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Archives of Gynecology and Obstetrics Apr 2024The purpose of this study was to evaluate the efficacy and safety of acupressure on nausea and vomiting during pregnancy. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The purpose of this study was to evaluate the efficacy and safety of acupressure on nausea and vomiting during pregnancy.
METHODS
PubMed, Embase, Springer, Web of Science, and the Cochrane Library were searched for all randomized controlled trials (RCT) of treating nausea and vomiting during pregnancy by acupressure from the inception date of database to July 31st, 2023. Study selection, data extraction, and risk of bias assessment were conducted independently by researchers. The methodological quality of included studies was evaluated by the Cochrane Collaboration's bias risk assessment tool, meta-analysis by Stata 17.0 software, and publication bias by Begg's test.
RESULTS
A total of 11 RCTs involving 1378 pregnant women were included in this review, which was assessed to be moderate quality. 10 RCTs involving 1298 pregnant women were assessed for the meta-analysis. The results revealed that acupressure showed significant difference on improvement in symptom score compared with sham acupressure (pooled MD, - 1.33; 95%CI [- 2.06, - 0.61]; P < 0.001) or control group (pooled MD, - 0.73; 95%CI [- 1.08, - 0.39]; P < 0.001), and incidence of effective rate compared with sham acupressure group (pooled RR, 1.78; 95%CI [1.03, 3.07]; P = 0.039). However, no statistical significance was found between acupressure and control group (pooled RR, 4.53; 95%CI [0.67, 30.48]; P = 0.120) on effective rate. On comparing acupressure with sham acupressure, there was no beneficial effect on preventing nausea and vomiting during pregnancy (pooled RR, 0.83; 95%CI [0.50, 1.38]; P = 0.476), shortening the duration of hospital stay (pooled MD, - 0.78; 95%CI [- 1.98, 0.41]; P = 0.199) and improving patient satisfaction (pooled RR, 1.36; 95%CI [0.47, 3.91]; P = 0.570). Begg's test did not reveal any publication bias. Only one RCT reported minimal acupressure-related adverse events.
CONCLUSION
Acupressure may have potential favorable or encouraging effect on treating nausea and vomiting during pregnancy, but strong supportive data are not yet available. Well-designed and large-scale RCTs should be conducted for assessing and confirming the efficacy and safety of acupressure in nausea and vomiting during pregnancy.
Topics: Female; Pregnancy; Humans; Acupressure; Randomized Controlled Trials as Topic; Vomiting; Nausea
PubMed: 38104041
DOI: 10.1007/s00404-023-07313-0 -
International Journal of Environmental... Feb 2023This study investigated the effects of non-pharmacological interventions on sleep in older people through a systematic review and meta-analysis. We conducted a... (Meta-Analysis)
Meta-Analysis Review
This study investigated the effects of non-pharmacological interventions on sleep in older people through a systematic review and meta-analysis. We conducted a literature search using eight electronic databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. Participant characteristics, the contents of the evaluated interventions, and the measured outcomes were systematically reviewed for 15 selected studies. We performed a meta-analysis to estimate the effect size for overall, aggregated sleep outcomes. Due to the small number of studies available for each intervention, only the overall effectiveness of non-pharmacological sleep interventions was evaluated. The evaluated interventions included exercise, aromatherapy, acupressure, cognitive behavior therapy, and meditation. Our results demonstrated that non-pharmacological interventions showed statistically significant effects on sleep (effect size = 1.00, 95% confidence interval: 0.16, 1.85, I = 92%, < 0.001). After confirming publication bias and removing outliers, we found no heterogeneity (I = 17%, = 0.298), with a decrease in effect size to 0.70 (95% confidence interval: 0.47, 0.93). Non-pharmacological interventions are effective for improving sleep in older adults. Future studies should continue to investigate sleep problems and interventions addressing these problems in this demographic, particularly in older women. Objective measures should be used to follow-up on the evaluated sleep interventions over the long term.
