BACKGROUND The benefits and risks of Xileisan(XLS)in the treatment of ulcerative colitis(UC)remain unclear.AIM The present study aimed to evaluate the efficacy and safety of the combination of XLS and mesalazine when ...BACKGROUND The benefits and risks of Xileisan(XLS)in the treatment of ulcerative colitis(UC)remain unclear.AIM The present study aimed to evaluate the efficacy and safety of the combination of XLS and mesalazine when treating UC.METHODS We searched eight databases for clinical trials evaluating the combination of XLS and mesalazine in the treatment of UC,up to January 2024.Meta-analysis and trial sequential analysis(TSA)were performed using Revman 5.3 and TSA 0.9.5.10 beta,respectively.RESULTS The present study included 13 clinical studies involving 990 patients,of which 501 patients received XLS combined with mesalazine while 489 patients received mesalazine alone.The meta-analysis showed that,in terms of efficacy,the combination of XLS and mesalazine significantly improved the clinical efficacy rate by 22%[risk ratio(RR)=1.22;95%CI:1.15–1.28;P<0.00001]and mucosal improvement rate by 25%(RR=1.25;95%CI:1.12–1.39;P=0.0001),while significantly reducing the duration of abdominal pain by 2.25 days[mean difference(MD)=-2.25;95%CI:-3.35 to-1.14;P<0.0001],diarrhea by 2.06 days(MD=-2.06;95%CI:-3.92 to-0.20;P=0.03),hematochezia by 2.32 days(MD=-2.32;95%CI:-4.02 to-0.62;P=0.008),tumor necrosis factor alpha by 16.25 ng/mL(MD=-16.25;95%CI:-20.48 to-12.01;P<0.00001),and interleukin-6 by 14.14 ng/mL(MD=-14.14;95%CI:-24.89 to-3.39;P=0.01).The TSA indicated conclusiveness in the meta-analysis of the efficacy endpoints.In terms of safety,the meta-analysis revealed that the combination of XLS and mesalazine did not increase the occurrence of total and gastrointestinal adverse events,abdominal distension,and erythema(P>0.05).The TSA showed non conclusive findings in the meta-analysis of the safety endpoints.Harbord’s test showed no publication bias(P=0.734).CONCLUSION Treatment with XLS alleviated the clinical symptoms,intestinal mucosal injury,and inflammatory response in patients with UC,while demonstrating good safety.展开更多
Objective:To conduct the meta-analysis and trial sequential analysis(TSA) on clinical trials of fire needling therapy in treatment of gouty arthritis and review systematically the clinical therapeutic effect of fire n...Objective:To conduct the meta-analysis and trial sequential analysis(TSA) on clinical trials of fire needling therapy in treatment of gouty arthritis and review systematically the clinical therapeutic effect of fire needling therapy on gouty arthritis so as to provide the medical evidences of the extensive application of this therapy in treatment of gouty arthritis.Methods:The relevant clinical trials of fire needling therapy for treatment of gouty arthritis were searched from China National knowledge Infrastructure,Wanfang Data Knowledge Service Platform,Chinese Science and Technology Journal Database,American Medical Online,Dutch Medical Literature Database and International Evidence-Based Medical library.Using Review Manager 5.3 software,the quality of the included trials was assessed and meta-analysis was performed.With TSA v0.9 software,the trial sequential analysis was conduced on the appropriate outcomes.Results:A total of 10 trials were included with 775 patients involved.The analysis results showed that compared with the western medication,the total effective rate(RR=1.14’95%CI [1.09,1.20]),the curative rate(RR=1.59’95%CI [1.33,1.89]),the reduced VAS score(MD=-1.44’ 95%CI [-1.93,-0.951]) and the reduced incidence of adverse reaction(RR=0.27’ 95% CI [0.09,0.76]) of the fire needling therapy were different significantly(all P <0.05).Regarding the reduction of blood uric acid(MD=-40.47’ 95%CI [-80.21,-0.72]) and the score of symptoms and physical signs(MD=-1.38’95% CI [-3.71,0.95]),the effect of fire needling therapy was similar to that of western medication group(both P≥0.05).The trial sequential analysis suggested that the result was reliable,in which,the total effective rate of fire needling therapy was much higher than the western medication.But,it was potentially a false-positive finding,in which,fire needling therapy was much more advantageous at reducing blood uric acid as compared with the western medication.Conclusion:Based on the analytic results,it can be determined that fire needling therapy,as an effective approach to the treatment of gouty arthritis,has a certain advantage as compared with western medication.Given the low overall quality of trials,it still needs high-quality clinical trial to verify the findings of this study results.展开更多
