ObjectiveTo summarize and evaluate the quality of methodology, report and evidence of the systematic reviews and meta-analyses (SRs/MAs) of acupuncture and moxibustion interventions for Parkinson's disease. MethodsEight databases including CNKI, WanFang Data, VIP, CBM, PubMed, EMbase, Cochrane Library and Web of Science were searched from inception to May 1, 2023. The quality of methodology, report and evidence involved in these studies were evaluated by AMSTAR 2, PRISMA and GRADE tool. ResultsA total of 28 SRs/MAs were included, and the findings of included studies showed that acupuncture and moxibustion had a clinical advantage for Parkinson's disease. The methodological quality of all studies was extremely low. Thirteen reports were relatively complete, 14 reports had certain flaws, and 1 report had relatively serious flaws. And of the 126 reports for seven outcomes, 1 was graded as high, 12 as moderate, 57 as low, and 56 as critically low. ConclusionThe current evidence shows that acupuncture and moxibustion have a certain clinical effect for Parkinson's disease, but the methodological quality and evidence quality of related SRs/MAs are low, and the standardization still needs to be improved. The efficacy of acupuncture and moxibustion in Parkinson's disease still needs to be verified by high-quality clinical studies in the future.
Objective To assess the efficacy and safety of acupuncture versus western medicine in the treatment of depression neurosis. Methods Randomized controlled trials (RCTs) involving acupuncture versus western medicine in the treatment of depression neurosis were identified from CBM (1978 to 2009),VIP (1989 to 2009),WANFANG Database (1998 to 2009), CNKI (1979 to 2009), PubMed (1966 to 2009), EMbase (1980 to 2009), and The Cochrane Library (Issue 4,2008). We also hand searched relevant journals from Tianjin University of Traditional Chinese Medicine. Data were extracted and evaluated by two reviewers independently with a specially designed extraction form. The Cochrane Collaboration’s RevMan 5.0.2 software was used for data analyses. Results A total of 9 trials involving 903 patients were included. Meta-analyses showed that the total effective rate in the acupuncture group was similar when compared with Dailixin (RR= 1.01, 95%CI 0.82 to 1.23) on 20 d, fluoxetine (RR= 1.06, 95%CI 0.82 to 1.37) at week 8, but showing difference between acupuncture and fluoxetine (RR= 1.15, 95CI 1.07 to 1.22) at week 12. As for the HAMD score, no significant difference was noted between acupuncture and Dailixin (WMD= 0.45, 95%CI – 2.47 to 3.37) at 20 d, or amitriptyline at week 6, or fluoxetine on 30 d, and weeks 4, 8, 12; there was a difference between acupuncture and amitriptyline observed at week 1 (WMD= – 2.67, 95%CI – 4.38 to – 0.96) and week 2 (WMD= – 2.18, 95%CI – 3.28 to – 1.08). In terms of the SDS scores, significant difference was found between acupuncture and fluoxetine (WMD= – 4.26, 95%CI – 6.67 to – 1.85) at week 6, but no difference at week 4 and 12. Four trials reported adverse events. One trial found that no adverse events existed in acupuncture according with TESS score, contrasting with thirst, constipation, vision vague, shimmy, fast heart rate, and some change in liver function and cardiogram in amitriptyline group.Two trials reported very low score in acupuncture showing difference when compared with the drugs. And one trial described that four people had stomach and intestinal tract disorders. While no adverse reactions happened in the acupuncture group. 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 neurosis.
Objective To analyze acupuncture resources in the Cochrane Database of Systematic Reviews (CDSR). Methods We identified acupuncture literature from CDSR (2008 year) electronically. W analyzed this literature by research time date, author, study contents, and conCochrane Library usions. Results We initially found 82 articles. Finally, we identified 67 systematic reviews. The number of acupuncture articles has increased all over the world with higher growth rate in China than overseas. The disease spectrum of acupuncture treatment increased widely, focusing on nervous system diseases and pain diseases. Eight articles (25.8%) definitely supported the efficacy of acupuncture. Twenty two articles (71%) considered the efficacy of acupuncture as uncertain owning to insufficient evidence. Just one article expressed that acupuncture treatment was ineffective according to current evidence.
Objective To assess the therapeutic effect of acupuncture for shoulder hand syndrome after stroke. Methods We searched MEDLINE (1966 to Sep. 2008), EMbase (1980 to Sept. 2008), CBM (1978 to Sept. 2008), VIP (1989 to Sept. 2008), WANFANG Database (1998 to Sept. 2008), CNKI (1979 to Sept. 2008) and handsearched relevant journals and conference proceedings. We included all randomized controlled trials (RCTs) and quasi-RCTs of acupuncture treatment for patients with shoulder hand syndrome. We evaluated the internal validity of the RCTs and quasi-RCTs. If all included trials were of high quality and homogeneity, then the meta-analysis was conducted. Results Three RCTs were identified but due to the defects in quality and clinical differences between the trials, data from these trials were not combined through meta-analysis, and a descriptive analysis was performed. The results showed that acupuncture was effective for treating shoulder hand syndrome. Conclusions The results of our review suggest that acupuncture may be effective for treating houlder hand syndrome, but because of the defects in the methodological quality of included trials, further large sample, double-blind RCTs are urgently needed.
Objective To explore the methods used for developing evidence-based clinical practice guidelines for acupuncture. Methods Based on the characteristics of acupuncture in traditional Chinese medicine,and principles of evidence-based medicine, this article introduces and summarizes the processes and methods for developing an evidence-based clinical practice guideline for acupuncture. We analyzed similarities and differences between clinical practice guidelines for acupuncture and for other interventions. We used an evidence-based clinical practice guideline of acupuncture for depression as an example to illustrate the methods of literature search, grading of evidence and recommendations, evidence evaluation and consensus formation. Results Preliminary recommendations on the methods for developing evidence-based clinical practice guidelines for acupuncture were made. Conclusion Based on the optimized rational methodology for developing clinical guidelines, evidence-based high-quality clinical practice guidelines for acupuncture could be established.
