Lesion discrimination with breath-hold hepatic diffusionweighted imaging:A meta-analysis

AIM:To investigate the diagnostic capability of breathhold diffusion-weighted imaging(DWI) for differentiation between malignant and benign hepatic lesions.METHODS:A total of 614 malignant liver lesions(132 hepatocellular carcinomas,468 metastases and 14 intrahepatic cholangiocarcinomas) and 291 benign liver lesions(102 hemangiomas,158 cysts,24 focal nodular hyperplasia,1 angiomyolipoma and 6 hepatic adenomas) were included from seven studies(eight sets of data).RESULTS:The pooled sensitivity and specificity of breath-hold DWI were 0.93 [95% confidence interval(CI):0.91-0.95] and 0.87(95%CI:0.83-0.91),respectively.The positive likelihood ratio and negative likelihood ratio were 7.28(95%CI:4.51-11.76) and 0.09(95%CI:0.05-0.17),respectively.The P value for χ2 heterogeneity for all pooled estimates was < 0.05.From the fitted summary receiver operating characteristic curve,the area under the curve and Q * index were 0.96 and 0.91,respectively.Publication bias was not present(t = 0.49,P = 0.64).The meta-regression analysis indicated that evaluated covariates including magnetic resonance imaging modality,echo time,mean age,maximum b factor,and number of b factors were not sources of heterogeneity(all P > 0.05).CONCLUSION:Breath-hold DWI is useful for differentiating between malignant and benign hepatic lesions.The diffusion characteristics of benign lesions that mimic malignant ones have rarely been investigated.

Improvement of Quality of Life with Shenfu Injection (参附注射液) in Non Small Cell Lung Cancer Patients Treated with Gemcitabine plus Cisplatin Regimen

Objective： To observe the effect of Shenfu injection （参附注射液, SFI） in treating non small cell lung cancer （NSCLC） patients on quality of life with gemcitabine （GEM） plus cisplatin （GP） regimen. Methods： Thirty-four patients were ready to receive GP regimen chemotherapy for treating NSCLC disease, according to lot-drawing, they were divided into SFI pre-treatment group （18 cases） and SFI post-treatment group （ 16 cases）. SFI pre-treatment group： During the first treatment course, chemotherapy was begun with SFI 60 ml, intravenous dripping on the 3rd day, once daily, consecutively for 10 days; on the 1st day, GP regimen （GEM 1250 mg/m^2 , intravenous dripping, on the 1st and 8th day; cisplatin 70 mg/m^2 on the 2nd day; 21 days as one cycle） was carried out; in the second treatment course GP regimen was merely given to serve as the self-control. SFI post-treatment group： the medicament sequence order was reversed from that of pre-treatment group. Using dual international quality of life （QOL） scores, the effect of SFI on the patients＂ QOL was observed through randomized self pre- and post- crossover control. Results： The QOL in the 34 patients after being treated by SFI in combination with GP chemotherapy regimen in one group, and GP chemotherapy regimen alone in the other, was improved in different degrees, with significant difference （P〈0.01）; comparision of SFI combined with GP chemotherapy regimen with GP chemotherapy alone showed that QOL in patients was significantly different （P〈0.01）. Conclusion： SFI could improve QOL in patients with NSCLC who were treated with GP regimen.

3.0 T proton magnetic resonance spectroscopy of the liver: Quantification of choline

AIM: To investigate the normal hepatic magnetic resonance spectroscopy findings choline/lipid2 (Cho/Lip2) associated with age and body mass index (BMI).METHODS: A total of 58 single-voxel proton spectra of the liver were acquired at 3.0 T using the eightchannel phased array abdominal coil as the receiver coil. Consecutive stacks of breath-hold spectra were acquired using the point resolved spectroscopy technique at a short echo time of 30 ms and a repetition time of 1500 ms. The spectra were processed with the SAGE software package. Areas and heights for metabolite resonance were obtained. Student's t test for unpaired data was used for comparisons of shimming, Cho/Lip2, and lipid content. RESULTS: There were significant negative correlations between the Cho/Lip2 peak height ratios and BMI (r=-0.615) and age (r=-0.398) (all P<0.01). Compared with the high-BMI group, the low-BMI group was younger (39.1±13.0 years vs 47.6±8.5 years, t=-2.954,P=0.005); had better water suppression (93.4%±1.4% vs 85.6%±11.6%, t=2.741, P=0.014); had higher Cho/Lip2 peak heights ratio (0.2±0.14 vs 0.05±0.04,t=6.033,P<0.000); and had lower lipid content (0.03±0.08 vs 0.29±0.31, t=-3.309, P=0.004). Compared with the older group, the younger group had better shimming effects (17.1±3.6 Hz vs 22.0±6.8 Hz, t=-2.919, P=0.008); higher Cho/Lip2 peak heights ratios (0.03±0.05vs 0.09±0.12,t=2.4, P=0.020); and lower lipid content (0.05±0.11 vs 0.23±0.32,t=-2.337,P=0.031). Compared with the lowcholine peak group, the high-choline peak group had lower lipid content (0.005±0.002 vs 0.13±0.23, t=-3.796,P<0.000); lower BMI (19.6±2.4vs 23.9±3.0, t=-4.410, P<0.000); and younger age (34.7±10.0 years vs 43.2±12.5 years, t=-2.088, P=0.041). CONCLUSION: Lipid accumulation could result from the increased fat in the body depending on age and BMI. Lipid can mask the resonance signal of choline.

