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Medicine Mar 2024Spastic paralysis is one of the most common sequelae of stroke, severely affecting patients' limb function and reducing their quality of life. Scalp acupuncture (SA) has... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Spastic paralysis is one of the most common sequelae of stroke, severely affecting patients' limb function and reducing their quality of life. Scalp acupuncture (SA) has been shown to significantly improve cerebral blood supply and reduce the severity of limb spasticity. This meta-analysis aims to systematically evaluate the clinical efficacy of SA in the treatment of post-stroke spastic paralysis, providing evidence-based medicine for clinical management of this condition.
METHODS
We comprehensively searched databases including China National Knowledge Infrastructure, Wanfang Data, VIP Chinese Science and Technology Periodical Database, China Biomedical Literature Database, PubMed, Embase, and Cochrane Library. Randomized controlled trials investigating the efficacy of SA in post-stroke spastic paralysis were identified until July 28, 2023. Meta-analysis was conducted using RevMan 5.4 and Stata17.0.
RESULTS
A total of 16 studies were included. Meta-analysis showed that the modified Ashworth spasticity assessment scale in the SA group was significantly higher than that in the rehabilitation group (mean difference [MD] = -0.56, 95% confidence interval [CI] [-0.75, -0.37], Z = 5.67, P < .00001). The simplified Fugl-Meyer motor function assessment scale in the SA group was significantly higher than that in the rehabilitation group (MD = 5.86, 95% CI [3.26, 8.46], Z = 4.41, P < .0001). The modified Barthel index assessment scale in the SA group was significantly higher than that in the rehabilitation group (MD = 5.79, 95% CI [4.73, 6.84], Z = 10.77, P < .00001). Additionally, the clinical effective rate in the SA group was significantly higher than that in the rehabilitation group (relative risk = 1.25, 95% CI [1.16, 1.36], Z = 5.42, P < .00001).
CONCLUSION
SA combined with rehabilitation therapy has certain advantages in reducing limb spasticity, improving limb function, and enhancing activities of daily living in patients with post-stroke spastic paralysis. This study provides reference and theoretical support for the promotion of SA in the treatment of this condition.
Topics: Humans; Activities of Daily Living; Muscle Spasticity; Quality of Life; Scalp; Stroke; Acupuncture Therapy; Stroke Rehabilitation; Hemiplegia; Paralysis; Upper Extremity; Paresis
PubMed: 38428878
DOI: 10.1097/MD.0000000000037167 -
Frontiers in Neuroscience 2024Many studies have investigated the efficacy of acupuncture in treating depression, but the mechanism of acupuncture for depression is still controversial and there is a...
BACKGROUND
Many studies have investigated the efficacy of acupuncture in treating depression, but the mechanism of acupuncture for depression is still controversial and there is a lack of meta-analysis of mechanisms. Consequently, we investigated acupuncture's efficacy and mechanism of depression.
METHODS
We searched the Cochrane Library, PubMed, EMBASE, Web of Science. The SYRCLE Risk of Bias Tool was used to assess bias risk. Meta-analysis was performed using Stata 15.0 for indicators of depression mechanisms, body weight and behavioral tests.
RESULTS
A total of 22 studies with 497 animals with depressive-like behaviors were included. Meta-analysis showed that acupuncture significantly increased BDNF [SMD = 2.40, 95% CI (1.33, 3.46); = 86.6%], 5-HT [SMD = 2.28, 95% CI (1.08, 3.47); = 87.7%] compared to the control group ( < 0.05), and significantly reduced IL-1β [SMD = -2.33, 95% CI (-3.43, -1.23); I2 = 69.6%], CORT [SMD = -2.81, 95% CI (-4.74, -0.87); = 86.8%] ( < 0.05). Acupuncture improved body weight [SMD = 1.35, 95% CI (0.58, 2.11); = 84.5%], forced swimming test [SMD = -1.89, 95% CI (-2.55, -1.24); = 76.3%], open field test (crossing number [SMD = 3.08, 95% CI (1.98, 4.17); = 86.7%], rearing number [SMD = 2.53, 95% CI (1.49, 3.57); = 87.0%]) ( < 0.05) compared to the control group.
CONCLUSION
Acupuncture may treat animals of depressive-like behaviors by regulating neurotrophic factors, neurotransmitters, inflammatory cytokines, neuroendocrine system.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023403318, identifier (CRD42023403318).