Objective:To evaluate the efficacy and safety of Rupi Sanjie(RPSJ)capsule plus the conventional surgical operation for treatment of hyperplasia nodule of mammary gland.Methods:A meta-analysis was conducted on randomiz...Objective:To evaluate the efficacy and safety of Rupi Sanjie(RPSJ)capsule plus the conventional surgical operation for treatment of hyperplasia nodule of mammary gland.Methods:A meta-analysis was conducted on randomized controlled trials(RCT)related to RPSJ capsule plus surgical operation in the treatment of hyperplasia nodule of mammary gland.The methodological quality of eligible RCTs was assessed according to the criteria from the Cochrane Handbook for Systematic Reviews of Interventions.RevMan5.3 and Stata14.0 were used for data analyses.Trial sequential analysis was performed to estimate the sample size of systematic review base on TSA software v0.9.Results:Twenty-two RCTs were totally included in this study,involving 2135 patients.The result showed the clinical recurrence rate of RPSJ capsule plus surgical treatment group was significantly lower than surgical treatment alone group(RR:0.25,95%CI[0.17,0.37],P<0.01).The clinical cure rate and total effective rate were higher in RPSJ capsule plus surgical treatment group than the conventional surgical treatment group(RR:1.63,95%CI[1.46,1.82],P<0.01);(RR:1.29,95%CI[1.22,1.37],P<0.01).Application of RPSJ capsule decreased the occurrence of adverse events including nausea,vomiting,irregular menstruation,constipation,dizziness,and headache etc.(RR:0.90,95%CI[0.54,1.49],P=0.68).The results of trial sequential analysis demonstrated that the current available data did not reach the expected value.Conclusion:RPSJ capsule plus the conventional surgical treatment was more effective in reducing the clinical recurrence rate,and improving the total clinical effective rate and clinical cure rate,with a decrease in the occurrence of adverse events.展开更多
Background:Traditional Chinese Medicines(TCM)had been indicated to benefit for the chronic non-infectious diseases,such as cancers,hypertension,primary dysmenorrheal,etc.Although randomized controlled trials(RCTs)had ...Background:Traditional Chinese Medicines(TCM)had been indicated to benefit for the chronic non-infectious diseases,such as cancers,hypertension,primary dysmenorrheal,etc.Although randomized controlled trials(RCTs)had been conducted,there was still the controversy on the efficacy of Jinhuang powder for diabetic foot ulcers(DFUs).Objective:This systematic review aimed to objectively evaluate the potential of Jinhuang powder for DFUs.Methods:Seven databases(CNKI,Chongqing VIP,Wanfang database,CBM,the Cochrane Library,PubMed and Web of Science)were searched to retrieve RCTs up to December,2016;and the relevant references of the eligible studies were screened.According to the eligible criteria,the literature was screened;data were extracted;and then the methodological quality was assessed.The meta-analysis,power analysis and trial sequential analysis(TSA)were performed by using Meta analyst software(version beta 3.13),Stata 12.0,Power and Precision statistical software package(Biostat)and TSA software(version0.9),respectively.Results:Finally,three RCTs with 198 participants were included.The results of meta-analysis showed that there were statistically significant differences between groups in(1)the cure rate(RR,1.25;95%CI.1.10to1.41;P=0.00)and(2)the wound healing time(SMD,-3.404;95%CI,-5.821 to -0.987;P=0.00).Three trials presented more than 80% power with 0.05α-errors in both outcomes and the power of two meta-analyses to pool different outcomes presented more than 95%.The TSA showed that the summary results were certain.Conclusion:The external application with Jinhuang powder was an effective and cost-effective therapy for DFUs.The power analysis and TSA showed that the efficacy of Jinhuang powder dressing for the treatment of DFUs is conclusive.展开更多
Objective： To evaluate the effect of moxibustion on knee osteoarthritis patients with cumulative meta-analysis, and trial sequential analysis was applied to test the authenticity of results. Methods： We searched Pub...Objective： To evaluate the effect of moxibustion on knee osteoarthritis patients with cumulative meta-analysis, and trial sequential analysis was applied to test the authenticity of results. Methods： We searched PubMed, EMbase, The Cochrane Library, CNKI and CBM to collect RCTs about moxibustion on knee osteoarthritis patients. The selection of literature, data extraction and evaluation of eligible literature were carried out independently by two reviewers. Then Stata11.0 software was used for data analysis. Result： Totally 11 RCTs involved 1005 patients were recruited. The results of meta-analysis showed that no significant differences were found between the two groups in VAS, moxibustion is better than drug therapy in effective rate [OR = 0.40, 95%CI （0.27, 0.60）] and knee score [SMD = -0.70, 95%CI （-1.22, -0.19）]. The result of trial sequential analysis indicated that the sample size didn＇t reach the TSA Boundary on VAS, the sample size of effectiveness achieved Require Information Size. In the indicator of knee score has obtained certain re- sult before reaching the Require Information Size. Conclusion： moxibustion is superior to drug therapy on treatment knee osteoarthritis. However, large sample size and high-quality studies are still needed.展开更多
