Efficacy of acupuncture combined with Chinese herbal medicine for the treatment of chronic nephritis: A protocol for systematic review and meta-analysis

Background:Chronic nephritis is a common kidney disease that afflicts people worldwide. The disease has main manifestations of proteinuria, hematuria, edema, and hypertension that are associated with kidney-damaging processes that eventually lead to kidney failure. Traditional Chinese medicine involving combination treatment with herbal remedies and acupuncture has been shown clinically to alleviate chronic nephritis, although to date no systematic review of the efficacy of this combination treatment for this purpose has been reported, prompting this study. Here we conducted a systematic review and meta-analysis of published randomized clinical trials to scientific evidence and credible medical references supporting the clinical efficacy of this combination treatment when used to treat chronic nephritis.Methods:We will search the following 8 electronic Chinese and English databases: Web of Science, PubMed, Cochrane Library, Embase, China Biomedical Literature Database, China National Knowledge Infrastructure, China Scientific Journal Database, and the Wanfang database. All electronic databases will be searched from inception to October 10, 2021. All statistical analyses will be performed using Review Manager Version 5.4 provided by the Cochrane Collaboration Network.Results:The protocol for systematic review and meta-analysis will be applied to evaluate the efficacy of acupuncture combined with Chinese herbal medicine for the treatment of chronic nephritis.Conclusion:We plan to submit the results of this research to a peer-reviewed journal.INPLASY registration number:INPLASY2021100051.     

Efficacy and safety of acupuncture combined with Chinese Herbal Medicine for diabetic nephropathy: A protocol for systematic review and meta-analysis

Background:Diabetic nephropathy (DN) is one of the most serious complications in the development of diabetes mellitus, which has become the main cause of end-stage renal disease and one of the main causes of death in diabetic patients. With the prevalence of diabetes, the number of patients at risk for developing DN is increasing, with 20–40 percent of all patients with diabetes at risk for developing DN. Acupuncture and Chinese herbal medicine treatments are often combined to treat DN; however, there has been no meta-analysis on their synergistic effects. Therefore, we aimed to perform a systematic review and meta-analysis to estimate the effectiveness of acupuncture combined with Chinese herbal medicine for DN treatment.Methods:Nine electronic databases were retrieved for this study. The English databases mainly retrieved PubMed, Web of Science, Embase, AMED, and the Cochrane Library, while the CNKI, VIP, CBM, and Wanfang databases were used to retrieve the Chinese literature. There is no definite time limit for the retrieval literature, and the languages are limited to Chinese and English. We will consider articles published between database initiation and August 2021. We used Review Manager 5.4, provided by the Cochrane Collaborative Network for statistical analysis. Clinical randomized controlled trials related to acupuncture combined with Chinese herbal medicine for DN were included in this study. Research selection, data extraction, and research quality assessments were independently completed by two researchers. We then assessed the quality and risk of the included studies and observed the outcome measures.Results:This study provides a high-quality synthesis to assess the effectiveness and safety of acupuncture combined with Chinese herbal medicine for treating DN.Conclusion:This systematic review will provide evidence to determine whether acupuncture combined with Chinese herbal medicine is an effective and safe intervention for patients with DN.Ethics and dissemination:The protocol of the systematic review does not require ethical approval because it does not involve humans. This article will be published in peer-reviewed journals and presented at relevant conferences.Registration number:INPLASY202180018     

Acupuncture combined with Chinese herbal medicine on non-alcoholic fatty liver disease: A protocol for systematic review and meta-analysis