Functional magnetic resonance imaging of regional homogeneity changes in parkinsonian resting tremor

Regional homogeneity analysis of low-frequency blood oxygenation level-dependent signals from neighboring voxels enables the analysis of local neuronal synchrony. Both structural magnetic resonance imaging and resting-state functional magnetic resonance imaging scans were collected from nine Parkinson＇s disease patients with right resting tremor, and from eight age-matched normal controls. Regional homogeneity was compared between Parkinson＇s disease patients and controls. The results revealed that regional homogeneity was increased in several brain regions, including the right precuneus, right superior parietal gyrus, left anterior cingulate cortex, right middle frontal gyrus and right inferior frontal gyrus. Conversely, regional homogeneity was decreased in the cerebellar vermis in Parkinson＇s disease patients compared with healthy controls.

Clinical observation of 36 patients with chronic nephritis proteinuria treated with Zhuangshen Gujing decoction

Objective:Our goal was to examine the impact of Zhuangshen Gujing decoction on proteinuria associated with chronic nephritis.Methods:72 patients with chronic nephritis proteinuria were divided randomly into two groups;one group was treated with Zhuangshen Gujing(n=36;treatment group)and the other group was treated with irbesartan(n=36;control group).After 6 months’treatment,urine protein and renal function were evaluated.Results:Proteinuria resolved completely in four patients in the treatment group;complete disease resolution was observed only among three individuals in the control group.Of the 32 cases remaining in the treatment group,15 had substantial responses to Zhuangshen Gujing decoction,9 had partial responses,and 8 had no response to treatment;the overall the response rate was 73.33%.Among the 33 cases remaining in the control group,12 had a substantial response to irbesartan,5 had a partial response,and 16 had no response to treatment;the overall response rate among the controls was 57.67%(P=0.031).We also observed statistically significant differences with respect to quantitative comparisons of urinary protein at 24 days after a single course of treatment(P=0.001).Conclusion:Zhuangshen Gujing decoction is effective in treating chronic nephritis proteinuria.

The Effects of Glomerular Endothelial Cell Autophagy on Diabetic Nephropathy

Diabetic nephropathy is one of the most common causes of end-stage renal disease worldwide and is associated with increased mortality in patients with type 1 and type 2 diabetes.Autophagy is a highly conserved"autophagy"pathway and is an important mechanism for maintaining glomerular and tubular homeostasis.Emerging evidence suggests that targeted autophagy pathway activation and restoration of autophagy activity may have renal protection.Glomerular endothelial cells are an important key factor in the development of diabetic nephropathy.Endothelial dysfunction is involved in the development of diabetic and non-diabetic glomerular injury and renal fibrosis.Evidence of glomerular endothelial dysfunction in the late stages of diabetic nephropathy,such as thrombotic microangiopathy,including impairment of glomerular capillary microaneurysms and glomerular membrane lysis autophagy,is related to the pathogenesis of diabetic nephropathy.Here,we mainly introduced the research progress of the effects of glomerular endothelial cell autophagy on diabetic nephropathy.