Objective:To systematically review the efficacy and clinical safety of Qizhi Weitong Granules(气滞胃痛颗粒)(QZWT)in the treatment of irritable bowel syndrome with predominant constipation(IBS-C).Methods:Randomized con...Objective:To systematically review the efficacy and clinical safety of Qizhi Weitong Granules(气滞胃痛颗粒)(QZWT)in the treatment of irritable bowel syndrome with predominant constipation(IBS-C).Methods:Randomized controlled trials(RCTs)of QZWT in patients with IBS-C were retrieved from Pub Med,EMBASE,Cochrane Library,China National Knowledge Infrastructure(CNKI),Wanfang,Chinese Scientific Journals Database(VIP),and Chinese Biological Medical Database(CBM)from inception to December 3,2022.Conventional meta-analysis with random-effects model or fixed-effects model and trial sequential analysis(TSA)were performed by Review Manager 5.4,Stata and TSA software.Results:A total of 4 RCTs and 368 patients with IBS-C were included in this study.The findings of the meta-analysis indicated that the cure and efficacy rate of the experimental group was significantly higher than that of the control group[RR=2.19;(95%CI,1.35–3.55),P<0.01;RR=1.14;(95%CI,1.03–1.27),P<0.05],while the result of Bristol Score was negative.The funnel plot was probably symmetry,and the P value was>0.05 in the Egger test,which confirmed the nonexistence of significant publication bias in this outcome.TSA showed the cumulative z-value crossed the traditional threshold and TSA threshold,while it didn't get to the required information size.Finally,2 studies reported adverse events after QZWT treatment,including 3 cases of diarrhea.No serious adverse events were reported.Conclusion:QZWT was an effective and safe complementary therapy in the treatment of IBS-C with no obvious adverse reactions.TSA analysis confirmed our meta-analysis results.Therefore,QZWT may be a potential candidate for the treatment of IBS-C.However,due to the limited quality of current studies,more long-term,randomized,double-blinded clinical trials are needed in future studies.展开更多
Objective:To evaluate the efficiency of Bushen Huoxue method with ACEI/ARB in treating diabetic kidney disease(stageⅢ).Methods:A total of 8 major electronic databases(CNKI,WanFang,VIP,Sinomed,Pubmed,Embase,Cochrane L...Objective:To evaluate the efficiency of Bushen Huoxue method with ACEI/ARB in treating diabetic kidney disease(stageⅢ).Methods:A total of 8 major electronic databases(CNKI,WanFang,VIP,Sinomed,Pubmed,Embase,Cochrane Liberary,Web of Science)were retrieved since the establishment of the database to October 9,2019.Two reviewers extracted data,and assessed the methodological quality of the included studies.The analysis was made by Stata 15.0 and TSA 0.9 softwares.Results:A total of 10 RCT studies were obtained,including 711 patients with diabetic kidney disease of stageⅢ.Meta-analysis showed that the method of Bushen Huoxue with ACEI/ARB could reduce UAER[WMD=-31.24,95%CI(-42.98,-19.51)],β2-GM[WMD=-92.95,95%CI(-166.05,-19.85)],LDL-C[WMD=-0.19,95%CI(0.19,-0.30)].However,there were no significant effect for HbAlc[WMD=-0.08,95%CI(-0.17,-0.00)],Scr[WMD=-12.96,95%CI(-39.82,13.90)],BUN[WMD=-0.14,95%CI(-0.44,0.17)].The result of TSA indicated that the method of Bushen Huoxue with ACEI/ARB was effective in the treatment of diabetic kidney disease of stageⅢ.Conclusion:The study show that the method of Bushen Huoxue with ACEI/ARB can reduce urinary protein,renal tubular injury and LDL-C in patients with diabetic kidney disease of stageⅢ,and had no effect on HbAlc and renal function.But the conclusion of this study needs further research of high quality.展开更多
