Effectiveness of acupuncture in postoperative ileus: a systematic review and Meta-analysis

OBJECTIVE: To conduct a systematic review and Meta-analysis of the effectiveness of acupuncture and common acupoint selection for postoperative ileus(POI).METHODS: Randomized controlled trials(RCTs)comparing acupuncture and non-acupuncture treatment were identified from the databases Pub Med, Cochrane, EBSCO(Academic Source Premier and MEDLINE), Ovid(including EvidenceBased Medicine Reviews), China National Knowledge Infrastructure, and Wanfang Data. The data from eligible studies were extracted and a Meta-analysis performed using a fixed-effects model.Results were expressed as relative risk(RR) for dichotomous data, and 95% CI(confidence intervals)were calculated. Each trial was evaluated using the CONSORT(Consolidated Standards of Reporting Trials) and STRICTA(STandards for Reporting Interventions in Controlled Trials of Acupuncture) guide-lines. The quality of the study was assessed using the Grading of Recommendations, Assessment, Development and Evaluation(GRADE) approach.RESULTS: Of the 69 studies screened, eight RCTs were included for review. Among these, four RCTs(with a total of 123 patients in the intervention groups and 124 patients in the control groups) met the criteria for Meta-analysis. The Meta-analysis results indicated that acupuncture combined with usual care showed a significantly higher total effective rate than the control condition(usual care)(RR1.09, 95% CI 1.01, 1.18; P = 0.02). Zusanli(ST 36) and Shangjuxu(ST 37) were the most common acupoints selected. However, the quality of the studies was generally low, as they did not emphasize the use of blinding.CONCLUSION: The results suggested that acupuncture might be effective in improving POI; however,a definite conclusion could not be drawn because of the low quality of trials. Further large-scale,high-quality randomized clinical trials are needed to validate these findings and to develop a standardized method of treatment. We hope that the present results will lead to improved research, resulting in better patient care worldwide.     

参菊洗剂治疗外阴阴道假丝酵母菌病的临床研究

目的 观察参菊洗剂治疗外阴阴道假丝酵母菌病的临床疗效。方法 将140例外阴阴道假丝酵母菌病患者随机分为2组。对照组70例予洁尔阴洗液治疗,治疗组70例予参菊洗剂治疗。2组均7 d为1个疗程,1个疗程后统计临床疗效,并观察2组治疗第4、7 d症状体征消失率。结果 治疗组总有效率92.86%,治愈率40.00%,对照组总有效率74.29%,治愈率28.57%,2组总有效率、治愈率比较差异均有统计学意义(P0.05),治疗组疗效优于对照组。治疗第4 d,2组外阴瘙痒消失率比较差异有统计学意义(P0.05),而2组白带量及白带性状改变消失率比较差异无统计学意义(P0.05);治疗第7 d,2组外阴瘙痒、白带量及性状改变消失率比较差异均有统计学意义(P0.05)。结论 参菊洗剂治疗外阴阴道假丝酵母菌病疗效确切。     

苦参凝胶联合抗真菌药治疗外阴阴道假丝酵母菌病的Meta分析

目的 系统评价苦参凝胶联合抗真菌药治疗外阴阴道假丝酵母菌病(vulvovaginal candidiasis,VVC)的临床疗效及安全性.方法 计算机检索PubMed、Web of Science、Embase、Cochrane Library、中国期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、维普(V...     