Background:Non-alcoholic fatty liver disease (NAFLD) is a global health burden. However, there are no approved drugs for NAFLD. A number of studies have shown that acupuncture combined with Chinese herbal medicine (CHM) can be beneficial for NAFLD. However, high-quality trials are still lacking. Therefore, we aimed to conduct a systematic review and meta-analysis to assess the effectiveness and safety of acupuncture combined with CHM for NAFLD.Methods:Eight electronic databases including PubMed, the Cochrane Library, Web of Science, EMBASE, China National Knowledge Infrastructure, Chinese Scientific and Technical Journals Database, and Wan-fang Database from inception to November 2021 will be searched. We will also search for Clinical Trials Registry Platforms as a supplement. Randomized controlled trials on acupuncture combined with CHM for NAFLD will be included. Literature screening, data extraction, and risk of bias assessment were independently conducted by 2 reviewers. All differences between the 2 reviewers will be discussed and resolved by a third reviewer. Revman5.3 software will be used for meta-analysis.Result:This study aimed to evaluate the effectiveness and safety of acupuncture combined with CHM for NAFLD.Conclusion:The findings of this study will provide more evidence to determine whether acupuncture combined with CHM for NAFLD is an effective and safe intervention for NAFLD.     

Efficacy and safety of traditional Chinese herbal medicine combined with HAART in the treatment of HIV/AIDS: A protocol for systematic review and meta-analysis

Background:Acquired immunodeficiency syndrome (AIDS) is one of the infectious diseases pandemic in the word. Traditional Chinese herbal medicine, as an alternative and complementary therapy of highly active antiretroviral therapy (HAART), has been put into the treatment of human immunodeficiency virus (HIV)/AIDS over 30 years due to its good therapeutic effects and high safety, while there is a lack of evidence-based medicine support. The purpose of this study is to explore the efficacy and safety of traditional Chinese herbal medicine combined with HAART for HIV/AIDS patients.Methods:We will search all randomized controlled trials of Chinese herbal medicine combined with HAART in the treatment of HIV/AIDS from electronic databases including PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure, WanFang, China Science and Technology Journal Database and Chinese Biomedical Literature Database from inception to December 31, 2021. Literature screening will be conducted through EndNote software, and data extraction will be processed according to inclusion and exclusion criteria by two independent researchers. We will use Review Manager 5.4 and Stata 16 software for data analysis and publication bias test.Results:This systematic review and meta-analysis will provide a high-quality evidence for the efficacy and safety of traditional Chinese herbal medicine combined with HAART in the treatment of HIV/AIDS.Conclusion:The conclusion of this review will provide an objective assessment to evaluate whether Chinese herbal medicine integrated with HAART has the effect of improving the efficiency and depressing the toxicity.Registration number:INPLASY2021110082.     

Acupuncture combine with Tuina for diabetic peripheral neuropathy: A protocol for a systematic review and meta-analysis

Background:Diabetic peripheral neuropathy (DPN) is one of the most common microvascular complications of diabetes mellitus, with an incidence ranging from 60% to 90%. With the change in modern dietary structure, the incidence of diabetes is increasing year by year, and DPN is also on the rise. Acupuncture and Tuina treatments are often combined to treat DPN; however, there has been no meta-analysis on their synergistic effect; therefore, we aimed to perform a systematic review and meta-analysis to estimate the effectiveness of acupuncture combined with Tuina in DPN treatment.Methods:Nine electronic databases were retrieved for this study. The English databases mainly retrieved PubMed, Web of Science, Embase, AMED, and the Cochrane Library, while the CNKI, VIP, CBM, and Wanfang databases were used to retrieve the Chinese literature; there was no definite time limit for the retrieval literature, and the languages were limited to Chinese and English. We will consider articles published between database initiation and November 2021. We used Review Manager 5.4 software provided by the Cochrane Collaborative Network for statistical analysis. We then assessed the quality and risk of the included studies and observed the outcome measures.Results:This study provides a high-quality synthesis to assess the effectiveness and safety of acupuncture combined with Tuina for treating DPN.Conclusion:This systematic review provided evidence to determine whether acupuncture combined with Tuina is an effective and safe intervention for patients with DPN.Ethics and dissemination:The protocol for this systematic review does not require ethical approval because it does not involve humans. This article will be published in peer-reviewed journals and presented at relevant conferences.Systematic review registration:INPLASY2021110017     

