ObjectivesTo comprehensively evaluate the methodological quality and applicability of the results of systematic reviews on acupuncture treatment for primary depression.MethodsWeb of Science, EMbase, PubMed, The Cochrane Library, CNKI, CBM, WanFang Data and VIP databases were electronically searched to collect systematic reviews/meta-analyses on acupuncture treatment for primary depression from inception to December 5th, 2018. Two researchers independently screened and extracted data by using tools of AMSTAR 2 to evaluate the methodological quality, using ROBIS to assess risk of bias, and using CASP-S.R to evaluate the applicability of the results.ResultsA total of 18 systematic reviews/meta-analyses were included, and all focused on acupuncture intervention, including 2 primary outcome indicators. According to AMSTAR 2 evaluation results, there were 4 high quality studies, 12 medium quality studies and 2 low quality studies; ROBIS results found 10 high bias risk studies, 7 low bias risk studies and 1 unclear; CASP-S.R showed only 4 design studies applicable to local individuals, and there were no studies on the relationship between design benefits, hazards and costs.ConclusionsThe quality of systematic reviews/meta-analyses for acupuncture treatment of primary depression is moderate, however with a certain bias. Most studies may not directly benefit local individuals. All studies have no relationship with cost hazards. It is expected for further reviewers to strictly follow systematic evaluation method to improve research quality and reduce bias, while the applicability of the systematic review to individuals from different regions should be considered as well as the relationship between the benefit and cost hazard. In addition, more valid RCTs are required to provide higher quality evidence and explore correlated and comprehensive mechanism.
Objective To evaluate the reporting quality of randomized controlled trials (RCTs) on acupuncture for acute ischemic stroke. Methods Six databases including The Cochrane Central Register of Controlled Trials (CENTRAL, Issue 4, 2005), MEDLINE (1966 to December 2005), EMbase (1984 to December 2005), China National Knowledge Infrastructure (CNKI, 1994 to December 2005), China Biomedicine Database disc (CBMdisc, 1980 to December 2005), VIP (a full text issues database of China, 1989 to December 2005) were searched systematically. Handsearch for further references was conducted. Language was limited to Chinese and English. We identified 74 RCTs that used acupuncture as an intervention and assessed the quality of these reports against the Consolidated Standards for Reporting of Trials (CONSORT) statement and Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA).Results In regard to the items in the CONSORT statement, 54 (73%) RCTs described baseline demographic and clinical characteristics in each group. Twenty-six (35%) mentioned the method of generating the random sequence, with 4 (5%) using a computer allocation. Only 6 (8%) RCTs had adequate allocation concealment, with 5 RCTs using sealed opaque envelopes and 1 RCT using centralized computer allocation. Only 8 (11%) RCTs used blinding, including 5 described as double-blind. Four (5%) RCTs reported the sample size calculation and 5 (7%) RCTs reported that an intention-to-treat (ITT) analysis. In regard to the items in STRICTA , only 4 (5%) RCTs reported the numbers of needles inserted. In 35 (47%) RCTs the needle type was reported, but only 26 (35%) mentioned the depths of insertion. Only 1 (1%) RCT mentioned the length of clinical experience and 6 (8%) RCTs reported the background of the acupuncture practitioners, but none stated the duration of their training.Conclusion The reporting quality of RCTs of acupuncture for acute ischemic stroke was low. The CONSORT statement and STRICTA should be used to standardize the reporting of RCTs of acupuncture.
ObjectivesTo analyze the current methodological and reporting quality of both domestic and overseas clinical practice guidelines on acupuncture, and to provide reference for the development of high quality acupuncture clinical practice guidelines.MethodsGIN, NICE, AHRQ, PubMed, EMbase, AMED, CINAHL, WanFang Data, CNKI, VIP and CBM databases were electronically searched to collect domestic and overseas clinical practice guidelines on acupuncture from inception to September, 2018. Two reviewers independently screened literature, extracted data and evaluated the methodological and reporting quality by using AGREE Ⅱ and RIGHT tools.ResultsA total of 23 acupuncture clinical practice guidelines were included, in which three were developed by foreign institutions, and the remaining 20 guidelines were jointly developed by WHO Western Pacific Region and China Institute of Acupuncture and Moxibustion. Three foreign and two domestic guidelines were selected for evaluation. The AGREE Ⅱ evaluation showed that the domestic guidelines have higher scores in terms of " scope and purpose”, " stakeholder involvement”, " rigor of development”, " applicability” and " clarity of presentation”, while only " editorial independence” is lower. The overall recommendation is stronger than the foreign guidelines. The RIGHT evaluation showed that for three foreign guidelines, the " reported” items accounted for 52.38%, " unreported” items accounted for 38.09%, " partly reported” items accounted for 6.66%%; however, for domestic guidelines, the " reported” accounted for 45.71%, " unreported” items accounted for 40%, and " partly reported” items accounted for 14.28% respectively. Overall, the difference is not significant (SD<10%). Due to the specificity of acupuncture interventions, the use of AGREEⅡ and RIGHT to evaluate acupuncture clinical practice guidelines still had barriers to some extend on its applicability.ConclusionThe methodological and reporting quality of acupuncture clinical practice guidelines are relatively low. It is urgent to further improve the methodological level and reporting standards of the guidelines, and to develop evaluation tools for the acupuncture field guidelines.
Currently, the recommendations of the clinical practice guidelines related to acupuncture in China and abroad are opaque to the source of the acupuncture prescription, there is a lack of comprehensive evaluation of the rationality of the acupuncture prescription, and the standards for the selection of the acupuncture prescription are opaque and nonstandard, and the writing and reporting details are insufficient, thus affecting the clinical applicability of the guidelines. To a certain extent, the utilization rate of the recommendations of the guidelines is low. This paper discusses the origin, rationality comprehensive evaluation, priority selection, writing and reporting of acupuncture prescriptions, and puts forward detailed methodological suggestions, to provide guidance makers of methodological optimization thoughts and suggestions for the evaluation, selection and writing of acupuncture prescriptions in the recommendations.