PubMed: 38426019
DOI: 10.3389/fnins.2024.1330594 -
Frontiers in Neurology 2024Cancer-related insomnia (CRI) takes a toll on many cancer survivors, causing distressing symptoms and deteriorating the quality of life. Acupuncture therapy has been...
OBJECTIVES
Cancer-related insomnia (CRI) takes a toll on many cancer survivors, causing distressing symptoms and deteriorating the quality of life. Acupuncture therapy has been used for CRI already. However, it is still uncertain which acupuncture regime is best for CRI. The primary objective of this review is to conduct a comparative evaluation and ranking of the effectiveness of different acupuncture therapies for CRI.
METHODS
Randomized controlled trials (RCTs) that were published up to July 31, 2023, from 8 databases (PubMed, Embase, Cochrane library, Web of Science, China National Knowledge Infrastructure, Wanfang Database, VIP Database, and China Biology Medicine disc) were integrated in this study. Trials that met the inclusion criteria were evaluated the risk of bias. Pittsburgh sleep quality index (PSQI) was used to assess the efficacy of different acupuncture therapies as the primary outcome. Then, STATA 15, R, and OpenBUGS were applied to perform the network meta-analysis. PRISMA statements were followed in this network meta-analysis.
RESULTS
A total of 37 studies were included in this review, involving 16 interventions with 3,246 CRI participants. Auriculotherapy + moxibustion [surface under the cumulative ranking curve (SUCRA) 98.98%] and auriculotherapy (SUCRA 77.47%) came out top of the ranking, which were more effective than control, medicine, usual care and sham acupuncture.
CONCLUSION
Auriculotherapy + moxibustion and auriculotherapy + acupuncture emerged as the top two acupuncture regimes for CRI and future studies should pay more attention to CRI.
CLINICAL TRIAL REGISTRATION
https://clinicaltrials.gov/, identifier INPLASY202210095.
PubMed: 38414556
DOI: 10.3389/fneur.2024.1342383 -
Alternative Therapies in Health and... Feb 2024The effectiveness of manual acupuncture for treating bronchial asthma is still debatable and broad, and the effects of different acupuncture points, treatment durations,...
OBJECTIVE
The effectiveness of manual acupuncture for treating bronchial asthma is still debatable and broad, and the effects of different acupuncture points, treatment durations, or illness trajectories have never been rigorously assessed. The objective of this revised systematic review and subgroup meta-analysis of randomized controlled trials (RCTs) is to ascertain the clinical efficacy of manual acupuncture on bronchial asthma and whether these effects varied depending on the acupuncture points, length of treatment, or course of the disease.
MATERIALS AND METHODS
PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria were followed for creating a systematic review and meta-analysis. From the beginning through March 25, 2022, six electronic databases were checked. For the treatment of asthma, all RCTs contrasting acupuncture therapy along with conventional treatment against conventional treatment alone were chosen. The information was examined using Review Manager version 5.3 and Comprehensive Meta-Analysis version 3. Clinical efficacy (including the effective rate and the recurrence rate) was the primary outcome, and pulmonary function (including FEV1%, PEF) and The secondary results were T-lymphocyte immunity (containing CD3+, CD4+, and CD8+). Based on the acupuncture points, length of therapy, and nature of the condition, subgroup analyses were carried out.
RESULTS
There were a total of 21 RCTs that enrolled 2510 individuals. According to the meta-findings, analysis's manual acupuncture in addition to conventional treatment significantly increased the effective rate when compared to conventional treatment alone [OR = 5.14 95% CI 3.58-7.38, P < .00001], lung functions [FEV1% (MD = 6.18, 95% CI 2.40-9.96, P = .001) and PEF (MD = 0.45 95% CI 0.18-0.73, P = .001)], immune functions [CD3+ T lymphocytes (MD = 7.55 95% CI 6.55-8.56, P < .00001), CD4+ T-lymphocytes (MD = 5.11 95% CI 4.09-6.13, P < .00001), T-lymphocyte CD8+ (MD = -0.37.11 95% CI -3.62--2.51, P < .00001)] and noteworthy reduction in the recurrence rate (OR = 0.19 95% CI 0.10-0.38, P < .00001). Results from the subgroup analysis were consistent.
CONCLUSION
Manual acupuncture combined with Western Medicine is more effective than conventional treatment alone for bronchial asthma. Combination therapy can significantly improve clinical efficacy, lung function, and immune function while reducing the relapse rate. But to further support the results of this investigation, high-quality RCTs with long-term outcomes are still required, taking into account the inherent limitations of the included studies.
