OBJECTIVE:To propose an automatic acupuncture robot system for performing acupuncture operations.METHODS:The acupuncture robot system consists of three components:automatic acupoint localization,acupuncture manipulati...OBJECTIVE:To propose an automatic acupuncture robot system for performing acupuncture operations.METHODS:The acupuncture robot system consists of three components:automatic acupoint localization,acupuncture manipulations,and De Qi sensation detection.The OptiTrack motion capture system is used to locate acupoints,which are then translated into coordinates in the robot control system.A flexible collaborative robot with an intelligent gripper is then used to perform acupuncture manipulations with high precision.In addition,a De Qi sensation detection system is proposed to evaluate the effect of acupuncture.To verify the stability of the designed acupuncture robot,acupoints'coordinates localized by the acupuncture robot are compared with the Gold Standard labeled by a professional acupuncturist using significant level tests.RESULTS:Through repeated experiments for eight acupoints,the acupuncture robot achieved a positioning error within 3.3 mm,which is within the allowable range of needle extraction and acupoint insertion.During needle insertion,the robot arm followed the prescribed trajectory with a mean deviation distance of 0.02 mm and a deviation angle of less than 0.15°.The results of the lifting thrusting operation in the Xingzhen process show that the mean acupuncture depth error of the designed acupuncture robot is approximately 2 mm,which is within the recommended depth range for the Xingzhen operation.In addition,the average detection accuracy of the De Qi keywords is 94.52%,which meets the requirements of acupuncture effect testing for different dialects.CONCLUSION:The proposed acupuncture robot system streamlines the acupuncture process,increases efficiency,and reduces practitioner fatigue,while also allowing for the quantification of acupuncture manipulations and evaluation of therapeutic effects.The development of an acupuncture robot system has the potential to revolutionize low back pain treatment and improve patient outcomes.展开更多
OBJECTIVE:To take Baihui(GV20)and Fengchi(GB20)targeting inflammatory response to regulate migraine as an example to describe a new method for studying the mechanism of stimulating acupoints.METHODS:The target informa...OBJECTIVE:To take Baihui(GV20)and Fengchi(GB20)targeting inflammatory response to regulate migraine as an example to describe a new method for studying the mechanism of stimulating acupoints.METHODS:The target information of Baihui(GV20)and Fengchi(GB20)was retrieved,and after intersection with migraine,Kyoto Encyclopedia of Genes and Genomes(KEGG),Reactome,and Uni Prot Keywords were used for functional enrichment.After selecting the main pathway,rats were selected and nitroglycerin was used for modeling,and the behavioral scores,inflammatory factors,heme oxygenase 1(HMOX1),protein kinase B(AKT1),signal transducer and activator of transcription 3(STAT3),phosphorylated extracellular signal-regulated kinase 1/2(P-ERK1/ERK2)and other states of the rats in the acupuncture,twisting,and electroacupuncture groups were compared.RESULTS:A total of 135 Baihui(GV20)targets and 27 Fengchi(GB20)targets were collected.A total of 73 target information were obtained after the intersection of these targets in migraine.These 73 targets have three main pathways:hypoxia-inducible factor 1(HIF-1)signaling pathway,signaling by interleukins and inflammatory response.The main targets in the pathway were verified and found that interleukin-1 beta(IL-1β),interleukin-6(IL-6),tumor necrosis factor-alpha(TNF-α)and HMOX1,AKT1,STAT3,P-ERK1/ERK2 can be regulated by Baihui(GV20)and Fengchi(GB20).CONCLUSION:Baihui(GV20)and Fengchi(GB20)can regulate migraine by regulating inflammatory factors and HMOX1,AKT1,STAT3,P-ERK1/ERK2 and other changes in HIF-1 signaling pathway,Signaling by Interleukins and Inflammatory response pathways.Based on systems biology and network pharmacology,and with the model of"acupoint-target-disease",explore the research methods of systematic acupuncture and moxibustion.We believe this is a usable research direction for exploring the mechanism of acupuncture stimulation.展开更多
Objective:In this study,we evaluated the methodological quality of systematic reviews on acupuncture and moxibustion for the prevention and management of cancer-related conditions,aiming to provide evidence-based supp...Objective:In this study,we evaluated the methodological quality of systematic reviews on acupuncture and moxibustion for the prevention and management of cancer-related conditions,aiming to provide evidence-based support and establish levels of evidence for clinical application.Method:A comprehensive search was conducted to identify systematic reviews on acupuncture and mox-ibustion for the prevention and management of cancer-related conditions,covering databases including PubMed,Embase,Cochrane Library,Web of Science,China National Knowledge Infrastructure,Chinese Biomedical Databases,China Science and Technology Journal Database,and Wanfang Data,from their in-ception to August 1,2024.The methodological quality of the included systematic reviews was assessed by using AMSTAR 2,and bubble plots were employed to visualize the evidence.Results:Overall,137 systematic reviews were included,with China being the most prolific country,with 117 reviews.These reviews addressed 21 cancer-related conditions,with the three most frequently stud-ied being cancer-related fatigue(25 reviews),nausea and vomiting(20 reviews),and cancer pain(19 re-views).The three most commonly used acupuncture modalities were manual acupuncture(81 reviews),electroacupuncture(55 reviews),and moxibustion(39 reviews).Quality assessment revealed that one systematic review was rated as“high quality,”eight as“low quality,”and 128 as“critically low quality,”primarily due to the absence of protocol registration and lists of excluded studies.Conclusion:Acupuncture and moxibustion have shown potential efficacy in alleviating cancer-related con-ditions and treatment-related adverse effects,and their clinical use has been widely reported.However,the overall methodological quality of the included systematic reviews was low,limiting the reliability and the strength of the evidence.Future high-quality studies are needed to improve the quality of evidence and support the standardized application and broader promotion of acupuncture and moxibustion clinical practice.展开更多
Background:Acupuncture has shown potential therapeutic benefits for individuals with simple obesity.However,some researchers argue that some of the effectiveness of acupuncture may be due to the placebo response.Objec...Background:Acupuncture has shown potential therapeutic benefits for individuals with simple obesity.However,some researchers argue that some of the effectiveness of acupuncture may be due to the placebo response.Objective:To understand the placebo response of acupuncture treatment in simple obesity,a systematic review and meta-analysis was designed based on the comparison between sham acupuncture before and after treatment.Search strategy:Eight databases(Pub Med,Web of Science,Cochrane Library,Embase,China National Knowledge Infrastructure,Wanfang Database,China Biology Medicine Database,and Chinese Scientific Journals Database)were searched from inception to August 1,2023.The Me SH search terms comprised obesity and acupuncture.Inclusion criteria:Randomized controlled trials(RCTs)using sham or placebo acupuncture as a control in treating obesity were enrolled.Data extraction and analysis:Two researchers independently extracted data,and the results were crosschecked after completion.Each RCT’s detailed sham/placebo acupuncture treatment protocol was assessed according to the SHam Acupuncture REporting guidelines.The revised Cochrane risk-of-bias tool for randomized trials and the Grading of Recommendations Assessment,Development,and Evaluation(GRADE)system were used to determine the risk of bias and quality of evidence,respectively.Body mass index(BMI)was defined as the primary outcome.Anthropometric parameters and laboratory test parameters related to obesity were defined as secondary outcomes.We used standardized mean difference(SMD)with 95%confidence interval(CI)to calculate treatment effects of outcomes.Results:Fifteen RCTs with a total of 1250 patients were included.The BMI significantly decreased after treatment in the sham acupuncture group compared to baseline(SMD 0.37,95%CI 0.09–0.66;I2=81%,random model;P<0.01).Treatment duration(P=0.02)and other interventions significantly impacted the placebo response rate(P=0.00).Conclusion:The placebo response of sham acupuncture was strong in the RCTs for simple obesity,and the effect sizes differed between various outcomes.The treatment duration and other interventions emerged as potential influencing factors for the placebo response of sham acupuncture.展开更多
Stroke,which is the second leading cause of mortality worldwide and the third leading cause of death and disability combined,[1]necessitates cost-effective rehabilitation interventions.Acupuncture is a traditional Chi...Stroke,which is the second leading cause of mortality worldwide and the third leading cause of death and disability combined,[1]necessitates cost-effective rehabilitation interventions.Acupuncture is a traditional Chinese medicine therapy that is increasingly recognized as a complementary stroke therapy.展开更多
Background:Acupuncture is widely used in modulating brain excitability and motor function,as a form of complementary and alternative medicine.However,there is no existing meta-analysis evaluating the effectiveness and...Background:Acupuncture is widely used in modulating brain excitability and motor function,as a form of complementary and alternative medicine.However,there is no existing meta-analysis evaluating the effectiveness and safety of acupuncture on corticospinal excitability(CSE),and the credibility of the evidence has yet to be quantified.Objective:This study was designed to assess the efficacy and safety of electroacupuncture(EA)and manual acupuncture(MA)in enhancing brain excitability,specifically focusing on CSE as measured by transcranial magnetic stimulation(TMS).Search strategy:This study followed a systematic approach,searching 9 databases up to August 2024 and examining grey literature,in compliance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Inclusion criteria:Studies were included if they compared the clinical efficacy of EA or MA with sham acupuncture,no treatment or usual training.Data extraction and analysis:Three investigators independently conducted literature screening,data extraction,and risk of bias assessment.The primary outcome focused on motor-evoked potentials as measured by TMS,with treatment effects quantified using mean differences or standardized mean differences between pre-and post-treatment.Subgroup analyses were conducted using mixed-effects models,while random-effects or fixed-effects models were used to estimate average treatment differences across studies.Results:Based on 34 studies involving 1031 adults,acupuncture techniques significantly enhanced CSE.EA had a greater impact than MA,with effect sizes of 0.53 mV vs 0.43 mV(95%confidence interval[CI]:[0.30,0.76],P<0.00001 vs 95%CI:[0.28,0.59],P<0.00001).The 5 most frequently used acupoints were LI4(Hegu,32 times),ST36(Zusanli,10 times),LI11(Quchi,7 times),TE5(Waiguan,6 times),and GB34(Yanglingquan,5 times).Conclusion:This systematic review indicates that both EA and MA could effectively and safely enhance CSE,bringing the corticospinal pathway closer to the threshold for firing,which may ultimately improve motor function.LI4,ST36,LI11,TE5 and GB34 are the most commonly used acupoints.展开更多