Background:Whether anesthetic depth affects postoperative outcomes remains controversial.This meta-analysis aimed to evaluate the effects of deepvs.light anesthesia on postoperative pain,cognitive function,recovery fr...Background:Whether anesthetic depth affects postoperative outcomes remains controversial.This meta-analysis aimed to evaluate the effects of deepvs.light anesthesia on postoperative pain,cognitive function,recovery from anesthesia,complications,and mortality.Methods:PubMed,EMBASE,and Cochrane CENTRAL databases were searched until January 2022 for randomized controlled trials comparing deep and light anesthesia in adult surgical patients.The co-primary outcomes were postoperative pain and delirium(assessed using the confusion assessment method).We conducted a meta-analysis using a random-effects model.We assessed publication bias using the Begg’s rank correlation test and Egger’s linear regression.We evaluated the evidence using the trial sequential analysis and Grading of Recommendations Assessment,Development and Evaluation(GRADE)methodology.We conducted subgroup analyses for pain scores at different postoperative time points and delirium according to cardiac or non-cardiac surgery.Results:A total of 26 trials with 10,743 patients were included.Deep anesthesia compared with light anesthesia(a mean difference in bispectral index of-12 to-11)was associated with lower pain scores at rest at 0 to 1 h postoperatively(weighted mean difference=-0.72,95%confidence interval[CI]=-1.25 to-0.18,P=0.009;moderate-quality evidence)and an increased incidence of postoperative delirium(24.95%vs.15.92%;risk ratio=1.57,95%CI=1.28-1.91,P<0.0001;high-quality evidence).No publication bias was detected.For the exploratory secondary outcomes,deep anesthesia was associated with prolonged postoperative recovery,without affecting neurocognitive outcomes,major complications,or mortality.In the subgroup analyses,the deep anesthesia group had lower pain scores at rest and on movement during 24 h postoperatively,without statistically significant subgroup differences,and deep anesthesia was associated with an increased incidence of delirium after non-cardiac and cardiac surgeries,without statistically significant subgroup differences.Conclusions:Deep anesthesia reduced early postoperative pain but increased postoperative delirium.The current evidence does not support the use of deep anesthesia in clinical practice.展开更多
Objective： To evaluate the efficacy and safety of the heated gel mattress for prevention of heat loss on preterm infants with hypothermia during the transport systematically and objectively. Methods： Systematic sear...Objective： To evaluate the efficacy and safety of the heated gel mattress for prevention of heat loss on preterm infants with hypothermia during the transport systematically and objectively. Methods： Systematic searches on PubMed, EM- BASE, Cochrane Library, Web of Science, CBM, CNKI, Wanfang and VIP were performed for randomized controlled trials （RCTs） or quasi-RCTs which explored the effects of heated gel mattress on prevention of hypothermia in premature infants relative to conventional alternatives. Studies were screened according to inclusion and exclusion criteria, extracted data and assessed quality. Then, meta-analysis and trial sequential analysis were performed by RevMan 5.3 and TSA vO.9 software developed at the Copenhagen Clinical Trials Center in Denmark, independently. Results： This systematic review included 10 studies which comprised 7 RCTs and 3 quasi-RCTs, encompassing 773 patients. The results of meta-analysis showed that in heated gel mattress group admission temperature on neonatal intensive care unit （SMD, 0.63; 95% CI, 0.40 to 0.87; P = 0.00）, incidence of hypothermia （RR, 0.73; 95% CI, 0.57 to 0.93; P = 0.01） and hyperthermia （RR, 1.82; 95% CI, 1.31 to 2.541 P = 0.00） compared with the control group had significantly statistical difference; however, there was no significant difference in admission temperature on exothermic mattresses or TransWarmer mattress group, mortality, sepsis, retinopathy of prematurity, intraventricular hemorrhage Ⅲ/Ⅳ between two groups, trial sequential analysis confirmed that the pooled results of admission temperature on neonatal intensive care unit and hyperthermia were stable and reliable; but the combination of low-temperature incidence and mortality indicators suggested that the sample size was insufficient. Conclusion： Heated gel mattress is a safe and effective re- warming intervention that can improve body temperature of hypothermic preterm infants during transport, reduce the incidence of hypothermia and does not increase the incidence of morbidity and complications. However, it is recommended that clinical monitoring of body temperature should be performed dynamically to decrease the potential risk of high fever. In addition, due to the limitation of quantity and quality of included studies, its cost-effectiveness and far-reaching influence on long-term follow-up outcomes need further evaluation through clinical multicenter, large sample, and high-quality research.展开更多
基金Discipline Construction Project of Hunan University of Chinese Medicine,No.22JBZ002.