Topics: Humans; Female; Aged; Sleep Wake Disorders; Cognitive Behavioral Therapy; Sleep; Aromatherapy; Meditation
PubMed: 36833796
DOI: 10.3390/ijerph20043101 -
Complementary Therapies in Clinical... Aug 2022and purpose: Among chronic kidney disease (CKD) patients, manipulative and body-based methods (MBM) have demonstrated efficacy in improving symptoms such as fatigue.... (Review)
Review
BACKGROUND
and purpose: Among chronic kidney disease (CKD) patients, manipulative and body-based methods (MBM) have demonstrated efficacy in improving symptoms such as fatigue. This review aims to summarize the efficacy and safety of MBM among CKD patients.
METHODS
A systematic review was performed in PubMed, Embase, Scopus, CINAHL, CENTRAL and PsycInfo. Randomised controlled trials (RCTs) which evaluated the use of MBM among adult CKD patients were included. The grading of recommendations, assessment, development, and evaluation (GRADE) approach was used to determine the risk of bias and certainty of evidence. The efficacy of each MBM was determined by reduction in symptom severity scores. All adverse reactions were documented.
RESULTS
Of 8529 articles screened, 55 RCTs were included. Acupressure (n = 23), massage therapy (n = 17), reflexology (n = 6) and acupuncture (n = 5) were the most studied MBMs. Acupressure and reflexology were shown to reduce sleep disturbance and fatigue by 6.2-50.0% and 9.1-37.7% respectively. For uremic pruritus, acupressure and acupuncture reduced symptoms by 34.5-77.7% and 56.5-60.2% respectively. Common adverse reactions associated with acupressure included intradialytic hypotension (20.4%) and dizziness (11.1%) while that of acupuncture included elbow soreness (7.5%) and bleeding (7.5%). No adverse effects were reported for massage therapy, moxibustion, reflexology and yoga therapy.
CONCLUSION
Acupressure, reflexology and massage therapies were the most well-studied MBMs which have demonstrated efficacy in alleviating sleep disturbance, fatigue and uremic pruritus symptoms in CKD patients.
Topics: Acupressure; Adult; Fatigue; Humans; Pruritus; Randomized Controlled Trials as Topic; Renal Insufficiency, Chronic
PubMed: 35439704
DOI: 10.1016/j.ctcp.2022.101593 -
Frontiers in Neuroscience 2023The number of randomized controlled trials using auricular stimulation (AS) such as transauricular vagus nerve stimulation, or other auricular electrostimulation or...
BACKGROUND
The number of randomized controlled trials using auricular stimulation (AS) such as transauricular vagus nerve stimulation, or other auricular electrostimulation or auricular acupuncture or acupressure, in experimental and clinical settings, has increased markedly over the last three decades. This systematic review focusses on cardiovascular effects of auricular stimulation.
METHODS AND ANALYSIS
The following databases were searched: MEDLINE (PubMed), EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), ISI Web of Science, and Scopus Database. RCTs were reviewed that had been published in English and European languages. Data collection and analysis was conducted by two reviewers independently. Quality and risk assessment of included studies was performed and the meta-analysis of the effect of the most frequently assessed biomarkers.
RESULTS
Altogether, 78 trials were included. 38 studies assessed heart rate (HR), 19 studies analyzed heart rate variability (HRV), 31 studies analyzed blood pressure (BP) and 7 studies were identified that measured oxygen saturation (O2), 2 studies on baroreflex sensitivity and 2 studies on skin conductance were evaluated in this review. 26 studies contained continuous data and were eligible for meta-analysis, 50 trials reported non continuous data and were evaluated descriptively. The overall quality of the studies was moderate to low. AS leads to a significant reduction of HR, the changes though were not considered an adverse reaction. Furthermore, when looking at HRV, AS was able to reduce the LF/HF ratio significantly compared to control procedures. No other cardiovascular parameters (blood pressure, oxygen saturation, baroreflex sensitivity) were changed significantly. AS produced only minor side effects in all trials.