完带汤化裁联合西药治疗复发性外阴阴道假丝酵母菌病的Meta分析

目的 系统评价完带汤化裁联合西药治疗复发性外阴阴道假丝酵母菌病（recurrent vulvovaginal candidiasis,RVVC）的有效性和安全性。方法 检索CNKI、Sinomed、WanFang、VIP、PubMed、Embase、Cochrane Library等数据库,筛选完带汤化裁联合西药治疗RVVC的临床随机对照研究,用RevMan5.3软件进行数据分析。结果 共纳入10个研究,病例1075例。Meta分析结果显示：完带汤化裁联合西药治疗RVVC有效率高于单纯西药,且可降低复发率,改善阴道微生态,两组比较有统计学差异。结论 完带汤化裁联合西药治疗RVVC具有良好效果。     

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 and safety of moxibustion in treatment of lumbar disc herniation: a systematic review and Meta-analysis

OBJECTIVE: To evaluate the effectiveness and safety of moxibustion therapy in the treatment of lumbar disc herniation(LDH).METHODS: Four Chinese databases and three English databases were searched from their inception to April 2018.Randomized controlled trials(RCTs)were included if moxibustion was used as the sole treatment or as a part of combination therapy with other treatments in patients with LDH.Two reviewers independently extracted the data and assessed the methodological quality using the Cochrane criteria for the risk of bias.The Meta-analysis was performed using Review Manager 5.3 software.RESULTS: In total, 16 RCTs including 1186 patients with LDH were analyzed.The Meta-analysis showed favorable effects of moxibustion in combination with massage therapy on the visual analog scale score compared with massage therapy alone[mean difference(MD) =-1.32, 95% confidence interval(CI)(-2.12,-0.51), P = 0.001].The subgroup Meta-analysis failed to show favorable effects of electro-acupuncture plus moxibustion on the efficacy rate compared with electro-acupuncture alone [relative risk(RR) = 1.06, 95% CI(0.98,1.14), P = 0.15].However, acupuncture or massage therapy plus moxibustion improved the efficacy rates compared with acupuncture or massage therapy alone [RR = 1.33, 95% CI(1.18, 1.49),P 0.000 01] [χ~2= 2.76, P = 0.25, I~2= 27%], [RR =1.15, 95% CI(1.06, 1.25), P = 0.001] [χ~2= 0.00, P =0.95, I~2= 0%].With respect to the Japanese Orthopaedic Association(JOA) scores, acupuncture or massage therapy in addition to moxibustion produced results different from those of acupuncture or massage therapy alone [MD = 5.58, 95% CI(4.15, 7.00), P 0.000 01] [χ~2= 0.58, P = 0.45, I~2=0%], [MD = 3.61, 95% CI(3.01, 4.21), P 0.000 01].There were no significant differences in the JOA score for subjective symptoms, objective symptoms, daily living ability, and other parameters.In six RCTs, no adverse reactions occurred during moxibustion.CONCLUSION: Whether moxibustion is an effective intervention for LDH is unclear because of the small sample size of qualified RCTs and the high risk of bias.More high-quality RCTs that overcome the methodological shortcomings of the existing evidence are needed.     

Effectiveness of Huachansu injection combined with chemotherapy for treatment of gastric cancer in China: a systematic review and Meta-analysis

OBJECTIVE: to evaluate the effectiveness and safety of Huachansu(HCS) injection plus chemotherapy in the treatment of gastric cancer.METHODS: A thorough and systematic retrieval of randomized controlled trials(RCTs) concerning HCS injection for treating gastric cancer was conducted in several electronic databases from inception to May 10, 2018. The quality of the RCTs was assessed by the Cochrane risk of bias tool. And the data about objective remission rate, performance status, adverse drug rea...     

Effectiveness and safety of Suxiao Jiuxin pill in treating acute coronary syndrome: a systematic review and Meta-analysis

