Objective:To evaluate the curative effect of"Cold-Dampness Epidemic Prescription(寒湿疫方)"on the main symptoms of quarantined people in community based on real-world research data,and to provide scientific ...Objective:To evaluate the curative effect of"Cold-Dampness Epidemic Prescription(寒湿疫方)"on the main symptoms of quarantined people in community based on real-world research data,and to provide scientific basis for Chinese medicine to fight Coronavirus disease 2019 under the"Wuchang Model".Methods:From February 4,2020 to March 5,2020,the data of community quarantined people who only took"Cold-Dampness Epidemic Prescription(寒湿疫方)"under the management of"Wuchang Model"were collected,and the demographic characteristics,basic diseases,distribution of sick people,treatment process,disappearance time of eight clinical symptoms,adverse reactions and clinical outcomes of patients were statistically analyzed.Results:A total of 951 quarantined people in COVID-19 community were included,including 440 males(46.27%)and 511 females(53.73%),the oldest was 89 years old,the youngest was 2 years old,and the average age was 43.34 years old;Among the quarantined population in the community,there were 141 cases diagnosed by CDC(14.83%),CDC excluded 810 cases(85.17%);106 cases of CDC were diagnosed as COVID-19,accounting for 47.96%of the self-reported cases,and 311 cases(32.70%)had previous medical history;696(73.19%)had no obvious symptoms,and 255(26.81%)developed fever,fatigue,cough,sputum,shortness of breath,loss of appetite,diarrhea and mood,of which 187(19.66%)had cough symptoms,followed by sputum coughing(14.30%)and fever(13.56%).Conclusion:"Cold-Dampness Epidemic Prescription(寒湿疫方)"is effective in treating the clinical symptoms of COVID-19 without obvious adverse reactions.展开更多
Objective:To assess efficacy of Chinese medicine(CM)on insomnia considering characteristics of treatment based on syndrome differentiation.Methods:A total of 116 participants aged 18 to 65 years with moderate and seve...Objective:To assess efficacy of Chinese medicine(CM)on insomnia considering characteristics of treatment based on syndrome differentiation.Methods:A total of 116 participants aged 18 to 65 years with moderate and severe primary insomnia were randomized to the placebo(n=20)or the CM group(n=96)for a 4-week treatment and a 4-week follow-up.Three CM clinicians independently prescribed treatments for each patient based on syndromes differentiation.The primary outcome was change in total sleep time(TST)from baseline.Secondary endpoints included sleep onset latency(SOL),wake time after sleep onset(WASO),sleep efficiency,Pittsburgh Sleep Quality Index(PSQI)and CM symptoms.Results:The CM group had an average 0.6 h more(95%confidence interval(CI):0.3–0.9,P<0.001)TST and 34.1%(10.3%–58.0%,P=0.005)more patients beyond 0.5 h TST increment than that of the placebo group.PSQI was changed–3.3(–3.8 to–2.7)in the CM group,a–2.0(–3.2 to–0.8,P<0.001)difference from the placebo group.The CM symptom score in the CM group decreased–2.0(–3.3 to–0.7,P=0.003)more than the placebo group.SOL and WASO changes were not significantly different between groups.The analysis of prescriptions by these clinicians revealed blood deficiency and Liver stagnation as the most common syndromes.Prescriptions for these clinicians displayed relative stability,while the herbs varied.All adverse events were mild and were not related to study treatment.Conclusions:CM treatment based on syndrome differentiation can increase TST and improve sleep quality of primary insomnia.It is effective and safe for primary insomnia.In future studies,the long-term efficacy validation and the exploratory of eutherapeutic clinicians'fixed herb formulas should be addressed.(Registration No.NCT01613183).展开更多
The clinical questions of acupuncture-moxibustion(Acup-Mox)guidelines are complicated,including not only the curative effect of Acup-Mox intervention measures,but also the operational elements of Acup-Mox.This paper a...The clinical questions of acupuncture-moxibustion(Acup-Mox)guidelines are complicated,including not only the curative effect of Acup-Mox intervention measures,but also the operational elements of Acup-Mox.This paper aimed to put forward the idea and process of collecting clinical questions in developing international acupuncture clinical practice guidelines.The experience was collected and the idea of collecting clinical questions of Acup-Mox was formed through expert consultation and discussion in combination with expert opinions.Based on the characteristics of Acup-Mox discipline.This paper put forward the thinking of collecting elements of clinical questions following the intervention-population-outcome-control(I-P-O-C)inquiry process,according to the discipline of Acup-Mox.It was emphasized that in the process of collecting clinical questions,"treatable population"and"alleviable outcome indicators"for a specific Acup-Mox intervention with certain therapeutic effect should be focused on,so as to highlight the pertinence of clinical questions of AcupMox guidelines in terms of population and outcome elements.展开更多