CONCLUSION
AS can lead to clinically safe reduction of HR and changes in the LF/HF ratio of the HRV, which is presumably via an increase in vagal activity. More research is needed to clarify whether AS can be used to modulate tachycardia or indications with autonomic imbalance.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=231885 PROSPERO, ID CRD42021231885.
PubMed: 37727325
DOI: 10.3389/fnins.2023.1227858 -
BMC Complementary Medicine and Therapies May 2020This is the second part of a large spectrum systematic review which aims to identify and assess the evidence for the efficacy of non-pharmacological acupuncture... (Meta-Analysis)
Meta-Analysis
BACKGROUND
This is the second part of a large spectrum systematic review which aims to identify and assess the evidence for the efficacy of non-pharmacological acupuncture techniques in the treatment of chronic obstructive pulmonary disease (COPD). The results of all techniques except for filiform needle are described in this publication.
METHODS
Eleven different databases were screened for randomised controlled trials up to June 2019. Authors in pairs extracted the data and assessed the risk of bias independently. RevMan 5.3 software was used for the meta-analysis.
RESULTS
Thirty-three trials met the inclusion criteria, which involved the follow techniques: AcuTENS (7 trials), moxibustion (11 trials), acupressure (7 trials), ear acupuncture (6 trials), acupressure and ear acupuncture combined (1 trial) and cupping (1 trial). Due to the great heterogeneity, only 7 meta-analysis could be performed (AcuTENS vs sham on quality of life and exercise capacity, acupressure vs no acupressure on quality of life and anxiety and ear acupuncture vs sham on FEV and FEV/FVC) with only acupressure showing statistical differences for quality of life (SMD: -0.63 95%CI: - 0.88, - 0.39 I = 0%) and anxiety (HAM-A scale MD:-4.83 95%CI: - 5.71, - 3.94 I = 0%).
CONCLUSIONS
Overall, strong evidence in favour of any technique was not found. Acupressure could be beneficial for dyspnoea, quality of life and anxiety, but this is based on low quality trials. Further large well-designed randomised control trials are needed to elucidate the possible role of acupuncture techniques in the treatment of COPD.
TRIAL REGISTRATION
PROSPERO (identifier: CRD42014015074).
Topics: Acupuncture Therapy; Humans; Pulmonary Disease, Chronic Obstructive; Randomized Controlled Trials as Topic
PubMed: 32375775
DOI: 10.1186/s12906-020-02899-3 -
Kidney360 Mar 2021Adults with dialysis-dependent ESKD experience higher rates of depression than the general population, yet efficacy of depression treatments in this population is not... (Review)
Review
Adults with dialysis-dependent ESKD experience higher rates of depression than the general population, yet efficacy of depression treatments in this population is not well understood. We conducted a systematic review of the benefits and harms of depression treatment in adults with ESKD. We searched multiple data sources through June 2020 for English-language, controlled trials that compared interventions for depression in adults with ESKD to another intervention, placebo, or usual care, and reported depression treatment-related outcomes. Observational studies were included for harms. Two investigators independently screened all studies using prespecified criteria. One reviewer abstracted data on study design, interventions, implementation characteristics, and outcomes, and a second reviewer provided confirmation. Two reviewers independently assessed study quality and resolved any discords through discussion or a third reviewer. Strength of evidence (SOE) was assessed and agreed upon by review-team consensus. We qualitatively analyzed the data and present syntheses in text and tables. We included 26 RCTs and three observational studies. SSRIs were the most studied type of drug and the evidence was largely insufficient. We found moderate SOE that long-term, high-dose vitamin D3 is ineffective for reducing depression severity. Cognitive behavioral therapy is more effective than (undefined) psychotherapy and placebo for depression improvement and quality of life (low SOE), and acupressure is more effective than usual care or sham acupressure in reducing depression severity (low SOE). There is limited research evaluating treatment for depression in adults with ESKD, and existing studies may not be generalizable to adults in the United States. Studies suffer from limitations related to methodologic quality or reporting. More research replicating studies of promising interventions in US populations, with larger samples, is needed. : PROSPERO, CRD42020140227.
