Effect and safety of acupotomy in treatment of knee osteoarthritis:a systematic review and Meta-analysis

OBJECTIVE: To evaluate the clinical efficacy and safety of acupotomy in treatment of knee osteoarthritis(OA).METHODS: Extensive literature searches were carried out in PubMed, EMBASE, Cochrane Library(Issue 5, 2017), Chinese Biomedical Literature Database, China National Knowledge Infrastructure Database, China Science and Technology Journal Database and Wanfang Database. All databases were retrieved from their inception until May 31, 2017.Randomized controlled trials incorporating acupotomy versus intra-articular sodium hyaluronate for knee osteoarthritis were included. According to Cochrane Reviews’ Handbook(5.2), two reviewers screened each article and extracted data independently and were blinded to the findings of each reviewer. Meta-analysis was performed by the Cochrane Collaboration’s RevMan 5.3 software.RESULTS: We identified 12 studies involving 1150 patients aged between 40 and 78 years old. The pooled analysis indicated that acupotomy showed a significant improvement for short-term effect[cure rate: odds ratio(OR) = 2.04, 95% confidence interval(CI)(1.46, 2.85), P < 0.01;total effective rate:OR = 2.25, 95% CI(1.55, 3.28), P < 0.01;pain score:standard mean difference(SMD) =-1.02;95% CI(-1.72,-0.31);P = 0.005;Western Ontario and McMaster Universities Questionnaire(WOMAC) score:SMD =-0.74;95% CI(-1.11,-0.37);P < 0.01];and also for long-term effect [total effective rate:OR = 2.99, 95%CI(1.88, 4.76), Z = 4.64, P < 0.01;pain score: SMD =-1.68;95% CI(-2.14,-1.22);P <0.001;WOMAC score: SMD =-0.91;95% CI(-1.40,-0.41);P < 0.001]. In addition, there was no obvious difference between acupotomy group and control group in adverse events [OR = 2.13, 95% CI(0.14, 32.28), P = 0.58].CONCLUSION: Acupotomy is a safe and effective treatment for KOA. However, due to the methodological deficiency of the included studies, well-designed randomized controlled trials are required to further confirm the findings.

Effect of Herb-Partitioned Moxibustion on Structure and Functional Prediction of Gut Microbiota in Rats with Irritable Bowel Syndrome with Diarrhea

Objective:The objective of this study was to observe the effect of herb-partitioned moxibustion(HPM)on the gut microbiota of rats with diarrhea-predominant irritable bowel syndrome(IBS-D).Materials and Methods:A total of 48 male rats were randomly divided into a normal control group and an irritable bowel syndrome(IBS)model group.Using acetic acid irrigation and constraint stress,an IBS-D rat model was developed.After the model was made,the IBS rats were divided into IBS,HPM group,and pinaverium bromide(PB)group.The HPM received HPM for 20 min every day,while the PB was given gastric perfusion once a day for 14 days.After modeling and treatment,the abdominal withdrawal reflex,fecal character score,and fecal water content of rats were scored,and a 16S rRNA sequencing analysis was performed on the gut microbiota.Results:After treatment,the fecal character score and fecal water content in the HPM increased significantly,while visceral sensitivity decreased.Investigation of 16S rDNA sequencing revealed that α-diversity was reduced in the IBS,and HPM could increase the diversity of flora.The flora structure of IBS-D rats changed.HPM can increase the abundance of probiotics such as Akkermansia and reduce the abundance of opportunistic pathogens such as Bacteroides and Prevotella.Functional prediction analysis showed that the HPM was mainly related to the bacillary secret system,tricarboxylic acid cycle,and other pathways.Conclusion:HPM can regulate the gut microbiota of rats with IBS-D.