Objectives We aimed to assess the methodological qual ity of RCT on acupuncture for migraine prophylaxis. Methods With the searching terms including acupuncture, migraine, prophylaxis and prevent, etc, the database of the Cochrane Library (Issue 4, 2007), MEDLINE (1966-2007), EMBase (1966-2007), CBM (1978-2007) and CMCC (1994-2007) were searched from their date of start publ ication. Chinese medical journals and relevant academic conference proceedings were hand searched as well. Several items in included trials were assessed, including methodology, diagnostic criteria, inclusion/exclusion criteria, acupuncture/control interventions, outcome measures and follow-up, etc. Result Among the 12 included trials, 9 trials overseas were high-qual ity and 3 in China were low-quality. Frequency or days of migraine attacks and SF-36/SF-12 were often evaluated as outcome measures in western countries, while headache index was used in China. Among the 12 trials, 9 reported the follow-up outcomes and 8 mentioned adverse events. Conclusion There was no high qual ity trial on acupuncture for migraine prophylaxis in China. The outcome measures in trials published in China by now can not evaluate the outcomes of acupuncture for migraine prophylaxis accurately. To study designs, advantages of trials oversea can be used for reference. To Chinese cl inical physicians, prophylactic therapy and abortive therapy of migraine should be distinguished in order to design high-qual ity study on acupuncture for migraine prophylaxis.
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.
針刺平行隨機對照試驗通常沒有準確報告試驗組和對照組的干預方法.為促進標準化,國際上有經驗的針刺醫師和研究者組成的小組制定了一些原則,即針刺臨床對照試驗中干預措施報告的標準(縮寫為STRICTA).在征求意見過程中,一些期刊編輯協助對此標準進行了修改,使之與隨機對照試驗報告的標準(CON-SORT)格式一致,作為該指南對針剌研究報告的延伸.參與此事的雜志編輯已確定要發表該標準,建議其作者群按照此標準準備論文,并將邀請更多雜志采用該標準.目的是使針剌對照試驗的干預措施充分報告,從而有利于對這些研究的嚴格評價、分析及這些措施的推廣.
ObjectiveTo systematically review the efficacy and safety of acupuncture on postpartum depression (PPD).MethodsPubMed, EMbase, The Cochrane Library, Web of Science, CNKI, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy and safety of acupuncture in treatment of PPD from inception to February 2021. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Meta-analysis was then performed by using Stata16.0 software.ResultsA total of 13 RCTs involving 899 patients were included. The results of meta-analysis showed that there was no significant difference between hand acupuncture and fluoxetine hydrochloride in HAMD score (MD=0.45, 95%CI ?0.52 to 1.41, P=0.36), clinical effective rate (RR=0.93, 95%CI 0.70 to 1.23, P=0.59), and clinical cure rate (RR=0.88, 95%CI 0.44 to 1.76, P=0.73). However, hand acupuncture was superior in safety to fluoxetine hydrochloride (RR=0.04, 95%CI 0.01 to 0.28, P<0.05). There was no significant difference in clinical effective rate (RR=1.08, 95%CI 0.87 to 1.36, P=0.49) and cure rate (RR=1.31, 95%CI 0.84 to 2.04, P=0.24) between both groups.ConclusionsThe current evidence shows that there are no differences between hand acupuncture and non-acupuncture in reducing HAMD score, improving the clinical effective rate and clinical cure rate. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusions.
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.
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.
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.
ObjectivesTo evaluate the quality of methodology and evidence of the exiting systematic reviews (SRs) of acupuncture therapy for post-stroke spastic paralysis.MethodsCNKI, CBM, The Cochrane Library, PubMed and EMbase databases were electronically searched to collect SRs of acupuncture therapy for post-stroke spastic paralysis from inception to December 16th, 2018. Two reviewers independently screened literature, extracted data, and evaluated the quality of methodology and evidence by AMSTAR 2 scale and GRADE system.ResultsA total of 7 SRs were included. The results showed that acupuncture therapy had obvious advantages in treating post-stroke spastic paralysis without obvious adverse reactions. The results of AMSTAR 2 scale showed that the failure of key items 2 and 7 resulted in extremely low methodological quality. The results of GRADE system showed that 46.15% of which were low-level evidence quality, 42.31% were medium, 11.54% were extremely low, and no evidence quality were high.ConclusionsCurrent evidence shows that acupuncture and moxibustion therapy is effective in treating spastic paralysis after stroke, however, the quality of the SRs is low. The studies are required to be standardized and combined with the characteristics of TCM to obtain high quality evidence in the future.
Objectives To systematically review the efficacy and safety of bonesetting combined acupuncture in the treatment of cervical vertigo. Methods PubMed, CNKI, VIP, CBM and WanFang Data databases were searched to collect randomized controlled trials (RCTs) on bonesetting combined acupuncture in the treatment of cervical vertigo from inception to February 15th, 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was performed by RevMan 5.3 software. Results Eighteenth RCTs involving 1 915 patients were included. The results of meta-analysis showed that, compared with acupuncture or bonesetting alone group, the effective rate in bonesetting combining acupuncture group was higher (RRacupuncture=1.17, 95%CI 1.12 to 1.23, P<0.000 01; RRbonesetting=1.16, 95%CI 1.10 to 1.23, P<0.000 01). Improvement of the cervical vertigo symptom and function in the combined group was better than that in the acupuncture group or bonesetting group (MDacupuncture=3.42, 95%CI 2.29 to 4.56, P<0.000 01; MDbonesetting=6.45, 95%CI 5.56 to 7.33, P<0.000 01). Average flow velocity of cervical vertigo basilar artery (BA) in the combined group was superior to the bonesetting group (MD=7.54, 95%CIP=0.02). 1.08 to 13.99, Conclusions Bonesetting combining acupuncture treatment of cervical vertigo in terms of effectiveness and function improvement are better than those of acupuncture alone or pure bonesetting. Due to the limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusions.
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.