[目的]系统评价抗阻运动在类风湿关节炎病人中的应用效果。[方法]计算机检索PubMed、Web of Science、Cochrane Library、EBSCO、中国知网、维普、万方数据库和中国生物医学文献数据库中有关类风湿关节炎病人进行抗阻运动的随机对照试验...[目的]系统评价抗阻运动在类风湿关节炎病人中的应用效果。[方法]计算机检索PubMed、Web of Science、Cochrane Library、EBSCO、中国知网、维普、万方数据库和中国生物医学文献数据库中有关类风湿关节炎病人进行抗阻运动的随机对照试验,检索时限为自建库起至2019年7月1日。由2名研究员独立筛选文献、提取资料及评价纳入研究的偏倚风险后,采用RevMan 5.3软件对数据进行Meta分析。[结果]最终纳入10项研究,共997例病人。Meta分析结果显示,与对照组相比,抗阻运动在一定程度上可以改善病人的活动能力[MD=-0.21,95%CI(-0.35,-0.07),P=0.002],降低关节疼痛感[SMD=-0.22,95%CI(-0.42,-0.02),P=0.03],缓解疾病活动度[MD=-0.53,95%CI(-1.01,-0.06),P=0.03],提高肌肉力量[SMD=1.02,95%CI(0.22,1.83),P=0.01],降低红细胞沉降率[MD=-6.75,95%CI(-10.27,-3.23),P=0.000 2],但在步行测试方面改善不明显[MD=-1.37,95%CI(-3.13,0.39),P=0.13]。[结论]现有证据表明抗阻运动可以缓解类风湿关节炎病人的病情,降低关节疼痛感,降低红细胞沉降率,改善关节功能,提高肌肉力量。展开更多
OBJECTIVE:To evaluate the available evidence from randomized controlled trials(RCTs)of moxibustion alone for lumbar disc herniation(LDH)treatment.METHODS:A systematic search of 10 databases(until August 30,2021)was us...OBJECTIVE:To evaluate the available evidence from randomized controlled trials(RCTs)of moxibustion alone for lumbar disc herniation(LDH)treatment.METHODS:A systematic search of 10 databases(until August 30,2021)was used to identify studies that reported the response rate,visual analogue scale(VAS)score,Japanese Orthopedic Association(JOA)score,and Oswestry Disability Index(ODI)score.Study selection and data extraction were independently performed by two reviewers.Cochrane criteria for risk of bias were used to assess the methodological quality of the trials.The Grading of Recommendations Assessment,Development,and Evaluation Methodology(GRADE)were also used to test the quality of the result evidence.RESULTS:Nineteen RCTs,including 1888 patients,met the inclusion criteria.Five studies showed no difference between moxibustion and acupuncture on response rate[risk ratio(RR)=1.07,95%CI(0.98,1.16),P=0.11].Meanwhile,six studies suggested that there is no significant difference between moxibustion and acupuncture on VAS score[mean difference(MD)=-0.43,95%CI(-0.91,0.05),P=0.08].Eight studies implied that there is no significant difference between moxibustion and acupuncture on JOA score[MD=0.84,95%CI(-1.27,2.96),P=0.44].Two studies indicated that moxibustion may have equivalent effects for treating LDH in the VAS score in comparison with drug therapy[MD=-1.16,95%CI(-2.63,0.31),P=0.12].The evidence level of results was determined to be very low to low.CONCLUSIONS:Based on the existing evidence,moxibustion may not be suitable for treating LDH alone,but it may be applied as an adjuvant treatment.Furthermore,well-designed RCTs with high quality and larger samples are still needed to evaluate the efficacy and safety of moxibustion alone for LDH treatment.展开更多
Objective To explore the mechanism of moxibustion for rheumatoid arthritis(RA)by observing the metabolite changes in urine using liquid chromatography-mass spectrometry(LC-MS)-based metabolomic analysis.Methods Twenty...Objective To explore the mechanism of moxibustion for rheumatoid arthritis(RA)by observing the metabolite changes in urine using liquid chromatography-mass spectrometry(LC-MS)-based metabolomic analysis.Methods Twenty-four rats were randomly divided into a control group,a model group,and a moxibustion group.Rats in the model and moxibustion groups were established as collagen-induced arthritis(CIA)models.The control and model groups did not receive any intervention;rats in the moxibustion group received moxibustion at Shenshu(BL23)and Zusanli(ST36).After three weeks of intervention,ankle joint,serum,and urine samples were collected for pathological examinations and metabolomic tests.Results After moxibustion treatment,the CIA rats showed increased body mass,reduced swelling of the hind paws and arthritis score,decreased serum cytokine levels,and improved histopathological evaluation of the ankle joint.Twenty-four significantly altered metabolites were found,mainly involved in alanine metabolism,taurine and hypotaurine metabolism,tricarboxylic acid cycle,phenylalanine metabolism,tyrosine metabolism,and primary bile acid biosynthesis.These metabolites may serve as potential biomarkers for RA.Conclusion Moxibustion can effectively resist inflammation in CIA rats.The potential biomarkers and the abnormal metabolic pathways of RA can be identified by LC-MS-based metabolomics.Metabolomics may be an effective way to explain the mechanism of moxibustion in treating RA.展开更多