Background Temporomandibular disorders(TMD)are the leading cause of chronic orofacial pain,which significantly affects patients’quality of life.However,the efficacy of acupuncture in the management of TMD remains unc...Background Temporomandibular disorders(TMD)are the leading cause of chronic orofacial pain,which significantly affects patients’quality of life.However,the efficacy of acupuncture in the management of TMD remains unclear.Objective This systematic review aimed to conduct a PRISMA-compliant review to critically assess the therapeutic efficacy of acupuncture as an intervention for patients with TMD.Methods We searched nine electronic databases for randomized controlled trials on acupuncture for TMD published up to February 4,2025.Eligible studies included adults diagnosed with TMD and compared acupuncture(manual,electroacupuncture,warm,auricular,thread-embedding,or laser)with conservative treatment(positive control)or sham acupuncture(negative control).Outcomes included pain intensity,mouth opening,pressure pain threshold,and adverse events.Risk of bias was assessed using ROB 2,and certainty of evidence was evaluated using GRADE.All outcome data were analyzed using RevMan 5.4 software.Low heterogeneity was defined as I^(2)≤50% and P≥0.1,in which case a fixed-effects model was applied.High heterogeneity(I^(2)>50% or P<0.1)prompted further analysis to identify its source.After excluding the influence of evident heterogeneity,a random-effects model was used for the meta-analysis.Results Of the 2664 screened records,14 randomized controlled trials involving 476 participants met the inclusion criteria.Acupuncture significantly reduced pain intensity compared with that of negative controls(MD=-1.75,95%confidence interval[CI]-2.47 to-1.03;P<0.00001;I^(2)=60%)but showed no difference compared with that of positive controls(MD=-0.06,95%CI-0.62 to 0.50;P=0.83;I^(2)=0%).No significant differences were observed in pain-free jaw opening,whereas acupuncture improved maximum mouth opening relative to negative controls(MD=1.80,95%CI 1.62 to 1.97;P<0.00001;I^(2)=0%).For pressure pain threshold,two small studies suggested greater increases with acupuncture.Safety data were limited,with only one trial reporting mild adverse events in the acupuncture group.Conclusion Based on limited evidence,acupuncture appears superior to negative controls in relieving pain associated with TMD but shows no significant advantage over positive controls.The certainty of the evidence for all outcomes,as assessed by GRADE,was low or very low.Therefore,these findings should be interpreted with caution.Future high-quality randomized controlled trials are warranted to further evaluate the role of acupuncture in the management of patients with TMD.展开更多
Objective:Breast cancer is the second most prevalent cause of mortality in women and the predominant malignancy type.However,breast cancer treatment faces challenges in managing aromatase inhibitor-induced arthralgia....Objective:Breast cancer is the second most prevalent cause of mortality in women and the predominant malignancy type.However,breast cancer treatment faces challenges in managing aromatase inhibitor-induced arthralgia.Aromatase inhibitors have been shown to decrease recurrence risk in hormone receptor-positive cases;however,joint discomfort remains the primary adverse effect.Randomized clinical trials have evaluated the therapeutic outcomes of acupuncture for medication-related musculoskeletal complications.This comprehensive analysis sought to elucidate both the therapeutic efficacy and placebo responses associated with acupuncture intervention.Methods:Two reviewers searched for randomized controlled trials(RCTs)in four English(PubMed,Embase,Web of Science,and the Cochrane Library)and four Chinese databases(CNKI,Wanfang Database,VIP,and SinoMed)from their inception to May 31,2024.Methodological quality was assessed using the Cochrane risk of bias tool.Data were synthesized using random effects models and presented with forest plots.Results:Seven trials involving 604 patients were included.The primary outcome and Brief Pain Inventory(BPI)score differed between the acupuncture and control groups(sham acupuncture or usual medication)in three subscales over the course of 6 weeks:worst pain:standardized mean difference(SMD)=-1.18,95%confidence interval(CI):-1.74,-0.63,P<0.001;painrelated interference:SMD=-0.87,95%CI:-1.70,-0.05,P=0.038;pain severity:SMD=-0.63,95%CI:-1.22,-0.04,P=0.036.No severe adverse events were reported in any study.Conclusions:This meta-analysis showed that acupuncture is a safe and effective treatment for patients with breast cancer with aromatase inhibitor-induced arthralgia during the course of 6 weeks.Improvements in the blinding method and clarification of the total treatment recommendations and intervals need to be explored further.展开更多
Background:Acupuncture therapy provides a complementary and alternative approach to treating major depressive disorder(MDD),but its efficacy and safety have still not been comprehensively assessed.Recently published s...Background:Acupuncture therapy provides a complementary and alternative approach to treating major depressive disorder(MDD),but its efficacy and safety have still not been comprehensively assessed.Recently published systematic reviews remain confusing and inconclusive.Objective:This systematic review evaluated the efficacy and safety of acupuncture therapy alone or combined with antidepressants for adult patients with mild and moderate MDD.Search strategy:Chinese Biomedical Literature Database,China National Knowledge Infrastructure Database,Wanfang Database,Chinese Science and Technology Journal Database,Pub Med,Embase,and Cochrane Library were searched from their inceptions to March 2025.Inclusion criteria:Randomized controlled trials that compared acupuncture therapy with antidepressants,or acupuncture therapy plus antidepressants with acupuncture therapy or antidepressants for adult patients with mild and moderate MDD were included.Data extraction and analysis:Five reviewers independently extracted data from original literature using a standardized form,and the data were verified by two reviewers to ensure accuracy.Statistical meta-analyses,publication bias analyses,and subgroup analyses were performed by using Review Manager 5.3 software.The Grading of Recommendations Assessment,Development,and Evaluation approach was used to assess the certainty of the evidence.Results:A total of 60 eligible studies including 4675 participants were included.Low-certainty evidence showed that compared with antidepressants,acupuncture therapy(standardized mean difference[SMD]=-0.57;95%confidence interval[CI]=[-0.87,-0.27];I^(2)=86%;P=0.006)or acupuncture therapy plus antidepressants(SMD=-1.00;95%CI=[-1.18,-0.81];I^(2)=77%;P<0.00001)may reduce the severity of depression at the end of treatment.Low-certainty evidence indicated that compared with acupuncture therapy alone,acupuncture therapy plus antidepressants slightly reduced the severity of depression at the end of treatment(SMD=-0.38;95%CI=[-0.61,-0.14];I^(2)=18%;P=0.002).Similar results were also found for acupuncture's relief of insomnia.The reported adverse effects of acupuncture therapy were mild and transient.For most of the subgroup analyses,acupuncture type,scale type,and the course of treatment did not show a significant relative effect.Conclusion:Acupuncture therapy may provide antidepressant effects and relieve insomnia with mild adverse effects for adult patients with mild and moderate MDD.But the certainty of evidence was very low.More high-quality,well designed,large-scale studies with long-term follow-up are needed in the future.展开更多
Background Chemotherapy-induced peripheral neuropathy(CIPN)is a common neurotoxic reaction for patients undergoing anticancer regimens.More and more studies show that acupuncture-moxibustion plays a positive role in t...Background Chemotherapy-induced peripheral neuropathy(CIPN)is a common neurotoxic reaction for patients undergoing anticancer regimens.More and more studies show that acupuncture-moxibustion plays a positive role in the management and prevention of CIPN.Objective To evaluate the clinical effect of acupuncture-moxibustion in patients with CIPN,with a focus on assessing its effectiveness on improving treatment response rates,alleviating pain,enhancing quality of life(QoL),and improving nerve conduction.Additionally,the study compares the differences in clinical effectiveness among various acupuncture therapies for CIPN management.Methods Six databases(PubMed,Embase,Cochrane Library,Web of Science,OVID,and China National knowledge infrastructure[CNKI])were searched from earliest available dates to December 1,2024,and only randomized controlled trials(RCTs)containing relevant search terms were included.Network meta-analysis of the RCT data were conducted to assess the effective rate of the treatment as the primary outcome.Nerve conduction,pain scores,and QoL were assessed as secondary outcomes.The version 2 of the Cochrane risk-of-bias tool for randomized trials(RoB 2)was used to examine methodological quality,and Stata 15.1 was used to take network meta-analysis.Results A total of 34 RCTs involving 2039 participants and 9 acupuncture-moxibustion therapies were included.The network meta-analysis evaluated the effect of different acupuncture therapies across four outcomes:effective rate,pain scores,QoL,and nerve conduction.For effective rate,electroacupuncture combined with moxibustion ranked first with a surface under the cumulative ranking curve(SUCRA)value of 62.9%,followed by acupoint application(56.9%)and moxibustion(52.3%).Electroacupuncture combined with moxibustion had the highest effective rate compared to standard of care treatments(odds ratio[OR]=1.62,95%confidence interval[CI]−5.18 to 8.43).For alleviating pain,auricular acupressure had the highest SUCRA value(85.9%),while electroacupuncture and electroacupuncture combined with three-edged needle ranked second(63.4%)and third(51.0%),respectively.Auricular acupressure significantly reduced pain(SMD=−1.73,95%CI−3.54 to 0.08).For QoL,warming needle ranked first(SUCRA=92.0%),followed by electroacupuncture(48.7%)and filiform needle(43.0%).Warming needle significantly improved QoL scores(SMD=−0.75,95%CI−1.66 to 0.15).For nerve conduction,electroacupuncture combined with three-edged needle had the highest SUCRA value(100%),while moxibustion and filiform needle ranked second(65.3%)and third(39.2%),respectively.Electroacupuncture combined with three-edged had the best neuroprotective effect(SMD=1.85,95%CI 1.23 to 2.47).Conclusion Network meta-analysis based on the primary outcome(effective rate)suggests that electroacupuncture combined with moxibustion seems to be the optimal acupuncture therapy for chemotherapy-induced peripheral neuropathy(CIPN).Secondary outcomes exhibited considerable heterogeneity:auricular acupressure demonstrated superior efficacy in pain relief,electroacupuncture combined with three-edged needle showed greater advantages in improving nerve conduction function,while warm needling was associated with more significant improvements in QoL.Given the variability in interventions across different outcome measures and the methodological limitations of included studies,the current evidence requires cautious interpretation.Systematic review registration:Registration number in PROSPERO:CRD42024560017.展开更多