文摘BACKGROUND The benefits and risks of Xileisan(XLS)in the treatment of ulcerative colitis(UC)remain unclear.AIM The present study aimed to evaluate the efficacy and safety of the combination of XLS and mesalazine when treating UC.METHODS We searched eight databases for clinical trials evaluating the combination of XLS and mesalazine in the treatment of UC,up to January 2024.Meta-analysis and trial sequential analysis(TSA)were performed using Revman 5.3 and TSA 0.9.5.10 beta,respectively.RESULTS The present study included 13 clinical studies involving 990 patients,of which 501 patients received XLS combined with mesalazine while 489 patients received mesalazine alone.The meta-analysis showed that,in terms of efficacy,the combination of XLS and mesalazine significantly improved the clinical efficacy rate by 22%[risk ratio(RR)=1.22;95%CI:1.15–1.28;P<0.00001]and mucosal improvement rate by 25%(RR=1.25;95%CI:1.12–1.39;P=0.0001),while significantly reducing the duration of abdominal pain by 2.25 days[mean difference(MD)=-2.25;95%CI:-3.35 to-1.14;P<0.0001],diarrhea by 2.06 days(MD=-2.06;95%CI:-3.92 to-0.20;P=0.03),hematochezia by 2.32 days(MD=-2.32;95%CI:-4.02 to-0.62;P=0.008),tumor necrosis factor alpha by 16.25 ng/mL(MD=-16.25;95%CI:-20.48 to-12.01;P<0.00001),and interleukin-6 by 14.14 ng/mL(MD=-14.14;95%CI:-24.89 to-3.39;P=0.01).The TSA indicated conclusiveness in the meta-analysis of the efficacy endpoints.In terms of safety,the meta-analysis revealed that the combination of XLS and mesalazine did not increase the occurrence of total and gastrointestinal adverse events,abdominal distension,and erythema(P>0.05).The TSA showed non conclusive findings in the meta-analysis of the safety endpoints.Harbord’s test showed no publication bias(P=0.734).CONCLUSION Treatment with XLS alleviated the clinical symptoms,intestinal mucosal injury,and inflammatory response in patients with UC,while demonstrating good safety.
基金Supported by National Natural Science Foundation of China:81460763,81960908.
文摘Objective:To conduct the meta-analysis and trial sequential analysis(TSA) on clinical trials of fire needling therapy in treatment of gouty arthritis and review systematically the clinical therapeutic effect of fire needling therapy on gouty arthritis so as to provide the medical evidences of the extensive application of this therapy in treatment of gouty arthritis.Methods:The relevant clinical trials of fire needling therapy for treatment of gouty arthritis were searched from China National knowledge Infrastructure,Wanfang Data Knowledge Service Platform,Chinese Science and Technology Journal Database,American Medical Online,Dutch Medical Literature Database and International Evidence-Based Medical library.Using Review Manager 5.3 software,the quality of the included trials was assessed and meta-analysis was performed.With TSA v0.9 software,the trial sequential analysis was conduced on the appropriate outcomes.Results:A total of 10 trials were included with 775 patients involved.The analysis results showed that compared with the western medication,the total effective rate(RR=1.14’95%CI [1.09,1.20]),the curative rate(RR=1.59’95%CI [1.33,1.89]),the reduced VAS score(MD=-1.44’ 95%CI [-1.93,-0.951]) and the reduced incidence of adverse reaction(RR=0.27’ 95% CI [0.09,0.76]) of the fire needling therapy were different significantly(all P <0.05).Regarding the reduction of blood uric acid(MD=-40.47’ 95%CI [-80.21,-0.72]) and the score of symptoms and physical signs(MD=-1.38’95% CI [-3.71,0.95]),the effect of fire needling therapy was similar to that of western medication group(both P≥0.05).The trial sequential analysis suggested that the result was reliable,in which,the total effective rate of fire needling therapy was much higher than the western medication.But,it was potentially a false-positive finding,in which,fire needling therapy was much more advantageous at reducing blood uric acid as compared with the western medication.Conclusion:Based on the analytic results,it can be determined that fire needling therapy,as an effective approach to the treatment of gouty arthritis,has a certain advantage as compared with western medication.Given the low overall quality of trials,it still needs high-quality clinical trial to verify the findings of this study results.