ObjectiveTo observe the clinical efficacy of acupuncture treatment on primary mild and moderate pruritus ani.
MethodsAccording to the diagnostic and inclusion criteria, 50 outpatients between March 2013 and March 2014 were randomly divided into acupuncture group and drug control group, with 25 cases in each. The acupuncture treatment group were treated by perianal local surrounding needling mostly with body acupuncture treatment for 14 times in 4 weeks. Drug control group were given oral antihistamine drugs and traditional Chinese medicine, pevisone cream rub for 4 weeks. Itching index scores, dermatology life quality index scores and treatment satisfaction were observed before and after treatment, and referral number and average number of pruritus of the two groups were observed in six months after the end of treatment.
ResultsAfter 4 weeks of treatment, itching index score of patients in the acupuncture treatment group was significantly lower than the drug control group; the dermatology life quality index scores and treatment satisfaction were significantly better than the drug control group, and in the six months after the end of treatment, referral number and the average number of pruritus were lower than the drug control group. The differences were statistically significant (P<0.05).
ConclusionClinical efficacy of acupuncture treatment on primary mild and moderate pruritus ani is significant, and the long term effect is stable.
ObjectivesTo evaluate the reporting quality of domestic and foreign randomized controlled trials (RCTs) on acupuncture for dry eye based on Consolidated Standards of Reporting Trials Expand Statement 2010 (CONSORT 2010) and Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA).MethodsCNKI, VIP, CBM, WanFang Data, PubMed, EMbase and The Cochrane Library databases were electronically searched to collect RCTs of acupuncture for dry eye at home and abroad from inception to February 2020. The reporting quality of the selected literature was evaluated with the items in the CONSORT and STRICTA, respectively.ResultsA total of 69 Chinese literatures and 8 English literatures were included. The average reporting rate of all items of CONSORT in Chinese and English literatures was 41.4% and 56.4%, respectively. The missing items of Chinese literature report primarily focused on the sections of “methodology”, “results”, and “other information”. The Chinese and English literature report rate was relatively close in terms of the literature report rate of STRICTA, and both were relatively complete in the description of acupuncture intervention.ConclusionsThe reporting quality of RCTs of acupuncture treatment for dry eye in China and abroad is generally low. Further improving the relevant reporting quality according to the CONSORT statement 2010 and STRICTA 2010 is urgent.
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 analyze the efficacy and safety of different acupuncture methods on outcome of in vitro fertilization-embryo transfer (IVF-ET). Methods The PubMed, EMbase, Cochrane Library, CNKI, VIP, WanFang Data and CBM databases were searched to collect randomized controlled trials (RCTs) related to the objectives of the study from the inception to April 16, 2023. After two investigators independently screened the literature, extracted the data and evaluated the risk of bias of the included studies, a network meta-analysis was performed using Stata 16.0 software. Results There were 62 trials total with 9844 patients, involving 7 interventions. Network meta-findings analysis revealed the following: ① Clinical pregnancy rate (CPR): needle warming > auricular acupressure > transcutaneous electrical acupoint stimulation (TEAS) > electroacupuncture > acupuncture > sham acupuncture > no adjunctive treatment; ② Live birth rate (LBR): electroacupuncture > auricular acupressure > TEAS > acupuncture > sham acupuncture > no adjunctive treatment. Conclusion?Needle warming assisted IVF-ET is superior to other acupuncture therapies in improving CPR, especially during the promotion period of excretion, and the selection of Zusanli, Guanyuan and uterine acupoints for 3-month cycles may have the best effect. And for the LBR, the effect of electroacupuncture is better than that of other therapies. Besides, auricular acupressure may have good therapeutic potential. Due to the limited quality and quantity of the included studies, more high quality studies are required to verify the above conclusions.
ObjectiveTo systematically review the efficacy and safety of acupuncture as adjuvant treatment on sepsis related gastrointestinal dysfunction. MethodsThe PubMed, Web of Science, Cochrane Library, WanFang Data, CNKI, VIP and SinoMed databases were electronically searched to collect randomized controlled trials (RCTs) related to the objectives from inception to July, 2024. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using RevMan 5.3 software. ResultsA total of 20 RCTs involving 1 384 patients were included. The results of meta-analysis showed that the bowel sound frequency per minute on the 7th day (MD=0.82, 95%CI 0.57 to 1.07, P<0.01), the effective rate of improvement in sepsis-related gastrointestinal dysfunction on the 7th day (RR=1.38, 95%CI 1.25 to 1.54, P<0.01), intra-abdominal pressure at 7th day (MD=?1.52, 95%CI ?2.21 to ?0.83, P<0.01), gastric residential volume on the 7th day (MD=?14.94, 95%CI ?24.72 to ?5.16, P<0.01), APACHE-Ⅱ score at 7th day (MD=?2.40, 95%CI ?3.56 to ?1.24, P<0.01), concentrations of procalcitonin on the 7th day (MD=?1.82, 95%CI ?2.68 to ?0.97, P<0.01) in the acupuncture group were all superior to the conventional treatment group. However, there was no significant difference between the two groups concerning the 28-day mortality. ConclusionCurrent evidence shows that acupuncture adjuvant treatment can promote the recovery of bowel sounds, reduce intra-abdominal pressure, and decrease gastric residual volume in patients with sepsis and gastrointestinal dysfunction, with good safety. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
