REVIEW OF ACUPUNCTURE FOR FROZEN SHOULDER

Objective To assess the efficacy and possible adverse effects of acupuncture on frozen shoulder. Methods Based on the key words, i.e. acupuncture, electroacupuncture, acupuncture-moxibustion, frozen shoulder, adhesive capsulitis, shoulder disorders etc., the Chinese databases were retrieved, including Oochrane Musculoskeleta Group, Oochrane Controlled Trials Register, Oochrane Complementary Medicine Field, and the central database of the Oochrane Library as well as MEDLINE, EMBASE and Chinese Biomedical CD （OBM-disc）. 20 Chinese medical journals and relevant academic conference proceedings have been searched manually. The reference lists of identified documents were checked as the supplementary retrieval. Results 6 randomized controlled trials on frozen shoulder with acupuncture and electroacupuncture were included, indicating quite advanced study quality. There were 34 to 257 participants in the trials, 668 in total. The total OR of CMS/OSA was OR 3.49 （95 % CI - 2.64 to 9.63）, the total OR of VAS was OR - 1.24 （95% CI -3.50 to 1.01）, the total OR of ROM was OR 35.70 （95% CI 22.91 to 48.49）; the total OR of MELLE was OR 4.30 （95% OI 2.32 to 7.98）. Conclusion It is shown in the present limited inclusive trials on frozen shoulder that acupuncture is the safe therapy and effective on improving the global function, relieving pain, and improving the range of motion of shoulder. All the therapeutic effects of acupuncture are superior to those in control group. However, much more high quality trials are required to provide much stronger evidence. Additionally, much more evidences on validity of frozen shoulder with other assessing indexes involved are required in the treatment with acupuncture.

Effectiveness of Moxibustion for Exercise-Induced Fatigue——A Systematic Review for Randomized Controlled Trials

Objective：To review and assess the effect of single moxibustion for exercise-induced fatigue（EIF）.Methods：Computer-search for 8 medical databases and 5 clinical trail registries were conducted for randomized controlled trials（RCTs）,added with hand-search for 10 Chinese acupuncture-moxibustion journals and additional references.Data from included RCTs were pooled by RevMan5.1.Methodology quality of RCTs was judged by Cochrane Collaboration assessment tool while quality of primary outcomes was evaluated by GRADE3.2.Results：Five RCTs were finally included,all reported in small sample size with high risk of bias.Comparisons on single moxibustion and rest relief（without treatment） were studied.Six outcomes were reported,all favored moxibustion to rest relief for EIF.Primary outcomes showed as rating of perceived exertion（RPE） with mean difference（MD）=-0.49,95%confidence interval（CI）[-0.80,-0.19],800-m race performance with MD=^-2.21,95%CI[-3.57,-0.85],and Harvard Step Index（HSI） with MD=14.75,95%CI[8.35,21.15].Moreover,all primary outcomes as RPE,800-m race performance and HSI were rated low quality.Conclusions：Single moxibustion might be considered effective for EIF.However,due to small samples of included RCTs,high risk of bias among studies and poor quality of primary outcomes and subjects restricted to Chinese athletes only,these results present limitation,and should be taken with caution for practice.More large-size studies with rigorous design are warranted to further test effectiveness of moxibustion for EIF.

The intervention effect of virtual reality technology on patients recovering from traumatic brain injury: a meta analysis

Objective:To systematically evaluate the intervention effect of virtual reality technology on patients recovering from traumatic brain injury.Methods:The computer retrieved CNKI,VIP,Wan Fang,Embase,The Cochrane Library and PubMed database,and collected randomized controlled trials of virtual reality technology combined with routine rehabilitation training and simple routine rehabilitation training on patients recovering from traumatic brain injury.The retrieval period was from the establishment of the database to July 2019.Two researchers independently screened the literature,extracted the data and evaluated the risk of bias in the included studies.RevMan 5.3 software was used for analysis.Results:A total of 7 articles were included.Meta-analysis results showed that virtual reality technology could significantly improve balance function(mean difference(MD)=3.72,95%confidence interval(CI)(2.61,4.83),P<0.001),daily living ability(MD=11.87,95%CI(10.42,13.32),P<0.001),and exercise ability(MD=3.83,95%CI(2.30,5.36),P<0.001).In the aspect of posture control ability,the trajectory motion length,trajectory velocity and peripheral area were improved(standardised mean difference(SMD)=0.80,95%CI(1.19,0.41),P<0.0001),(SMD=0.95,95%CI(1.45,0.45),P=0.0002),(SMD=0.69,95%CI(1.11,0.26),P=0.001).Conclusion:Virtual reality technology can significantly improve the balance function,daily living ability,motor function and postural control ability of patients recovering from cerebral trauma.Limited by the quantity and quality of the included studies,the above conclusions need to be verified by more high-quality studies.

