针灸治疗纤维肌痛:证据图

Objective:The body of research on acupuncture as a treatment strategy for fibromyalgia(FM)is steadily growing.This evidence map identifies,describes,and summarizes the current status of studies conducted to evaluate the efficacy of acupuncture for FM,identify research gaps,and provide information that could guide the design of future studies.Methods:Seven electronic databases–Cochrane Library,PubMed,Embase,China Biomedical Literature Database,VIP,Wanfang Database,and Chinese National Knowledge Infrastructure–were searched for relevant articles on acupuncture for FM.The search period was from the dates of inception of the databases to December 19,2022.Original clinical studies and systematic reviews on the use of acupuncture-related modalities for the treatment of FM were included.The basic information,quality assessments,and evidence maps of the included studies are presented as charts and bubble plots.The quality assessment tools used for evaluating the different types of studies included in the present study were Cochrane Collaboration’s tool,Canadian Institute of Health Economics quality appraisal tool,and A MeaSurement Tool to Assess systematic Reviews 2.Results:Fifty studies were included in this study.Of these,39(78.00%)were randomized controlled trials(RCTs),6(12.0%)were case series,and 5(10.0%)were systematic reviews.The included studies focused on manual acupuncture and conventional treatment in the treatment and control groups,respectively.The outcomes analyzed in the RCTs included pain(94.9%),sleep quality(46.2%),depression(46.2%),physical function(46.2%),stiffness(35.9%),well-being(35.9%),work status(35.9%),anxiety(33.3%),fatigue(33.3%),quality of life(17.9%),and overall effective rate(10.3%).The methodological quality of most of the studies was low or critically low regardless of the study design.In most studies,the therapeutic effect of acupuncture was significantly superior to that of the comparator.

A global review of acupuncture and moxibustion recommendations in guidelines/expert consensus for chemotherapy-and/or radiotherapy-induced nausea and/or vomiting

Objective:To summarize and analyze the recommendations of acupuncture and moxibustion in the global guidelines/expert consensus of chemotherapy-and/or radiotherapy-induced nausea and/or vomiting,providing a basis for the development of clinical practice guidelines on acupuncture and moxibustion for chemotherapy-and/or radiotherapy-induced nausea and/or vomiting.Methods:We systematically searched 7 comprehensive databases,7 guideline libraries and 4 websites of societies/associations.The retrieval period was from the inception to April 1,2023.Two researchers independently screened the literature,extracted data,and used the Scientific,Transparent,and Applicable Rankings(STAR)tool to evaluate the quality of guidelines/expert consensus that contained acupuncture and moxibustion recommendations,and analyzed acupuncture and moxibustion recommendations in guidelines/expert consensus and their evidence base.Results:A total of 56 guidelines/expert consensus related to the prevention and treatment of chemotherapy-and/or radiotherapy-induced nausea and/or vomiting were included,and 22 guidelines/expert consensus contained acupuncture and moxibustion recommendations,with a total of 34 recommendations on acupuncture and moxibustion(27 supports,4 neutrals,3 objections).The STAR evaluation(excluding 1 patient version of guideline)showed that none of the guidelines/expert consensus was with high quality,95.24%(20/21)with medium quality,and 4.76%(1/21)with low quality.Although there were many recommendations of acupuncture and moxibustion in the existing guidelines/expert consensus,there was great heterogeneity among the acupuncture and moxibustion treatment regimens.Moreover,most of the guidelines/expert consensus did not describe the details of acupuncture and moxibustion treatment regimens,such as acupuncture and moxibustion manipulation,acupoint selection,course and timing of treatment,which is difficult to guide the clinical practice of acupuncture and moxibustion.Conclusion:Developing clinical practice guidelines of acupuncture and moxibustion for chemotherapyand/or radiotherapy-induced nausea and/or vomiting according to the items of the STAR tool was urgent,so as to clarify the details of acupuncture and moxibustion regimens and provide standardized treatment regimens to guide the clinical practice of acupuncture and moxibustion.

针灸缓解带状疱疹后遗神经痛患者疼痛:概况性评价

Objective:To summarize the available evidence of acupuncture for pain relief in the patients with postherpetic neuralgia(PHN)using a scoping review.Methods:Seven electronic databases of the original studies of acupuncture on PHN were retrieved.The search time was from the inception to May 1,2021.Two researchers screened the title,abstract and full text of each article independently.The original studies that was met the inclusion criteria were collected and analyzed,and finally presented with a qualitative description.Results:A total of 216 original studies were eligible and all of them were randomized controlled trials.The acupuncture therapies with the highest use frequency included manual acupuncture,pricking and cupping and electroacupuncture.Acupuncture therapies were mostly combined with other interventions in studies.There were large differences in acupoint selection,time duration for single treatment and the total treatment times.It was believed in all of the included studies that acupuncture was effective of pain relief in PHN and 85.65%of the studies obtained the minimum clinical importance difference(MCID),suggesting the clinical effectiveness.The adverse reaction of acupuncture was low in its incidence,and mostly transient in occurrence.Conclusion:The study type of acupuncture for PHN is relatively simple.Most studies show the advantages of acupuncture in pain relief of PHN.The quality of study needs to be improved.

Acupuncture for atopic eczema:Evidence mapping-based randomized controlled trials,systematic reviews,and meta-analyses

Background:Acupuncture is used to relieve symptoms,reducing recurrence,and improve the lives of patients with skin diseases.Objective:To identify,describe,and organize the available evidence on acupuncture for atopic eczema(AE)using evidence mapping of randomized controlled trials(RCTs),systematic reviews(SRs),and metaanalyses.Methods:We searched eight databases from inception to October 30,2021,for RCTs,SRs,and metaanalyses of acupuncture for patients with AE.Two reviewers screened the papers,before extracting the data and assessing the quality of the included studies.The basic and clinical characteristics,and quality of assessment of the studies were assessed using descriptive statistics and qualitative analyses.A bubble plot was used to visualize the evidence map to indicate the relationship between the type and frequency of outcomes,the quality and overall effects of acupuncture,and the outcomes of the studies.Results:Forty-five studies(Forty RCTs,five SRs,and meta-analyses)were included.The number of publications increased rapidly after 2013 and peaked in 2019.The most frequently applied intervention was one type of acupuncture therapy.The most frequent comparison was between acupuncture and active medicine.The symptomatic outcome was the most commonly used,and the quality of the included studies was relatively low.All included studies showed a significantly better outcome in the acupuncture group compared to the control group(P<0.05).Most outcomes in the included studies were of low or critically low quality.Several symptomatic outcomes and health-related quality of life outcomes in the included RCTs indicated moderate quality,while some symptomatic outcomes and global symptom improvement in the included SRs and meta-analyses indicated low quality.Conclusion:The majority of studies related to acupuncture for AE indicated promising results,but with relatively low quality;thus,further studies with more robust designs should be conducted to validate the results.