Efficacy and safety of acupuncture combined with Chinese herbal medicine in the treatment of type 2 diabetes mellitus: A protocol for a systematic review and meta-analysis

Background:Diabetes has become a global public health problem and danger to human health. Diabetes is the main cause of blindness, kidney failure, heart attack, stroke, and lower limb amputation. According to the latest epidemiological survey and research, the overall prevalence of diabetes in mainland China is 11.2%, of which type 2 diabetes mellitus (T2DM) accounts for more than 90% acupuncture combined with Chinese herbal medicine have been widely used in the treatment of T2DM. However, we have not found a meta-analysis of their synergistic effects. Therefore, this systematic review and meta-analysis aims to evaluate the efficacy and safety of acupuncture combined with Chinese herbal medicine in the treatment of T2DM.Method:From inception up to September 20, 2021, the PubMed, Web of Science, Embase, AMED, Cochrane Library, CNKI, VIP, CBM, and Wanfang databases will be searched. The publication date or language will not be limited. We will apply a combination of medical keywords, including “acupuncture”, “Chinese herbal medicine”, and “type 2 diabetes mellitus”. We will also check other ongoing and unpublished studies in the clinical trial registry. At the same time, we will manually search all reference lists from relevant systematic reviews to find other eligible studies. We will use Review Manager software (REVMAN v5.3 Cochrane Collaboration) to meta-analyze the selected literature. The study for acupuncture combined with Chinese herbal medicine in the treatment of T2DM was a randomized controlled study. Two researchers will independently review the research selection, data extraction, and research quality assessments. Finally, we will observe the outcome measures.Results:This study will generate evidence-based data on the treatment of T2DM with acupuncture combined with Chinese herbal medicine and will provide new ideas and treatment modalities to investigate in future research.     

Preventive effect and safety of Chinese herbal medicine mouthwash in chemotherapy-induced oral mucositis: A protocol for systematic review and meta analysis

Background:Oral mucositis (OM), one of the most common side effects for cancer patients who have undergone chemotherapy, can cause severe impairment to patients’ functional ability and impact their quality of life, resulting in delayed and/or incomplete treatment. Traditional Chinese medicine offers empirical herbal decoctions to gargle for the prevention of chemotherapy-induced OM; however, evidence for its clinical efficacy and safety is lacking. Therefore, we provide a protocol to evaluate the preventive effect and safety of Chinese herbal medicine mouthwash in chemotherapy-induced OM.Methods:We will comprehensively retrieve relevant articles published till August 15, 2020, in the following electronic databases: the Cochrane Library, PubMed, EMBASE, Chinese National Knowledge Infrastructure Database, Chinese Biomedical Literature Database, Chinese Science and Technique Journals Database, and the Wan-fang Database. Only randomized controlled trials will be included. We will use the criteria provided by the Cochrane Handbook for quality assessment and risk assessment of the included studies and use the RevMan 5.3 software for meta-analysis of the preventive effect and safety.Results:This study will assess the preventive effect and safety of Chinese herbal medicine mouthwash in chemotherapy-induced OM.Conclusion:This systematic review will provide evidence-based medical corroboration for the clinical application of the Chinese herbal medicine mouthwash in chemotherapy-induced OM.PROSPERO registration number:CRD42020206614.     

Acupuncture methods for diabetic peripheral neuropathy: A protocol for a Bayesian network meta-analysis

Background:Many clinical trials and systematic reviews have suggested that acupuncture (include moxibustion) could be effective in the treatment of diabetic peripheral neuropathy (DPN). However, clinical practices vary greatly leads to different choices which are mainly based on personal experience. The aim of this Bayesian network meta-analysis is to compare the efficacy of different acupuncture methods for DPN.Methods:Randomized controlled trials on acupuncture treatment of DPN published before January of 2021 will be searched in 9 databases including Medline, Web of Science, PubMed, Cochrane Library, Excerpta Medica Database, Sinomed, China National Knowledge Infrastructure, WanFang, and China Science and Technology Journal Database. The methodological assessment performed using the risk of bias assessment tool of Cochrane, and the level of evidence quality for the main results will be evaluated by a recommended grading, evaluation, formulation, and evaluation system approach. Bayesian network meta-analysis will be conducted using STATA V.14.0 and WinBUGS V.1.4.3.Results:The primary outcome involves: clinical efficacy. The secondary outcomes include: motor nerve conduction velocity, sensory nerve conduction velocity, Toronto clinical scoring system, Michigan neuropathy screening instrument, the modified Toronto Clinical Neuropathy Scale, the Utah early neuropathy scale, or the neuropathy disability score, and adverse reactions.Conclusion:To find the most effective acupuncture therapy for the treatment of DPN supported by evidence-based medicine.     