REGISTRATION NUMBER
PROSPERO (no. CRD42022357805) (https://www.crd.york.ac.uk/prospero/).
PubMed: 38401063
DOI: No ID Found -
Medicine Feb 2024This study aimed to evaluate the efficacy and safety of electroacupuncture (EA) in the treatment of benign prostatic hyperplasia. (Meta-Analysis)
Meta-Analysis
BACKGROUND
This study aimed to evaluate the efficacy and safety of electroacupuncture (EA) in the treatment of benign prostatic hyperplasia.
METHODS
Seven databases were searched from the inception of each database to March 31, 2023, including PubMed, Web of Science, Cochrane, Embase, China National Knowledge Infrastructure, Wanfang, and China Biology Medicine. The modified Jadad scale was used to assess literature quality, and literature inclusion and exclusion were conducted in strict accordance with the criteria of a score of ≥4. The risk of bias was evaluated using the Cochrane risk of bias tool. The pooled effect size of the binary data was measured by odds ratio (OR) and 95% confidence interval (CI), and the pooled effect size of the continuous data was presented as weighted mean difference (WMD) and 95% CI. If I² was larger than 50%, a random effects model was adopted, and otherwise, a fixed effects model was used. Additionally, publication bias assessment and sensitivity analysis were conducted.
RESULTS
A total of 325 records were retrieved, and finally 9 randomized controlled trial studies were included, involving 1045 patients. Meta-analysis revealed that the EA group had better improvement than the control group in terms of clinical effective rate (odds ratio = 3.92, 95% CI = 2.38 to 6.47, I² = 0%, P < .001), International Prostate Symptom Score (WMD = -4.99, 95% CI = -6.15 to -3.84, I² = 76.9%, P < .001), maximum urinary flow rate (WMD = -4.99, 95% CI = -6.15 to -3.84, I² = 87.4%, P < .001), and post-void residual volume (WMD = -17.12, 95% CI = -29.49 to -4.75, I² = 89.1%, P < .01). There was no statistical significance in prostate volume and adverse events between the EA group and the control group (P > .05).
CONCLUSION
EA is effective in the treatment of benign prostatic hyperplasia with acceptable overall safety.
Topics: Male; Humans; Electroacupuncture; Prostatic Hyperplasia; Transurethral Resection of Prostate; Treatment Outcome; China; Randomized Controlled Trials as Topic
PubMed: 38394501
DOI: 10.1097/MD.0000000000037324 -
Medicine Feb 2024Cancer pain is one of the most intolerable and frightening symptoms of cancer patients. However, the clinical effect of the three-step analgesic ladder method (TSAL) is... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Cancer pain is one of the most intolerable and frightening symptoms of cancer patients. However, the clinical effect of the three-step analgesic ladder method (TSAL) is not satisfactory. The combination of external treatment of traditional Chinese medicine (TCM) can improve the clinical effect.
OBJECTIVE
This study used network meta-analysis to compare the effects of different external treatment methods of TCM combined with TSAL on cancer pain.
METHODS
Databases searched by our team included Google Scholar, Web of Science, Scopus, Embase, PubMed, and Cochrane Library. Randomized controlled trials related to the external treatment of TCM combined with TSAL for cancer pain were screened from the establishment of the database till now. The above literature extracted clinical efficacy, NRS score, KPS score, analgesic onset time, and duration as the main results after the screening. The 95% confidence interval (95% CI) of OR value and SMD value was used as the effect index to compare the difference in efficacy of different interventions, and the ranking was conducted. STATA 17.0 software was used for the statistical analysis of the above data.
RESULTS
A total of 78 studies were included, including 8 interventions and 5742 participants. Based on ranking probability, the clinical effective rate of manual acupuncture combined with TSAL was the best when the intervention time was set at 4 weeks [OR = 5.42, 95% CI (1.99,14.81)], and the improvement effect on KPS score was also the best [SMD = 0.97, 95% CI (0.61, 1.33)]. Acupoint external application was the best intervention in reducing NRS score [SMD = -1.14, 95% CI (-1.90, -0.93)]. Acupoint moxibustion combined with TSAL was considered to be the most effective intervention to prolong the duration of analgesia [SMD = 1.69, 95% CI (0.84, 2.54)] and shortening the onset time of analgesia [SMD = -3.00, 95% CI (-4.54, -1.47)].