Background: Low back pain(LBP) is a prevalent and debilitating condition that poses a significant burden on healthcare systems. Acupuncture has been proposed as a promising intervention for LBP, but the evidence suppo...Background: Low back pain(LBP) is a prevalent and debilitating condition that poses a significant burden on healthcare systems. Acupuncture has been proposed as a promising intervention for LBP, but the evidence supporting its specific effect is insufficient, and the use of sham acupuncture as a control in clinical trials presents challenges due to variations in sham acupuncture techniques and the magnitude of the placebo effect.Objective: To investigate the magnitude of the placebo response of sham acupuncture in trials of acupuncture for nonspecific LBP, and to assess whether different types of sham acupuncture are associated with different responses. Methods: Four databases including PubMed, EMBASE, MEDLINE, and the Cochrane Library were searched through April 15, 2023, and randomized controlled trials(RCTs) were included if they randomized patients with LBP to receive acupuncture or sham acupuncture intervention. The main outcomes included the placebo response in pain intensity, back-specific function and quality of life. Placebo response was defined as the change in these outcome measures from baseline to the end of treatment. Random-effects models were used to synthesize the results, standardized mean differences(SMDs, Hedges’ g) were applied to estimate the effect size. Results: A total of 18 RCTs with 3,321 patients were included. Sham acupuncture showed a noteworthy pooled placebo response in pain intensity in patients with LBP [SMD –1.43, 95% confidence interval(CI) –1.95 to –0.91, I2=89%]. A significant placebo response was also shown in back-specific functional status(SMD –0.49, 95% CI –0.70 to –0.29, I2=73%),but not in quality of life(SMD 0.34, 95% CI –0.20 to 0.88, I2=84%). Trials in which the sham acupuncture penetrated the skin or performed with regular needles had a significantly higher placebo response in pain intensity reduction, but other factors such as the location of sham acupuncture did not have a significant impact on the placebo response.Conclusions: Sham acupuncture is associated with a large placebo response in pain intensity among patients with LBP. Researchers should also be aware that the types of sham acupuncture applied may potentially impact the evaluation of the efficacy of acupuncture. Nonetheless, considering the nature of placebo response, the effect of other contextual factors cannot be ruled out in this study.(PROSPERO registration No. CRD42022304416)展开更多
Background:Currently,more and more infertility couples are opting for combined acupuncture to improve success rate of in vitro fertilization(IVF).However,evidence from acupuncture for improving IVF pregnancy outcomes ...Background:Currently,more and more infertility couples are opting for combined acupuncture to improve success rate of in vitro fertilization(IVF).However,evidence from acupuncture for improving IVF pregnancy outcomes remains a matter of debate.Objective:To quantitatively summarized the evidence of the efficacy of acupuncture among women undergoing IVF by means of systematic review and meta-analysis.Methods:Four English(PubMed,Web of Science,EMBASE,and Cochrane Register of Controlled Clinical Trials)and Four Chinese databases(Wanfang Databases,Chinese National Knowledge Infrastructure,Chinese Science and Technology Periodical Database,and SinoMed)were searched from database inception until July 2,2023.Randomized controlled trials(RCTs)that evaluated the acupuncture’s effects for women undergoing IVF were included.The subgroup analysis was conducted with respect to the age of participants,different acupuncture types,type of control,acupuncture timing,geographical origin of the study,whether or not repeated IVF failure,and acupuncture sessions.Sensitivity analyses were predefined to explore the robustness of results.The primary outcomes were clinical pregnancy rate(CPR)and live birth rate(LBR),and the secondary outcomes were ongoing pregnancy rate and miscarriage rate.Random effects model with I^(2)statistics were used to quantify heterogeneity.Publication bias was estimated by funnel plots and Egger’s tests.Results:A total of 58eligible RCTs representing 10,968 women undergoing IVF for pregnant success were identified.Pooled CPR and LBR showed a significant difference between acupuncture and control groups[69 comparisons,relative risk(RR)1.19,95%confidence intervals(CI)1.12 to 1.25,I^(2)=0],extremely low evidence;23 comparisons,RR 1.11,95%CI 1.02 to 1.21,I^(2)=14.6,low evidence,respectively.Only transcutaneous electrical acupoint stimulation showed a positive effect on both CPR(16 comparisons,RR 1.17,95%CI 1.06 to 1.29;I^(2)=0,moderate evidence)and LBR(9 comparisons,RR 1.20,95%CI 1.04 to 1.37;I^(2)=8.5,extremely low evidence).Heterogeneity across studies was found and no studies were graded as high-quality evidence.Conclusion:Results showed that the convincing evidence levels on the associations between acupuncture and IVF pregnant outcomes were relatively low,and the varied methodological design and heterogeneity might influence the findings.(Registration No.PROSPERO CRD42021232430)展开更多
