ObjectiveTo provide a scoping review of the clinical studies of acupuncture on Alzheimer' s disease (AD). MethodsThe CNKI, WanFang Data, VIP, CBM, Web of Science, PubMed, EMbase, Cochrane Library databases, and ClinicalTrials.gov, ChiCTR clinical trial registration systems were searched to collect clinical studies on acupuncture treatment of AD from inception to May 14, 2022. Scope review method was used to summarize and analyze the publication year trend, type, degree of disease, traditional Chinese medicine (TCM) syndrome differentiation, sample size, treatment plan, intervention time, and outcome. ResultsA total of 226 clinical original research were included. This field emerged in 1995 and has been increasing. The main type of clinical research was randomized controlled trials. 56 studies paid attention to the severity of AD. Only 54 studies classified AD according to different criteria of TCM syndrome differentiation. There were only 4 studies with large sample size (>200 cases). Conventional acupuncture was the main intervention method in clinical research, with a total of 129 articles. Electroacupuncture was the main special acupuncture method, a total of 31 articles. More than 70 % of the studies had a course of intervention between 84 and 168 days. Among the 12 types of outcome indicators, cognitive function, clinical efficiency, activity function evaluation, cerebrospinal fluid and blood biomarkers, and adverse reactions were the most concerned outcomes. However, less attention was paid to neuropsychiatric symptoms and quality of life in AD patients. Acupuncture could improve the cognitive function of AD patients, but the current clinical related mechanism research was shallow, and the acupuncture point selection was also more diverse. ConclusionThe clinical research of acupuncture in AD has formed a scale, but the current research type is single. The clinical research design schemes are various but not yet unified, and there is a lack of relevant authoritative TCM standards.
Objective To make an individualized treatment plan concerning a newborn with meconium aspiration syndrome combined with persistent pulmonary hypertension. Methods Based on the clinical questions raised by a newborn with meconium aspiration syndrome combined with persistent pulmonary hypertension, we searched The Cochrane Library (Issue 3, 2009), MEDLINE (1980 to June 2009), ACP Journal Club (1991 to June 2009), and Chinese Journal Fulltext Database (1994 to June 2009) for systematic reviews, randomized controlled trials (RCTs) and case-control studies. The quality of the included studies was assessed. Results A total of 9 RCTs, 1 health economic evaluation, 1 meta analysis, and 2 systematic reviews were considered eligible. The evidence indicated that the use of ECMO in infants of PPHN had shown a decreased risk of death, but not cost-saving from a societal perspective; iNO treatment could improve the PaO2 and resulted in a reduction in the incidence of requirement for ECMO; there were not randomized controlled trials regarding the treatment of PPHN by hyperventilation, high-frequency ventilation, alkali infusion, pulmonary vasodilators (magnesium sulfate, tolazoline, prostaglandin or prostacyclin, milrinone), surfactant therapy; oral sildenafil could lower oxygenation index (OI) and result in a reduction in the incidence of death. The individualized treatment plans of oral sildenafil were developed based on the available evidence, existing conditions of the hospital, and the values of children with families. After 1 month of treatment, the FiO2 returned to normal and symptoms were alleviated. Conclusion The treatment efficacies and the survival rates in meconium aspiration syndrome combined with PPHN have been improved by determining an individualized treatment plan according to evidence-based methods.
ObjectiveTo summarize and evaluate the quality of methodology, report and evidence of the systematic reviews and meta-analyses (SRs/MAs) of acupuncture and moxibustion interventions for Parkinson's disease. MethodsEight databases including CNKI, WanFang Data, VIP, CBM, PubMed, EMbase, Cochrane Library and Web of Science were searched from inception to May 1, 2023. The quality of methodology, report and evidence involved in these studies were evaluated by AMSTAR 2, PRISMA and GRADE tool. ResultsA total of 28 SRs/MAs were included, and the findings of included studies showed that acupuncture and moxibustion had a clinical advantage for Parkinson's disease. The methodological quality of all studies was extremely low. Thirteen reports were relatively complete, 14 reports had certain flaws, and 1 report had relatively serious flaws. And of the 126 reports for seven outcomes, 1 was graded as high, 12 as moderate, 57 as low, and 56 as critically low. ConclusionThe current evidence shows that acupuncture and moxibustion have a certain clinical effect for Parkinson's disease, but the methodological quality and evidence quality of related SRs/MAs are low, and the standardization still needs to be improved. The efficacy of acupuncture and moxibustion in Parkinson's disease still needs to be verified by high-quality clinical studies in the future.