针刺平行随机对照试验通常没有准确报告试验组和对照组的干预方法.为促进标准化,国际上有经验的针刺医师和研究者组成的小组制定了一些原则,即针刺临床对照试验中干预措施报告的标准(缩写为STRICTA).在征求意见过程中,一些期刊编辑协助对此标准进行了修改,使之与随机对照试验报告的标准(CON-SORT)格式一致,作为该指南对针剌研究报告的延伸.参与此事的杂志编辑已确定要发表该标准,建议其作者群按照此标准准备论文,并将邀请更多杂志采用该标准.目的是使针剌对照试验的干预措施充分报告,从而有利于对这些研究的严格评价、分析及这些措施的推广.
Objective To assess the efficacy of acupuncture versus western medicine in the treatment of depression in China. Methods Randomized controlled trials (RCTs) involving acupuncture versus western medicine in the treatment of depression in China were identified from CNKI (1979 to 2007), VIP (1989 to 2007), WANFANG Database (1998 to 2007) and CBM (1978 to 2007). We also hand searched relevant journals and conference proceedings. Data were extracted and evaluated by two reviewers independently with a specially designed extraction form. The Cochrane Collaboration’s RevMan4.2.8 software was used for data analyses. Results A total of 8 trials involving 619 patients were included. Meta-analyses showed that the total effective rate in the acupuncture group was similar when compared with fluoxetine (RR 1.03, 95%CI 0.94 to 1.14), doxepin (RR 1.14, 95%CI 0.91 to 1.43), amitriptyline (RR 0.95, 95%CI 0.70 to 1.29) and venlafaxine (RR 1.02, 95%CI 0.90 to 1.16). As for the HAMD score at week 2, no significant difference was noted between acupuncture and fluoxetine (WMD 0.03, 95%CI -1.26 to 1.31) or amitriptyline (WMD –?0.33, 95%CI –?1.88 to 1.23); for the HAMD score at week 4, no significant difference was observed between acupuncture and fluoxetine (WMD –?0.24, 95%CI –?1.85 to 1.37) or amitriptyline (WMD –?0.57, 95%CI –?2.02 to 0.88); for the HAMD score at week 6, acupuncture also had similar effects to fluoxetine (WMD –?0.19, 95%CI –?1.51 to 1.13). In terms of the SDS scores at week 2, 4, 6 and 8, no significant differences were noted between acupuncture and fluoxetine. Two trials reported adverse events and these observed no adverse events in the acupuncture group, but 31 and 25 patients experienced adverse events in the western medicine groups of these two trials. Conclusion Acupuncture is not inferior to western medicine, and it is worth noting that acupuncture is associated with few adverse reactions. Further large-scale trials are required to define the role of acupuncture in the treatment of depression.
ObjectiveTo select the key questions of the reporting quality of acupuncture therapy network meta-analysis. MethodsA question pool about reporting quality of acupuncture therapy network meta-analysis was conducted by preliminary literature research and qualitative systematic review. A correspondence questionnaire was designed and the selection of key questions was carried out through two rounds of expert consultation using the Delphi method. ResultsA total of 21 key questions were selected for the network meta-analysis report standard of acupuncture, including whether to report details of acupuncture interventions (e.g., needle type, acupoints used, number of needles inserted, depth of needle insertion, retention time, needling techniques, and treatment duration), diagnostic criteria for diseases or traditional Chinese medicine syndromes, and qualifications of acupuncture practitioners. Of these, the only three key questions answered by the preferred reporting items for systematic reviews and network meta-analysis (PRISMA-NMA) were summary, protocol and registration, and source of funding, while the remaining 19 were specific to acupuncture-related report standards. ConclusionThe conducted key question on reporting guideline of acupuncture network meta-analysis can improve the standardization and rigor of relevant research and better utilize its academic and clinical value.