基金Standardization Project of Clinical Application Guide for Chinese Patent Medicine in the Treatment of Dominant Diseases(No.SATCM-2015-BZ402)。
文摘Objective:To evaluate the efficacy and safety of Rupi Sanjie(RPSJ)capsule plus the conventional surgical operation for treatment of hyperplasia nodule of mammary gland.Methods:A meta-analysis was conducted on randomized controlled trials(RCT)related to RPSJ capsule plus surgical operation in the treatment of hyperplasia nodule of mammary gland.The methodological quality of eligible RCTs was assessed according to the criteria from the Cochrane Handbook for Systematic Reviews of Interventions.RevMan5.3 and Stata14.0 were used for data analyses.Trial sequential analysis was performed to estimate the sample size of systematic review base on TSA software v0.9.Results:Twenty-two RCTs were totally included in this study,involving 2135 patients.The result showed the clinical recurrence rate of RPSJ capsule plus surgical treatment group was significantly lower than surgical treatment alone group(RR:0.25,95%CI[0.17,0.37],P<0.01).The clinical cure rate and total effective rate were higher in RPSJ capsule plus surgical treatment group than the conventional surgical treatment group(RR:1.63,95%CI[1.46,1.82],P<0.01);(RR:1.29,95%CI[1.22,1.37],P<0.01).Application of RPSJ capsule decreased the occurrence of adverse events including nausea,vomiting,irregular menstruation,constipation,dizziness,and headache etc.(RR:0.90,95%CI[0.54,1.49],P=0.68).The results of trial sequential analysis demonstrated that the current available data did not reach the expected value.Conclusion:RPSJ capsule plus the conventional surgical treatment was more effective in reducing the clinical recurrence rate,and improving the total clinical effective rate and clinical cure rate,with a decrease in the occurrence of adverse events.
文摘Background:Traditional Chinese Medicines(TCM)had been indicated to benefit for the chronic non-infectious diseases,such as cancers,hypertension,primary dysmenorrheal,etc.Although randomized controlled trials(RCTs)had been conducted,there was still the controversy on the efficacy of Jinhuang powder for diabetic foot ulcers(DFUs).Objective:This systematic review aimed to objectively evaluate the potential of Jinhuang powder for DFUs.Methods:Seven databases(CNKI,Chongqing VIP,Wanfang database,CBM,the Cochrane Library,PubMed and Web of Science)were searched to retrieve RCTs up to December,2016;and the relevant references of the eligible studies were screened.According to the eligible criteria,the literature was screened;data were extracted;and then the methodological quality was assessed.The meta-analysis,power analysis and trial sequential analysis(TSA)were performed by using Meta analyst software(version beta 3.13),Stata 12.0,Power and Precision statistical software package(Biostat)and TSA software(version0.9),respectively.Results:Finally,three RCTs with 198 participants were included.The results of meta-analysis showed that there were statistically significant differences between groups in(1)the cure rate(RR,1.25;95%CI.1.10to1.41;P=0.00)and(2)the wound healing time(SMD,-3.404;95%CI,-5.821 to -0.987;P=0.00).Three trials presented more than 80% power with 0.05α-errors in both outcomes and the power of two meta-analyses to pool different outcomes presented more than 95%.The TSA showed that the summary results were certain.Conclusion:The external application with Jinhuang powder was an effective and cost-effective therapy for DFUs.The power analysis and TSA showed that the efficacy of Jinhuang powder dressing for the treatment of DFUs is conclusive.