OBJECTIVE: To evaluate the effectiveness and safety of Suxiao Jiuxin pill(SX) in acute coronary syndrome(ACS) treatment.METHODS: An extensive search of four English databases(Medline/Pub Med, Cochrane Library, Embase, and World Health Organization International Clinical Trials Registration Platform) and four Chinese databases(Chinese National Knowledge Infrastructure, Wanfang, China Science and Technology Journal, and Chinese Biomedical Literature Service System) was performed. Randomized, controlled trials(RCTs) involving SX combined with conventional therapy versus conventional therapy were included. The extracted data included populations, interventions, outcomes, and risk of bias. The cardiovascular events served as the primary outcome. Review Manager 5.3 software was used for data analysis. Relative risks(RRs) with 95% confidence intervals(CIs) were the effect measure.RESULTS: A total of eight RCTs with 979 patients were included. There were 559 patients with unstable angina(UA) in six RCTs and 420 patients with acute myocardial infarction(AMI) in two RCTs. Our review showed that SX plus conventional therapy might reduce the incidence of the total endpoint(RR: 0.34, 95% CI: 0.17, 0.68, P = 0.002), with no obvious adverse events(RR: 1.29, 95% CI: 0.60, 2.77, P =0.52) compared with conventional therapy for patients with UA. Additionally, SX plus conventional therapy also reduced the incidence of the total endpoint(RR: 0.35, 95% CI: 0.18, 0.68, P = 0.002) compared with conventional therapy in patients with AMI. SX plus conventional therapy also reduced the incidence of ventricular fibrillation(RR: 0.23, 95%CI: 0.10, 0.57, P = 0.001) compared with conventional therapy in patients with AMI.CONCLUSION: Our results suggest that SX is beneficial for treating patients with UA or AMI. However,our findings should be treated with caution because of the poor methodological quality of the included trials. Therefore, more multicenter,large-sample, high-quality RCTs are required to provide high-quality evidence.     

Shenkang injection improves coagulation in patients with chronic kidney disease: a systematic review and Meta-analysis

OBJECTIVE: To investigate the effect of Shenkang injection(SKI) on chronic kidney disease(CKD).METHODS: Seven databases including Cochrane Central Register of Controlled Trials, PubMed, EMBASE, MEDLINE, China National Knowledge Infrastructure, Wanfang Database, and CQVIP from their inception to March 2018 were searched. Only randomized controlled trials that evaluated conventional treatment and conventional treatment with SKI in CKD patients were investigated. Outcomes such as fibrinogen(FIB), D-dimer, prothrombin time(PT), activated partial thromboplastin time(APTT), and the side effects of SKI were analyzed using Revman 5.3 software. The quality of the studies was assessed using the Cochrane Collaboration's Risk of Bias tool and the quality of evidence was assessed using GRADEpro.RESULTS: Four randomized controlled trials were investigated in our analysis, and these studies were of moderate quality. For FIB and D-dimer, SKI had a superior effect compared with the control group[mean difference(MD)=-1.23, 95% confidence interval(CI):-1.46,-0.99, P 0.01; MD =-0.36, 95%CI:-0.51,-0.21, P 0.01, respectively]. SKI increased APTT and PT compared with the control(MD = 7.34, 95% CI: 3.05, 11.62, P 0.01; MD = 3.40,95% CI: 2.2, 4.61, P 0.01, respectively). In the four studies, there were no side effects that were related to SKI.CONCLUSION: SKI may be effective in improving coagulation in patients with CKD without obvious adverse reactions. However, more well-designed studies are required to confirm the findings.     

Effectiveness of Chinese herbal medicine for primary Raynaud's phenomenon: a systematic review and Meta-analysis of randomized controlled trials