基金Supported by the National Natural Science Foundation of China:Study on Multi-target Regulation Mechanism of Moxibustion on Rheumatoid Arthritis Based on Signal Pathway of Lipid Metabolism Network(No.81774383)Study on the Multi target Effect Mechanism of Moxibustion Intervention on Ankylosing Spondylitis Based on Metabolic Proteomics and System Bioinformatics Cross linking Analysis between Genomics(No.81904274)Supported by the"Research and Innovation Plan for Postgraduates in Jiangsu Province"of the Nanjing University of Chinese Medicine:Clinical Experimental Study on the Effect of Different Moxibustion Duration on Lumbar Disc Herniation(SJCX20_0524),Clinical Study on the Treatment of Lumbar Disc Herniation with Thunder Fire Moxibustion and Common Moxibustion(SJCX20_0525)。
文摘OBJECTIVE:To evaluate the available evidence from randomized controlled trials(RCTs)of moxibustion alone for lumbar disc herniation(LDH)treatment.METHODS:A systematic search of 10 databases(until August 30,2021)was used to identify studies that reported the response rate,visual analogue scale(VAS)score,Japanese Orthopedic Association(JOA)score,and Oswestry Disability Index(ODI)score.Study selection and data extraction were independently performed by two reviewers.Cochrane criteria for risk of bias were used to assess the methodological quality of the trials.The Grading of Recommendations Assessment,Development,and Evaluation Methodology(GRADE)were also used to test the quality of the result evidence.RESULTS:Nineteen RCTs,including 1888 patients,met the inclusion criteria.Five studies showed no difference between moxibustion and acupuncture on response rate[risk ratio(RR)=1.07,95%CI(0.98,1.16),P=0.11].Meanwhile,six studies suggested that there is no significant difference between moxibustion and acupuncture on VAS score[mean difference(MD)=-0.43,95%CI(-0.91,0.05),P=0.08].Eight studies implied that there is no significant difference between moxibustion and acupuncture on JOA score[MD=0.84,95%CI(-1.27,2.96),P=0.44].Two studies indicated that moxibustion may have equivalent effects for treating LDH in the VAS score in comparison with drug therapy[MD=-1.16,95%CI(-2.63,0.31),P=0.12].The evidence level of results was determined to be very low to low.CONCLUSIONS:Based on the existing evidence,moxibustion may not be suitable for treating LDH alone,but it may be applied as an adjuvant treatment.Furthermore,well-designed RCTs with high quality and larger samples are still needed to evaluate the efficacy and safety of moxibustion alone for LDH treatment.
文摘Objective To explore the mechanism of moxibustion for rheumatoid arthritis(RA)by observing the metabolite changes in urine using liquid chromatography-mass spectrometry(LC-MS)-based metabolomic analysis.Methods Twenty-four rats were randomly divided into a control group,a model group,and a moxibustion group.Rats in the model and moxibustion groups were established as collagen-induced arthritis(CIA)models.The control and model groups did not receive any intervention;rats in the moxibustion group received moxibustion at Shenshu(BL23)and Zusanli(ST36).After three weeks of intervention,ankle joint,serum,and urine samples were collected for pathological examinations and metabolomic tests.Results After moxibustion treatment,the CIA rats showed increased body mass,reduced swelling of the hind paws and arthritis score,decreased serum cytokine levels,and improved histopathological evaluation of the ankle joint.Twenty-four significantly altered metabolites were found,mainly involved in alanine metabolism,taurine and hypotaurine metabolism,tricarboxylic acid cycle,phenylalanine metabolism,tyrosine metabolism,and primary bile acid biosynthesis.These metabolites may serve as potential biomarkers for RA.Conclusion Moxibustion can effectively resist inflammation in CIA rats.The potential biomarkers and the abnormal metabolic pathways of RA can be identified by LC-MS-based metabolomics.Metabolomics may be an effective way to explain the mechanism of moxibustion in treating RA.
