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.
ObjectiveTo observe the clinical effect of combined traditional Chinese and Western medicine in the treatment of knee osteoarthritis (KOA).
MethodsA total of 180 KOA patients treated between January 2012 and June 2015 were randomly assigned to 3 groups: Chinese medicine group (group A, n=60) with acupuncture and irradiation therapy of specific electromagnetic wave therapeutic apparatus , western medicine group (group B, n=60) with oral glucosamine hydrochloride tablets and knee joint cavity injection of sodium hyaluronate, and integrated traditional Chinese and Western medicine group (group C, n=60) with treatments combining those in both group A and B. The treatment course was 6 weeks. The Western Ontario & McMaster University (WOMAC) osteoarthritis index score and total effective rate were evaluated before treatment and 2 weeks after treatment, end of treatment and 5 months after treatment.
ResultsAfter treatment, the average improvement of WOMAC scores in the three groups was significantly different (P ＜ 0.05) . The total effective rate was 78.33% in group A, 83.33% in group B, and 91.67% in group C. The difference of total effective rate between group C and A, and between group C and B was statistically significant (P＜0.05) ; and it was also statistically significant between group A and B (P ＜ 0.05) . There were two cases of adverse reactions in group A, two in group B, and two in group C, and the reactions were all relatively mild without any serious adverse events.
ConclusionsChinese medicine and western medicine are both effective and safe for the treatment of KOA. When they are combined, the effect is further enhanced with no increase of adverse reactions.
Objective To assess the efficacy and safety of acupuncture versus western medicine in the treatment of parkinson disease. Methods Randomized controlled trials (RCTs) involving acupuncture versus western medicines in the treatment of parkinson disease were identified from CBM (1978 to 2008), VIP (1989 to 2008), Wanfang Database (1998 to 2008), CNKI (1979 to 2008), PubMed (1966 to 2008), EMbase (1980 to 2008), and The Cochrane Library (Issue 4, 2008). And some relevant journals were handsearched. Data were extracted and evaluated by two reviewers independently with a specially-designed extraction form. The Cochrane Collaboration’s RevMan 5.0.20 software was used for meta-analyses. Results A total of 13 trials involving 832 patients were included. The result of meta-analyses showed that the total effective rates of the acupuncture group or of the group of acupuncture plus Madopar were similar when compared with Madopar alone in Webster score. (1) The total effective rate: The total effective rate in acupuncture plus Madopar was similar when compared with Madopar alone in UPDRS score at Day 30 (RR=1.33, 95%CI 0.95 to 1.88) and Day 66 (RR=1.38, 95%CI 0.84 to 2.24), but there were significant differences between acupuncture plus Madopar and Madopar alone (RR=1.61, 95%CI (1.19 to 2.17) at Day 84. The total effective rate in acupuncture plus benserazide-levodopa was higher than benserazide-levodopa alone (RR=1.70, 95%CI 1.08 to 2.68) at Day 66. (2)Webster score: There were no significant differences between acupuncture and Madopar at Day 30 (WMD= –2.51, 95%CI –2.83 to –2.19) and at Day 63 (WMD= –2.48, 95%CI –3.01 to –1.95). There were significant differences between acupuncture plus Madopar and Madopar alone at Day 30 (WMD= –13.48, 95%CI –15.35 to –11.61), but not at Day 42 (WMD= 0.50, 95%CI –1.22 to 2.22). (3) UPDRS score: There were no significant differences between acupuncture and Madopar at Day 60 (WMD= –7.19, 95%CI –14.49 to 0.11). There were significant differences between acupuncture plus Madopar and Madopar alone at Day 30 (WMD= 7.07 and 95%CI 2.95 to 11.19) and at Day 84 (WMD= –12.49,95%CI –16.75 to –8.23), but no significant differences were found at Day 66 and Day 33 (WMD= –14.90, 95%CI –31.89 to 2.09; WMD= –8.60, 95%CI –21.51 to 4.31).But there were statistical differences between acupuncture plus Madopar and Madopar alone at Day 30 (WMD= 7.07, 95%CI 2.95 to 11.19). There were no differences between acupuncture plus benserazide-levodopa and benserazide-levodopa alone at Day 66 (WMD=-10.80,95%CI-21.78 to 0.18) and at Day 33 (WMD=-15.60,95%CI-28.38 to -2.82). (4) Adverse reaction: Three trials reported adverse reactions including dizziness, heartbeat acceleration, slight mouth drying and nausea, but all of these were relieved or disappeared in the course of treatment. Conclusion Acupuncture is safe and effective in the treatment of parkinson disease. Acupuncture plus western drugs may be superior to western drugs alone. Because of the defects in the methodological quality of the included trials, the conclusion is to be confirmed by more high-quality RCTs.