Objective To assess the efficacy and safety of treating post-stroke depression with acupuncture compared to western medicine systematically. Methods Databases were retrieved such as Cochrane Library, PubMed, Web of Si...Objective To assess the efficacy and safety of treating post-stroke depression with acupuncture compared to western medicine systematically. Methods Databases were retrieved such as Cochrane Library, PubMed, Web of Sicence, EMbase, CBM, CNKI and WanFang Data so as to look up randomized controlled trials （RCT） of treating post-stroke depression with acupuncture and western medicine, and the time limit for the retrieval spanned from the date of database established to September 2013. By extracting data and evaluating methodological quality of included studies according to inclusion and exclusion criteria, RevMan 5.2 software was applied for Meta-analysis and evidence quality was assessed by adopting the GRADE system. Results Atotal of 23 RCTs （845 patients with post-stroke depression） were included in this study. It was revealed by Meta-analysis that the differences of the two groups were statistically significant in terms of HAMD scale scores measured at the end of the treatment by comparing the treatment of acupuncture and western medicine [SMD=0.26, 95% CI （0.11, 0.40）], but via susceptibility analysis （excluding low quality studies）, the differences were not statistically significant [SMD=-0.06, 95% CI （-0.37, 0.25）], and the reliability of the results was low; in terms of adverse events, the differences were statistically significant [RR= 0.32, 95% Cl （0.19, 0.53）], and the risk of adverse events reduced by 68% in the acupuncture group. From the assessment on evidence quality grade based on GRADE system, it was revealed that HAMD scores and adverse events were evidences with fairly low quality. Conclusion Although this system assessment showed that treating post-stroke depression with acupuncture was more effective compared with western medicine, the result was less reliable and quality of evidences was poor. The above-mentioned results need more high- quality randomized controlled trials for further verification.展开更多
Background:Acupuncture therapy has shown promise for effectively relieving preoperative anxiety.Nevertheless,previous findings from randomized controlled trials(RCTs)are inconsistent and must be examined in detail.Obj...Background:Acupuncture therapy has shown promise for effectively relieving preoperative anxiety.Nevertheless,previous findings from randomized controlled trials(RCTs)are inconsistent and must be examined in detail.Objective:This study systematically evaluates the efficacy and safety of acupuncture therapy for preoperative anxiety as well as the quality of evidence supporting this application.Search strategy:The China National Knowledge Infrastructure Database,Wanfang Data Journal Database,Chinese Biomedical Literature Database,Chongqing VIP,Embase,Pub Med and Cochrane Library Databases were queried from their inception to 19,February 2020,using keywords such as“acupuncture therapy,”“preoperative”and“anxioty.”Manual searches expanded the search breadth and included conference abstracts and other reference lists.Inclusion criteria:RCTs were included in the current study if they contained a comparison between a group of anxiety patients that received acupuncture therapy and a control group that received sham acupuncture.Data extraction and analysis:Literature was reviewed,and various articles were selected using the Note Express 3.2.0 software.Two researchers independently screened and extracted data and evaluated the risk of bias in the included studies.The Rev Man 5.3 software was used for data aggregation and the Grades of Recommendation,Assessment,Development and Evaluation(GRADE)assessment was used to evaluate the quality of the study outcomes.Results:Twelve studies were included in the review,containing a total of 916 patients.Meta-analysis showed that,compared with the control group,patients who received acupuncture therapy had reduced State-Trait Anxiety Inventory Scale(STAI-S)score(mean difference[MD]=–9.07,95%confidence interval[CI][–13.19 to–4.96],P<0.0001)and Visual Analogue Scale(VAS)score(MD=–1.37,95%CI[–2.29 to–0.45],P=0.003).However,for the Hamilton Anxiety Scale(HAMA)score,there was no difference between the two groups(MD=–3.98,95%CI[–12.89 to 4.92],P=0.38).Further,the GRADE assessment demonstrated that the STAI-S was of moderate quality,the VAS of low quality and the HAMA of very low quality.Conclusion:Acupuncture therapy may be able to decrease anxiety in preoperative patients,but the results need to be further verified due to the small sample sizes and the low quality of evidence to date.展开更多
Acupuncture has reportedly improved memory and cognitive impairment in both animal and clinical studies. It may be an effective treatment for Alzheimer's disease (AD). The purpose of this meta-analysis was to revi...Acupuncture has reportedly improved memory and cognitive impairment in both animal and clinical studies. It may be an effective treatment for Alzheimer's disease (AD). The purpose of this meta-analysis was to review the effectiveness of acupuncture for the treatment of AD. Eight databases were searched for articles published up to and including July 2017, and 13 studies fulfilling the inclusion criteria were identified. The main outcomes assessed were clinical efficacy rate, Mini-Mental State Examination score, Ability of Daily Living Scale score, Alzheimer's Disease Assessment Scale-Cognition score, Hasegawa's Dementia Scale (HDS) score, and adverse events. The methodological quality of the articles was assessed using Cochrane's risk of bias. All the studies compared the efficacy of acupuncture with that of medication, and were published in Chinese journals. Meta-analysis revealed that acupuncture yielded positive results as determined via all the indexes scored except the HDS (95% CI -0.26 to 0.90, Z=0.35, P=0.73). Only one of the studies reported adverse events associated with acupuncture and medication. The rate of adverse events in the medication group was 13%. In most of the studies assessed in the current metaanalysis, acupuncture alone was better than conventional western medicines for the treatment of AD.展开更多
BACKGROUND Functional dyspepsia(FD)is a common digestive disease with limited therapeutic options.According to evidence-based clinical practice,acupuncture or electroacupuncture(EA)seems to be a promising therapy for ...BACKGROUND Functional dyspepsia(FD)is a common digestive disease with limited therapeutic options.According to evidence-based clinical practice,acupuncture or electroacupuncture(EA)seems to be a promising therapy for patients with FD.However,there is still a lack of systematic reviews that have analyzed current clinical trials for a better understanding of mechanisms involved in the ameliorating effect of acupuncture and EA on FD.AIM To evaluate the results and qualities of existing clinical evidence for researching the underlying mechanisms of acupuncture/EA in treating FD.METHODS A systematic search of the literature was performed to identify randomized controlled trials in which research on the mechanism of acupuncture or EA was conducted in FD patients.Databases searched included PubMed,EMBASE,Cochrane Library,and Web of Science.Data extraction and quality assessment were completed by two investigators independently and the results of quality evaluation were exported through Review Manager V5.3.RESULTS Eight studies were included in this review with a total of 17 items for detecting techniques for mechanistic research.Positive effects of acupuncture and EA were observed in regulating gastric motility,gastric accommodation,mental status,gastrointestinal hormones,and central and autonomic functions while improving dyspeptic symptoms and quality of life.CONCLUSION The key findings of this systematic review support the potential of acupuncture and EA in altering the heterogeneous pathophysiology in patients with FD.However,high-quality studies with well-planned designs are necessary to provide more credible evidence.展开更多
The purpose of this work was to assess the evidence for effectiveness of acupuncture （AC） treatment in gastrointestinal diseases. A systematic review of the Medline-cited literature for clinical trials was performed...The purpose of this work was to assess the evidence for effectiveness of acupuncture （AC） treatment in gastrointestinal diseases. A systematic review of the Medline-cited literature for clinical trials was performed up to May 2006. Controlled trials assessing acupuncture point stimulation for patients with gastrointestinal diseases were considered for inclusion. The search identified 18 relevant trials meeting the inclusion criteria. Two irritable bowel syndrome （IBS） trials, 1 Crohn＇s disease and 1 colitis ulcerosa trial had a robust random controlled trial （RCT） design. In regard to other gastrointestinal disorders, study quality was poor. In all trials, quality of life （QoL） improved significantly independently from the kind of acupuncture, real or sham. Real AC was significantly superior to sham acupuncture with regard to disease activity scores in the Crohn and Colitis trials. Efficacy of acupuncture related to QoL in IBS may be explained by unspecific effects. This is the same for QoL in inflammatory bowel diseases （IBD）, whereas specific acupuncture effects may be found in clinical scores. Further trials for IBDs and in particular for all other gastrointestinal disorders would be necessary to evaluate the efficacy of acupuncture treatment. However, it must be discussed on what terms patients benefit when this harmless and obviously powerful therapy with regard to QoL is demystified by further placebo controlled trials.展开更多
OBJECTIVE: To investigate the effects of combined acupuncture and eugenol on learning-memory ability and the antioxidation system of the hippocampus in Alzheimer disease (AD) rats. METHODS: Sixty Sprague Dawley rats, ...OBJECTIVE: To investigate the effects of combined acupuncture and eugenol on learning-memory ability and the antioxidation system of the hippocampus in Alzheimer disease (AD) rats. METHODS: Sixty Sprague Dawley rats, weighing (300±10) g, were randomly divided with 10 rats per group into a normal control group, AD model group, AD with cut olfactory nerve group, Xiu three-needle group, eugenol group, and combined acupuncture and eugenol group. The AD model was established by injection of amyloid β1-40 (Aβ 1-40). Morris maze tests were conducted for evaluating the learning-memory ability. Content of malo- ndialdehyde (MDA) and activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in the hippocampus were detected. RESULTS: The average escape latency and the mean swimming distance in the normal control group, the Xiu three-needle group, the eugenol group, and the combined acupuncture and euge-nol group were significantly shorter than those in the AD model group (all P<0.01). The combined acupuncture and eugenol group had shorter escape latency and mean swimming distance than those in the Xiu three-needle group and the eugenol group. There were no significant differences between the Xiu three-needle group and the eugenol group and between the AD group and the AD with cut olfactory nerve group (P>0.05). Compared with the normal control group, the MDA content in the hippocampus significantly increased (P<0.05) and GSH-Px and SOD activities significantly decreased in the AD model group (P<0.01). Compared with the AD model group, significantly decreased (P< 0.01) and SOD and GSH-Px activities significantly increased in the Xiu three-needle group, eugenol group, and combined acupuncture and eugenol group (P<0.05). Compared with the Xiu three-needle group and eugenol group, the MDA content significantly decreased (P<0.05) and SOD and GSH-Px activities increased (P<0.05) in the combined acupuncture and eugenol group. There were no significant differences among the three indices between the Xiu three-needle group and the eugenol group and between the AD model group and the AD with cut olfactory nerve group (P>0.05). CONCLUSION: Both Xiu three-needle and eugenol can increase learning-memory ability, decrease MDA content, and increase SOD and GSH-Px activities in the hippocampus in AD rats. The combination of acupuncture with eugenol has stronger effects, and the effects depend on the olfactory pathway.展开更多