Acupuncture combined with Tongxieyaofang for diarrhea-type irritable bowel syndrome: A protocol for meta-analysis

Background:As a traditional Chinese medicine external treatment method, acupuncture is characterized by simple operation, significant treatment effect and few side effects. Tong-Xie-Yao-Fang (TXYF), a Chinese patent medicine, combined with acupuncture has been widely used on treating Diarrhea Predominant Irritable Bowel Syndrome (IBS-D). However, the efficacy and safety of TXYF combined with acupuncture for the treatment of IBS-D are unclear. This study aims to investigate verify the efficacy and safety of TXYF combined with acupuncture for IBS-D.Methods and analysis:Randomized controlled trials of TXYF combined with acupuncture for all IBS-D will be searched in PubMed, the Cochrane Library, Embase, Web of Science, the China National Knowledge Infrastructure, Wanfang Database, Chinese Science and Technology Periodical Database, and Chinese Biomedical Literature Database from inception to October 20, 2020. And Baidu Scholar, Google Scholar, International Clinical Trials Registry Platform, and Chinese Clinical Trials Registry will be searched to obtain more relevant studies comprehensively. The methodological qualities, including the risk of bias, will be evaluated using the Cochrane risk of bias assessment tool, while confidence in the cumulative evidence will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Two researchers will perform data extraction and risk of bias assessment independently. Statistical analysis will be conducted in RevMan 5.3.Results:Based on the current evidence, the potential rank of the efficacy and safety of TXYF plus acupuncture for IBS-D will be assessed.Conclusion:The findings of the study will provide helpful evidence for the efficacy and safety of TXYF combined with acupuncture in the treatment of IBS-D, facilitating clinical practice and further scientific studies.     

Chinese herbal medicine for hypertension complicated with hyperlipidemia: A protocol for a systematic review and meta-analysis

Background:Hypertension combined with hyperlipidemia (HTN-HLP), as a common clinical chronic disease combination, will increase the incidence of cardiovascular and cerebrovascular diseases, increase the occurrence of sudden death and other adverse events. At present, the commonly used therapeutic drugs are mainly combined with antihypertensive drugs and lipid-lowering drugs, which not only have poor compliance, but also have adverse reactions. Currently, traditional Chinese medicine, as a traditional medicine in China, has been applied in clinical practice for thousands of years and has rich clinical experience in treating HTN-HLP. However, there is no systematic evaluation of the efficacy, safety and improvement of patients’ quality of life. This systematic review and meta-analysis will assess studies of the effects and safety of Chinese herbal medicine (CHM) for HTN-HLP patients.Methods:We will search PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science (ISI), China National Knowledge Infrastructure, Wan fang Database, Chinese Scientific Journals Full-Text Database (VIP) and China Biological Medicine Database from the time when databases were established to 01, February 2021. After a series of screening, randomized controlled trials (RCTs) will be included related to CHM for HTN-HLP. Two researchers will assess the RCTs through the Cochrane bias risk assessment tool. And the evidence grade of the results will be evaluated by GRADEprofiler software.Results:This study will provide a reliable evidence for the efficiency of antihypertensive and reducing blood lipids of CHM for HTN-HLP.Conclusion:We will summarize the methods and provide sufficient evidence to confirm the efficacy and safety of CHM for HTN-HLP.INPLASY registration number:INPLASY2020110144.     