OBJECTIVE: To evaluate the effectiveness of Chinese herbal medicine for primary Raynaud's phenomenon(PRP).METHODS: The Cochrane Central Register of Controlled Trials, Pub Med, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, China Science and Technology Journal Database, and Wanfang Database were searched up to February 13, 2018. Randomized controlled trials(RCTs) on treatment of PRP with Chinese herbal medicine compared with placebo, blank control,lifestyle changes, or calcium antagonists were identified and reviewed. The quality of included trials was assessed using a risk of bias tool.RESULTS: Eight RCTs involving 674 participants were included. The methodological quality of the included trials was generally poor. Meta-analysis of two trials showed that Buyang Huanwu Tang plus Danggui Sini Tang produced greater improvement in global symptoms than nifedipine. One trial showed that Danggui Sini Tang and a self-composed Chinese herbal medicine decoction, respectively, produced greater improvement in global symptoms than nifedipine alone. In one trial, modified Danggui Sini Tang showed greater improvement in global symptoms and arterial peak systolic velocity compared with nifedipine. One trial showed that Jiejing Tongmi Tang produced greater improvement in global symptoms, plasma endothelin, and plasma nitric oxide than cinepazide maleate injection. However, Jiejing Tongmi Tang did not produce a significant difference in skin temperature and peripheral artery blood stream drawing after cold pressor testing compared with cinepazide maleate injection. None of the trials reported frequency of attacks, duration of attacks, participant preference scores, or adverse events.CONCLUSION: Chinese herbal medicine may have a positive effective on PRP. However, owing to weak methodology, the benefits of Chinese herbal medicine for PRP are inconclusive. More rigorously designed studies are needed to confirm these findings.     

Efficacy of Cordyceps sinensis as an adjunctive treatment in hemodialysis patients: a systematic review and Meta-analysis

OBJECTIVE: To evaluate current evidence on the efficacy and safety of Cordyceps sinensis(cordyceps)or its fermented products used as an adjunctive treatment in patients undergoing maintenance hemodialysis.METHODS: The Cochrane Central Register of Controlled Trials(CENTRAL), EMBASE, MEDLINE, China National Knowledge Infrastructure(CNKI) and Wanfang Database were searched for relevant randomized controlled trials up to March 2016. Two review authors independently selected trials for inclusion,extracted data, assessed the methodological quality and rated the quality of evidence with the Grading of Recommendations, Assessment, Development and Evaluation approach.RESULTS: Twelve studies involving 655 participants were included. Evidence of low to moderate-quality showed that cordyceps plus conventional treatment compared to conventional treatment alone significantly improved C-reactive protein [standardized mean difference(SMD)-0.61; 95% confi-dence intervals(CI)-1.00 to-0.22], high-sensitivity C-reactive protein [weighted mean difference(WMD)-3.44 mg/L; 95% CI-3.89 to-2.99], serum albumin(WMD 3.07 g/L; 95% CI 1.59 to 4.55),malondialdehyde(WMD-1.95 nmol/L; 95% CI-2.24 to-1.66), and hemoglobin(WMD 9.56 g/L;95% CI 3.65 to 15.47) levels. However, there was no significant improvement for serum creatinine and low-density lipoprotein cholesterol. Overall, most trials either did not monitor adverse events or poorly documented them.CONCLUSION: Given the small number of trials included, the unclear methodological quality of the included trials, and the high heterogeneity in pooled analyses, the evidence obtained in this review is insufficient to recommend the use of cordyceps as adjunctive treatment in hemodialysis patients.     

Effectiveness of Chinese herbal medicine combined with conventional medicine on acute exacerbation of chronic obstructive pulmonary disease: a systematic review and Meta-analysis

OBJECTIVE: To systematically evaluate the efficacy and safety of Chinese herbal medicine(CHM) combined with conventional Western Medicine(CWM) on acute exacerbation of chronic obstructive pulmonary disease(AECOPD) based on high-quality randomized placebocontrolled trials. METHODS: We searched PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure Database, Chinese Biomedical Literature Database, China Science and Technology Journal Database, and Wanfang databases for randomize...     

Effectiveness and safety of traditional Chinese medical therapy for cancer-related fatigue: a systematic review and Meta-analysis of randomized controlled trials

OBJECTIVE: To assess the effectiveness and safety of traditional Chinese medical therapy for cancer-related fatigue.METHODS: We systematically searched eight electronic databases up to June 2017 for randomized clinical trials of traditional Chinese medical therapy for cancer-related fatigue. Two authors independently extracted data and assessed the risk bias of the included trials using the Cochrane Handbook.Data were analyzed by Rev Man 5.2 software.RESULTS: A total of 23 trials involving 1832 ...     