The Extraarticular Symptoms Influence ACR Response in the Treatment of Rheumatoid Arthritis with Biomedicine: A Single-blind, Randomized, Controlled, Multicenter Trial in 194 patients

Objective: The extraarticular symptoms are important in the pattern differentiation of traditional Chinese medicine (TCM), and the present study is designed in an attempt to find the associations between the extraarticular symptoms and American College of Rheumatology (ACR) Response in 194 cases of rheumatoid arthritis (RA) treated with biomedicine. Methods: The data were obtained from a randomized clinical trial. One hundred ninety-four RA patients were treated with the biomedical therapy (diclofenec, methotrexate and sulfasalazine). ACR20 response in 24 weeks was used for the efficacy evaluation. Eighteen symptoms (including 13 extraarticular symptoms) that TCM practitioners focus on were collected for exploration on the association between the symptoms and the efficacy of the biomedical therapy with association rules method. Results: After 24 weeks, a total of 135 patients receiving biomedicine had achieved an ACR20 response. The association rules analysis on each symptom showed that soreness in the waist was more associated with ACR20 response, but with lower support (selected sample size based, 20.10% and 14.95% respectively); cold intolerance and cold joint were found to be associated with ACR20 response with higher support (48.97% and 53.61% respectively), and the confidences (predicted effective rate) were 73.08% and 71.23% respectively. The associations between combination of symptoms (among them, there was at least one extraarticular symptom) and ACR20 response indicated that cold intolerance or cold joint with higher confidence and support were the most important extraarticular symptoms. Conclusion: The RA patients with "cold intolerance" and "cold joints", which are the extraarticular symptoms that TCM practitioners focus on, may show higher ACR20 response when treated with the biomedical approach.

Analysis of the risk factors of clopidogrel response in a Han Chinese population undergoing percutaneous coronary intervention

Background Clopidogrel is an antiplatelet drug, which requires the effiux pump P-glycoprotein （multidrug resistance-1, MDR1） encoded by the ABCB1 gene for intestinal absorption. However, recent studies evaluating the relationship between ABCB 1 genetic polymorphisms and clopidogrel response have shown conflicting results due to both genetic and non-genetic factors. This study aimed to analyze the risk factors of clopidogrel response in a Han Chinese population undergoing percutaneous coronary intervention （PCI）. Methods A total of 520 Han Chinese patients with coronary artery disease undergoing planned drug-eluting stent placement and receiving dual-antiplatelet therapy were sequentially recruited and followed up for 1 year. The effects of clinical risk fac- tors and ABCB1 genetic polymorphisms on major adverse cardiovascular events （MACE） within 1 year or bleeding within 6 months after PCI were assessed. Results The patients were comprised of 82% men and 40% smokers. Diabetes, hypertension and low ejection fraction were associated with higher risk of MACE within 1 year after PCI. The hazard ratios [HR] and 95% confidence intervals [CI] were 3.15 [1.46-6.78], 2.78 [1.51-5.10] and 0.98[0.95-1.00], respectively. Diabetes and female were also significantly associated with bleeding risk within 6 months （odds ratio [OR] [95%CI]： 1.96 [1.11-3.44] and 2.20 [1.20-4.05]. Use of angiotensin-converting enzyme inhibitors （ACEIs） was associated with a low risk of bleeding events （OR [95%CI]： 0.53 [0.31-0.91]）. There was no significant impact of ABCB1 c.1236 C〉T, ABCB1 c.2677 G〉T/A, or ABCB1 c.3435 C〉T on the risk of MACE within 1 year or occurrence of bleeding within 6 months after PCI. Conclusions These results suggest a lack of association between ABCB1 genetic variants and adverse cardiovascular outcomes. However, diabetes, hypertension and low ejection fraction are high risk factors of MACE. In addition, diabetes and female are a high risk of bleeding, which can be reduced by use of ACEIs.

Short-term effects of cupping and scraping therapy for chronic nonspecific low-back pain:A prospective,multicenter randomized trial