Objective To evaluate the efficacy of acupuncture and moxibustion (acup-moxi) therapy for breech presentation. Methods We electronically searched The Cochrane Library (Issue 1, 2008), PubMed (1980 to Mar. 2008), MEDLINE (1966 to 2008), Ovid EBM Database (1991 to 2008), CBMdisc (1978 to Mar. 2008), VIP (1989 to Mar. 2008), CNKI (1979 to Mar. 2008), and WangFang Database (1983 to Mar. 2008), as well as handsearched seven traditional Chinese medicine journals to obtain randomized control trials (RCTs) about acup-moxi for breech presentation. Quality assessment was conducted according to the Cochrane Handbook for Systematic Reviews of Interventions 5.0.1. Meta-analyses were performed for the results of homogeneous studies using RevMan 5.0 software. Results Eight RCTs involving 1 341 patients met the inclusion criteria. Five trials were of relatively high quality and 3 were of low quality. The pooled analysis of six trials showed that acup-moxi was superior in cephalic presentation with RR=1.38, and 95%CI 1.20 to 1.58. Conclusion Acup-moxi can increase the successful rate of cephalic presentation in the treatment of breech presentation compared with no (routine care) or knee-chest position treatment.
Objective To assess the methodological quality and reporting quality of meta-analysis published in Chinese Acupuncture & Moxibustion. Methods We searched CNKI database to collect meta-analysis published in Chinese Acupuncture & Moxibustion up to 2015. Methodological quality assessment was carried out using AMSTAR tool, and quality assessment was carried out by PRISMA checklist. Data analysis was performed by using SPSS 19.0 software. Results A total of 31 meta-analyses were enrolled. Among all the 31 meta-analyses, the first authors came from 19 institutions, and 21 meta-analysis were supported by fundings. All meta-analyses were about the evaluations of acupuncture intervention, involving 10 disease systems (ICD-10) and sub-health. The mean score of the methodological assessment was 7.42±1.13. In addition, the mean score of reporting quality was 18.79±2.04. Conclusion The meta-analyses published in Chinese Acupuncture & Moxibustion have high quality on methodology as well as reporting. Due to the limited quality and quantity of included studies, the above results are needed to be further assessed by more studies.
Objective To examine the efficacy of acupuncture in hastening recovery and reducing long-term morbidity from Bell’s palsy. Methods We searched the Cochrane Neuromuscular Disease Group Register Group (Till Feb. 2002), MEDLINE (Jan. 1966 to Dec. 2002); EMBASE (Jan. 1980 to Dec. 2002), LILACS (Jan. 1982 to Dec. 2002) and Chinese Biomedical Retrieval System (Jan. 1978 to Dec. 2002). We also searched grey literature. We identified all randomised or quasi-randomised controlled trials involving acupuncture in the treatment of Bell’s palsy, selected the trials ment the inclusion criteria, assessed the methodological quality, extracted data on trials’ patients, interventions, outcome measurements and results and undertook analysis. Results Three small randomised controlled trials were included but due to some flaws in study designs or reporting and clinical differences between trials, data from trials were not combined in a meta-analysis，and a descriptive analysis was performed.The result indicated a positive effect of acupuncture (all Plt;0.01). Conclusions Three small studies in this review suggested a beneficial effect but the poor quality of the trials precludes us from drawing firm conclusions. There is a need for high quality randomized controlled trials (RCTs) using a study design which assures high internal validity.
支气管哮喘( 简称哮喘) 是一种以多种细胞特别是肥大细胞、嗜酸粒细胞和T 淋巴细胞等炎性细胞参与的气道慢性炎性反应和以气道高反应性为特征的疾病[1] 。目前全球大约有3.0 亿哮喘患者, 占世界人口的1% ～3% , 我国大约有2 500 万哮喘患者, 哮喘的发病率和死亡率在世界范围内一直呈增高趋势[2] 。2008 年在美国估计有210 万人或1.1% 的人口在过去的12个月内寻求针刺治疗, 4% 的美国人表示在他们的生活中曾使用过针刺疗法[3] 。针刺治疗哮喘在我国已有千年历史, 且相当普遍。目前哮喘的治疗仍以现代医学为主, 但尚无根治方法, 针刺治疗哮喘主要目标是控制哮喘复发, 提高患者的生命质量。
ObjectivesTo analyze the development of acupuncture registered trials based on WHO international clinical trial registration platform (ICTRP) in the past 5 years.MethodsWHO ICTRP database was electronically searched to collect acupuncture-related clinical trials registered from January 1st, 2014 to December 31st, 2018. Two reviewers independently screened items, extracted data, and descriptive analysis was performed for the included trials.ResultsThe results showed that there were 1 556 registered clinical trials on acupuncture, and the most registered year was 2017. China was in the main country in applying for acupuncture-related clinical trials, however, the most registered unit was Kyung Hee University in Korea. The trials were mainly interventional research, mostly used randomized, blinded methods, and design modes were mainly based on parallel trials. In clinical trial phase, the majority were in the clinical trial period of treatment of new technologies. The field of clinical research was expected to be on pain in the future.ConclusionsAlthough acupuncture research is currently in a good stage of development, it should still value on the quality and innovative training of relevant trials, strengthen Chinese ties with other countries, focus on regional, domestic and international cooperation, expand research types, and enhance acupuncture applicability.