Acupuncture-a national heritage of China to the world:international clinical research advances from the past decade

Acupuncture originated in China and is an important component of traditional Chinese medicine.The elucidation of its anesthetic mechanisms,the medical needs of Western societies,as well as the proven therapeutic effects of this technique have made it the most widely used medical practice in the world.The concept of evidence-based medicine has been introduced in acupuncture research for technical improvement and the production of high-quality clinical evidence.Upon reviewing the acupuncture clinical research over the past 10years,we found the gradually increasing range of diseases that it benefits,from pain management to neoplasms and genitourinary,digestive,and mental disorders.Acupuncture is included in a number of international guidelines for clinical practice.However,high-quality clinical evidence to support the efficacy and effectiveness of acupuncture is lacking as a result of multiple exceptional clinical trials conducted by Western researchers that have yielded antagonistic results.Future clinical research should focus on exploring objective evaluation methods for studying the therapeutic effects of acupuncture.

培土生金法对小儿反复呼吸道感染缓解期肺脾气虚证相关免疫机制研究

目的 研究培土生金法对小儿反复呼吸道感染（RRTI）缓解期肺脾气虚证年呼吸道发病次数和免疫相关机制的影响。方法 筛选患儿分为4组：对照组（17例,不给予药物干预）、中药组（36例,参苓白术颗粒,每次1.5-3 g,每日2次）、西药组（36例,匹多莫德颗粒,每次0.4 g,每日2次）和中西药联合组（37例,参苓白术颗粒＋匹多莫德颗粒）,治疗8周,观察患儿年发病次数和免疫相关指标变化。结果 培土生金法可减少反复呼吸道感染年发病次数（P〈0.05）,调节T淋巴细胞亚群自稳状态,升高血清免疫球蛋白含量（P〈0.05）。结论 培土生金法对缓解期小儿反复呼吸道感染肺脾气虚证,有减少其年发病次数和调节免疫功能的作用。

Acupuncture and related therapies used as add-on to conventional treatments for heart failure:A systematic review of pairwise and network meta-analyses

Objective: This study aimed to assess and compare the clinical efficacy and safety of acupuncture and related therapies(ARTs) add-on to conventional treatment(CT) for heart failure(HF) through pairwise and network meta-analyses.Methods: Six electronic databases, including PubMed, the Cochrane Central Register of Controlled Trials(CENTRAL), EMBASE, Chinese Biomedical Literature Database(CBM), China National Knowledge Infrastructure(CNKI) and Wanfang Database were searched from inceptions to December 2017. Randomized controlled trials(RCTs) regarding ARTs combining with CT for HF were eligible. The primary outcomes were changes in heart function classification(HFC) according to New York Heart Association class and left ventricular ejection fraction(LVEF). Risk of bias assessment was conducted by two independent authors.Pairwise and network meta-analyses were performed using STATA 13.0 and WinBUGS 1.4.3 software.Results: A total of 26 RCTs were enrolled for analyses, with 5 kinds of ARTs and 2116 patients in all. Pairwise meta-analyses showed that acupoint application(OR: 3.28, 95%CI[2.26, 4.76]), acupuncture(OR: 2.78, 95%CI[1.21, 6.41]), acupoint injection(OR: 3.33, 95%CI[1.85, 6.00]) and moxibustion(OR: 2.51,95%CI[1.02, 6.21]) could significantly improve HFC when they were used as add-on to CT. Acupoint application(MD: 3.57, 95%CI[ 1.45, 5.70]),acupuncture(MD: 7.75, 95%CI[2.33. 13.17]). acupoint injection(MD:4.81, 95%CI[2.99, 6.63]) and moxibustion(MD: 6.99, 95%CI[3.62, 10.36]) were significantly beneficial in improving LVEF. Network meta-analyses showed that acupoint injection(SUCRA = 70.0%) and acupuncture(SUCRA = 90.4%) respectively had the greatest probability in improving HFC and LVEF.Conclusion: Most of the included ARTs add-on to CT was effective in improving HFC and LVEF. Acupoint injection and acupuncture may respectively have better effect than others for HFC and LVEF. However,due to the small sample size and poor quality of the included studies, hence well-designed RCTs are needed to confirm our findings.This study was registered in PROSPERO, CRD42018087700.

Study on timing and dosage of acupuncture in stroke treatment

Objective： To summarize the timing-efficacy relationship and the dosage–efficacy relationship of acupuncture in stroke treatment. Method： Literature research was conducted for quantitative clinical studies of acupuncture in stroke treatment, with the entry point on the timing factor and dosage factor. A hierarchical analysis was performed on observing the time–efficacy relationship and the dosage–efficacy relationship before, during and after acupuncture. Results： Though the retrieved studies differ especially in such timing factors as needle retaining time, acupuncture interval and course, they share an agreement in the acupuncture intervention time point, acupuncture timing, specificity of acupoints and acupuncture manipulation. Conclusion： The optimal stimulation is the core of the research on the timing-efficacy relationship and the dosage–efficacy relationship of acupuncture and also the key to the clinical efficacy.