Topics: Adult; Cognitive Behavioral Therapy; Depression; Humans; Psychotherapy; Quality of Life; Renal Dialysis
PubMed: 35369008
DOI: 10.34067/KID.0003142020 -
Evidence-based Complementary and... 2021We aim to provide available synthesized evidence of the efficacy and safety of auricular acupressure for cancer patients with sleep disturbance. (Review)
Review
AIM
We aim to provide available synthesized evidence of the efficacy and safety of auricular acupressure for cancer patients with sleep disturbance.
METHODS
Randomized controlled clinical trials (RCTs) were identified from PubMed, EMBASE, Web of Science, The Cochrane Library, PsycINFO, Chinese Biomedical Database, China National Knowledge Infrastructure, Chongqing VIP, and Wanfang Data, and the search date ranged from the inception of the databases to May 2021. Literature screening and data extraction were independently performed by three researchers. The Cochrane collaboration's tool for assessing the risk of bias was applied to evaluate the risk of bias of the RCTs included. The extracted data were analyzed using Rev-Man 5.4.1 software.
RESULTS
Nine trials involving 688 participants met the inclusion criteria and were included in the qualitative analysis; 6 trials involving 485 participants were included in the meta-analysis. Synthesized results showed that auricular acupressure had a significant effect on reducing the total Pittsburgh Sleep Quality Index (PSQI) score (MD = -3.88, 95% CI (-5.24, -2.53), < 0.00001), and the scores of five PSQI components, sleep latency (MD = -0.53, 95% CI (-0.73, -0.32), < 0.00001), subjective sleep quality (MD = -0.79, 95% CI (-1.05, -0.53), < 0.00001), sleep duration (MD = -0.50, 95% CI (-0.69, -0.31), < 0.0001), daytime dysfunction (MD = -0.53, 95% CI (-0.77, -0.29), < 0.0001), and sleep disturbances (MD = -0.54, 95% CI (-0.60, -0.49), < 0.00001), were also obviously decreased after the intervention of auricular acupressure. Shenmen and heart were the most commonly selected auricular acupoints, the main intervention durations ranged from 10 to 42 days, and the pressing times of auricular acupoints were 1-6 times a day, 1-5 min each time. One trial reported slight and transient pain caused by auricular acupressure, while the remaining 8 trials did not report obvious side effects.
CONCLUSION
Auricular acupressure can significantly improve the sleep quality of cancer patients with sleep disturbance, with no obvious side effects. Rigorously designed clinical trials are necessary for the further support of the clinical application.
PubMed: 34691214
DOI: 10.1155/2021/3996101 -
Frontiers in Public Health 2021The mind-body therapies of traditional Chinese medicine include several intervention types and combine physical poses with conscious relaxation and breathing...
The mind-body therapies of traditional Chinese medicine include several intervention types and combine physical poses with conscious relaxation and breathing techniques. The purpose of this Evidence Map is to describe these different interventions and report related health outcomes. This evidence map is based on the 3iE Evidence Gap Map methodology. We searched seven electronic databases (BVS, PUBMED, EMBASE, PEDro, ScienceDirect, Web of Sciences, and PschyInfo) from inception to November 2019 and included systematic reviews only. Systematic reviews were analyzed based on AMSTAR 2. We used Tableau to graphically display quality assessment, the number of reviews, outcomes, and effects. The map is based on 116 systematic reviews and 44 meta-analyses. Most of the reviews were published in the last 5 years. The most researched interventions were Tai Chi and Qi Gong. The reviews presented the following quality assessment: 80 high, 43 moderate, 23 low, and 14 critically low. Every 680 distinct outcome effect was classified: 421 as potential positive; 237 as positive; 21 as inconclusive/mixed; one potential negative and none no effect. Positive effects were related to chronic diseases; mental indicators and disorders; vitality, well-being, and quality of life. Potential positive effects were related to balance, mobility, Parkinson's disease, hypertension, joint pain, cognitive performance, and sleep quality. Inconclusive/mixed-effects justify further research, especially in the following areas: Acupressure as Shiatsu and Tuiná for nausea and vomiting; Tai Chi and Qi Gong for acute diseases, prevention of stroke, stroke risk factors, and schizophrenia. The mind-body therapies from traditional Chinese medicine have been applied in different areas and this Evidence Map provides a visualization of valuable information for patients, professionals, and policymakers, to promote evidence-based complementary therapies.