基金The National Key Research and Development Plan"Public Safety Risk Prevention and Control and Emergency Technical Equipment"Key Project"Clinical Evaluation Research on Chinese Medicine Intervention in COVID-19 Recovery Period"(2020YFC0845000)。
文摘Objective:To evaluate the curative effect of"Cold-Dampness Epidemic Prescription(寒湿疫方)"on the main symptoms of quarantined people in community based on real-world research data,and to provide scientific basis for Chinese medicine to fight Coronavirus disease 2019 under the"Wuchang Model".Methods:From February 4,2020 to March 5,2020,the data of community quarantined people who only took"Cold-Dampness Epidemic Prescription(寒湿疫方)"under the management of"Wuchang Model"were collected,and the demographic characteristics,basic diseases,distribution of sick people,treatment process,disappearance time of eight clinical symptoms,adverse reactions and clinical outcomes of patients were statistically analyzed.Results:A total of 951 quarantined people in COVID-19 community were included,including 440 males(46.27%)and 511 females(53.73%),the oldest was 89 years old,the youngest was 2 years old,and the average age was 43.34 years old;Among the quarantined population in the community,there were 141 cases diagnosed by CDC(14.83%),CDC excluded 810 cases(85.17%);106 cases of CDC were diagnosed as COVID-19,accounting for 47.96%of the self-reported cases,and 311 cases(32.70%)had previous medical history;696(73.19%)had no obvious symptoms,and 255(26.81%)developed fever,fatigue,cough,sputum,shortness of breath,loss of appetite,diarrhea and mood,of which 187(19.66%)had cough symptoms,followed by sputum coughing(14.30%)and fever(13.56%).Conclusion:"Cold-Dampness Epidemic Prescription(寒湿疫方)"is effective in treating the clinical symptoms of COVID-19 without obvious adverse reactions.
基金Supported by the National Natural Science Foundation of China(No.81973713 and No.81303149)。
文摘Objective:To assess efficacy of Chinese medicine(CM)on insomnia considering characteristics of treatment based on syndrome differentiation.Methods:A total of 116 participants aged 18 to 65 years with moderate and severe primary insomnia were randomized to the placebo(n=20)or the CM group(n=96)for a 4-week treatment and a 4-week follow-up.Three CM clinicians independently prescribed treatments for each patient based on syndromes differentiation.The primary outcome was change in total sleep time(TST)from baseline.Secondary endpoints included sleep onset latency(SOL),wake time after sleep onset(WASO),sleep efficiency,Pittsburgh Sleep Quality Index(PSQI)and CM symptoms.Results:The CM group had an average 0.6 h more(95%confidence interval(CI):0.3–0.9,P<0.001)TST and 34.1%(10.3%–58.0%,P=0.005)more patients beyond 0.5 h TST increment than that of the placebo group.PSQI was changed–3.3(–3.8 to–2.7)in the CM group,a–2.0(–3.2 to–0.8,P<0.001)difference from the placebo group.The CM symptom score in the CM group decreased–2.0(–3.3 to–0.7,P=0.003)more than the placebo group.SOL and WASO changes were not significantly different between groups.The analysis of prescriptions by these clinicians revealed blood deficiency and Liver stagnation as the most common syndromes.Prescriptions for these clinicians displayed relative stability,while the herbs varied.All adverse events were mild and were not related to study treatment.Conclusions:CM treatment based on syndrome differentiation can increase TST and improve sleep quality of primary insomnia.It is effective and safe for primary insomnia.In future studies,the long-term efficacy validation and the exploratory of eutherapeutic clinicians'fixed herb formulas should be addressed.(Registration No.NCT01613183).
基金Supported by National Key R&D Program of China(Nos.2019YFC1712200 and 2019YFC1712201)。
文摘The clinical questions of acupuncture-moxibustion(Acup-Mox)guidelines are complicated,including not only the curative effect of Acup-Mox intervention measures,but also the operational elements of Acup-Mox.This paper aimed to put forward the idea and process of collecting clinical questions in developing international acupuncture clinical practice guidelines.The experience was collected and the idea of collecting clinical questions of Acup-Mox was formed through expert consultation and discussion in combination with expert opinions.Based on the characteristics of Acup-Mox discipline.This paper put forward the thinking of collecting elements of clinical questions following the intervention-population-outcome-control(I-P-O-C)inquiry process,according to the discipline of Acup-Mox.It was emphasized that in the process of collecting clinical questions,"treatable population"and"alleviable outcome indicators"for a specific Acup-Mox intervention with certain therapeutic effect should be focused on,so as to highlight the pertinence of clinical questions of AcupMox guidelines in terms of population and outcome elements.