Efficacy and safety of acupuncture combined with Chinese herbal medicine in the treatment of primary liver cancer: A protocol for systematic review and meta-analysis

Background:Primary liver cancer (PLC) is a common cancer, and its morbidity and mortality are ranked 6th and 3rd in the world for malignant tumors, respectively. And this number is still on the rise, seriously endangering people''s health. In recent years, acupuncture combined with Chinese herbal medicine have been widely used in the treatment of PLC, and there are few restrictions. However, we have not found a meta-analysis of their synergistic effects. Therefore, this systematic review and meta-analysis will evaluate the efficacy and acupuncture combined with Chinese herbal medicine in the treatment of primary liver cancer.Method:We will search the following databases from inception up to August 20, 2021: PubMed, Web of Science, Embase, AMED, Cochrane Library, CNKI, VIP, CBM, and Wanfang. There will be no restrictions regarding publication date or language. We will apply a combination of medical keywords and words, including “acupuncture,” “Chinese herbal medicine” and “primary liver cancer”. Additionally, we will manually search all reference lists from relevant systematic reviews to find other eligible studies. We will use the random effects model in REVMAN v5.3 for meta-analysis. The study for acupuncture combined with Chinese herbal medicine in the treatment of PLC was a randomized controlled study. Two researchers will independently review the research selection, data extraction, and research quality assessments. Finally, we will observe the outcome measures.Results:This study will provide evidence-based medical evidence for the treatment of PLC with a combination of acupuncture and Chinese herbal medicine, and provide new ideas and methods for the treatment of PLC.Registration number: INPLASY202180103     

Therapeutic effect of acupuncture combined montelukast sodium on cough variant asthma in children: A protocol for systematic review and meta-analysis

Background:Cough variant asthma in children is a special type of asthma. Although there are many effective cases of combined acupuncture and western medicine in the clinical treatment of this kind of children, there is no standardized acupuncture combined with western medicine to evaluate the curative effect. Therefore, combined with existing reports, a systematic review and meta-analysis of acupuncture combined with montelukast sodium in the treatment of cough variant asthma in children were carried out to obtain conclusive results.Methods:The following electronic databases will be searched: PubMed, the Cochrane Library, Embase, Web of Science, Medline, CNKI, Chinese Biomedical Literature Database, VIP, and Wan Fang databases. We will consider articles published between database initiation and October 2021. We will use Review Manager 5.4, provided by the Cochrane Collaborative Network for statistical analysis. Clinical randomized controlled trials related to acupuncture combined with montelukast sodium on cough variant asthma in children were included in this study. Language is limited to both Chinese and English. Research selection, data extraction, and research quality assessments were independently completed by two researchers. We then assessed the quality and risk of the included studies and observed the outcome measures.Results:This study provides a high-quality synthesis to assess the effectiveness and safety of acupuncture combined with montelukast sodium on cough variant asthma in children.Conclusion:This systematic review will provide evidence to determine whether acupuncture combined with montelukast sodium is an effective and safe intervention for patients with cough variant asthma in children.INPLASY Registration number:INPLASY2021110006.     

Efficacy and safety of acupuncture combined with Chinese herbal medicine in the treatment of angina pectoris of coronary heart disease (CHD): A protocol for systematic review and meta analysis