文摘Objective： To evaluate the effect of moxibustion on knee osteoarthritis patients with cumulative meta-analysis, and trial sequential analysis was applied to test the authenticity of results. Methods： We searched PubMed, EMbase, The Cochrane Library, CNKI and CBM to collect RCTs about moxibustion on knee osteoarthritis patients. The selection of literature, data extraction and evaluation of eligible literature were carried out independently by two reviewers. Then Stata11.0 software was used for data analysis. Result： Totally 11 RCTs involved 1005 patients were recruited. The results of meta-analysis showed that no significant differences were found between the two groups in VAS, moxibustion is better than drug therapy in effective rate [OR = 0.40, 95%CI （0.27, 0.60）] and knee score [SMD = -0.70, 95%CI （-1.22, -0.19）]. The result of trial sequential analysis indicated that the sample size didn＇t reach the TSA Boundary on VAS, the sample size of effectiveness achieved Require Information Size. In the indicator of knee score has obtained certain re- sult before reaching the Require Information Size. Conclusion： moxibustion is superior to drug therapy on treatment knee osteoarthritis. However, large sample size and high-quality studies are still needed.
基金supported by National Natural Science Foundation of China:International (regional)cooperation and exchange project (81820108033)China Academy of Chinese Medical Sciences Youth Talent Project (ZZ14-YQ-020)。
文摘Objective:To systematically review the efficacy and clinical safety of Qizhi Weitong Granules(气滞胃痛颗粒)(QZWT)in the treatment of irritable bowel syndrome with predominant constipation(IBS-C).Methods:Randomized controlled trials(RCTs)of QZWT in patients with IBS-C were retrieved from Pub Med,EMBASE,Cochrane Library,China National Knowledge Infrastructure(CNKI),Wanfang,Chinese Scientific Journals Database(VIP),and Chinese Biological Medical Database(CBM)from inception to December 3,2022.Conventional meta-analysis with random-effects model or fixed-effects model and trial sequential analysis(TSA)were performed by Review Manager 5.4,Stata and TSA software.Results:A total of 4 RCTs and 368 patients with IBS-C were included in this study.The findings of the meta-analysis indicated that the cure and efficacy rate of the experimental group was significantly higher than that of the control group[RR=2.19;(95%CI,1.35–3.55),P<0.01;RR=1.14;(95%CI,1.03–1.27),P<0.05],while the result of Bristol Score was negative.The funnel plot was probably symmetry,and the P value was>0.05 in the Egger test,which confirmed the nonexistence of significant publication bias in this outcome.TSA showed the cumulative z-value crossed the traditional threshold and TSA threshold,while it didn't get to the required information size.Finally,2 studies reported adverse events after QZWT treatment,including 3 cases of diarrhea.No serious adverse events were reported.Conclusion:QZWT was an effective and safe complementary therapy in the treatment of IBS-C with no obvious adverse reactions.TSA analysis confirmed our meta-analysis results.Therefore,QZWT may be a potential candidate for the treatment of IBS-C.However,due to the limited quality of current studies,more long-term,randomized,double-blinded clinical trials are needed in future studies.
基金Key research project of capital medical development researcher fund(No.2018-1-4161)。
文摘Objective:To evaluate the efficiency of Bushen Huoxue method with ACEI/ARB in treating diabetic kidney disease(stageⅢ).Methods:A total of 8 major electronic databases(CNKI,WanFang,VIP,Sinomed,Pubmed,Embase,Cochrane Liberary,Web of Science)were retrieved since the establishment of the database to October 9,2019.Two reviewers extracted data,and assessed the methodological quality of the included studies.The analysis was made by Stata 15.0 and TSA 0.9 softwares.Results:A total of 10 RCT studies were obtained,including 711 patients with diabetic kidney disease of stageⅢ.Meta-analysis showed that the method of Bushen Huoxue with ACEI/ARB could reduce UAER[WMD=-31.24,95%CI(-42.98,-19.51)],β2-GM[WMD=-92.95,95%CI(-166.05,-19.85)],LDL-C[WMD=-0.19,95%CI(0.19,-0.30)].However,there were no significant effect for HbAlc[WMD=-0.08,95%CI(-0.17,-0.00)],Scr[WMD=-12.96,95%CI(-39.82,13.90)],BUN[WMD=-0.14,95%CI(-0.44,0.17)].The result of TSA indicated that the method of Bushen Huoxue with ACEI/ARB was effective in the treatment of diabetic kidney disease of stageⅢ.Conclusion:The study show that the method of Bushen Huoxue with ACEI/ARB can reduce urinary protein,renal tubular injury and LDL-C in patients with diabetic kidney disease of stageⅢ,and had no effect on HbAlc and renal function.But the conclusion of this study needs further research of high quality.