OBJECTIVE： To assess the effectiveness and safety of acupuncture therapy for angina pectoris. METHODS： Randomized controlled trials （RCTs） concerned with acupuncture treatment of angina pectoris were identified by...OBJECTIVE： To assess the effectiveness and safety of acupuncture therapy for angina pectoris. METHODS： Randomized controlled trials （RCTs） concerned with acupuncture treatment of angina pectoris were identified by searching Academic Source Premier, MEDLINE, Science Citation Index Expanded, and three Chinese databases （China biol- ogy medicine database, China national knowledge infrastructure, and VlP database for Chinese techni- cal periodicals）. The valid data were extracted in ac- cordance with our inclusion and exclusion criteria. The main outcomes of the included studies were synthesized using Revman 5.1. RESULTS： Twenty-one articles on 16 individual studies were included and evaluated as having high or moderate risk of bias according to the stan- dards of the Cochrane Collaboration. Meta-analysis indicated that acupuncture combined with conven- tional drugs （ACCD） was superior to conventional drugs alone in reducing the incidence of acute myocardial infarction （AMI） [0R=0.18, 95%CI （0.04,0.84）, P=0.03]. Moreover, ACCD was superior to con- ventional drugs in the relief of angina symptoms [0R=4.23, 95%C/（2.73, 6..56）, P〈0.00001], and im- provement of electrocardiography （ECG） [0R=2.61, 95%C/（1.83, 3.73）, P〈0.00001]. Acupuncture by it- self was also superior to conventional drugs for angi- na symptoms [0R=3.59, 95%C/（1.76, 7.92）, P=0.0004] and ECG improvement [0R=3.07, 95%C/（1.54, 6.10）, P=0.001]. ACCD was superior to conventional drugs in shortening the time to onset of angina relief [WMD=-1.40, 95% CI （-1.65, -1.15）, P〈 0.00001]. However, the time to onset was signifi- cantly longer for acupuncture treatment than for conventional treatment alone [WMD=2A3, 95%O （1.63, 3.23）, P〈0.000 01]. CONCLUSION： ACCD reduced the occurrence of AMI, and both acupuncture and ACCD relieved an- gina symptoms and improved ECG. However, com- pared with conventional treatment, acupuncture showed a longer delay before its onset of action. This indicates that acupuncture is not suitable for emergency treatment of heart attack. Owing to the poor quality of the current evidence, the findings of this systematic review need to be verified by more RCTs to enhance statistical power.展开更多
OBJECTIVE:To evaluate the efficacy and safety of acupuncture and moxibustion therapy(AMT) for cancerrelated psychological symptoms(CRPS) of insomnia,depression and anxiety.METHODS:Seven databases were searched for ran...OBJECTIVE:To evaluate the efficacy and safety of acupuncture and moxibustion therapy(AMT) for cancerrelated psychological symptoms(CRPS) of insomnia,depression and anxiety.METHODS:Seven databases were searched for randomized controlled trials(RCT) comparing AMT to routine care or conventional drug for alleviating CRPS of insomnia,depression,and anxiety before April 2020.Two independent reviewers performed the data extraction and assessed the risk of bias.RESULTS:A total of 30 RCTs involving 2483 cancer patients were enrolled.The pooled analysis indicated that the treatment group was significantly better than the control group in improving the depression effective rate [RR = 1.29,95% CI(1.12,1.49),P = 0.0004],the quality of life(QOL) [MD = 1.11,95% CI(0.80,1.42),P < 0.000 01],and reducing Self-rating Anxiety Scale(SAS) [MD =﹣7.75,95% CI(﹣10.44,﹣5.05),P < 0.000 01].But there was no statistically significant difference between two groups in improving the insomnia effective rate [RR = 1.18,95% CI(0.93,1.51),P = 0.18].The subgroup analysis showed the effectiveness of different intervention on CRPS.Compared with routine care,AMT helps relieve CRPS better evaluated by Pittsburgh Sleep Quality Index(PSQI),Hamilton Depression Scale(HAMD),and Self-rating Depression Scale(SDS),and depression effective rate.Compared with conventional drug,AMT performs better evaluated by SDS,depression effective rate and QOL.Moreover,the conventional drug showed higher treatment efficacy on improving insomnia effective rate compared with AMT.Compared to conventional drug,AMT plus conventional drug resulted in a significant reduction on CRPS such as PSQI,HAMD,SDS,and SAS,and also had a meaningful improvement on insomnia effective rate,depression effective rate and QOL.Fewer published reports were found on the adverse events of AMT than the conventional drug.CONCLUSION:The results suggested that AMT might be effective in improving CPRI;however,a definite conclusion could not be drawn because the quality of trials are low.Further large-scale and high-quality RCTs to verify the efficacy and safety of AMT on CRPS are still warranted.展开更多
Background: Some depressed patients receive acupuncture as an adjunct to their conventional medications.Objective: This review aims to provide evidence on whether acupuncture can enhance the therapeutic effectiveness ...Background: Some depressed patients receive acupuncture as an adjunct to their conventional medications.Objective: This review aims to provide evidence on whether acupuncture can enhance the therapeutic effectiveness of antidepressants for treating depression, and explore whether acupuncture can reduce the adverse reactions associated with antidepressants.Search strategy: English and Chinese databases were searched for randomized controlled trials(RCTs)published until December 1, 2021.Inclusion criteria: RCTs with a modified Jadad scale score ≥ 4 were included if they compared a group of participants with depression that received acupuncture combined with antidepressants with a control group that received antidepressants alone.Data extraction and analysis: Meta-analysis was performed, and statistical heterogeneity was assessed based on Cochran’s Q statistic and its related P-value. Primary outcomes were the reduction in the severity of depression and adverse reactions associated with antidepressants, while secondary outcomes included remission rate, treatment response, social functioning, and change in antidepressant dose.The Grading of Recommendations Assessment, Development and Evaluation(GRADE) framework was used to evaluate the overall quality of evidence in the included studies.Results: This review included 16 studies(with a total of 1958 participants). Most studies were at high risk of performance bias and at low or unclear risk of selection bias, detection bias, attrition bias, reporting bias, and other bias. Analysis of the 16 RCTs showed that, compared with antidepressants alone, acupuncture along with antidepressants reduced the Hamilton Depression Rating Scale-17(HAMD-17) scores(standard mean difference [SMD]-0.44, 95% confidence interval [CI]-0.55 to-0.33, P < 0.01;I^(2)= 14%), Self-rating Depression Scale(SDS) scores(SMD-0.53, 95% CI-0.84 to-0.23, P < 0.01;I^(2)= 79%), and the Side Effect Rating Scale(SERS) scores(SMD-1.11, 95% CI-1.56 to-0.66, P < 0.01;I^(2)= 89%). Compared with antidepressants alone, acupuncture along with antidepressants improved World Health Organization Quality of Life-BREF scores(SMD 0.31, 95% CI 0.18 to 0.44, P < 0.01;I^(2)= 15%), decreased the number of participants who increased their antidepressant dosages(relative risk[RR] 0.32, 95% CI 0.22 to 0.48, P < 0.01;I^(2)= 0%), and resulted in significantly higher remission rates(RR1.52, 95% CI 1.26 to 1.83, P < 0.01;I^(2)= 0%) and treatment responses(RR 1.35, 95% CI 1.24 to 1.47, P < 0.01;I^(2)= 19%) in terms of HAMD-17 scores. The HAMD-17, SDS and SERS scores were assessed as low quality by GRADE and the other indices as being of moderate quality.Conclusion: Acupuncture as an adjunct to antidepressants may enhance the therapeutic effectiveness and reduce the adverse drug reactions in patients receiving antidepressants. These findings must be interpreted with caution, as the evidence was of low or moderate quality and there was a lack of comparative data with a placebo control.Systematic review registration: INPLASY202150008.展开更多
OBJECTIVE: To evaluate the clinical effectiveness and safety of acupoint catgut embedding and acupuncture on simple obesity by Meta-analysis. METHODS: Studies on clinical randomized controlled trials of acupoint catgu...OBJECTIVE: To evaluate the clinical effectiveness and safety of acupoint catgut embedding and acupuncture on simple obesity by Meta-analysis. METHODS: Studies on clinical randomized controlled trials of acupoint catgut embedding for simple obesity which were published from January 2015 to November 2020 were searched in Cochrane Central Register of Control Trials(Central), Pub Med, China Science and Technology Journal Database, China National Knowledge Infrastructure Database and Wanfang databases. And those that met the inclusion criteria were screened. Rev Man5.3 was used for Meta-analysis. The “Risk of Bias” tool was used to evaluate the quality of included studies. R studio software was used for the measurement of publication bias. RESULTS: A total of 33 studies were included for Metaanalysis, including 2685 patients with simple obesity. Meta-analysis results showed the comparison of effectiveness rate was relative risk(RR) = 1.12, 95%CI(1.08, 1.16), body mass index(BMI) was mean difference(MD) =-1.12, 95%CI(-2.09,-0.14), waist circumference was MD =-2.14, 95%CI(-4.22,-0.06), and body mass was MD =-2.36, 95%CI(-3.99,-0.73). On the basis of diet and exercise intervention, the effectiveness rate [RR = 1.12, 95%CI(1.05, 1.19)], BMI [MD =-0.88, 95%CI(-1.35,-0.40)], waist circumference [MD =-1.10, 95%CI(-4.27, 2.07)], and body mass [MD =-0.68, 95%CI(-2.90, 1.54)]. The risk of bias of included literatures was low. CONCLUSIONS: Acupoint catgut embedding therapy was slightly better than acupuncture therapy in most of the outcomes. Moreover, the treatment frequency of acupoint catgut embedding is less with larger stimulation intensity, which is more conducive to clinical promotion.展开更多
基金Modernization of Traditional Chinese Medicine Project of National Key R&D Program of China:The construction of the theoretical system of Traditional Chinese Medicine nonpharmacological therapy based on body surface stimulation(2023YFC3502704)Sichuan Provincial Science and Technology Program Project:Research and Development of Chinese Medicine Intelligent Tongue Diagnosis Equipment for Digestive System Chinese Medicine Advantageous Diseases(2023YFS0327)+2 种基金Research and Development of Chinese Medicine Intelligent Detection System for Intestinal Functions(2024YFFK0044)Research and Application of Chinese Medicine Diagnosis and Treatment Program for Herpes Zoster Treated by Shu Pai Fire Acupuncture(2024YFFK0089)Major Research and Development Project of The China Academy of Chinese Medical Sciences Innovation:Construction and application of the theoretical research mode of Traditional Chinese Medicine diagnosis and treatment of modern diseases(CI2021A00104)。
文摘OBJECTIVE:To propose an automatic acupuncture robot system for performing acupuncture operations.METHODS:The acupuncture robot system consists of three components:automatic acupoint localization,acupuncture manipulations,and De Qi sensation detection.The OptiTrack motion capture system is used to locate acupoints,which are then translated into coordinates in the robot control system.A flexible collaborative robot with an intelligent gripper is then used to perform acupuncture manipulations with high precision.In addition,a De Qi sensation detection system is proposed to evaluate the effect of acupuncture.To verify the stability of the designed acupuncture robot,acupoints'coordinates localized by the acupuncture robot are compared with the Gold Standard labeled by a professional acupuncturist using significant level tests.RESULTS:Through repeated experiments for eight acupoints,the acupuncture robot achieved a positioning error within 3.3 mm,which is within the allowable range of needle extraction and acupoint insertion.During needle insertion,the robot arm followed the prescribed trajectory with a mean deviation distance of 0.02 mm and a deviation angle of less than 0.15°.The results of the lifting thrusting operation in the Xingzhen process show that the mean acupuncture depth error of the designed acupuncture robot is approximately 2 mm,which is within the recommended depth range for the Xingzhen operation.In addition,the average detection accuracy of the De Qi keywords is 94.52%,which meets the requirements of acupuncture effect testing for different dialects.CONCLUSION:The proposed acupuncture robot system streamlines the acupuncture process,increases efficiency,and reduces practitioner fatigue,while also allowing for the quantification of acupuncture manipulations and evaluation of therapeutic effects.The development of an acupuncture robot system has the potential to revolutionize low back pain treatment and improve patient outcomes.