Sodium Tanshinone Ⅱ A Sulfonate Injection as Adjuvant Treatment for Unstable Angina Pectoris: A Meta-Analysis of 17 Randomized Controlled Trials

Objective： To systematically evaluate the effectiveness and safety of Sodium Tanshinone ⅡA Sulfonate Injection（STS） as one adjuvant therapy for treating unstable angina pectoris（UAP）. Methods： Randomized controlled trials（RCTs） of UAP treated by STS were searched in the China National Knowledge Infrastructure Database（CNKI）, VIP Database for Chinese Technical Periodicals（VIP）, Wanfang Database, the Chinese Biomedical Literature Database（CBM）, Web of Science, the Cochrane Library, Embase, and Pub Med, which from inception to January, 2016. The Cochrane Risk Assessment Tool was used to evaluate the methodological quality of the RCTs. The Review Manager 5.3 software was used to conduct the metaanalysis. Results： The results showed that 17 RCTs involving 1,372 patients were included. The meta-analysis indicated that the combined use of STS and Western medicine（WM） in the treatment of UAP can obviously improve the total effective rate [risk ratio（RR）=1.31, 95% confidence interval（CI）（1.24,1.39）, P〈0.0001], and the total effective rate of electrocardiogram [RR=1.43, 95% CI（1.30,1.56）, P〈0.0001], decrease the level of CRP [mean difference（MD）=–3.06, 95%CI（–3.85, –2.27）, P〈0.00001], fibrinogen [MD=–1.03, 95% CI（–1.16, –0.89）, P〈0.00001], and whole blood high shear viscosity [MD=–0.70, 95% CI（–0.92, –0.49）, P〈0.00001]. Additionally, the occurrence of adverse drug reaction of the experimental group was significantly higher than that of the control group [RR=3.57, 95% CI（1.28, 9.94）, P〈0.05]. Conclusions： Compared with WM, the combined use of STS was more effective.

Traditional Chinese Medicine for Diminished Ovarian Reserve: A Systematic Review and Meta-analysis

Objective To assess the effectiveness and safety of traditional Chinese medicine（TCM）for women with diminished ovarian reserve（DOR）.Methods A literature search was conducted in eight electronic databases for randomized controlled trials.Results Seventeen randomized controlled trials involving 1174 patients were included.Meta-analysis indicated that TCM was superior to Western medicine（WM）in reducing basal serum FSH level[MD=-1.70,95%CI（-2.63,-0.77）;P=0.0004]and FSH/LH（MD=-0.43,95%CI[-0.56,-0.30];P=0.0001）,and the effect was more obvious two months after the last treatment（MD=-4.60,95%CI[-6.26,-2.90],P〈0.000 01 and MD=-0.56,95%CI[-0.85,-0.28],P=0.0001）,and increasing antral follicle count（AFC）（MD=0.44,95%CI[0.04-0.83];P=0.03）.The review also revealed the positive role of CMM as an adjuvant to IVF-ET in improving pregnancy rate（PR=1.75,95%CI[1.25,2.46];P=0.001）.Conclusion TCM,with its unique way of replenishing the kidney,may provide an effective and safe alternative therapy to patients with DOR.

Toward Evidence-Based Chinese Medicine：Status Quo,Opportunities and Challenges

How to test the treatments of Chinese medicine（CM） and make them more widely accepted by practitioners of Western medicine and the international healthcare community is a major concern for practitioners and researchers of CM.For centuries,various approaches have been used to identify and measure the efficacy and safety of CM.However,the high-quality evidence related to CM that produced in China is still rare.Over the recent years,evidence-based medicine（EBM） has been increasingly applied to CM,strengthening its theoretical basis.This paper reviews the past and present state of CM,analyzes the status quo,challenges and opportunities of basic research,clinical trials,systematic reviews,clinical practice guidelines and clinical pathways and evidence-based education developed or conducted in China,pointing out how EBM can help to make CM more widely used and recognized worldwide.