Background As one of the most common musculoskeletal ailments,chronic nonspecific low-back pain(CNLBP)causes persistent disability and substantial medical expenses.Epidemiological evidence shows that the incidence rate of CNLBP in young and middle-aged people who are demanded rapidly recovery and social contribution is rising.Recent guidelines indicate a reduced role for medicines in the management of CNLBP.Objective The present study investigates the short-term effects of cupping and scraping therapy using a medicated balm,compared to nonsteroidal anti-inflammatory drug(NSAID)with a capsaicin plaster,in the treatment of CNLBP.Design,setting,participants and interventions We designed a prospective multicenter randomized clinical trial enrolling patients from January 1,2022 to December 31,2022.A total of 156 patients with CNLBP were randomized into two parallel groups.Diclofenac sodium-sustained release tablets were administered orally to participants in the control group for one week while a capsaicin plaster was applied externally.Patients in the test group were treated with cupping and scraping using a medical device and medicated balm.Main outcome measures Primary outcome was pain recorded using the visual analogue scale(VAS).Two secondary outcomes were recorded using the Japanese Orthopedic Association low-back pain scale(JOA)and the traditional Chinese medicine(TCM)syndrome integral scale(TCMS)as assessment tools.Results Between baseline and postintervention,all changes in outcome metric scales were statistically significant(P<0.001).Compared to the control group,patients in the test group had a significantly greater treatment effect in all outcome variables,as indicated by lower VAS and TCMS scores and higher JOA scores,after the one-week intervention period(P<0.001).Further,according to the findings of multivariate linear regression analysis,the participants’pain(VAS score)was related to their marital status,age,smoking habits and body mass index.No adverse reactions were reported for any participants in this trial.Conclusion The effectiveness of TCM combined with the new physiotherapy tool is superior to that of NSAID combined with topical plasters,regarding to pain intensity,TCM symptoms and quality of life.The TCM plus physiotherapy also showed more stable and long-lasting therapeutic effects.

Effect of Yangxinkang Tablets(养心康片)on Chronic Heart Failure:A Multi-Center Randomized Double-Blind Placebo-Controlled Trial

Objectives： To investigate the safety and efficacy of Yangxinkang Tablets （养心康片） in patients with chronic heart failure （CHF） and syndrome of qi and yin deficiency, blood stasis, and water retention. Methods： In a double-blinded, randomized, placebo-controlled, multicenter clinical trail, 228 patients with CHF New York Heart Association （NYHA） class Ⅱ or Ⅲ in stage C were assigned by randomized block method to two groups in a 1：1 ratio to undergo either conventional Western treatment or conventional treatment plus Yangxinkang Tablets for 4 weeks. The outcome measure were effect of cardiac function, Chinese medicine （CM） syndromes, scores of symptoms, signs, and quality of life measured by Minnesota Living with heart failure questionnaire （MLHFQ） before and after the treatment. Results： Totally 112 patients were analyzed in the treatment group and 109 in the control group. They were comparable in NYHA functional class, basic parameters and primary diseases before treatment. Cardiac function and CM syndromes were greatly ameliorated in both groups after treatment. Total effective rates of cardiac function and CM syndrome in the treatment group were significantly higher than those in the control group （P〈0.05）. Total symptom score and sign score in the treatment group decreased significantly after treatment （P〈0.01）, which were significantly lower than those in the control group （P〈0.05）. There were statistically significant differences in post-treatment scores of gasp, cough with phlegm, pulmonary rales and jugular vein engorgement between the two groups （P〈0.05 or P〈0.01）. Three MLHFQ scores decreased significantly in both groups after treatment （P〈0.01）. Post-treatment total scale score and physical subscale score in the treatment group and the reduction of them showed statistically significant differences （P〈0.05） as compared with the control group. There was no significant difference between the two groups in emotional subscale score and the reduction after treatment （P〉0.05）. There was no obvious adverse reaction in either group noted during the study. Conclusions： Yangxinkang Tablets were safe and efficacious in improving cardiac function, CM syndromes, symptoms, signs, and quality of life in patients with CHF class Ⅱ or Ⅲ in stage C on the base of conventional treatment.

A Clinical Study on Global TCM Therapy in Treating Senile Advanced Non-small Cell Lung Cancer

Objective： To assess the clinical efficacy of global traditional Chinese medicine （TCM） therapy in treating senile advanced non-small cell lung cancer （NSCLC）, with the aim of seeking a standardized, rational and economical way to treat advanced NSCLC in old patients. Methods： A retrospective analysis and comparison was carried out in 86 patients with senile advanced NSCLC, 44 treated by global TCM （TCM group） and 42 by chemotherapy （control group） through dynamical observation on related indexes including tumor size, quality of life and the survival time, as well as on the fee for medical service at various time points in the course of the treatment. Results： The changes of tumor size, score of clinical main symptoms and behavior condition （by ZPS scoring）, as well as survival rates in the two groups at corresponding time points, were not different significantly （P〉0.05）. The mean survival time in the TCM group was 13.20 ± 1.52 months and that in the chemotherapy group was 13.45 ±1.94 months, showing insignificant difference between them. However, the median survival time in the TCM group （12 months） was actually longer than that in the chemotherapy group （9 months, P〈0.05）. The mean daily expense and the mean expense （RMB yuan） for each patient in the TCM group were significantly lower than that in the control group, which was 180.73 ±93.21 vs 825.84 ±329.63 for the mean daily expense and 34 077.21 ±14 638.04 vs 58 516.59 ±45 429.76 for the mean expense for each patient （both P〈0.01）. Conclusion： Treatment of senile advanced NSCLC with TCM alone has its apparent superiority in stabilizing tumor focus, improving clinical symptoms, elevating quality of life and prolonging the survival time. TCM is also less expensive, making it a good alternative therapeutic approach for this specific group of people.