基金the Study on the Mechanism of Action of Dutong and Tiaoshen Acupuncture in Improving Upper Limb Motor Function After Ischemic Stroke based on Functional Near-infrared Spectroscopy Technology(Science and Technology Program of Panyu,2022-Z04-107)。
文摘OBJECTIVE:To take Baihui(GV20)and Fengchi(GB20)targeting inflammatory response to regulate migraine as an example to describe a new method for studying the mechanism of stimulating acupoints.METHODS:The target information of Baihui(GV20)and Fengchi(GB20)was retrieved,and after intersection with migraine,Kyoto Encyclopedia of Genes and Genomes(KEGG),Reactome,and Uni Prot Keywords were used for functional enrichment.After selecting the main pathway,rats were selected and nitroglycerin was used for modeling,and the behavioral scores,inflammatory factors,heme oxygenase 1(HMOX1),protein kinase B(AKT1),signal transducer and activator of transcription 3(STAT3),phosphorylated extracellular signal-regulated kinase 1/2(P-ERK1/ERK2)and other states of the rats in the acupuncture,twisting,and electroacupuncture groups were compared.RESULTS:A total of 135 Baihui(GV20)targets and 27 Fengchi(GB20)targets were collected.A total of 73 target information were obtained after the intersection of these targets in migraine.These 73 targets have three main pathways:hypoxia-inducible factor 1(HIF-1)signaling pathway,signaling by interleukins and inflammatory response.The main targets in the pathway were verified and found that interleukin-1 beta(IL-1β),interleukin-6(IL-6),tumor necrosis factor-alpha(TNF-α)and HMOX1,AKT1,STAT3,P-ERK1/ERK2 can be regulated by Baihui(GV20)and Fengchi(GB20).CONCLUSION:Baihui(GV20)and Fengchi(GB20)can regulate migraine by regulating inflammatory factors and HMOX1,AKT1,STAT3,P-ERK1/ERK2 and other changes in HIF-1 signaling pathway,Signaling by Interleukins and Inflammatory response pathways.Based on systems biology and network pharmacology,and with the model of"acupoint-target-disease",explore the research methods of systematic acupuncture and moxibustion.We believe this is a usable research direction for exploring the mechanism of acupuncture stimulation.
基金Supported by WFAS 2023 International Standard Project of Acupuncture-Moxibustion:WFASRP2023-SC05Tianjin Nankai District Pilot Demonstration Project for Integrated Inheritance and Innovation of Traditional Chinese Medicine:20250102001Beijing Natural Science:7252224。
文摘Objective:In this study,we evaluated the methodological quality of systematic reviews on acupuncture and moxibustion for the prevention and management of cancer-related conditions,aiming to provide evidence-based support and establish levels of evidence for clinical application.Method:A comprehensive search was conducted to identify systematic reviews on acupuncture and mox-ibustion for the prevention and management of cancer-related conditions,covering databases including PubMed,Embase,Cochrane Library,Web of Science,China National Knowledge Infrastructure,Chinese Biomedical Databases,China Science and Technology Journal Database,and Wanfang Data,from their in-ception to August 1,2024.The methodological quality of the included systematic reviews was assessed by using AMSTAR 2,and bubble plots were employed to visualize the evidence.Results:Overall,137 systematic reviews were included,with China being the most prolific country,with 117 reviews.These reviews addressed 21 cancer-related conditions,with the three most frequently stud-ied being cancer-related fatigue(25 reviews),nausea and vomiting(20 reviews),and cancer pain(19 re-views).The three most commonly used acupuncture modalities were manual acupuncture(81 reviews),electroacupuncture(55 reviews),and moxibustion(39 reviews).Quality assessment revealed that one systematic review was rated as“high quality,”eight as“low quality,”and 128 as“critically low quality,”primarily due to the absence of protocol registration and lists of excluded studies.Conclusion:Acupuncture and moxibustion have shown potential efficacy in alleviating cancer-related con-ditions and treatment-related adverse effects,and their clinical use has been widely reported.However,the overall methodological quality of the included systematic reviews was low,limiting the reliability and the strength of the evidence.Future high-quality studies are needed to improve the quality of evidence and support the standardized application and broader promotion of acupuncture and moxibustion clinical practice.
基金supported by grants from the National Natural Science Foundation of China(82405192)the Capital’s Funds for Health Improvement and Research(CFH 2022-2-20213,CFH 2022-1-2021)+1 种基金the project of"Friendship Seed Plan"Talent Project of Beijing Friendship Hospital,Capital Medical University(YYZZ202333)Beijing key project of major disease by Chinese medicine and Western medicine(Fatty liver,No.2023BJSZDYNJBXTGG-017)。
文摘Background:Acupuncture has shown potential therapeutic benefits for individuals with simple obesity.However,some researchers argue that some of the effectiveness of acupuncture may be due to the placebo response.Objective:To understand the placebo response of acupuncture treatment in simple obesity,a systematic review and meta-analysis was designed based on the comparison between sham acupuncture before and after treatment.Search strategy:Eight databases(Pub Med,Web of Science,Cochrane Library,Embase,China National Knowledge Infrastructure,Wanfang Database,China Biology Medicine Database,and Chinese Scientific Journals Database)were searched from inception to August 1,2023.The Me SH search terms comprised obesity and acupuncture.Inclusion criteria:Randomized controlled trials(RCTs)using sham or placebo acupuncture as a control in treating obesity were enrolled.Data extraction and analysis:Two researchers independently extracted data,and the results were crosschecked after completion.Each RCT’s detailed sham/placebo acupuncture treatment protocol was assessed according to the SHam Acupuncture REporting guidelines.The revised Cochrane risk-of-bias tool for randomized trials and the Grading of Recommendations Assessment,Development,and Evaluation(GRADE)system were used to determine the risk of bias and quality of evidence,respectively.Body mass index(BMI)was defined as the primary outcome.Anthropometric parameters and laboratory test parameters related to obesity were defined as secondary outcomes.We used standardized mean difference(SMD)with 95%confidence interval(CI)to calculate treatment effects of outcomes.Results:Fifteen RCTs with a total of 1250 patients were included.The BMI significantly decreased after treatment in the sham acupuncture group compared to baseline(SMD 0.37,95%CI 0.09–0.66;I2=81%,random model;P<0.01).Treatment duration(P=0.02)and other interventions significantly impacted the placebo response rate(P=0.00).Conclusion:The placebo response of sham acupuncture was strong in the RCTs for simple obesity,and the effect sizes differed between various outcomes.The treatment duration and other interventions emerged as potential influencing factors for the placebo response of sham acupuncture.
基金supported by the social development project of the National Social Science Fund Project(No.17BTQ063)National Natural Science Foundation of China(72174094).
文摘Stroke,which is the second leading cause of mortality worldwide and the third leading cause of death and disability combined,[1]necessitates cost-effective rehabilitation interventions.Acupuncture is a traditional Chinese medicine therapy that is increasingly recognized as a complementary stroke therapy.
文摘Background:Acupuncture is widely used in modulating brain excitability and motor function,as a form of complementary and alternative medicine.However,there is no existing meta-analysis evaluating the effectiveness and safety of acupuncture on corticospinal excitability(CSE),and the credibility of the evidence has yet to be quantified.Objective:This study was designed to assess the efficacy and safety of electroacupuncture(EA)and manual acupuncture(MA)in enhancing brain excitability,specifically focusing on CSE as measured by transcranial magnetic stimulation(TMS).Search strategy:This study followed a systematic approach,searching 9 databases up to August 2024 and examining grey literature,in compliance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Inclusion criteria:Studies were included if they compared the clinical efficacy of EA or MA with sham acupuncture,no treatment or usual training.Data extraction and analysis:Three investigators independently conducted literature screening,data extraction,and risk of bias assessment.The primary outcome focused on motor-evoked potentials as measured by TMS,with treatment effects quantified using mean differences or standardized mean differences between pre-and post-treatment.Subgroup analyses were conducted using mixed-effects models,while random-effects or fixed-effects models were used to estimate average treatment differences across studies.Results:Based on 34 studies involving 1031 adults,acupuncture techniques significantly enhanced CSE.EA had a greater impact than MA,with effect sizes of 0.53 mV vs 0.43 mV(95%confidence interval[CI]:[0.30,0.76],P<0.00001 vs 95%CI:[0.28,0.59],P<0.00001).The 5 most frequently used acupoints were LI4(Hegu,32 times),ST36(Zusanli,10 times),LI11(Quchi,7 times),TE5(Waiguan,6 times),and GB34(Yanglingquan,5 times).Conclusion:This systematic review indicates that both EA and MA could effectively and safely enhance CSE,bringing the corticospinal pathway closer to the threshold for firing,which may ultimately improve motor function.LI4,ST36,LI11,TE5 and GB34 are the most commonly used acupoints.