The use of placebo controls in acupuncture trials has been an international concern for many years. We discussed some common problems in placebo controls and introduced four kinds of control methods (sham acupuncture, non-points acupuncture, minimal acupuncture and non-specific sites acupuncture). For sham acupuncture, non-points acupuncture and non-specific sites acupuncture, patients who have received acupuncture are liable to doubt the intervention they are taking. Minimal acupuncture has better reliability but is limited to use in many diseases for its physiological effect. Needling on some special parts of the body, for example, head and back side of the body, can make balance among factors as reliability, physiological effect and feasibility. This paper recommends a control method needling special parts according to the tradiontional acupuncture theory, which provides references for acupuncture clinical trials.
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.
Objective To assess the effectiveness of acupuncture for tension-type headache. Methods A systematic review of the relevant randomized controlled trials (RCTs) of acupuncture for tension-type headache was performed using the methods of The Cochrane Collaboration. Trials were collected from The Cochrane Library, Issue 4, 2003, MEDLINE (1966 to March 2004), CBM (1978 to August 2003), VIP (1989 to April 2003) and handsearched all related articles published in Chinese in 2003. The quality of literature was reviewed, and data were extracted by two reviewers independently. Meta-analysis was conducted using RevMan 4.2 software. Results Thirteen RCTs involving 571 patients were included, of the thirteen RCTs, six were of high methodological quality according to Jadad scale (the Jadad score≥3), and “sham acupuncture” was used as controlled intervention in eight trials. Meta-analysis indicated that no statistical difference was detected between acupuncture and sham acupuncture groups on effectiveness with RR 1.55, 95%CI 0.97 to 2.47 and P=0.07 at the end of treatment. No statistical difference was detected between acupuncture and sham acupuncture groups on visual analogue scale at the end of treatment with WMD －0.55, 95%CI －1.20 to 0.09 and P=0.09; at the end of follow-up of less than 2 months with WMD －0.22, 95%CI －0.87 to 0.42 and P= 0.50 and at the end of follow-up of more than 2 months with WMD －0.65, 95% CI －1.41 to 0.11 and P=0.09. Conclusions Comparing acupuncture with sham acupuncture and other treatments, current evidence can not evaluate whether acupuncture is significantly effective for tension-type headache, more RCTs of high methodological quality are required.