亚健康与中医体质类型相关性研究的系统评价和Meta分析＊

目的 总结亚健康与中医体质类型相关性研究及现状，探讨亚健康的中医体质分布规律，为亚健康的中医药养生保健提供循证医学证据，为传统中医功能声称的保健食品功能研究提供方向。方法 计算机检索中国知网（CNKI）、万方数据（WANFANG DATA）、重庆维普（CQVIP）、PubMed及EMBASE数据库，纳入所有评价亚健康与中医体质类型相关性的临床研究文献。采用R version 4.0.4软件进行单率Meta分析、OR值（odds ratio）及其95% CI （confidence interval）表达效应值。结果 共纳入31项研究，研究总样本量为55 059例，其中亚健康人群43 707例，一般人群11 352例。平和质、气虚质、阳虚质、气郁质为亚健康人群占比前四的体质，比例分别为21.4%（95% CI：16.2-27.2%）、21.2%（95% CI：18.0-24.4%）、16.2%（95% CI：13.7-18.7%）、13.5%（95% CI：11.2-16.2%）。对亚健康人群及一般人群进行比较，发现气郁质、气虚质、阳虚质、平和质发生亚健康风险的OR值分别为4.97（95% CI：3.03-8.15）、3.99（95% CI：2.17-7.31）、2.30（95% CI：1.52-3.48）、0.15（95% CI：0.10-0.24），差异均具有统计学意义，表明偏颇体质是发生亚健康的风险因素，而平和质是发生亚健康的保护因素。从性别来看，亚健康男性和女性的气虚质、痰湿质、湿热质的比例相当，而女性的阳虚质、阴虚质、气郁质、血瘀质的比例要高于男性。纳入研究的方法学质量整体偏低，漏斗图分析显示存在发表偏倚风险。结论 气郁质、气虚质、阳虚质是亚健康人群的主要偏颇体质类型，也是发生亚健康的风险因素。建议今后研究进一步探讨3大偏颇体质与亚健康的关联性，为亚健康的中医药养生保健提供有价值的参考。     

Effectiveness and safety of auriculotherapy for breastfeeding: a systematic review

OBJECTIVE: To summarize and critically evaluate the evidence pertaining to the effectiveness and safety of auriculotherapy for breastfeeding.METHODS: We performed a systematic search of10 databases from their inception dates to May 15,2017. Randomized controlled trials evaluating the effectiveness and safety of auriculotherapy for breastfeeding were included. Risk of bias was assessed using the Cochrane risk of bias tool.RESULTS: This review included 31 randomized controlled trials with 5389 par...     

Acupoint application therapies for essential hypertension: a systematic review and Meta-analysis

OBJECTIVE: To evaluate the efficacy and safety of acupoint application therapies(AA) for hypertension. METHODS: We searched Pub Med, EMBASE, the Cochrane Center Controlled Trials Register, Chinese National Knowledge Infrastructure, Chinese Scientific Journal Database, and Wanfang Med Online Database from their inceptions to October 7, 2019. No language restriction was applied. We included randomized clinical trials testing AA against Western Medicine, AA versus placebo, AA combined with Western ...     

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...     

Acupuncture and moxibustion for malignant tumor patients with psychological symptoms of insomnia,anxiety and depression: a systematic review and Meta-analysis

OBJECTIVE: To evaluate the efficacy and safety of acupuncture and moxibustion therapy(AMT) for cancerrelated psychological symptoms(CRPS) of insomnia, depression and anxiety. METHODS: Seven databases were searched for randomized controlled trials(RCT) comparing AMT to routine care or conventional drug for alleviating CRPS of insomnia, depression, and anxiety before April 2020. Two independent reviewers performed the data extraction and assessed the risk of bias. RESULTS: A total of 30 RCTs invol...