文摘Background Temporomandibular disorders(TMD)are the leading cause of chronic orofacial pain,which significantly affects patients’quality of life.However,the efficacy of acupuncture in the management of TMD remains unclear.Objective This systematic review aimed to conduct a PRISMA-compliant review to critically assess the therapeutic efficacy of acupuncture as an intervention for patients with TMD.Methods We searched nine electronic databases for randomized controlled trials on acupuncture for TMD published up to February 4,2025.Eligible studies included adults diagnosed with TMD and compared acupuncture(manual,electroacupuncture,warm,auricular,thread-embedding,or laser)with conservative treatment(positive control)or sham acupuncture(negative control).Outcomes included pain intensity,mouth opening,pressure pain threshold,and adverse events.Risk of bias was assessed using ROB 2,and certainty of evidence was evaluated using GRADE.All outcome data were analyzed using RevMan 5.4 software.Low heterogeneity was defined as I^(2)≤50% and P≥0.1,in which case a fixed-effects model was applied.High heterogeneity(I^(2)>50% or P<0.1)prompted further analysis to identify its source.After excluding the influence of evident heterogeneity,a random-effects model was used for the meta-analysis.Results Of the 2664 screened records,14 randomized controlled trials involving 476 participants met the inclusion criteria.Acupuncture significantly reduced pain intensity compared with that of negative controls(MD=-1.75,95%confidence interval[CI]-2.47 to-1.03;P<0.00001;I^(2)=60%)but showed no difference compared with that of positive controls(MD=-0.06,95%CI-0.62 to 0.50;P=0.83;I^(2)=0%).No significant differences were observed in pain-free jaw opening,whereas acupuncture improved maximum mouth opening relative to negative controls(MD=1.80,95%CI 1.62 to 1.97;P<0.00001;I^(2)=0%).For pressure pain threshold,two small studies suggested greater increases with acupuncture.Safety data were limited,with only one trial reporting mild adverse events in the acupuncture group.Conclusion Based on limited evidence,acupuncture appears superior to negative controls in relieving pain associated with TMD but shows no significant advantage over positive controls.The certainty of the evidence for all outcomes,as assessed by GRADE,was low or very low.Therefore,these findings should be interpreted with caution.Future high-quality randomized controlled trials are warranted to further evaluate the role of acupuncture in the management of patients with TMD.
基金supported by the National Key R&D Program of China(2019YFC1712200-2019YFC1712204)the National Natural Science Foundation of China(82004467,82030125)the Youth Project of Traditional Chinese Medicine-Integration of Traditional and Western Medicine Projects of Tianjin Health Commission(No.2025027).
文摘Objective:Breast cancer is the second most prevalent cause of mortality in women and the predominant malignancy type.However,breast cancer treatment faces challenges in managing aromatase inhibitor-induced arthralgia.Aromatase inhibitors have been shown to decrease recurrence risk in hormone receptor-positive cases;however,joint discomfort remains the primary adverse effect.Randomized clinical trials have evaluated the therapeutic outcomes of acupuncture for medication-related musculoskeletal complications.This comprehensive analysis sought to elucidate both the therapeutic efficacy and placebo responses associated with acupuncture intervention.Methods:Two reviewers searched for randomized controlled trials(RCTs)in four English(PubMed,Embase,Web of Science,and the Cochrane Library)and four Chinese databases(CNKI,Wanfang Database,VIP,and SinoMed)from their inception to May 31,2024.Methodological quality was assessed using the Cochrane risk of bias tool.Data were synthesized using random effects models and presented with forest plots.Results:Seven trials involving 604 patients were included.The primary outcome and Brief Pain Inventory(BPI)score differed between the acupuncture and control groups(sham acupuncture or usual medication)in three subscales over the course of 6 weeks:worst pain:standardized mean difference(SMD)=-1.18,95%confidence interval(CI):-1.74,-0.63,P<0.001;painrelated interference:SMD=-0.87,95%CI:-1.70,-0.05,P=0.038;pain severity:SMD=-0.63,95%CI:-1.22,-0.04,P=0.036.No severe adverse events were reported in any study.Conclusions:This meta-analysis showed that acupuncture is a safe and effective treatment for patients with breast cancer with aromatase inhibitor-induced arthralgia during the course of 6 weeks.Improvements in the blinding method and clarification of the total treatment recommendations and intervals need to be explored further.
基金supported by the National Natural Science Foundation of China(No.82474644)the National Key R&D Foundation of China(No.2017YFC1703600)+1 种基金the Shenzhen“Sanming Project”(No.202101007)the Shenzhen Science and Technology Program(No.JCYJ2022081810080300)。
文摘Background:Acupuncture therapy provides a complementary and alternative approach to treating major depressive disorder(MDD),but its efficacy and safety have still not been comprehensively assessed.Recently published systematic reviews remain confusing and inconclusive.Objective:This systematic review evaluated the efficacy and safety of acupuncture therapy alone or combined with antidepressants for adult patients with mild and moderate MDD.Search strategy:Chinese Biomedical Literature Database,China National Knowledge Infrastructure Database,Wanfang Database,Chinese Science and Technology Journal Database,Pub Med,Embase,and Cochrane Library were searched from their inceptions to March 2025.Inclusion criteria:Randomized controlled trials that compared acupuncture therapy with antidepressants,or acupuncture therapy plus antidepressants with acupuncture therapy or antidepressants for adult patients with mild and moderate MDD were included.Data extraction and analysis:Five reviewers independently extracted data from original literature using a standardized form,and the data were verified by two reviewers to ensure accuracy.Statistical meta-analyses,publication bias analyses,and subgroup analyses were performed by using Review Manager 5.3 software.The Grading of Recommendations Assessment,Development,and Evaluation approach was used to assess the certainty of the evidence.Results:A total of 60 eligible studies including 4675 participants were included.Low-certainty evidence showed that compared with antidepressants,acupuncture therapy(standardized mean difference[SMD]=-0.57;95%confidence interval[CI]=[-0.87,-0.27];I^(2)=86%;P=0.006)or acupuncture therapy plus antidepressants(SMD=-1.00;95%CI=[-1.18,-0.81];I^(2)=77%;P<0.00001)may reduce the severity of depression at the end of treatment.Low-certainty evidence indicated that compared with acupuncture therapy alone,acupuncture therapy plus antidepressants slightly reduced the severity of depression at the end of treatment(SMD=-0.38;95%CI=[-0.61,-0.14];I^(2)=18%;P=0.002).Similar results were also found for acupuncture's relief of insomnia.The reported adverse effects of acupuncture therapy were mild and transient.For most of the subgroup analyses,acupuncture type,scale type,and the course of treatment did not show a significant relative effect.Conclusion:Acupuncture therapy may provide antidepressant effects and relieve insomnia with mild adverse effects for adult patients with mild and moderate MDD.But the certainty of evidence was very low.More high-quality,well designed,large-scale studies with long-term follow-up are needed in the future.
基金Supported by National Key Research and Development Program of China:2022YFC3500701。
文摘Background Chemotherapy-induced peripheral neuropathy(CIPN)is a common neurotoxic reaction for patients undergoing anticancer regimens.More and more studies show that acupuncture-moxibustion plays a positive role in the management and prevention of CIPN.Objective To evaluate the clinical effect of acupuncture-moxibustion in patients with CIPN,with a focus on assessing its effectiveness on improving treatment response rates,alleviating pain,enhancing quality of life(QoL),and improving nerve conduction.Additionally,the study compares the differences in clinical effectiveness among various acupuncture therapies for CIPN management.Methods Six databases(PubMed,Embase,Cochrane Library,Web of Science,OVID,and China National knowledge infrastructure[CNKI])were searched from earliest available dates to December 1,2024,and only randomized controlled trials(RCTs)containing relevant search terms were included.Network meta-analysis of the RCT data were conducted to assess the effective rate of the treatment as the primary outcome.Nerve conduction,pain scores,and QoL were assessed as secondary outcomes.The version 2 of the Cochrane risk-of-bias tool for randomized trials(RoB 2)was used to examine methodological quality,and Stata 15.1 was used to take network meta-analysis.Results A total of 34 RCTs involving 2039 participants and 9 acupuncture-moxibustion therapies were included.The network meta-analysis evaluated the effect of different acupuncture therapies across four outcomes:effective rate,pain scores,QoL,and nerve conduction.For effective rate,electroacupuncture combined with moxibustion ranked first with a surface under the cumulative ranking curve(SUCRA)value of 62.9%,followed by acupoint application(56.9%)and moxibustion(52.3%).Electroacupuncture combined with moxibustion had the highest effective rate compared to standard of care treatments(odds ratio[OR]=1.62,95%confidence interval[CI]−5.18 to 8.43).For alleviating pain,auricular acupressure had the highest SUCRA value(85.9%),while electroacupuncture and electroacupuncture combined with three-edged needle ranked second(63.4%)and third(51.0%),respectively.Auricular acupressure significantly reduced pain(SMD=−1.73,95%CI−3.54 to 0.08).For QoL,warming needle ranked first(SUCRA=92.0%),followed by electroacupuncture(48.7%)and filiform needle(43.0%).Warming needle significantly improved QoL scores(SMD=−0.75,95%CI−1.66 to 0.15).For nerve conduction,electroacupuncture combined with three-edged needle had the highest SUCRA value(100%),while moxibustion and filiform needle ranked second(65.3%)and third(39.2%),respectively.Electroacupuncture combined with three-edged had the best neuroprotective effect(SMD=1.85,95%CI 1.23 to 2.47).Conclusion Network meta-analysis based on the primary outcome(effective rate)suggests that electroacupuncture combined with moxibustion seems to be the optimal acupuncture therapy for chemotherapy-induced peripheral neuropathy(CIPN).Secondary outcomes exhibited considerable heterogeneity:auricular acupressure demonstrated superior efficacy in pain relief,electroacupuncture combined with three-edged needle showed greater advantages in improving nerve conduction function,while warm needling was associated with more significant improvements in QoL.Given the variability in interventions across different outcome measures and the methodological limitations of included studies,the current evidence requires cautious interpretation.Systematic review registration:Registration number in PROSPERO:CRD42024560017.