Objective To systematically review the efficacy and safety of acupuncture for the treatment of tumor-related cognitive dysfunction. Methods The PubMed, The Cochrane Library, EMbase, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect studies on acupuncture for the treatment of tumor-related cognitive dysfunction from the establishment of the database to February 13th, 2022. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.4.1 software. Results A total of 16 studies involving 1 361 patients were included. The results of meta-analysis showed that the mini-mental state examination (MD=1.82, 95%CI 1.49 to 2.15, P<0.000 01) and Montreal cognitive assessment (MD=1.56, 95%CI 0.83 to 2.29, P<0.0001) scores of the acupuncture treatment group were superior to those in the control group. Furthermore, the acupuncture treatment group showed a reduced incidence of postoperative cognitive dysfunction (RR=0.50, 95%CI 0.39 to 0.63, P<0.000 01) and decreased levels of interleukin-6 (MD=?10.43, 95%CI ?14.91 to ?5.95, P<0.000 01), interleukin-1β (MD=?47.14, 95%CI ?63.92 to ?30.36, P<0.000 01), and tumor necrosis factor-α (MD=?9.13, 95%CI ?12.38 to ?5.89, P<0.000 01). In contrast, the visual analog scale score of the acupuncture treatment group (MD=?1.26, 95%CI ?2.06 to ?0.47, P=0.002) was better than that of the control group. No significant difference was found in the level of central nervous system-specific protein (S100β) (MD=?0.06, 95%CI ?0.13 to 0.01, P=0.12) between the two groups. Conclusion Acupuncture therapy can improve tumor-related cognitive function in patients. Its curative effect is better than that of non-acupuncture therapy; however, its ability to reduce S100β levels is not significantly different from that of non-acupuncture therapy. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo systematically review the efficacy of acupuncture for PCOS infertility.MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect randomized controlled trials (RCTs) of acupuncture for PCOS infertility from inception to January 5th, 2020. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Meta-analysis was then performed using RevMan 5.3 software.ResultsA total of 28 RCTs involving 2 192 patients were included. The results of meta-analysis showed that compared with western medicine alone, acupuncture could increase the pregnancy rate (RR=1.80, 95%CI 1.45 to 2.23, P<0.000 01) and ovulation rate (RR=1.33, 95%CI 1.15 to 1.54, P=0.000 1), and reduce levels of LH (SMD=?0.62, 95%CI ?0.96 to ?0.28, P=0.000 4) and LH/FSH (SMD=?0.65, 95%CI ?1.02 to ?0.29, P=0.000 5). Acupuncture combined with western medicine could increase the pregnancy rate (RR=1.75, 95% CI 1.50 to 2.03, P<0.000 01) and ovulation rate (RR=1.29, 95%CI 1.18 to 1.41, P<0.000 01), decrease levels of LH (SMD=?1.09, 95%CI ?1.64 to ?0.53, P=0.000 1), LH/FSH (SMD=?1.30, 95%CI ?2.35 to ?0.25, P=0.02), and levels of T (SMD=?1.13, 95%CI ?1.59 to ?0.66, P<0.000 01).ConclusionsCurrent evidence shows that acupuncture alone or combined with western medicine can significantly improve ovulation rate, pregnancy rate and reduce hormone level. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusions.
This study aimed to provide suggestions for future researchers to select and optimize sham acupuncture reporting guidelines in acupuncture clinical trials. Through qualitative analysis, we compared the basic information and concrete contents between Acupuncture Controls gUideline for Reporting humAn Trials and Experiments (ACURATE) and SHam Acupuncture REporting guidelines in clinical trials (SHARE) developed by researchers from China and Korea. In addition, the similarities and differences of the two guidelines were illustrated through a specific case. We found that the two guidelines had their own characteristics and emphasis in content, but both emphasized the reports of detailed information and background factors of sham acupuncture compared with the previous STRICTA and TIDieR-Placebo checklist. In terms of item division, we found that the ACURATE split the same topic into several items to emphasize the importance of each item content. SHARE emphasized the comprehensive reports of sham acupuncture by combining several items into a single item. In terms of item content, ACURATE also focused on combination therapy, the information regarding sham acupuncture provided to participants, and any differences in treatment settings between versus/sham acupuncture, which had some referential meaning for setting sham acupuncture control. SHARE also focused on sham acupuncture detailed information, practitioner, and modifications, etc. Case analysis showed that there were some "not reported" or "partially reported" items in both guidelines. Therefore, it is suggested that researchers can use the above two guidelines to complement and learn from each other to report sham acupuncture. In addition, it is necessary for researchers to verify the operability and practicability of the above two guidelines, and provide suggestions for optimizing and updating them in the future.
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.