Background:Coronary heart disease (CHD) angina pectoris is a clinical syndrome in which episodic chest pain or chest discomfort is the main manifestation of temporary ischemia and hypoxia of the myocardium due to coronary atherosclerosis and coronary artery functional changes (spasm). A large amount of clinical evidence confirms that acupuncture combined with Chinese herbal medicine in the treatment of CHD and angina pectoris can relieve the symptoms of angina pectoris and improve the performance of electrocardiograph ischemia; It still has obvious therapeutic effects in regulating the levels of cardiovascular regulatory peptides ET and cGRP. To better evaluate the effectiveness and safety of acupuncture combined with Chinese herbal medicine in the treatment of CHD and angina pectoris, we designed a systematic evaluation program to provide a reliable scientific basis for the future use of this method.Methods:Search Pubmed database, Embase, Cochrane library, Chinese Biomedical Literature CD-ROM Database (CBMdisk), China Journal Network Full-text Database (CNKI), Wanfang Database, Web of Science (SCI-E), the retrieval time is established from each database Until October 2021, search for relevant eligible randomized controlled trials with keywords or subject terms “acupuncture”, “Chinese herbal medicine”, and “CHD angina”. Outcome indicators were clinical symptoms of CHD and angina pectoris, changes in electrocardiogram, changes in blood lipids, and significant improvement in traditional Chinese medicine syndromes before and after treatment. Two researchers independently carried out data extraction and quality assessment, and use RevMan5.3 software to carry out final data analysis and assessment.Results:This study provides a reliable clinical scientific basis for acupuncture combined with Chinese herbal medicine for the treatment of CHD and angina pectoris.Conclusion:Acupuncture combined with Chinese herbal medicine can effectively relieve the clinical symptoms of CHD and angina pectoris and improve the performance of electrocardiograph. At the same time, it can reduce the cardiovascular regulatory peptide ET and increase the level of cGRP in the patient''s plasma, thus confirming its effectiveness and safety.     

Effectiveness of acupuncture for multiple sclerosis: A protocol for systematic review and meta-analysis

Background:Multiple sclerosis (MS) is an autoimmune disease characterized by white matter inflammatory demyelination in the central nervous system (CNS). Its clinical manifestations include decreased vision, diplopia, and limb weakness. As a green and simple traditional Chinese medicine method, acupuncture is gradually recognized by the public. At present, there is still a lack of systematic evaluation on acupuncture treatment of MS. This study aims to evaluate the safety and effectiveness of acupuncture in the treatment of MS, in order to provide a basis for clinical decision-making.Methods:Randomized controlled trials (RCTs) of acupuncture for MS will be searched in the relevant database, including PubMed, MEDLINE, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure Database (CNKI), WanFang Database, China Biology Medicine Database (CBM), Chinese Scientific Journals Database (VIP), regardless of publication date, or language. All relevant RCTs of electronic searches will be exported to EndNote X9.1 software. Data analysis will be performed using RevMan 5.4 and STATA 14.2 software.Results:Our study aims to explore the efficacy of acupuncture for MS and to provide up-to-date evidence for clinical of MS. We will publish our research results in peer review journals.Conclusion:This study will perform a comprehensive systematic review and meta-analysis on the efficacy of acupuncture for MS, making up for the lack of relevant evidence of the clinical use of acupuncture.     

Efficacy and safety of acupuncture combined with Chinese herbal medicine traditional Chinese medicine for poststroke cognitive impairment: A protocol for a systematic review and meta-analysis

Background:Poststroke cognitive impairment (PSCI) is often secondary to poststroke, which is common in stroke patients, induced difficulty in rehabilitation and seriously affects their quality of life. Currently, effective treatments are still limited. Researches show that acupuncture combined with traditional Chinese medicine (TCM) has a good effect on PSCI. However, there is no consistent conclusion at present. Therefore, THE purpose of this study is to assess the effectiveness and safety of acupuncture combined with TCM in the treatment of PSCI.Methods:We will search the following databases from inception to January, 2022: the Cochrane Library, PubMed, Embase, Medline, Web of Science, China National Knowledge Infrastructure, China Biology Medicine, Wan Fang data, and the Chinese Science and Technology Periodical Database. All randomized controlled trials eligible for acupuncture combined with TCM for PSCI will be included in this study. Study selection, data extraction, and quality assessment will be performed by 2 reviewers independently. Bias risk assessment and data synthesis will be performed using the Review Manager software (RevMan, version 5.3) and R (version 3.6.1) software.Results:We will synthesize the current studies to evaluate the effectiveness and safety of acupuncture combined with TCM in the treatment of PSCI.Conclusion:The systematic review will provide a new paradigm for acupuncture combined with TCM in the intervention of PSCI, and further provide scientific evidence for the efficacy and safety of acupuncture combined with TCM in the treatment of PSCI.Trial registration number:INPLASY202220062.     