目的:比较针刺配合中国灸穴位贴敷与单纯针刺治疗膝骨关节的临床疗效。方法:将60例符合膝骨关节炎诊断的病员随机分为针刺加中国灸治疗组和单纯针刺对照组,两组均取穴血海、梁丘、犊鼻、膝眼、鹤顶、阳陵泉治疗,治疗组每天加用中国灸穴位贴敷治疗。10次一疗程,2个疗程后观察疗效。结果:治疗组30例中显效20例,好转8例,无效2例,总有效率为93.3%。对照组30例中显效9例,好转16例,无效5例,总有效率为83.3%。两组有效率有显著性差异（Plt;0.05）。结论:针刺配合中国灸穴位贴敷治疗膝骨关节疗效优于单纯针刺。
ObjectiveTo evaluate the reporting quality of systematic reviews (SRs)/meta-analyses on acupuncture focusing on literature screening results and explore the influencing factors of the complete reporting.MethodsPubMed, EMbase, CNKI, WanFang Data, and VIP databases were searched to collect SRs/meta-analyses on acupuncture from inception to December 31st, 2019. Two reviewers independently screened literature, extracted data and evaluated the reporting quality of literature screening results of SRs/meta-analyses on acupuncture based on PRISMA statement. Logistic regression model analysis was applied to explore the influencing factors of the complete reporting rate of literature screening results. Statistical analysis was performed by using Excel 2016 and SPSS 16.0 software.ResultsA total of 1 227 SRs/meta-analyses were included. Only 62.3% SRs fully reported the four parts of literature screening results. The parts with a low reporting rate included the number of studies assessed for eligibility (73.2%) and the reasons for exclusions at each stage (67.0%). And the reporting rate of the literature screening flowchart was also low (63.6%). The reporting rate of literature screening results in Chinese SRs was lower than that in English SRs, and there was significantly statistical difference (P<0.001). Multivariate logistic regression analysis showed that the type of published journal, publication year, pages of article and the number of searched databases were correlated with the complete reporting rate of literature screening results (P<0.001).ConclusionsThe complete reporting rate of the literature screening results of SRs on acupuncture is low, especially in Chinese SRs. The complete reporting rate of literature screening results is significantly higher for SRs published after PRISMA statement, in SCI journals, with longer length and more searched databases.
Objective To assess the effectiveness and safety of various types of acupuncture in the treatment of mammary dysplasia. Methods We searched The Cochrane Library, CENTRAL, MEDLINE (1966 to 2004), EMBASE (1980 to 2004), CBM (1975 to 2004), CNKI (1997 to 2004) and reference lists, databases of ongoing trials and relevent academic conference proceedings. Results Five studies involving 534 women ranging from 78 to 180 met the inclusion criteria. The recovery rates of two groups in one study showed acupuncture was statistically superior to Rupixiao (RR 9.00, 95%CI 2.29 to 35.43; RR 8.04, 95%CI 2.20 to 32.02), six good improvement rates (including groups analysis) indicated that there was no significant difference between acupuncture and other therapies. None of the studies reported incidence of adverse reaction. Conclusions Overall, there is no conclusive evidence for acupuncture in the treatment of mammary dysplasia because the quality of included studies and amount of evidence are both poor and insufficient. There is an urgent need for larger, well-designed randomised controlled trials to assess the effectiveness and adverse-effect of acupuncture.
