chinese Medicines for uncomplicated acute lower respiratory tract infections in adults

OBJECTIVE:To compare clinical practice guideline recommendations on the use of oral patent Traditional Chinese Medicines(PTCMs) for uncomplicated acute lower respiratory tract infections(ALRTIs)in adults with the existing evidence using results of a systematic review of randomized controlled trials(RCTs).METHODS:A systematic review on RCTs and a systematic review of current guidelines on orally taken PTCMs for uncomplicated ALRTIs were performed.Pub Med,Cochrane Library,EMBASE and four Chinese databases were searched from inception to September 2016 for RCTs testing orally taken PTCMs for uncomplicated ALRTIs(excluding pneumonia).Two reviewers independently screened each study,extracted study data,and assessed risk of bias.Disagreements were resolved through discussion or by consultation with a third reviewer.Clinical practice guidelines for uncomplicated ALRTIs containing PTCM recommendations were identified and quality appraised.The quality of pooled evidence of the RCTs and the guidelines was assessed with GRADE and AGREE Ⅱ respectively.The consistency of the evidence base in RCTs and the guideline recommendations were then compared.RESULTS:For the systematic review of RCTs,4810 papers were identified,among which 29 RCTs(5093 patients) were included in the review.PTCMs compared to placebo increased the effective treatment rate of cough(3 trials,949 patients,risk ratio(RR) 2.50,1.16 to 5.43;low certainty);improved assessment of global health(3 trials,948 patients,RR1.70,1.44 to 2.01;low certainty);and increased the effective rate of specific symptom relief(1 trial,478 patients,RR 4.01,2.76 to 5.81;moderate certainty).21 trials(3432 patients) compared effects of different PTCMs.For the guideline evaluation,29 PTCMs were recommended for the use of uncomplicated ALRTIs,of which27 had no supportive evidence from RCTs.CONCLUSION:The evidence base of PTCMs for uncomplicated ALRTIs is weak and the guideline recommendations were based on almost no clinical trial evidence.Rigorous clinical research is urgently needed to inform the clinical use of these herbal medicines.Further training in evidence-based medicine methods for Traditional Chinese Medicine guideline developers is essential.     

Bibliometric analysis of acupuncture research through the Web of Science database from 1990 to 2019

Background:The main points of focus of bibliometric analysis of acupuncture treatment of diseases include pain(headache,low back pain),insomnia,and knee osteoarthritis,for example.In this paper,we analyze the frontiers,hotspots,and research trends of acupuncture over the past 30 years and compare them for each of three 10-year periods.Methods:All the studies on acupuncture research in three different periods(1990–1999,2000–2009,2010–2019)were collected from the Web of Science database.The evolution of the research,hotspots,and trends in acupuncture were explored intuitively by analyzing the frequency,betweenness centrality,and subject word clustering of the three periods.Results:(1)1990–1999,the main content relating to research was the mechanism of research of acupuncture treatment of pain.Naloxone was the high-frequency subject word,and centrality included,for example,the spinal cord,enkephalin,smoking cessation,and detoxification.The results of keyword cluster analysis showed that the main research content included capsaicin-induced neurogenic edema,chemical dependency treatment,afferent fiber,and sufferers from xerostomia.(2)2000–2009,during this stage,the frequency of keywords appeared in new research content such as randomized controlled trials of acupuncture and low back pain,but pain still dominated the main research content.From the perspective of intermediary centrality,along with the rise in randomized controlled trials,there were many important meta-analyses,as well as the management of acupuncture treatment.The main elements of the keyword cluster analysis included,for example,systematic review,randomized controlled pilot study,add-on therapy,brief overview,and ovarian morphology.(3)2010–2019,during this period,compared with the previous two stages,there was increased frequency of keywords,a growth in clinical randomized controlled trials,and distribution of centrality was evident in the emergence of acupuncture in care,osteoarthritis treatment,and breast cancer research.The keyword clustering covered,for example,neural specificity,inflammatory reaction,chronic pain,sleep pattern,and consort statement.Conclusion:This article summarizes the trend of development of acupuncture from 1990 to 2019 and compares the main research categories and hotspots in each of three different 10-year periods within this span,thereby helping elucidate the research direction within the field.     

Traditional Chinese medicine for acute mountain sickness prevention:A systematic review and meta-analysis of randomized controlled trialsOA

Objective: To evaluate the efficacy of traditional Chinese medicine(TCM) for preventing acute mountain sickness(AMS).Methods: We included randomized controlled trials(RCTs) which evalueded the effect of TCM for preventing AMS, compared with a placebo, no treatment or acetazolamide. The literature was searched in 6major databases. RevMan 5.4 software was used for the meta-analysis. The relative risk for discrete variables and the mean difference for continuous variables with 95% confidence interv...     