基金Supported by Special Project for Practice Development of National TCM Clinical Research Bases:JDZX 2012154
文摘Objective To assess the efficacy and safety of treating post-stroke depression with acupuncture compared to western medicine systematically. Methods Databases were retrieved such as Cochrane Library, PubMed, Web of Sicence, EMbase, CBM, CNKI and WanFang Data so as to look up randomized controlled trials （RCT） of treating post-stroke depression with acupuncture and western medicine, and the time limit for the retrieval spanned from the date of database established to September 2013. By extracting data and evaluating methodological quality of included studies according to inclusion and exclusion criteria, RevMan 5.2 software was applied for Meta-analysis and evidence quality was assessed by adopting the GRADE system. Results Atotal of 23 RCTs （845 patients with post-stroke depression） were included in this study. It was revealed by Meta-analysis that the differences of the two groups were statistically significant in terms of HAMD scale scores measured at the end of the treatment by comparing the treatment of acupuncture and western medicine [SMD=0.26, 95% CI （0.11, 0.40）], but via susceptibility analysis （excluding low quality studies）, the differences were not statistically significant [SMD=-0.06, 95% CI （-0.37, 0.25）], and the reliability of the results was low; in terms of adverse events, the differences were statistically significant [RR= 0.32, 95% Cl （0.19, 0.53）], and the risk of adverse events reduced by 68% in the acupuncture group. From the assessment on evidence quality grade based on GRADE system, it was revealed that HAMD scores and adverse events were evidences with fairly low quality. Conclusion Although this system assessment showed that treating post-stroke depression with acupuncture was more effective compared with western medicine, the result was less reliable and quality of evidences was poor. The above-mentioned results need more high- quality randomized controlled trials for further verification.
基金funded by grants from Shanghai Threeyear Action Plan for Further Development of Chinese Medicine ZY(2018–2020)-CCCX-1005the Planned Science Program of the Shanghai University of Traditional Chinese Medicine(No.2019LK089)Science and Technology Commission of Shanghai Municipality,China(No.18401970601)。
文摘Background:Acupuncture therapy has shown promise for effectively relieving preoperative anxiety.Nevertheless,previous findings from randomized controlled trials(RCTs)are inconsistent and must be examined in detail.Objective:This study systematically evaluates the efficacy and safety of acupuncture therapy for preoperative anxiety as well as the quality of evidence supporting this application.Search strategy:The China National Knowledge Infrastructure Database,Wanfang Data Journal Database,Chinese Biomedical Literature Database,Chongqing VIP,Embase,Pub Med and Cochrane Library Databases were queried from their inception to 19,February 2020,using keywords such as“acupuncture therapy,”“preoperative”and“anxioty.”Manual searches expanded the search breadth and included conference abstracts and other reference lists.Inclusion criteria:RCTs were included in the current study if they contained a comparison between a group of anxiety patients that received acupuncture therapy and a control group that received sham acupuncture.Data extraction and analysis:Literature was reviewed,and various articles were selected using the Note Express 3.2.0 software.Two researchers independently screened and extracted data and evaluated the risk of bias in the included studies.The Rev Man 5.3 software was used for data aggregation and the Grades of Recommendation,Assessment,Development and Evaluation(GRADE)assessment was used to evaluate the quality of the study outcomes.Results:Twelve studies were included in the review,containing a total of 916 patients.Meta-analysis showed that,compared with the control group,patients who received acupuncture therapy had reduced State-Trait Anxiety Inventory Scale(STAI-S)score(mean difference[MD]=–9.07,95%confidence interval[CI][–13.19 to–4.96],P<0.0001)and Visual Analogue Scale(VAS)score(MD=–1.37,95%CI[–2.29 to–0.45],P=0.003).However,for the Hamilton Anxiety Scale(HAMA)score,there was no difference between the two groups(MD=–3.98,95%CI[–12.89 to 4.92],P=0.38).Further,the GRADE assessment demonstrated that the STAI-S was of moderate quality,the VAS of low quality and the HAMA of very low quality.Conclusion:Acupuncture therapy may be able to decrease anxiety in preoperative patients,but the results need to be further verified due to the small sample sizes and the low quality of evidence to date.
基金The study was supported by the National Natural Science Foundation of China (No.81574065).
文摘Acupuncture has reportedly improved memory and cognitive impairment in both animal and clinical studies. It may be an effective treatment for Alzheimer's disease (AD). The purpose of this meta-analysis was to review the effectiveness of acupuncture for the treatment of AD. Eight databases were searched for articles published up to and including July 2017, and 13 studies fulfilling the inclusion criteria were identified. The main outcomes assessed were clinical efficacy rate, Mini-Mental State Examination score, Ability of Daily Living Scale score, Alzheimer's Disease Assessment Scale-Cognition score, Hasegawa's Dementia Scale (HDS) score, and adverse events. The methodological quality of the articles was assessed using Cochrane's risk of bias. All the studies compared the efficacy of acupuncture with that of medication, and were published in Chinese journals. Meta-analysis revealed that acupuncture yielded positive results as determined via all the indexes scored except the HDS (95% CI -0.26 to 0.90, Z=0.35, P=0.73). Only one of the studies reported adverse events associated with acupuncture and medication. The rate of adverse events in the medication group was 13%. In most of the studies assessed in the current metaanalysis, acupuncture alone was better than conventional western medicines for the treatment of AD.
基金Supported by the National Natural Science Foundation of China,No.81703923 and No.81820108033.
文摘BACKGROUND Functional dyspepsia(FD)is a common digestive disease with limited therapeutic options.According to evidence-based clinical practice,acupuncture or electroacupuncture(EA)seems to be a promising therapy for patients with FD.However,there is still a lack of systematic reviews that have analyzed current clinical trials for a better understanding of mechanisms involved in the ameliorating effect of acupuncture and EA on FD.AIM To evaluate the results and qualities of existing clinical evidence for researching the underlying mechanisms of acupuncture/EA in treating FD.METHODS A systematic search of the literature was performed to identify randomized controlled trials in which research on the mechanism of acupuncture or EA was conducted in FD patients.Databases searched included PubMed,EMBASE,Cochrane Library,and Web of Science.Data extraction and quality assessment were completed by two investigators independently and the results of quality evaluation were exported through Review Manager V5.3.RESULTS Eight studies were included in this review with a total of 17 items for detecting techniques for mechanistic research.Positive effects of acupuncture and EA were observed in regulating gastric motility,gastric accommodation,mental status,gastrointestinal hormones,and central and autonomic functions while improving dyspeptic symptoms and quality of life.CONCLUSION The key findings of this systematic review support the potential of acupuncture and EA in altering the heterogeneous pathophysiology in patients with FD.However,high-quality studies with well-planned designs are necessary to provide more credible evidence.
文摘The purpose of this work was to assess the evidence for effectiveness of acupuncture （AC） treatment in gastrointestinal diseases. A systematic review of the Medline-cited literature for clinical trials was performed up to May 2006. Controlled trials assessing acupuncture point stimulation for patients with gastrointestinal diseases were considered for inclusion. The search identified 18 relevant trials meeting the inclusion criteria. Two irritable bowel syndrome （IBS） trials, 1 Crohn＇s disease and 1 colitis ulcerosa trial had a robust random controlled trial （RCT） design. In regard to other gastrointestinal disorders, study quality was poor. In all trials, quality of life （QoL） improved significantly independently from the kind of acupuncture, real or sham. Real AC was significantly superior to sham acupuncture with regard to disease activity scores in the Crohn and Colitis trials. Efficacy of acupuncture related to QoL in IBS may be explained by unspecific effects. This is the same for QoL in inflammatory bowel diseases （IBD）, whereas specific acupuncture effects may be found in clinical scores. Further trials for IBDs and in particular for all other gastrointestinal disorders would be necessary to evaluate the efficacy of acupuncture treatment. However, it must be discussed on what terms patients benefit when this harmless and obviously powerful therapy with regard to QoL is demystified by further placebo controlled trials.
基金Supported by a Grant from the National Natural Sciences Foundation of China(No.30973792)
文摘OBJECTIVE: To investigate the effects of combined acupuncture and eugenol on learning-memory ability and the antioxidation system of the hippocampus in Alzheimer disease (AD) rats. METHODS: Sixty Sprague Dawley rats, weighing (300±10) g, were randomly divided with 10 rats per group into a normal control group, AD model group, AD with cut olfactory nerve group, Xiu three-needle group, eugenol group, and combined acupuncture and eugenol group. The AD model was established by injection of amyloid β1-40 (Aβ 1-40). Morris maze tests were conducted for evaluating the learning-memory ability. Content of malo- ndialdehyde (MDA) and activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in the hippocampus were detected. RESULTS: The average escape latency and the mean swimming distance in the normal control group, the Xiu three-needle group, the eugenol group, and the combined acupuncture and euge-nol group were significantly shorter than those in the AD model group (all P<0.01). The combined acupuncture and eugenol group had shorter escape latency and mean swimming distance than those in the Xiu three-needle group and the eugenol group. There were no significant differences between the Xiu three-needle group and the eugenol group and between the AD group and the AD with cut olfactory nerve group (P>0.05). Compared with the normal control group, the MDA content in the hippocampus significantly increased (P<0.05) and GSH-Px and SOD activities significantly decreased in the AD model group (P<0.01). Compared with the AD model group, significantly decreased (P< 0.01) and SOD and GSH-Px activities significantly increased in the Xiu three-needle group, eugenol group, and combined acupuncture and eugenol group (P<0.05). Compared with the Xiu three-needle group and eugenol group, the MDA content significantly decreased (P<0.05) and SOD and GSH-Px activities increased (P<0.05) in the combined acupuncture and eugenol group. There were no significant differences among the three indices between the Xiu three-needle group and the eugenol group and between the AD model group and the AD with cut olfactory nerve group (P>0.05). CONCLUSION: Both Xiu three-needle and eugenol can increase learning-memory ability, decrease MDA content, and increase SOD and GSH-Px activities in the hippocampus in AD rats. The combination of acupuncture with eugenol has stronger effects, and the effects depend on the olfactory pathway.