The effectiveness of Chinese herbal medicine for tic disorders in children and adolescents: A protocol for systematic review and meta analysis

Background:The tic disorders are common neuropsychiatric disorders that affects the growth and development of children and adolescents. Chinese herbal medicine is commonly used for the treatment of tic disorders. However, there is no consensus on the difference in clinical efficacy compared with routine treatment. Therefore, we plan to perform a systematic review and meta-analysis to review the clinical efficacy of Chinese herbal medicine for tic disorders.Methods:Cochrane Central Register of Controlled Trials, PubMed, EMBASE, Chinese National Knowledge Infrastructure, Chinese Bio-medical Database, and Wanfang database will be searched from their inception until March 31, 2021. The meta-analysis will be conducted with Review Manager 5.3 software to systematically review the clinical efficacy and safety of Chinese herbal medicine for tic disorders. The primary outcome will include the improvement rate (amount) of tic symptoms using related scales or methods, and the secondary outcome will include adverse events.Results:This analysis will provide useful information about clinical efficacy and safety of Chinese herbal medicine for tic disorders.Conclusions:Our study will generate strong evidence of Chinese herbal medicine for patients with tic disorders and provide suggestions for clinical practice.     

Acupuncture and massage combined with rehabilitation therapy for hemiplegia after stroke: A protocol for systematic review and meta-analysis

Background:The purpose of this study was to evaluate the effectiveness and safety of acupuncture and massage combined with rehabilitation in the treatment of hemiplegia after stroke.Methods:To collect relevant literature, we will research following databases: Medicine, PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wan-Fang Database, Chongqing VIP Chinese Science and Technology Periodicaols Database, and China Biomedical Database; the time is from its creation to May 2021, and the language is limited to Chinese and English. In addition, we will retrieve other literature resources, including the Chinese Clinical Trial Register and conference articles. Two reviewers will independently complete the literature screen and data extraction and quality assessment of the included studies will be independently completed by two other researchers. The primary outcomes included the Modified Ashworth scale and the simplified Fugl-Meyer Assessment scale. The Modified Barthel Index, the China Stroke Scale, and adverse reactions as secondary outcomes were assessed. RevMan V.5.4.1 software will be used for meta-analysis, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) will be used to assess the quality of evidence.Results:This systematic review will provide a high-quality synthesis to evaluate the efficacy and safety of acupuncture and massage combined with rehabilitation in the treatment of hemiplegia after stroke, providing a reference for the safe and effective treatment of hemiplegia after stroke.Conclusion:This study provides evidence that acupuncture and massage combined with rehabilitation therapy is effective.Ethics and dissemination:The protocol of the systematic review does not require ethical approval because it does not involve humans. This article will be published in peer-reviewed journals and presented at relevant conferences.Systematic review registration:INPLASY202210026.     

Acupuncture combined tuina for oculomotor paralysis: A protocol for systematic review and meta-analysis

Background:Oculomotor paralysis (OP) is a neurologic syndrome with multiple causes of oculomotor nerve and its dominant tissue and muscle dysfunction. Acupuncture combined with tuina is a wide-ranging used rehabilitation therapy, although there is short of supporting evidence for its efficacy and safety in patients with OP. The purpose of this systematic review was to estimate and synthesize evidence of the efficacy and safety of acupuncture combined with tuina in the treatment of OP.Methods:Electronic databases, including PubMed, Web of Science, Cochrane Library, EMBASE, Technology Journal and China Science, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, and Wanfang,adopt an appropriate search strategy. RevMan V.5.3.5 software will be used for data synthesis, bias risk, and subgroup analyses.Results:This study provides high-quality evidence to assess the effectiveness and safety of acupuncture combined with tuina for OP.Conclusion:This systematic review explores whether acupuncture combined with tuina is an effective and safe intervention for OP.Ethics and dissemination:Private information from individuals will not publish. This systematic review does not involve endangering participant rights. Ethical approval was not obtained. The results may be published in a peer-reviewed journal or disseminated at relevant conferences.PROSPERO registration number:PROSPERO CRD42021266447     