不同针灸疗法治疗中风后痉挛性偏瘫的网状Meta分析

Objective:To perform a network meta-analysis on four commonly used acupuncture therapies(electroacupuncture,fire acupuncture,warm acupuncture,and filiform needling) and rehabilitation therapy in the treatment of post-stroke spastic hemiplegia so as to compare the differences in clinical therapeutic effect between acupuncture therapy and rehabilitation therapy as well as among different therapeutic methods of acupuncture.Methods:A computer-based retrieval was conducted in Chinese and English databases,i.e.CNKI,WanFang,VIP,SinoMed,PubMed,Embase,Web of Science and Cochrane library.The search period limit was from the database establishment to April 17,2020.Data analysis was performed through Revman 5.3,Gemtc 0.14.3 and Stata 14.2.Results:A total of 27 trials were finally eligible,including 1880 patients,943 patients of which were in observation group and 937 patients in control group.In terms of the improvement of effective rate,electroacupuncture,fire needling,warm acupuncture and filiform needling methods were all better than rehabilitation therapy,and among which,warm acupuncture was the highest in probability to be the optimal measure.Regarding the improvement in Fugl-Meyer Assessment(FMA) motor function score,fire needling,warm acupuncture and filiform needling methods were all better than rehabilitation therapy,and among which,fire needling method was the highest in probability to be the optimal measure.In view of the improvement of BI score,fire needling method was better than electroacupuncture and filiform needling method,while,warm acupuncture was better than electroacupuncture,thus,fire needling method may be the optimal measure.For the modified Ashworth muscular tension assessment,there was no significant differences in pairwise comparison among different interventions and warm acupuncture was probably the optimal measure.Conclusion:The overall therapeutic effect of 4 acupuncture therapies is better than rehabilitation therapy on post-stroke spastic hemiplegia,respectively,among which,the therapeutic effect of warm acupuncture and fire needling method is the best.However,because of a limitation of the varieties of acupuncturemoxibustion therapy and the number of included trials,it needs to conduct more rigorous and scientific randomized controlled trials so that this conclusion can be further confirmed.     

ACUPUNCTURE RELIEVES PAIN IN REFLEX SYMPATHETIC DYSTROPHY:PITFALLS IN THE ANALYSIS OF RESULTS

Objective: Despite thousands of years of utilizing acupuncture for relief of pain, there is considerable controversy whether acupuncture deserves to be considered an efficacious modality along with medications and operations.Many publications claiming to answer this most important question have inspired more controversy regarding experimental design, designation of adequate controls and avoiding the dreaded placebo effect.Methods: We present a retrospective series of patients all of whom have severe chronic pain of the extremities with the unequivocal diagnosis of reflex sympathetic dystrophy.The patients were included if they had 15 treatments with acupuncture.The patients were treated in a single practice of acupuncture by two of the authors.There was no standardization of treatment given to each patient.The treatments were modified at each session.Objective date collected included the pain level on a 0 to 10 visual analogue scale and other functional data such as range of motion and daily activities.Results: At each treatment time, the acupuncture treatment significantly decreased the pain level from the value before the treatment to the pain level after the acupuncture treatment.Firsttreatment pre-treatment pain level: 7.43±2.15, post treatment 3.86±2.76(P0.0019).Over the course of the initial 15 treatments, the pre-treatment pain level did not significantly decline.Treatment number 15 had an average pain level of 6.5±1.51(P0.40).Conclusions: The treatment with acupuncture unequivocally caused a significant reduction in pain level on each treatment day; however, 15 treatments with acupuncture did not significantly produce a lasting effect.However, reviewing each individual charted data and analyzing the individual patient course gives a more accurate picture of the effect of acupuncture on patients with c omplex pain problems.     

COMPARATIVE ANALYSIS ON THERAPEUTIC EFFECTS OF APOPLEXY TREATED BY XINGNAO KAIQIAO ACUPUNCTURE METHOD AND WESTERN MEDICINE

The therapeutic effects of Xingnao Kaiqiao (醒脑开窍) acupuncture method and West-ern medicine treating apoplexy were compared in this paper. The results show that the total effectiverate is over 90. 00% in acupuncture group for treating motor dysfunction of limbs and main clinicalsymptotns, especially for treating paralysis of extremities, the total effective rate is up to 97. 72%,which is obviously better than that of Western medicine; moreover, the acupuncture has a special ef-fectiveness for restoring the function of cerebral tissue, and treating aphasia and central facial palsy.The characteristics of Xingnao Kaiqiao acupuncture method were described too.