基金Supported by the National Basic Research Program of China(973 Program) for "Basic Research on Acupoint Specificity Along Medians and its Crucial Influential Factors"(No. 2012CB518501)
文摘OBJECTIVE： To assess the effectiveness and safety of acupuncture therapy for angina pectoris. METHODS： Randomized controlled trials （RCTs） concerned with acupuncture treatment of angina pectoris were identified by searching Academic Source Premier, MEDLINE, Science Citation Index Expanded, and three Chinese databases （China biol- ogy medicine database, China national knowledge infrastructure, and VlP database for Chinese techni- cal periodicals）. The valid data were extracted in ac- cordance with our inclusion and exclusion criteria. The main outcomes of the included studies were synthesized using Revman 5.1. RESULTS： Twenty-one articles on 16 individual studies were included and evaluated as having high or moderate risk of bias according to the stan- dards of the Cochrane Collaboration. Meta-analysis indicated that acupuncture combined with conven- tional drugs （ACCD） was superior to conventional drugs alone in reducing the incidence of acute myocardial infarction （AMI） [0R=0.18, 95%CI （0.04,0.84）, P=0.03]. Moreover, ACCD was superior to con- ventional drugs in the relief of angina symptoms [0R=4.23, 95%C/（2.73, 6..56）, P〈0.00001], and im- provement of electrocardiography （ECG） [0R=2.61, 95%C/（1.83, 3.73）, P〈0.00001]. Acupuncture by it- self was also superior to conventional drugs for angi- na symptoms [0R=3.59, 95%C/（1.76, 7.92）, P=0.0004] and ECG improvement [0R=3.07, 95%C/（1.54, 6.10）, P=0.001]. ACCD was superior to conventional drugs in shortening the time to onset of angina relief [WMD=-1.40, 95% CI （-1.65, -1.15）, P〈 0.00001]. However, the time to onset was signifi- cantly longer for acupuncture treatment than for conventional treatment alone [WMD=2A3, 95%O （1.63, 3.23）, P〈0.000 01]. CONCLUSION： ACCD reduced the occurrence of AMI, and both acupuncture and ACCD relieved an- gina symptoms and improved ECG. However, com- pared with conventional treatment, acupuncture showed a longer delay before its onset of action. This indicates that acupuncture is not suitable for emergency treatment of heart attack. Owing to the poor quality of the current evidence, the findings of this systematic review need to be verified by more RCTs to enhance statistical power.
基金Supported by Beijing Municipal Science and Technology Commission:Demonstration and Popularization of Traditional Chinese Medicine Standardized Diagnosis and Treatment of Common Complications of Malignant Tumors(No.Z191100008319006)Beijing Postdoctoral Science Foundation:Clinical Study of Five Elements Acupuncture and Moxibustion in Treatment of TumorRelated Insomnia(No.EE2019-22)Key Medical Discipline of Suzhou:Rehabilitation of Traditional Chinese Medicine(No.Szxk201822)。
文摘OBJECTIVE:To evaluate the efficacy and safety of acupuncture and moxibustion therapy(AMT) for cancerrelated psychological symptoms(CRPS) of insomnia,depression and anxiety.METHODS:Seven databases were searched for randomized controlled trials(RCT) comparing AMT to routine care or conventional drug for alleviating CRPS of insomnia,depression,and anxiety before April 2020.Two independent reviewers performed the data extraction and assessed the risk of bias.RESULTS:A total of 30 RCTs involving 2483 cancer patients were enrolled.The pooled analysis indicated that the treatment group was significantly better than the control group in improving the depression effective rate [RR = 1.29,95% CI(1.12,1.49),P = 0.0004],the quality of life(QOL) [MD = 1.11,95% CI(0.80,1.42),P < 0.000 01],and reducing Self-rating Anxiety Scale(SAS) [MD =﹣7.75,95% CI(﹣10.44,﹣5.05),P < 0.000 01].But there was no statistically significant difference between two groups in improving the insomnia effective rate [RR = 1.18,95% CI(0.93,1.51),P = 0.18].The subgroup analysis showed the effectiveness of different intervention on CRPS.Compared with routine care,AMT helps relieve CRPS better evaluated by Pittsburgh Sleep Quality Index(PSQI),Hamilton Depression Scale(HAMD),and Self-rating Depression Scale(SDS),and depression effective rate.Compared with conventional drug,AMT performs better evaluated by SDS,depression effective rate and QOL.Moreover,the conventional drug showed higher treatment efficacy on improving insomnia effective rate compared with AMT.Compared to conventional drug,AMT plus conventional drug resulted in a significant reduction on CRPS such as PSQI,HAMD,SDS,and SAS,and also had a meaningful improvement on insomnia effective rate,depression effective rate and QOL.Fewer published reports were found on the adverse events of AMT than the conventional drug.CONCLUSION:The results suggested that AMT might be effective in improving CPRI;however,a definite conclusion could not be drawn because the quality of trials are low.Further large-scale and high-quality RCTs to verify the efficacy and safety of AMT on CRPS are still warranted.
基金supported by a grant from National Natural Science Foundation of China (grant number 82104983)Scientific Research Program by Traditional Chinese Medicine Bureau of Guangdong Province,China (grant number 20201103)Fundamental Research Funds for the Central Universities,China (grant number 21620362)。
文摘Background: Some depressed patients receive acupuncture as an adjunct to their conventional medications.Objective: This review aims to provide evidence on whether acupuncture can enhance the therapeutic effectiveness of antidepressants for treating depression, and explore whether acupuncture can reduce the adverse reactions associated with antidepressants.Search strategy: English and Chinese databases were searched for randomized controlled trials(RCTs)published until December 1, 2021.Inclusion criteria: RCTs with a modified Jadad scale score ≥ 4 were included if they compared a group of participants with depression that received acupuncture combined with antidepressants with a control group that received antidepressants alone.Data extraction and analysis: Meta-analysis was performed, and statistical heterogeneity was assessed based on Cochran’s Q statistic and its related P-value. Primary outcomes were the reduction in the severity of depression and adverse reactions associated with antidepressants, while secondary outcomes included remission rate, treatment response, social functioning, and change in antidepressant dose.The Grading of Recommendations Assessment, Development and Evaluation(GRADE) framework was used to evaluate the overall quality of evidence in the included studies.Results: This review included 16 studies(with a total of 1958 participants). Most studies were at high risk of performance bias and at low or unclear risk of selection bias, detection bias, attrition bias, reporting bias, and other bias. Analysis of the 16 RCTs showed that, compared with antidepressants alone, acupuncture along with antidepressants reduced the Hamilton Depression Rating Scale-17(HAMD-17) scores(standard mean difference [SMD]-0.44, 95% confidence interval [CI]-0.55 to-0.33, P < 0.01;I^(2)= 14%), Self-rating Depression Scale(SDS) scores(SMD-0.53, 95% CI-0.84 to-0.23, P < 0.01;I^(2)= 79%), and the Side Effect Rating Scale(SERS) scores(SMD-1.11, 95% CI-1.56 to-0.66, P < 0.01;I^(2)= 89%). Compared with antidepressants alone, acupuncture along with antidepressants improved World Health Organization Quality of Life-BREF scores(SMD 0.31, 95% CI 0.18 to 0.44, P < 0.01;I^(2)= 15%), decreased the number of participants who increased their antidepressant dosages(relative risk[RR] 0.32, 95% CI 0.22 to 0.48, P < 0.01;I^(2)= 0%), and resulted in significantly higher remission rates(RR1.52, 95% CI 1.26 to 1.83, P < 0.01;I^(2)= 0%) and treatment responses(RR 1.35, 95% CI 1.24 to 1.47, P < 0.01;I^(2)= 19%) in terms of HAMD-17 scores. The HAMD-17, SDS and SERS scores were assessed as low quality by GRADE and the other indices as being of moderate quality.Conclusion: Acupuncture as an adjunct to antidepressants may enhance the therapeutic effectiveness and reduce the adverse drug reactions in patients receiving antidepressants. These findings must be interpreted with caution, as the evidence was of low or moderate quality and there was a lack of comparative data with a placebo control.Systematic review registration: INPLASY202150008.
基金Supported by National Administration of Traditional Chinese Medicine Project:Innovation Team and Talents Cultivation Program of National Administration of Traditional Chinese Medicine (No. ZYYCXTD-C-202006)。
文摘OBJECTIVE: To evaluate the clinical effectiveness and safety of acupoint catgut embedding and acupuncture on simple obesity by Meta-analysis. METHODS: Studies on clinical randomized controlled trials of acupoint catgut embedding for simple obesity which were published from January 2015 to November 2020 were searched in Cochrane Central Register of Control Trials(Central), Pub Med, China Science and Technology Journal Database, China National Knowledge Infrastructure Database and Wanfang databases. And those that met the inclusion criteria were screened. Rev Man5.3 was used for Meta-analysis. The “Risk of Bias” tool was used to evaluate the quality of included studies. R studio software was used for the measurement of publication bias. RESULTS: A total of 33 studies were included for Metaanalysis, including 2685 patients with simple obesity. Meta-analysis results showed the comparison of effectiveness rate was relative risk(RR) = 1.12, 95%CI(1.08, 1.16), body mass index(BMI) was mean difference(MD) =-1.12, 95%CI(-2.09,-0.14), waist circumference was MD =-2.14, 95%CI(-4.22,-0.06), and body mass was MD =-2.36, 95%CI(-3.99,-0.73). On the basis of diet and exercise intervention, the effectiveness rate [RR = 1.12, 95%CI(1.05, 1.19)], BMI [MD =-0.88, 95%CI(-1.35,-0.40)], waist circumference [MD =-1.10, 95%CI(-4.27, 2.07)], and body mass [MD =-0.68, 95%CI(-2.90, 1.54)]. The risk of bias of included literatures was low. CONCLUSIONS: Acupoint catgut embedding therapy was slightly better than acupuncture therapy in most of the outcomes. Moreover, the treatment frequency of acupoint catgut embedding is less with larger stimulation intensity, which is more conducive to clinical promotion.