Antipyretic Effect of Herba Ephedrae-Ramulus Cinnamomi Herb Pair on Yeast-Induced Pyrexia Rats: A Metabolomics Study

Objective： To investigate the antipyretic mechanism of Herba Ephedrae （Eph）-Ramulus Cinnamomi （RC） herb pair on yeast-induced pyrexia in rats. Methods： Totally 30 qualified male SD rats were randomly assigned to the normal control （NC） group, the pyrexia model （model） group, the Eph, RC and Eph-RC treatment groups by a random digital table, 6 rats in each group. Each rat received a 20% aqueous suspension of yeast （10 mL/kg） except the NC group. The 3 treatment groups were administered 8.1, 5.4 and 13.5 g/kg Eph, RC and Eph-RC respectively at 5 and 12 h after yeast injection, the NC group and the model groups were administered equal volume of distilled water. Rectal temperatures were measured at 0, 6, 8, 10, 12, 15, 18, 24 and 30 h and urine was collected prior to yeast injection and at 6, 10, 18, 24, 30, and 36 h after yeast injection. Then urine metabolomic profiling by gas chromatography tandem mass spectrometry, coupled with multivariate statistical analysis and pattern recognition techniques were used to explore the antipyretic effects of Eph-RC. Partial least squares discriminate analysis was used to analyze the metabolomics dataset including classification and regression in metabolomics plot profiling. Results： Compared with the NC group, rectal temperatures were significantly higher in the model group （P〈0.01）, while 3 treatment groups decreased significantly compared with the model group （P〈0.05 or P〈0.01）. Rectal temperatures of Eph-RC-treated rats started to go down at 6 h, and markedly decreased at 8, 12, 15, 18 and 24 h （P〈0.05 or P〈0.01）, while those of the Eph and RC groups had decreased firstly at 8 h and were markedly lower at 12 h （P〈0.05 or P〈0.01）. Seventeen potential biomarkers related to pyrexia were confirmed and identified, including pyruvic acid, L-phenylalanine, L-tyrosine, phenylacetic acid, hippuric acid, succinic acid, citrate and so on. Eight potential alterations of metabolic pathways including phenylalanine metabolism, citrate cycle, tryptophan metabolism, biosynthesis of valine, leucine and isoleucine, were identified in relation to the antipyretic effects of Eph-RC using MetPA software. Conclusion： The antipyretic effect of Eph-RC herb pair on yeast-induced pyrexia in rats involved correction of perturbed amino acid, fatty acid, and carbohydrate metabolism according to the metabolic pathway analysis with MetPA.

Bushen Qiangjin capsule(补肾强筋胶囊) inhibits the Wnt/β-catenin pathway to ameliorate papain-induced knee osteoarthritis in rats

OBJECTIVE:To evaluate the molecular mechanism underlying the beneficial effect of Bushen Qiangjin capsule(补肾强筋胶囊,BSQJ),a Traditional Chinese Medicine,on knee osteoarthritis(KOA).METHODS:In the present study,32 female Sprague-Dawley rats were randomly divided into four groups:control,KOA,high-dose BSQJ(H-BSQJ),and low-dose BSQJ(L-BSQJ).After successfully establishing the KOA model by intra-articular injection of papain,H-BSQJ and L-BSQJ groups were intragastrically administered 0.243 and 0.122 g/kg BSQJ,respectively,daily for 6 weeks.At the end of the experiment,knee articular cartilage tissues of rats were collected for evaluation by hematoxylin and eosin staining,Safranin O-Fast Green staining,and terminal deoxynucleotidyl transferase-mediated d UTP nick-end labeling assay.Serum interleukin-1βand tumor necrosis factor-αlevels of rats were detected with an enzyme-linked immunosorbent assay method.Gene expression of Wnt-4,β-catenin,Frizzled-2,glycogen synthase kinase-3β(GSK-3β),cysteinyl aspartate-specific proteinases 3 and 9(caspases 3 and 9),collagen typeⅡalpha 1(Col2 a1),and matrix metalloproteinases 1 and 13(MMP-1 and MMP-3)of rat knee articular cartilage was quantified by reverse transcription-quantitative polymerase chain reaction analysis.Wnt-4,β-catenin,Frizzled-2,GSK-3β,cleaved caspase-3,and cleaved caspase-9 protein expression in rat knee articular cartilage was determined by western blot analysis.RESULTS:BSQJ obviously reduced pathological damage and matrix degradation of articular cartilage in KOA rats.Compared with the KOA group,H-BSQJ rats exhibited downregulated m RNA and protein expression of Wnt-4,β-catenin,Frizzled-2,and caspase-3,as well as upregulated m RNA and protein expression of GSK-3β.In addition,H-BSQJ significantly increased m RNA expression of Col2 a1 and decreased m RNA expression of MMP-1 and MMP-13.CONCLUSION:BSQJ exerted a beneficial effect on KOA by a mechanism involving downregulation of the Wnt/β-catenin pathway,which inhibited both cartilage extracellular matrix degradation and chondrocyte apoptosis to ameliorate KOA in rats.