Chinese herbal medicine for previous cesarean scar defect: A protocol for systematic review and meta-analysis

Background: Previous cesarean scar defect (PCSD) is a gynecological disease that can cause bleeding after intercourse, prolonging menstrual period, intermenstrual bleeding, dysmenorrhea, and even lead to infertility. Chinese herbal medicine plays an important role in the treatment of gynecological diseases in China and East Asia. This study aims to assess the efficacy and safety of Chinese herbal medicine for PCSD.Methods: We search the following databases: PubMed, the Cochrane Library, Chinese Biomedical Literature Database (CB), Chinese Science and Technique Journals Database (VIP), EMBASE, Chinese National Knowledge Infrastructure Database (CNKI), and the Wanfang Database. Other sources will also be searched like Google Scholar and gray literature. All databases mentioned above are searched from the start date to the latest version. Randomized controlled trials will be included which recruiting PCSD participants to assess the efficacy and safety of Chinese herbal medicines against controls (placebo or other therapeutic agents). Primary outcomes will include the size of PCSD, menstrual cycle, menstrual phase, menstrual volume, duration of disease, security index. Two authors will independently scan the searched articles, extract the data from attached articles, and import them into Endnote X8 and use Microsoft Excel 2013 to manage data and information. We will assess the risk of bias by Cochrane tool of risk of bias. Disagreements will be resolved by consensus or the participation of a third party. All analysis will be performed based on the Cochrane Handbook for Systematic Reviews of Interventions. The meta-analysis in this review will use RevMan 5.3 software.Results: The study aims to evaluate the efficacy and safety of the treatment that Chinese herbal medicine for PCSD.Conclusion: This study of the meta-analysis could provide evidence for clinicians and help patients to make a better choice.INPLASY registration number:INPLASY202090080     

Traditional Chinese medicine fumigation as auxiliary treatment of diabetic peripheral neuropathy: A protocol for systematic review and meta-analysis

Background:Diabetic peripheral neuropathy (DPN) is 1 of the most common clinical complications of diabetes, which seriously affects the quality of life of patients and causes a substantial economic burden on diabetes care. The pathogenesis of DPN is complex. There is no targeted treatment method, and mainstream treatment methods have low efficacy and large side effects. Traditional Chinese medicine has rich clinical experience in the prevention and treatment of diabetic peripheral neuropathy, which has dramatically improved the quality of life of patients. It is clinically proven that traditional Chinese medicine fumigants (TCMF) have apparent effects in treating diabetic peripheral neuropathy. Therefore, we aim to systematically review the effectiveness and safety of TCMF for DPN.Methods:We will search the following databases: PubMed, Embase, Cochrane Library, MEDLINE, the China National Knowledge Infrastructure, the Chinese Biomedical Literature Database, Cqvip Database, and Wanfang Data. Besides, we will also search for clinical trial registrations, potential grey literature, relevant conference abstracts, and reference lists of established studies. The studies published from the inception of the database to November 2020 will be retrieved. The randomized controlled trials on TCMF for DPN will be included. Also, we will search for clinical trial registrations, potential grey literature, relevant conference abstracts, and reference lists of established studies. The main result is clinical efficacy and nerve conduction velocity. Fasting blood glucose, 2 hours postprandial blood glucose, blood lipid, glycosylated hemoglobin, and adverse events are secondary results. We will perform the analyses using RevMan V.5.3 software.Results:This study will provide a high-quality comprehensive evaluation of the efficacy and safety of TCMF in the treatment of DPN.Conclusions:This systematic review will evaluate the effectiveness and safety of TCMF in the treatment of DPN, and provide the latest evidence for clinical application.INPLASY registration number:INPLASY2020110137.