CONCLUSIONS
TSAL combined with manual acupuncture is the best in terms of clinical efficacy and improvement of patients' functional activity status. With the extension of treatment time, the intervention of this kind of treatment on the clinical effect is more pronounced. Acupoint external application also has a unique advantage in reducing the pain level of patients. From the point of view of analgesic duration and duration of analgesia, combined acupoint moxibustion has the best effect.
Topics: Humans; Medicine, Chinese Traditional; Cancer Pain; Network Meta-Analysis; Acupuncture Therapy; Pain; Analgesics; Neoplasms
PubMed: 38394488
DOI: 10.1097/MD.0000000000037024 -
Integrative Cancer Therapies 2024Breast cancer is the most commonly diagnosed cancer worldwide, and most patients experience fatigue. However, there are no effective treatments for cancer-related... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Breast cancer is the most commonly diagnosed cancer worldwide, and most patients experience fatigue. However, there are no effective treatments for cancer-related fatigue (CRF). Several randomized controlled trials (RCTs) have suggested that moxibustion improves CRF. We conducted a systematic review and meta-analysis to compare the differences in fatigue scale scores, quality of life, and clinical efficacy in patients with breast cancer who developed CRF and did versus did not receive moxibustion.
METHODS
RCTs were searched in 7 databases using a standardized search method from database inception to March 2023, and RCTs that met the inclusion criteria were selected.
RESULTS
Among 1337 initially identified RCTs, 10 RCTs involving 744 participants were selected for this study. The meta-analysis involved assessment of the revised Piper Fatigue Scale scores, Cancer Fatigue Scale scores, Karnofsky Performance Scale scores, Athens Insomnia Scale scores, clinical efficacy, and Qi deficiency syndrome scale scores. Compared with the control, moxibustion was associated with significantly better Piper Fatigue Scale scores ( < 0.0001), quality of life [Karnofsky Performance Scale scores ( < 0.0001)], clinical efficacy ( = 0.0007), and Qi deficiency syndrome scale scores ( = 0.02).
CONCLUSIONS
Moxibustion improves CRF in patients with breast cancer. The efficacy of moxibustion should be further examined by high-quality studies in various countries with patients subdivided by their breast cancer treatment status.
REGISTRATION
PROSPERO ID: CRD42023451292.
Topics: Humans; Female; Moxibustion; Breast Neoplasms; Quality of Life; Fatigue; Treatment Outcome
PubMed: 38372234
DOI: 10.1177/15347354241233226 -
Heliyon Feb 2024Previous studies have reported alterations in brain structure in major depressive disorder (MDD) patients with suicide attempts. However, age-related changes in suicidal...
BACKGROUND
Previous studies have reported alterations in brain structure in major depressive disorder (MDD) patients with suicide attempts. However, age-related changes in suicidal MDD patients remain unclear.
METHODS
We performed a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Embase, PubMed, and Web of Science were searched to identify relevant studies from inception to January 2023. All voxel-based and surface-based morphometry studies comparing suicidal MDD patients to MDD or healthy controls were included. Studies were then grouped by age range (old, middle-age, adolescent) and the commonalities and age-related structural brain alterations were summarized. The included studies were evaluated using the Newcastle-Ottawa Scale (NOS).
RESULTS
A total of 17 studies met the inclusion criteria, including 3 of late-life depression (LLD) patients, 11 of middle-aged depression (MAD) patients, and 3 of adolescent depression (AOD) patients. The majority of studies had moderate to high NOS scores, indicating good quality. Patients in all three age groups exhibited extensive alterations in the lateral, medial, and orbital regions of the frontal lobes. Furthermore, suicidal MAD patients showed a specific decrease in the gray matter volume of the dorsolateral prefrontal cortex compared to suicidal LLD patients. Cortical thickness and left angular gyrus volume were decreased in suicidal MAD and suicidal LLD patients, but increased in suicidal AOD patients.
CONCLUSION
This systematic review summarizes structural brain changes in suicidal MDD patients at three age groups: elderly, middle-aged, and adolescent. These findings help elucidate the common circuitry of MDD related to suicide over the lifespan and highlight unique circuitry associated with different ages. These findings may help predict the risk of suicide in MDD patients at different ages.
PubMed: 38317985
DOI: 10.1016/j.heliyon.2024.e24894 -
World Journal of Clinical Cases Jan 2024Yangxue Qingnao Granules (YXQN) is a Chinese patent medicine that has been commonly used in the clinical treatment of migraine.
BACKGROUND
Yangxue Qingnao Granules (YXQN) is a Chinese patent medicine that has been commonly used in the clinical treatment of migraine.
AIM
To assess the efficacy and safety of YXQN alone for the treatment of migraine.
