Background The clinical efficacy of acupuncture is a topic that has received worldwide attention. In recent years, the rise of evidence-based medicine has led to calls for the clinical curative effects of acupuncture ...Background The clinical efficacy of acupuncture is a topic that has received worldwide attention. In recent years, the rise of evidence-based medicine has led to calls for the clinical curative effects of acupuncture to be tested through objective, standardized, systematic evaluation. The results of systematic reviews for clinical trials on the efficacy of acupuncture directly affect the development of acupuncture medicine. Because of its rigorous methods and its capability to provide the very latest results, the Cochrane Database of Systematic Reviews（CDSR） is recognized worldwide as one of the most reliable sources for scientific evidence. Objective Assess the current system evaluation related to acupuncture in CDSR and the Cochrane Collaboration. Methods Based on the protocols described in the Cochrane library review and the Cochrane Collaboration, and considering the registered titles in the data base, the following key terms were selected： acupuncture, transcutaneous electrical nerve stimulation, electroacupuncture, needle and acupressure. Results The 275 articles were retrieved. According to inclusion and exclusion criteria, 139 articles were eventually chosen for inclusion. We found a growing number of acupuncture related CDSR annual reviews and protocols on the overall Before 2014. The published acupuncture related reviews, protocols and registered titles concerning the subject involve 34 Cochrane Review Groups. Through analyzing the 84 reviews related to acupuncture, we concluded that these studies show a rather low rate of efficacy overall for acupuncture. Of the 84, 19（22.62%） concluded that there is evidence for the efficacy of acupuncture,2（2.38%） showed acupuncture treatment were not more effective than controls and the remaining 63（75.00%） showed that the efficacy of acupuncture were uncertain. Conclusions By analyzing and summarizing the acupuncture reviews published in the CDSR before 2014, we found that current research shows acupuncture treatment is most effective for treating pain and related symptoms（57.89%）. However, studies showing lack of efficacy or uncertain results far outweighed the studies with positive results. We discuss the possible reasons for this and beleive it is related to the overall quality of research, poorly designed sham acupuncture, lack of standard procedures for locating points and needling, and lack of attention to individual differences.展开更多
The key health issues for women tend to be primarily associated with the female reproductive system. There are also other gender priorities and consequences associated with ageing, which require effective intervention...The key health issues for women tend to be primarily associated with the female reproductive system. There are also other gender priorities and consequences associated with ageing, which require effective interventions. Acupuncture is used worldwide and its evidence base is increasing on both mechanisms of action and its effectiveness in clinical care. Although acupuncture may be a valuable addition to healthcare for some conditions, it is rarely fully integrated into mainstream Western medicine clinical practice. Inadequate design and poor reporting of clinical trials have been barriers. Additionally systematic reviews and meta-analyses have tended to be equivocal and have reported that there is insufficient evidence for its recommendation. Future research should focus on ensuring good trial design including cost effectiveness and qualitative data and using a more pragmatic stance which reflects acupuncture in clinical practice. Undoubtedly, effective interventions are always needed to ensure the best health outcomes and address preventable deaths, morbidities, and disabilities among women but integration will be compromised unless underpinned by good evidence.展开更多
Acupuncture is a traditional empirical medicine, and evidence-based medicine（EBM） is a new medical method and development of the empirical medicine. Since 1990s, Chinese acupuncture workers began to absorb and use t...Acupuncture is a traditional empirical medicine, and evidence-based medicine（EBM） is a new medical method and development of the empirical medicine. Since 1990s, Chinese acupuncture workers began to absorb and use the methods and principles of EBM to guide acupuncture clinical research and practice. Now more and more domestic acupuncture clinicians use and follow the methods and principles of EBM. On the systemic review of acupuncture-associated articles in Cochrane library, previously effective acupuncture therapy lacks adequate evidences, which may be related to the low quality of randomized controlled trials（RCTs）. In the future, only developing specialized team of acupuncture clinical research and clinical research center can radically elevate the levels of acupuncture clinical research and evaluation. Meanwhile, developing China＇s evidence-based acupuncture should base itself on the characteristics of acupuncture, such as emphasis on original research in ancient books, high-quality single RCTs and systemic review of non-randomized researches.展开更多
The aim of this study was to establish clinical practice guidelines for acupuncture-moxibustion by retrieving relevant literature and adopting the best current national and international evidence, according to experts...The aim of this study was to establish clinical practice guidelines for acupuncture-moxibustion by retrieving relevant literature and adopting the best current national and international evidence, according to experts＇ experience and patients＇ values. This was achieved using the Grade of Recommendations Assessment, Development and Evaluation（GRADE） system combined with a wide range of national experts＇ consensus, in order to provide reliable evidence for acupuncture-moxibustion treatment of scapulohumeral periarthritis, and to ensure the safety and effectiveness of the treatment.展开更多
With the increase in the number of acupuncture clinical trials, systematic reviews are used to summarize key results across many disciplines. Meta-analysis is a popular method for synthesizing evidence as it provides ...With the increase in the number of acupuncture clinical trials, systematic reviews are used to summarize key results across many disciplines. Meta-analysis is a popular method for synthesizing evidence as it provides a succinct way of summarizing evidence quantitatively. Due to clinical heterogeneity, however, it is not always possible to use meta-analysis. Instead, a qualitative method is used. The purpose of this paper is to summary the findings of current research on the Global Impression Method （GIM）; a method used to synthesize the results of clinically heterogeneous randomized controlled trial （RCT） in systematic reviews. The results indicate that there is moderate to substantial intra-rater and inter-rater agreement when judging the results of the forest plots using a global impression and simplified version of the best evidence synthesis （BES） method when compared to the results of meta-analyses. Thus, the GIM can be used for researchers to synthesize results of RCT. The quality of the individual study can be taken into consideration after this process to determine a more precise strength of the evidence, therefore, GIM worthy to be used in acupuncture or other studies.展开更多
