OBJECTIVE:To systematically review the efficacy and safety ofTraditional Chinese Medicine(TCM)interventions,compared with control interventions(placebo or conventional Western medical therapy),in the treatment of acqu...OBJECTIVE:To systematically review the efficacy and safety ofTraditional Chinese Medicine(TCM)interventions,compared with control interventions(placebo or conventional Western medical therapy),in the treatment of acquired immunodeficiency syndrome(AIDS).METHODS:Electronic databases including PubMed,the Cochrane Library,China National Knowledge Infrastructure(CNKI),and Wanfang Data were searched to identify relevant randomized controlled trials(RCTs)published as of May 2012.Studies were selected according to the specified inclusion and exclusion criteria and then subjected to methodological quality assessment,data extraction,and meta-analysis according to the Cochrane Handbook for Systematic Reviews of Interventions.RESULTS:Twelve RCTs involving 881 patients with AIDS were included.Methodological quality assessment showed that two were high-quality,two were moderate-quality,and eight were low-quality.Meta-analysis showed that TCM interventions were associated with significantly reduced plasma viral load compared with placebo[odds ratio OR=2.46,95%confidence interval CI(1.02,5.94);P=0.04].However,the reductions in plasma viral load significantly favored conventional Western medical therapy alone over integrated traditional Chinese and Western medical therapy[OR=0.16,95%CI(0.05,0.55);P=0.004].Patients receiving TCM interventions had significantly higher CD4+T lymphocyte counts compared with those on placebo[OR=2.54,95%CI(1.40,4.60);P=0.002].In addition,TCM interventions were significantly more likely to have improved clinical symptoms[OR=2.82,95%CI(1.85,4.31);P<0.00001].TCM interventions conferred a similar risk of adverse events(AEs)compared with control interventions[OR=1.87,95%CI(0.58,6.01);P=0.29].CONCLUSION:Current evidence suggests that TCM interventions are significantly more effective than placebo in reducing plasma viral load and increasing CD4+T lymphocyte count in patients with AIDS.When compared with conventional Western medical therapy,TCM interventions were significantly less effective in reducing plasma viral load,although they were associated with a higher percentage of patients with improved symptoms.Patients receiving TCM interventions did not seem to be at an increased risk of AEs.展开更多
The aim of this article was to assess the clinical evidence for or against the blinding effect of non-penetrating sham needle as placebo needle. This systematic review included randomized controlled trials(RCTs) of ac...The aim of this article was to assess the clinical evidence for or against the blinding effect of non-penetrating sham needle as placebo needle. This systematic review included randomized controlled trials(RCTs) of acupuncture taking non-penetrating sham acupuncture as placebo needle. Systematic searches were conducted in 13 electronic databases up to July 2012: Medline, PubMed, the Cochrane Library, CINAHL, EMBASE, a Chinese medical database. All parallel or cross-over RCTs of acupuncture for the blinding effect of non-penetrating needle were chosen without language restrictions. Finally, totally 7 RCTs met the inclusion criteria. In conclusion, our systematic review and meta-analysis demonstrate that the non-penetrating needle is an effective instrument for placebo control in the acupuncture RCTs.展开更多
基金Supported by International Cooperation Project,the Ministry of Science and Technology of the People's Republic of China(S2013ZR0063)Guangxi Key Technologies R&D Program(No.1298003-1-1,11107009-1-3)+2 种基金Guangxi Natural Science Foundation(No.0832016Z)China Postdoctoral Science Foundation(Post Doctor of China Central South Uni-versity 2013M531816)Guangxi Administration of Traditional Chinese Medicine(GZKZ-G1105,GZKZ10-054,2012032)
文摘OBJECTIVE:To systematically review the efficacy and safety ofTraditional Chinese Medicine(TCM)interventions,compared with control interventions(placebo or conventional Western medical therapy),in the treatment of acquired immunodeficiency syndrome(AIDS).METHODS:Electronic databases including PubMed,the Cochrane Library,China National Knowledge Infrastructure(CNKI),and Wanfang Data were searched to identify relevant randomized controlled trials(RCTs)published as of May 2012.Studies were selected according to the specified inclusion and exclusion criteria and then subjected to methodological quality assessment,data extraction,and meta-analysis according to the Cochrane Handbook for Systematic Reviews of Interventions.RESULTS:Twelve RCTs involving 881 patients with AIDS were included.Methodological quality assessment showed that two were high-quality,two were moderate-quality,and eight were low-quality.Meta-analysis showed that TCM interventions were associated with significantly reduced plasma viral load compared with placebo[odds ratio OR=2.46,95%confidence interval CI(1.02,5.94);P=0.04].However,the reductions in plasma viral load significantly favored conventional Western medical therapy alone over integrated traditional Chinese and Western medical therapy[OR=0.16,95%CI(0.05,0.55);P=0.004].Patients receiving TCM interventions had significantly higher CD4+T lymphocyte counts compared with those on placebo[OR=2.54,95%CI(1.40,4.60);P=0.002].In addition,TCM interventions were significantly more likely to have improved clinical symptoms[OR=2.82,95%CI(1.85,4.31);P<0.00001].TCM interventions conferred a similar risk of adverse events(AEs)compared with control interventions[OR=1.87,95%CI(0.58,6.01);P=0.29].CONCLUSION:Current evidence suggests that TCM interventions are significantly more effective than placebo in reducing plasma viral load and increasing CD4+T lymphocyte count in patients with AIDS.When compared with conventional Western medical therapy,TCM interventions were significantly less effective in reducing plasma viral load,although they were associated with a higher percentage of patients with improved symptoms.Patients receiving TCM interventions did not seem to be at an increased risk of AEs.
基金supported by Traditional Chinese Medicine and Integrated Traditional and Western Medicine Scientific Research Project of Tianjin Municipal Administration of Traditional Chinese Medicine(No.11047)Development Plan of Changjiang Scholars and Innovative Research Team
文摘The aim of this article was to assess the clinical evidence for or against the blinding effect of non-penetrating sham needle as placebo needle. This systematic review included randomized controlled trials(RCTs) of acupuncture taking non-penetrating sham acupuncture as placebo needle. Systematic searches were conducted in 13 electronic databases up to July 2012: Medline, PubMed, the Cochrane Library, CINAHL, EMBASE, a Chinese medical database. All parallel or cross-over RCTs of acupuncture for the blinding effect of non-penetrating needle were chosen without language restrictions. Finally, totally 7 RCTs met the inclusion criteria. In conclusion, our systematic review and meta-analysis demonstrate that the non-penetrating needle is an effective instrument for placebo control in the acupuncture RCTs.