METHODS
We searched 10 databases to identify relevant randomized controlled trials (RCTs) published before September 2022. Two review authors independently searched and screened the literature, extracted the data, and assessed the methodological quality of the studies using criteria from ROB 2.0, and analyzed the data using Review Manager 5.4 software.
RESULTS
A total of 12 RCTs including 767 participants with migraine met the selection criteria. We divided these studies into comparisons of YXQN with placebo, routine treatment drugs, and other Chinese patent medicines. The meta-analysis showed the following: (1) Efficacy: The YXQN group outperformed the placebo group [relative risk (RR) = 0.29, 95% confidence interval (95%CI): 0.15-0.43, < 0.00001], routine treatment group (RR = 0.18, 95%CI: 0.09-0.27, < 0.0001), and Chinese patent medicine group (RR = 0.27, 95%CI: 0.13-0.41, < 0.001); (2) frequency of headache: There was a significant difference between YXQN placebo [mean difference (MD) = -1.25, 95%CI: -1.60 to -0.90, < 0.00001], routine treatment drugs (MD = -0.85, 95%CI: -1.15 to -0.56, < 0.00001), and Chinese patent medicine (MD = -0.91, 95%CI: -1.35 to -0.46, < 0.0001); (3) headache duration: We found great heterogeneity between studies, with no differences between YXQN and placebo (MD = -0.61, 95%CI: -1.53 to -0.31, = 0.19) and routine treatment drugs (MD = -0.22, 95%CI: -0.89 to 0.46, < 0.53). YXQN was more effective than other Chinese patent medicines in reducing headache duration (MD = -1.24, 95%CI: -1.70 to -0.77, < 0.00001); and (4) headache severity: There was no significant difference between YXQN placebo (MD = -1.67, 95%CI: -3.52 to 0.19, = 0.08), routine treatment drugs (MD = -0.53, 95%CI: -2.02 to 0.96, = 0.68), and other Chinese patent medicines (MD = -0.49, 95%CI: -2.83 to 1.85, = 0.68). Mild gastrointestinal adverse reactions were reported in three cases.
CONCLUSION
This study revealed that YXQN is effective and safe for treatment of migraine.
PubMed: 38313632
DOI: 10.12998/wjcc.v12.i2.335 -
Heliyon Jan 2024Nausea and vomiting, which cause considerable multifaceted effects, are commonly experience in early pregnancy. Various therapeutic strategies are employed, including...
BACKGROUND
Nausea and vomiting, which cause considerable multifaceted effects, are commonly experience in early pregnancy. Various therapeutic strategies are employed, including both conventional agents and complementary medicine. However, the effectiveness of complementary medicine remains controversial. The objective of this meta-analysis is to evaluate efficacy and safety of acupuncture and moxibustion in pregnant women.
METHODS
We conducted a comprehensive search using electronic databases such as PubMed, Embase, ISI Web, Medline, Cochrane, clinicaltrial.gov, and several Chinese databases. A total of 21 randomized controlled trials were included in this study for quantitative analysis. Forest plots were utilized to evaluate the efficacy and safety of acupuncture and moxibustion. Egger's test was employed to assess publication bias.
RESULTS
The pooled analysis revealed that the acupuncture/moxibustion group was more effective than control group in alleviating nausea and vomiting in early pregnant women (RR: 0.28; 95%CI: 0.21, 0.37). Similar results were observed when comparing the acupuncture group to traditional herbs (RR: 0.08; 95 % CI: 0.01, 0.60), conventional therapy (RR: 0.15; 95 % CI: 0.04, 0.57), and the blank control group (RR: 0.33; 95 % CI: 0.22, 0.51). Moxibustion also exhibited the ability to alleviate nausea and vomiting compared with the blank control group (RR: 0.21; 95 % CI: 0.08, 0.52). As for safety, there were no significant differences in severe adverse events between the acupuncture group and the control group (RR: 0.77; 95%CI: 0.52, 1.14), the blank control group (RR: 0.61; 95%CI: 0.34, 1.10), the sham acupuncture group (RR: 1.05; 95%CI: 0.63, 1.73), or the conventional therapy group (RR: 0.32; 95%CI: 0.06, 1.55).
CONCLUSION
Acupuncture and moxibustion might be effective for the management of nausea and vomiting in early pregnant women. Moreover, acupuncture might be a relatively safe treatment for pregnancy.
PubMed: 38298660
DOI: 10.1016/j.heliyon.2024.e24439