基金Supported by National Natural Science Foundation of China:8140349481303025,reference number:2014CB543201
文摘Background The clinical efficacy of acupuncture is a topic that has received worldwide attention. In recent years, the rise of evidence-based medicine has led to calls for the clinical curative effects of acupuncture to be tested through objective, standardized, systematic evaluation. The results of systematic reviews for clinical trials on the efficacy of acupuncture directly affect the development of acupuncture medicine. Because of its rigorous methods and its capability to provide the very latest results, the Cochrane Database of Systematic Reviews（CDSR） is recognized worldwide as one of the most reliable sources for scientific evidence. Objective Assess the current system evaluation related to acupuncture in CDSR and the Cochrane Collaboration. Methods Based on the protocols described in the Cochrane library review and the Cochrane Collaboration, and considering the registered titles in the data base, the following key terms were selected： acupuncture, transcutaneous electrical nerve stimulation, electroacupuncture, needle and acupressure. Results The 275 articles were retrieved. According to inclusion and exclusion criteria, 139 articles were eventually chosen for inclusion. We found a growing number of acupuncture related CDSR annual reviews and protocols on the overall Before 2014. The published acupuncture related reviews, protocols and registered titles concerning the subject involve 34 Cochrane Review Groups. Through analyzing the 84 reviews related to acupuncture, we concluded that these studies show a rather low rate of efficacy overall for acupuncture. Of the 84, 19（22.62%） concluded that there is evidence for the efficacy of acupuncture,2（2.38%） showed acupuncture treatment were not more effective than controls and the remaining 63（75.00%） showed that the efficacy of acupuncture were uncertain. Conclusions By analyzing and summarizing the acupuncture reviews published in the CDSR before 2014, we found that current research shows acupuncture treatment is most effective for treating pain and related symptoms（57.89%）. However, studies showing lack of efficacy or uncertain results far outweighed the studies with positive results. We discuss the possible reasons for this and beleive it is related to the overall quality of research, poorly designed sham acupuncture, lack of standard procedures for locating points and needling, and lack of attention to individual differences.
文摘The key health issues for women tend to be primarily associated with the female reproductive system. There are also other gender priorities and consequences associated with ageing, which require effective interventions. Acupuncture is used worldwide and its evidence base is increasing on both mechanisms of action and its effectiveness in clinical care. Although acupuncture may be a valuable addition to healthcare for some conditions, it is rarely fully integrated into mainstream Western medicine clinical practice. Inadequate design and poor reporting of clinical trials have been barriers. Additionally systematic reviews and meta-analyses have tended to be equivocal and have reported that there is insufficient evidence for its recommendation. Future research should focus on ensuring good trial design including cost effectiveness and qualitative data and using a more pragmatic stance which reflects acupuncture in clinical practice. Undoubtedly, effective interventions are always needed to ensure the best health outcomes and address preventable deaths, morbidities, and disabilities among women but integration will be compromised unless underpinned by good evidence.
文摘Acupuncture is a traditional empirical medicine, and evidence-based medicine（EBM） is a new medical method and development of the empirical medicine. Since 1990s, Chinese acupuncture workers began to absorb and use the methods and principles of EBM to guide acupuncture clinical research and practice. Now more and more domestic acupuncture clinicians use and follow the methods and principles of EBM. On the systemic review of acupuncture-associated articles in Cochrane library, previously effective acupuncture therapy lacks adequate evidences, which may be related to the low quality of randomized controlled trials（RCTs）. In the future, only developing specialized team of acupuncture clinical research and clinical research center can radically elevate the levels of acupuncture clinical research and evaluation. Meanwhile, developing China＇s evidence-based acupuncture should base itself on the characteristics of acupuncture, such as emphasis on original research in ancient books, high-quality single RCTs and systemic review of non-randomized researches.
基金Supported by standardization of traditional Chinese medicine,State Administration of Traditional Chinese Medicine of the People’s Republic of China:ZYYS-2009-0009-8special project of construction of TCM Master CHENG Xin-nong’s Inheritance Studio,State Administration of Traditional Chinese Medicine of the People’s Republic of China
文摘The aim of this study was to establish clinical practice guidelines for acupuncture-moxibustion by retrieving relevant literature and adopting the best current national and international evidence, according to experts＇ experience and patients＇ values. This was achieved using the Grade of Recommendations Assessment, Development and Evaluation（GRADE） system combined with a wide range of national experts＇ consensus, in order to provide reliable evidence for acupuncture-moxibustion treatment of scapulohumeral periarthritis, and to ensure the safety and effectiveness of the treatment.
文摘With the increase in the number of acupuncture clinical trials, systematic reviews are used to summarize key results across many disciplines. Meta-analysis is a popular method for synthesizing evidence as it provides a succinct way of summarizing evidence quantitatively. Due to clinical heterogeneity, however, it is not always possible to use meta-analysis. Instead, a qualitative method is used. The purpose of this paper is to summary the findings of current research on the Global Impression Method （GIM）; a method used to synthesize the results of clinically heterogeneous randomized controlled trial （RCT） in systematic reviews. The results indicate that there is moderate to substantial intra-rater and inter-rater agreement when judging the results of the forest plots using a global impression and simplified version of the best evidence synthesis （BES） method when compared to the results of meta-analyses. Thus, the GIM can be used for researchers to synthesize results of RCT. The quality of the individual study can be taken into consideration after this process to determine a more precise strength of the evidence, therefore, GIM worthy to be used in acupuncture or other studies.
