Objective To compare and rank the clinical effects of different acupuncture and related therapies on hyperlipidemia patients.Methods We used network meta-analysis(NMA)to evaluate direct and indirect effects in studies...Objective To compare and rank the clinical effects of different acupuncture and related therapies on hyperlipidemia patients.Methods We used network meta-analysis(NMA)to evaluate direct and indirect effects in studies of acupuncture and related therapies for hyperlipidemia.Databases PubMed,EMBASE,Cochrane Library,the China Biology Medicine(CBM),the China National Knowledge Infrastructure(CNKI),Wanfang Data and the Chinese Scientific Journal Database(VIP)were searched to collect randomized controlled trials(RCTs)of acupuncture and related therapies in the treatment of hyperlipidemia.The data were analyzed using Stata 15.0 and WinBUGS 1.4.3 software after two researchers independently screened the literature,extracted the data,and assessed the risk of bias in the included studies.Results We analyzed a total of 36 eligible studies that included 3124 patients,involving 12 types of acupuncture and related therapies and comprehensive therapies.The results of the NMA showed that:for the total cholesterol(TC),acupoint catgut embedding(ACE),simple acupuncture(ACU),acupoint injection(AI),electroacupuncture(EA),western medicine of statins(WM),and combination of acupuncture and related therapies(combined therapies)were all more effective than placebo(P<0.05).For triacylglycerol(TG),ACU,EA,warming acupuncture(WA),WM and combined therapies were better than placebo(P<0.05),while WA was better than Chinese herb(CH)(P<0.05).For low-density lipoprotein cholesterol(LDL-C),combined therapies were more effective than lifestyle modification(LM)(P<0.05).For high-density lipoprotein cholesterol(HDL-C),auricular acupoint stimulation(AAS),ACE,ACU,AI,CH,EA,LM,moxibustion(MOX),WM,combined therapies and placebo were all worse than WA(P<0.05),while WM and combined therapies were better than ACU(P<0.05).Combined ranking results suggest that ACU and combined therapies may be the optimal intervention.Conclusions The efficacy of all kinds of acupuncture-related therapies in patients with hyperlipidemia is better than lifestyle changes.However,for different outcome indicators,all kinds of acupuncture-related therapies have their advantages and disadvantages,and comprehensive ranking results suggest that ACU and combined therapies may be the optimal intervention.展开更多
As the worldwide population ages, the prevalence of Alzheimer's disease (AD) increases. However, the results of promising medications have been unsatisfactory. Chinese acupuncture has a long history of treating de...As the worldwide population ages, the prevalence of Alzheimer's disease (AD) increases. However, the results of promising medications have been unsatisfactory. Chinese acupuncture has a long history of treating dementia, but lack of evidence from well-designed randomized controlled trials that validate its efficacy and safety, as well as its lack of clear underlying mechanisms, contribute to its limited application in clinical practice. In recent years, brain imaging technologies, such as functional magnetic resonance imaging and positron emission tomography, have been used to assess brain responses to acupuncture in a dynamic, visual, and objective way. These techniques are frequently used to explore neurological mechanisms of responses to acupuncture in AD and provide neuroimaging evidence as well as starting points to elucidate the possible mechanisms. This review summarizes the existing brain imaging evidence that explains the effects of acupuncture for AD and analyzes brain responses to acupuncture at cognitive-related acupoints [Baihui (GV 20), Shenmen (HT 7), Zusanli (ST 36), Neiguan (PC 6), and Taixi (KI 3)] from perspectives of acupoint specificity and acupoint combinations. Key issues and directions to consider in future studies are also put forward. This review should deepen our understanding of how brain imaging studies can be used to explore the underlying mechanisms of acupuncture in AD.展开更多
基金We thank for the funding support from the“Qihuang”Project on the Inheritance and Innovation of Traditional Chinese Medicine funded by National Administration of Traditional Chinese Medicine(No.284,2018).
文摘Objective To compare and rank the clinical effects of different acupuncture and related therapies on hyperlipidemia patients.Methods We used network meta-analysis(NMA)to evaluate direct and indirect effects in studies of acupuncture and related therapies for hyperlipidemia.Databases PubMed,EMBASE,Cochrane Library,the China Biology Medicine(CBM),the China National Knowledge Infrastructure(CNKI),Wanfang Data and the Chinese Scientific Journal Database(VIP)were searched to collect randomized controlled trials(RCTs)of acupuncture and related therapies in the treatment of hyperlipidemia.The data were analyzed using Stata 15.0 and WinBUGS 1.4.3 software after two researchers independently screened the literature,extracted the data,and assessed the risk of bias in the included studies.Results We analyzed a total of 36 eligible studies that included 3124 patients,involving 12 types of acupuncture and related therapies and comprehensive therapies.The results of the NMA showed that:for the total cholesterol(TC),acupoint catgut embedding(ACE),simple acupuncture(ACU),acupoint injection(AI),electroacupuncture(EA),western medicine of statins(WM),and combination of acupuncture and related therapies(combined therapies)were all more effective than placebo(P<0.05).For triacylglycerol(TG),ACU,EA,warming acupuncture(WA),WM and combined therapies were better than placebo(P<0.05),while WA was better than Chinese herb(CH)(P<0.05).For low-density lipoprotein cholesterol(LDL-C),combined therapies were more effective than lifestyle modification(LM)(P<0.05).For high-density lipoprotein cholesterol(HDL-C),auricular acupoint stimulation(AAS),ACE,ACU,AI,CH,EA,LM,moxibustion(MOX),WM,combined therapies and placebo were all worse than WA(P<0.05),while WM and combined therapies were better than ACU(P<0.05).Combined ranking results suggest that ACU and combined therapies may be the optimal intervention.Conclusions The efficacy of all kinds of acupuncture-related therapies in patients with hyperlipidemia is better than lifestyle changes.However,for different outcome indicators,all kinds of acupuncture-related therapies have their advantages and disadvantages,and comprehensive ranking results suggest that ACU and combined therapies may be the optimal intervention.
基金Supported by National Natural Science Foundation of China(No.81373741)Chinese Medicine and Integrated Medicine Research Projects(2017,No.20) funded by Health and Family Planning Commission of Hubei Province(No.24)Hubei Provincial Collaborative Innovation Center of Preventive Treatment by Acupuncture and Moxibustion(2014,No.8)
文摘As the worldwide population ages, the prevalence of Alzheimer's disease (AD) increases. However, the results of promising medications have been unsatisfactory. Chinese acupuncture has a long history of treating dementia, but lack of evidence from well-designed randomized controlled trials that validate its efficacy and safety, as well as its lack of clear underlying mechanisms, contribute to its limited application in clinical practice. In recent years, brain imaging technologies, such as functional magnetic resonance imaging and positron emission tomography, have been used to assess brain responses to acupuncture in a dynamic, visual, and objective way. These techniques are frequently used to explore neurological mechanisms of responses to acupuncture in AD and provide neuroimaging evidence as well as starting points to elucidate the possible mechanisms. This review summarizes the existing brain imaging evidence that explains the effects of acupuncture for AD and analyzes brain responses to acupuncture at cognitive-related acupoints [Baihui (GV 20), Shenmen (HT 7), Zusanli (ST 36), Neiguan (PC 6), and Taixi (KI 3)] from perspectives of acupoint specificity and acupoint combinations. Key issues and directions to consider in future studies are also put forward. This review should deepen our understanding of how brain imaging studies can be used to explore the underlying mechanisms of acupuncture in AD.