Topics: Humans; Medicine, Chinese Traditional; Mind-Body Therapies; Quality of Life; Tai Ji
PubMed: 34988045
DOI: 10.3389/fpubh.2021.659075 -
Healthcare (Basel, Switzerland) Mar 2023In situations where death by suicide is a major global issue and effective prevention and management approaches are lacking, acupuncture improves some risk factors for... (Review)
Review
In situations where death by suicide is a major global issue and effective prevention and management approaches are lacking, acupuncture improves some risk factors for suicide, including depression, and it has been used for a long time in clinical settings. Herein, we aimed to assess the effectiveness and safety of acupuncture in the treatment of suicidal behaviors. Fourteen electronic databases were searched for studies published up to 7 September 2022. Original interventional studies of acupuncture in suicide prevention were included. The primary outcome was the validated measure of suicidal ideation. The risk of bias in the included studies was assessed using an appropriate assessment tool. Due to the heterogeneity of the included studies, only qualitative analyses were conducted. Eight studies on manual acupuncture (50%), electro-acupuncture (37.5%), and acupressure (12.5%) were included. In particular, three studies (37.5%) used the National Acupuncture Detoxification Association protocol to stimulate the bilateral sympathetic, Shenmen, kidney, liver, and lung auricular points. Acupuncture was effective in direct and indirect outcomes related to suicidal behavior, not only for participants with suicidal behavior, but also for those with other conditions, including depression. A decrease in salivary cortisol was the only biological indicator of acupuncture in patients with suicidal ideation. However, the methodological quality of the included studies was not optimal. In conclusion, acupuncture may reduce the risk of suicidal behavior in clinical and non-clinical populations. Owing to clinical heterogeneity, low methodological quality, and the small number of included studies, further high-quality studies should assess the effectiveness of acupuncture.
PubMed: 37046882
DOI: 10.3390/healthcare11070955 -
Cancer Nursing Apr 2023Nausea and vomiting are distressing symptoms reported by pediatric oncology patients during cancer treatment. More than 40% of them experience these symptoms even after...
BACKGROUND
Nausea and vomiting are distressing symptoms reported by pediatric oncology patients during cancer treatment. More than 40% of them experience these symptoms even after receiving antiemetics.
OBJECTIVE
Given the limitations of pharmacological interventions, this systematic review synthesized the evidence for the effectiveness of complementary and alternative medicine in controlling nausea and vomiting among pediatric oncology patients.
METHODS
Ten databases were searched to identify relevant randomized controlled trials. The risk of bias of selected studies was graded using the Cochrane risk-of-bias tool for randomized trials. The primary outcomes were nausea and vomiting. The secondary outcomes were intervention adherence and number of adverse events.
RESULTS
Nineteen papers met the inclusion criteria and were included in the review. Sixteen studies showed high risk of bias. The tested interventions were acupuncture, acupressure, aromatherapy, hypnosis, massage, active cognitive distraction/relaxation techniques, creative arts therapy, psychoeducation, and combined massage and acupressure. Acupuncture, hypnosis, and massage interventions improved nausea and vomiting. Fifteen trials reported intervention adherence; only 7 monitored adverse events. The most common reason for dropout was refusal from patients and/or their guardians. A total of 34 adverse events were noted.
CONCLUSIONS
There is insufficient evidence that complementary and alternative medicine is effective, feasible, or safe in controlling nausea and vomiting among pediatric oncology patients due to high risk of bias.
IMPLICATIONS FOR PRACTICE
Acupuncture, hypnosis, and massage appear to have therapeutic benefits. However, more robust studies are needed to address the identified methodological issues and determine the real value of these 3 interventions.
PubMed: 37026978
DOI: 10.1097/NCC.0000000000001239