Objective To investigate the combined effects of digastric muscle low frequency modulated medium frequency electro-acupuncture therapy and voice training for dysphagia in patients who underwent aortic arch surgery. Methods Forty-two consecutive patients with dysphagia after aortic arch surgery between October 2014 and November 2017 were divided into two groups including an observation group and a control group. There were 21 patients in each group. There were 17 males and 4 females at age of 51.0±6.5 years in the observation group, while 18 males and 3 females at age of 49.8±7.3 years in the control group. The patients in the observation group underwent electroacupuncture therapy and voice training (20 min per day for each therapy, 2 weeks), while the patients in the control group only received safe swallowing education and rehabilitation guidance (2 weeks). The test results, such as fibrolaryngoscope and functional oral intake scale (FOIS) score, and the data of computer phonatory detection, before and after the intervention were compared. Results The fibrolaryngoscope of vocal cords significantly decreased and the FOIS score significantly increased after digastric muscle low frequency modulated medium frequency electro-acupuncture therapy and voice training in the observation group(6.30 vs. 4.60, P<0.05). Bucking was obviously reduced. The indicators of hoarse degree, such as median pitch, fundamental frequency, jitter (0.60%±0.96%vs. 1.99%±1.86%, P=0.033), shimmer (2.47%±4.26% vs. 5.89%±3.66%, P=0.043), maximum phonation time (15.31±9.10 s vs. 3.72±8.83 s, P=0.006), maximum and loud phonation time (9.30±5.73 s vs. 2.32±2.99 s, P=0.039), mean noise-to-harmonics ratio (23.99±10.17 vs .9.98±9.37, P=0.006) and mean harmonics-to-noise ratio (0.03±0.02 vs. 0.17±0.23, P=0.019) improved after the treatment in both groups. But the improvement in the observation group was significantly better than that in the control group. Conclusion The combination of digastric muscle low frequency modulated medium frequency electro-acupuncture therapy and voice training on dysphagia in patients who underwent aortic arch surgery can significantly improve the swallowing function of patients. Meanwhile, it also helps the recovery of phonic function and improves the ability of feeding and communication in these patients.
Objective To systematically evaluate the effect of occupational protection education towards needle stick injuries among nursing students in China. Methods A computerized literature searching was carried out from October 2002 to October 2012 in following databases: PubMed, CNKI, WanFang Data and VIP, so as to collect all controlled studies about the effects of preventing needle stick injuries between students who had occupational protection education and those who had not. Two reviewers independently screened the studies according to the inclusive and exclusive criteria, extracted the data, and assessed the quality. Then RevMan 5.0 software was used for meta-analysis. Results A total of 10 studies involving 2 197 nursing students were included. Ten studies indicated that protection education could reduce the incidence of needle stick injuries by 33%; 3 studies indicated that protection education could increase the awareness rate of protective knowledge by 52%; and 4 studies indicated that protection education could increase the correct treatment rate after injuries by 61%. Conclusion Occupational protection education before internship is effective to prevent needle stick injuries among nursing students. However, because of the limitation of this study, more high quality studies are needed to further confirm its effectiveness and to provide targeted advices for formulating preventive measures.
ObjectiveTo investigate the feasibility of establishing intervertebral disc degeneration (IDD) model by using minimally invasive acupuncture and rotary-cutting. MethodsForty New Zealand white rabbits [male or female, (2.9±0.3) kg in weight] were randomly divided into control group (n=20) and experimental group (n=20). No treatment was done in the control group; percutaneous puncture was performed on L4, 5 and L5, 6 intervertebral disc by using 18G needle under C-arm X-ray monitoring for rotary-cutting of nucleus pulposus to promote degeneration of the disc in the experimental group. At 4, 8, 12, and 16 weeks after operation, general observation and MRI observation were done, and intervertebral disc degeneration was accessed based on Pfirrmann grade; the specimens were harvested for Masson staining and Safranine O staining. ResultsThe nucleus pulposus showed dark colors and reduced elasticity in the experimental group when compared with the control group. T2-weighted MRI images indicated that the disc signal intensity of control group had no obvious change at early stage, and weakened slightly at late stage; disc signal intensity of the experimental group decreased with time. According to Pfirrmann grade for disc degeneration, disc degeneration degree was significantly aggravated with time in 2 groups (P < 0.05); degeneration was significantly more severe in the experimental group than the control group at the other time points (P < 0.05) except 4 weeks (P > 0.05). Masson staining results showed that irregular arrangement of annulus with integrate structure was observed in the control group with time; the annulus of the experimental group arranged in disorder, or even disc fibrous circle rupture appeared with time. Safranin O staining showed that the nucleus pulposus cells reduced significantly in the experimental group, but did not in the control group. ConclusionMinimally invasive acupuncture and rotary-cutting could successfully establish the IDD model in rabbits.