Anti-hypertensive and endothelia protective effects of Fufang Qima capsule(复方芪麻胶囊) on primary hypertension via adiponectin/adenosine monophosphate activated protein kinase pathway

OBJECTIVE:To investigate the potential mechanism of the vascular remodeling effect and provide additional information about anti-hypertension activity of Fufang Qima capsule(复方芪麻胶囊,QM).METHODS:Spontaneous hypertensive rats(SHRs)were used to study the underlying mechanism of the anti-hypertension activity of QM.In this study,SHRs were randomly divided into 5 groups:model group,Telmisartan group(7.2 mg/kg,p.o.),and three QM groups(0.9298,1.8596,and 3.7192 g/kg,p.o.).Wistar Kyoto rats(WKY)were used as normal control group.Blood pressure(BP),aorta,perivascular adipose tissue(PVAT)histology were investigated to evaluate the effect of QM.Nitric oxide(NO)and endothelial nitric oxide synthase(eNOS)phosphorylation were measured.Adiponectin(APN)secretion,as well as APN signal pathway proteins including APN,adiponectin receptors(R1 and R2)and adenosine 5’-monophosphate-activated protein kinase(AMPK)were all analyzed.RESULTS:QM significantly reduced BP and ameliorated the vascular pathological change,i.e.intima media thicken and collagen fiber hyperplasia.Meanwhile,QM increased concentration of NO and the phosphorylation of eNOS in the aorta.The anti-hypertensive and endothelia-protective effect of QM could be attributed to activating APN/AMPK pathway by up-regulating the expression of APN in PVAT and APN Receptor 2,AMPKαand phosphorylated AMPKαin the aorta.CONCLUSION:The QM alleviation effect mechanism for primary hypertension was via modulating the APN/AMPK signal pathway.

Identification and analysis of key microRNAs derived from osteoarthritis synovial fluid exosomes

To the Editor:Osteoarthritis(OA)is one of the most common age-related diseases and is characterized by synovial inflammation and progressive degradation of cartilage.It was reported that one-third of 65-year-olds and 303 million people globally were affected by OA in 2017.[1,2]Although there is extensive research published on OA,its pathogenesis remains unclear and controversial.Cartilage degeneration is considered a key pathological factor that leads to disease progression.

针灸治疗原发性高血压的系统评价再评价

目的:对针灸治疗原发性高血压(EH)的系统评价或Meta分析进行再评价,提出合理建议以促进临床研究规范化.方法:采用计算机检索荷兰医学文摘数据库(EMBASE)、PubMed、中国知网(CNKI)、重庆维普数据库(CQVIP)、中国生物医学文献数据库(CBM)及万方学术期刊全文数据库(Wanfang),搜集针灸治疗EH的系统评价或Meta分析.时间从建库至2020年7月,按照纳入标准与排除标准,对文献进行筛选和数据提取.采用系统回顾和荟萃分析的首选报告项目(PRISMA)量表,系统评价方法学质量评价工具2(AMSTAR 2)量表,推荐分级的评价、制定与评估(GRADE)量表对文献进行质量与证据等级评估.结果:共纳入14篇文献,含10篇中文文献和4篇英文文献,为2012年至2019年期间发表,涵盖70个结局指标.方法学质量均为极低,文献报告质量相对完全或存在一定缺陷,证据质量等级均为低级或极低级.结论:目前针灸治疗EH的系统评价和Meta分析的方法学质量和结局指标证据等级都较低,报告质量也有待进一步提高.