基金the National Natural Science Foundation of China(No.82174234)the National Science Fund for Distinguished Young Scholars(No.81825024)。
文摘Background: Low back pain(LBP) is a prevalent and debilitating condition that poses a significant burden on healthcare systems. Acupuncture has been proposed as a promising intervention for LBP, but the evidence supporting its specific effect is insufficient, and the use of sham acupuncture as a control in clinical trials presents challenges due to variations in sham acupuncture techniques and the magnitude of the placebo effect.Objective: To investigate the magnitude of the placebo response of sham acupuncture in trials of acupuncture for nonspecific LBP, and to assess whether different types of sham acupuncture are associated with different responses. Methods: Four databases including PubMed, EMBASE, MEDLINE, and the Cochrane Library were searched through April 15, 2023, and randomized controlled trials(RCTs) were included if they randomized patients with LBP to receive acupuncture or sham acupuncture intervention. The main outcomes included the placebo response in pain intensity, back-specific function and quality of life. Placebo response was defined as the change in these outcome measures from baseline to the end of treatment. Random-effects models were used to synthesize the results, standardized mean differences(SMDs, Hedges’ g) were applied to estimate the effect size. Results: A total of 18 RCTs with 3,321 patients were included. Sham acupuncture showed a noteworthy pooled placebo response in pain intensity in patients with LBP [SMD –1.43, 95% confidence interval(CI) –1.95 to –0.91, I2=89%]. A significant placebo response was also shown in back-specific functional status(SMD –0.49, 95% CI –0.70 to –0.29, I2=73%),but not in quality of life(SMD 0.34, 95% CI –0.20 to 0.88, I2=84%). Trials in which the sham acupuncture penetrated the skin or performed with regular needles had a significantly higher placebo response in pain intensity reduction, but other factors such as the location of sham acupuncture did not have a significant impact on the placebo response.Conclusions: Sham acupuncture is associated with a large placebo response in pain intensity among patients with LBP. Researchers should also be aware that the types of sham acupuncture applied may potentially impact the evaluation of the efficacy of acupuncture. Nonetheless, considering the nature of placebo response, the effect of other contextual factors cannot be ruled out in this study.(PROSPERO registration No. CRD42022304416)
基金Supported by the National Science Fund for Distinguished Young Scholars(No.81825024)。
文摘Background:Currently,more and more infertility couples are opting for combined acupuncture to improve success rate of in vitro fertilization(IVF).However,evidence from acupuncture for improving IVF pregnancy outcomes remains a matter of debate.Objective:To quantitatively summarized the evidence of the efficacy of acupuncture among women undergoing IVF by means of systematic review and meta-analysis.Methods:Four English(PubMed,Web of Science,EMBASE,and Cochrane Register of Controlled Clinical Trials)and Four Chinese databases(Wanfang Databases,Chinese National Knowledge Infrastructure,Chinese Science and Technology Periodical Database,and SinoMed)were searched from database inception until July 2,2023.Randomized controlled trials(RCTs)that evaluated the acupuncture’s effects for women undergoing IVF were included.The subgroup analysis was conducted with respect to the age of participants,different acupuncture types,type of control,acupuncture timing,geographical origin of the study,whether or not repeated IVF failure,and acupuncture sessions.Sensitivity analyses were predefined to explore the robustness of results.The primary outcomes were clinical pregnancy rate(CPR)and live birth rate(LBR),and the secondary outcomes were ongoing pregnancy rate and miscarriage rate.Random effects model with I^(2)statistics were used to quantify heterogeneity.Publication bias was estimated by funnel plots and Egger’s tests.Results:A total of 58eligible RCTs representing 10,968 women undergoing IVF for pregnant success were identified.Pooled CPR and LBR showed a significant difference between acupuncture and control groups[69 comparisons,relative risk(RR)1.19,95%confidence intervals(CI)1.12 to 1.25,I^(2)=0],extremely low evidence;23 comparisons,RR 1.11,95%CI 1.02 to 1.21,I^(2)=14.6,low evidence,respectively.Only transcutaneous electrical acupoint stimulation showed a positive effect on both CPR(16 comparisons,RR 1.17,95%CI 1.06 to 1.29;I^(2)=0,moderate evidence)and LBR(9 comparisons,RR 1.20,95%CI 1.04 to 1.37;I^(2)=8.5,extremely low evidence).Heterogeneity across studies was found and no studies were graded as high-quality evidence.Conclusion:Results showed that the convincing evidence levels on the associations between acupuncture and IVF pregnant outcomes were relatively low,and the varied methodological design and heterogeneity might influence the findings.(Registration No.PROSPERO CRD42021232430)
