Influencing factors on efficacy of summer acupoint application treatment for allergic rhinitis:a retrospective study

OBJECTIVE:Allergic rhinitis(AR) is a common health problem.Summer acupoint application treatment(SAAT) is reported to effectively treat and prevent AR from seasonal onset.In the present study,we aimed to evaluate its effects,especially on the course of AR,through a retrospective study.METHOD:A cross-sectional multicenter study was performed based on patients treated between 2008 and 2009 in 13 clinical centers in China.A total of 1058 outpatients aged ≥2 years with documented AR and ≥1 year SAAT were eligible for enrollment.A case report form(CRF) was completed by both patient and doctor.The CRF was designed to collect data on the patient's history of SAAT,AR condition,and self-reported health condition.The outcomes(dependent variables) were incidence and intensity of AR and concomitant medications used.Data were analyzed with ordinal logistic regression(OLR).RESULTS:Treatment course and seasonal pattern of AR were related to all dependent variables positively.After controlling for sample bias and confounding factors,the findings suggested that a 3-year treatment course had better efficacy(OR/incidence of AR:2.57,95%CI:1.76-3.76;OR/intensity of AR:2.17,95%CI:1.50-3.17;OR/concomitant medications:2.20,95% CI:1.50-3.23) compared with a 2-year or less treatment course.CONCLUSION:The results showed that:1)the length of treatment course was positively associated with the efficacy of SAAT(the longer the treatment course,the better the efficacy);and 2)SAAT was more efficacious in treating seasonal AR than non-seasonal AR.

International patient registry on acupuncture therapy for premature ovarian insufficiency:Challenges and opportunities

Premature ovarian insufficiency（POI） affects seriously physical and mental health of the patients. Studies show that acupuncture may be promising in treating POI. yet evidence is insufficient. International patient registry, one form of observational study, is designed for evaluating effectiveness and safety of acupuncture in real-world clinical settings. We will face a series of opportunities and challenges. The opportunities are as follows：（1） Interdisciplinary cooperation can improve the effect of acupuncture for POI.（2） The protocol for acupuncture to treat POI has room for improvement.（3） The patient registry study can make up the shortcomings of randomized controlled trials.（4） The patient registry study can collect real-world data and explore responses of different populations to acupuncture and can be the foundation for the successive studies. International patient registry may face technological, ethical and financial challenges, while the established International Patient Registry Platform of Acupuncture-Moxibustion（www.amreg.org：8082/v3） is actively responding to these challenges. Till now there have been more than 300 patients of POI enrolled on this platform.

Successful spontaneous pregnancy with acupuncture after premature ovarian failure

In this paper, a case of premature ovarian failure （POF）, accompanied with amenorrhea for 2 years was reported. After 2 months of acupuncture, the patient＇s menstruation was resumed, and after 11 months of treatment, the patient had a spontaneous pregnancy. It is suggested that acupuncture should be used for the patient with POF as early as possible, and if necessary, hormone replacement therapy is still needed, and it is still expected to obtain spontaneous pregnancy before completely exhausted of ovarian function.

Application of Grading of Recommendations Assessment, Development, and Evaluation （GRADE） to the guideline development for clinical practice with acupuncture and moxibustion

Grading of Recommendations Assessment, Development, and Evaluation （GRADE） offers a worldwide approach to guideline development for clinical practice. For the clinical practice of acupuncture therapy, 18 evidence-based guidelines have been developed in China using GRADE. In this study, we review the advantages and limitations of the GRADE approach in the guideline development for acupuncture and moxibustion and propose some solutions to these limitations. Scientific advantages of rating the quality of evidence, outcome-centric direction, overall progression to develop recommendations, and strength of recommendations providing specific clinical guidance are the advantages of GRADE. The limitations of GRADE in the development of guidelines for acupuncture and moxibustion include rating the quality of evidence for ancient literature and literature on famous traditional Chinese medicine experts＇ experiences and specific guidelines for formulating recommendations from evidence. In the guideline development for clinical practice with acupuncture and moxibustion, we suggest that a specific method should be explored based on the GRADE approach and the characteristics of acupuncture therapy.