基金Jiangsu Government Scholarship for Overseas Studies(No.JS-2018-178)Six Talent Peaks Project in Jiangsu Province(No.WSN-022)。
文摘Background:Whether anesthetic depth affects postoperative outcomes remains controversial.This meta-analysis aimed to evaluate the effects of deepvs.light anesthesia on postoperative pain,cognitive function,recovery from anesthesia,complications,and mortality.Methods:PubMed,EMBASE,and Cochrane CENTRAL databases were searched until January 2022 for randomized controlled trials comparing deep and light anesthesia in adult surgical patients.The co-primary outcomes were postoperative pain and delirium(assessed using the confusion assessment method).We conducted a meta-analysis using a random-effects model.We assessed publication bias using the Begg’s rank correlation test and Egger’s linear regression.We evaluated the evidence using the trial sequential analysis and Grading of Recommendations Assessment,Development and Evaluation(GRADE)methodology.We conducted subgroup analyses for pain scores at different postoperative time points and delirium according to cardiac or non-cardiac surgery.Results:A total of 26 trials with 10,743 patients were included.Deep anesthesia compared with light anesthesia(a mean difference in bispectral index of-12 to-11)was associated with lower pain scores at rest at 0 to 1 h postoperatively(weighted mean difference=-0.72,95%confidence interval[CI]=-1.25 to-0.18,P=0.009;moderate-quality evidence)and an increased incidence of postoperative delirium(24.95%vs.15.92%;risk ratio=1.57,95%CI=1.28-1.91,P<0.0001;high-quality evidence).No publication bias was detected.For the exploratory secondary outcomes,deep anesthesia was associated with prolonged postoperative recovery,without affecting neurocognitive outcomes,major complications,or mortality.In the subgroup analyses,the deep anesthesia group had lower pain scores at rest and on movement during 24 h postoperatively,without statistically significant subgroup differences,and deep anesthesia was associated with an increased incidence of delirium after non-cardiac and cardiac surgeries,without statistically significant subgroup differences.Conclusions:Deep anesthesia reduced early postoperative pain but increased postoperative delirium.The current evidence does not support the use of deep anesthesia in clinical practice.
文摘Objective： To evaluate the efficacy and safety of the heated gel mattress for prevention of heat loss on preterm infants with hypothermia during the transport systematically and objectively. Methods： Systematic searches on PubMed, EM- BASE, Cochrane Library, Web of Science, CBM, CNKI, Wanfang and VIP were performed for randomized controlled trials （RCTs） or quasi-RCTs which explored the effects of heated gel mattress on prevention of hypothermia in premature infants relative to conventional alternatives. Studies were screened according to inclusion and exclusion criteria, extracted data and assessed quality. Then, meta-analysis and trial sequential analysis were performed by RevMan 5.3 and TSA vO.9 software developed at the Copenhagen Clinical Trials Center in Denmark, independently. Results： This systematic review included 10 studies which comprised 7 RCTs and 3 quasi-RCTs, encompassing 773 patients. The results of meta-analysis showed that in heated gel mattress group admission temperature on neonatal intensive care unit （SMD, 0.63; 95% CI, 0.40 to 0.87; P = 0.00）, incidence of hypothermia （RR, 0.73; 95% CI, 0.57 to 0.93; P = 0.01） and hyperthermia （RR, 1.82; 95% CI, 1.31 to 2.541 P = 0.00） compared with the control group had significantly statistical difference; however, there was no significant difference in admission temperature on exothermic mattresses or TransWarmer mattress group, mortality, sepsis, retinopathy of prematurity, intraventricular hemorrhage Ⅲ/Ⅳ between two groups, trial sequential analysis confirmed that the pooled results of admission temperature on neonatal intensive care unit and hyperthermia were stable and reliable; but the combination of low-temperature incidence and mortality indicators suggested that the sample size was insufficient. Conclusion： Heated gel mattress is a safe and effective re- warming intervention that can improve body temperature of hypothermic preterm infants during transport, reduce the incidence of hypothermia and does not increase the incidence of morbidity and complications. However, it is recommended that clinical monitoring of body temperature should be performed dynamically to decrease the potential risk of high fever. In addition, due to the limitation of quantity and quality of included studies, its cost-effectiveness and far-reaching influence on long-term follow-up outcomes need further evaluation through clinical multicenter, large sample, and high-quality research.
