Objective To analyze acupuncture resources in the Cochrane Database of Systematic Reviews (CDSR). Methods We identified acupuncture literature from CDSR (2008 year) electronically. W analyzed this literature by research time date, author, study contents, and conCochrane Library usions. Results We initially found 82 articles. Finally, we identified 67 systematic reviews. The number of acupuncture articles has increased all over the world with higher growth rate in China than overseas. The disease spectrum of acupuncture treatment increased widely, focusing on nervous system diseases and pain diseases. Eight articles (25.8%) definitely supported the efficacy of acupuncture. Twenty two articles (71%) considered the efficacy of acupuncture as uncertain owning to insufficient evidence. Just one article expressed that acupuncture treatment was ineffective according to current evidence.
Objective To evaluate the efficacy of acupuncture and moxibustion (acup-moxi) therapy for breech presentation. Methods We electronically searched The Cochrane Library (Issue 1, 2008), PubMed (1980 to Mar. 2008), MEDLINE (1966 to 2008), Ovid EBM Database (1991 to 2008), CBMdisc (1978 to Mar. 2008), VIP (1989 to Mar. 2008), CNKI (1979 to Mar. 2008), and WangFang Database (1983 to Mar. 2008), as well as handsearched seven traditional Chinese medicine journals to obtain randomized control trials (RCTs) about acup-moxi for breech presentation. Quality assessment was conducted according to the Cochrane Handbook for Systematic Reviews of Interventions 5.0.1. Meta-analyses were performed for the results of homogeneous studies using RevMan 5.0 software. Results Eight RCTs involving 1 341 patients met the inclusion criteria. Five trials were of relatively high quality and 3 were of low quality. The pooled analysis of six trials showed that acup-moxi was superior in cephalic presentation with RR=1.38, and 95%CI 1.20 to 1.58. Conclusion Acup-moxi can increase the successful rate of cephalic presentation in the treatment of breech presentation compared with no (routine care) or knee-chest position treatment.
ObjectiveTo assess the methodological quality of systematic reviews of Tai Chi for preventing falls in the elderly and the quality of evidence for outcome indicators.MethodsPubMed, Web of Science, The Cochrane Library, EMbase, CNKI, WanFang Data, CBM and VIP databases were electronically retrieved. According to the inclusion criteria and exclusion criteria, the final articles were selected and the relevant literature information was extracted by reading the abstract and the full text. The methodological quality of the included systematic reviews was evaluated using AMSTAR 2 tool, and the quality of the outcome indicators of the included systematic reviews was further graded according to the GRADE system.ResultsA total of 11 systematic reviews/meta-analyses were included. The AMSTAR 2 evaluation showed that 10 studies were in critically-low methodological quality, and 1 study was in low methodological quality. The GRADE evaluation results showed that among the 36 outcome indicators included, there were 10 intermediate quality indicators, 20 low-level quality indicators and 6 extremely low-level quality indicators. Among the indicators of intermediate quality, single-leg stand test (MD = 5.33, 95%CI 3.35 to 7.32, P< 0.01; WMD = 1.76, 95%CI −7.00 to 10.52, P< 0.01), time up and go test (MD = 1.04, 95%CI 0.67 to 1.41, P< 0.01), the berg balance scale (MD = 2.18, 95%CI 0.93 to 3.43, P< 0.01), number of falls (RR = 0.82, 95%CI 0.73 to 0.92), P< 0.01), the incidence of 2-falls (OR = 0.69, 95%CI 0.49 to 0.97, P< 0.01) and the incidence of 3-falls (OR = 0.39, 95%CI 0.21 to 0.73, P< 0.01). The results of the above indicators were statistically significant, indicating that Tai Chi was better than control group.ConclusionsAt present, the methodological quality of relevant systematic reviews of Tai Chi for preventing falls in the elderly was relatively low and the quality of the evidence was not good, so it can’t be proved that Tai Chi can effectively prevent falls in the elderly, which needs to be further studied at a high level.
ObjectivesTo comprehensively evaluate the methodological quality and applicability of the results of systematic reviews on acupuncture treatment for primary depression.MethodsWeb of Science, EMbase, PubMed, The Cochrane Library, CNKI, CBM, WanFang Data and VIP databases were electronically searched to collect systematic reviews/meta-analyses on acupuncture treatment for primary depression from inception to December 5th, 2018. Two researchers independently screened and extracted data by using tools of AMSTAR 2 to evaluate the methodological quality, using ROBIS to assess risk of bias, and using CASP-S.R to evaluate the applicability of the results.ResultsA total of 18 systematic reviews/meta-analyses were included, and all focused on acupuncture intervention, including 2 primary outcome indicators. According to AMSTAR 2 evaluation results, there were 4 high quality studies, 12 medium quality studies and 2 low quality studies; ROBIS results found 10 high bias risk studies, 7 low bias risk studies and 1 unclear; CASP-S.R showed only 4 design studies applicable to local individuals, and there were no studies on the relationship between design benefits, hazards and costs.ConclusionsThe quality of systematic reviews/meta-analyses for acupuncture treatment of primary depression is moderate, however with a certain bias. Most studies may not directly benefit local individuals. All studies have no relationship with cost hazards. It is expected for further reviewers to strictly follow systematic evaluation method to improve research quality and reduce bias, while the applicability of the systematic review to individuals from different regions should be considered as well as the relationship between the benefit and cost hazard. In addition, more valid RCTs are required to provide higher quality evidence and explore correlated and comprehensive mechanism.
ObjectiveTo analyze the characteristics and reporting quality of the registered health Qigong-related clinical trials, and to analyze the progress and shortcomings of health Qigong-related clinical trials.MethodsChinese Clinical Trial Registry (ChiCTR) and ClinicalTrials.gov were electronically searched to collect the health Qigong-related clinical trials from inception to October 15st, 2020. Characteristics of trials were analyzed in the aspects of basic information, funding source, study content and more. The quality of registration was evaluated by WHO Trial Registration Data Set (TRDS).ResultsA total of 121 registered clinical trials were included. The annual registration quantity has been increasing with a peak (33.06%) reached in 2020. Among the registered trials, Baduanjin exercise- related studies accounted for the highest proportion (65.29%). The quantity of studies registered in Shanghai accounted for the most (29.75%). The largest contribution of registered trials was from Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine (5.79%). 50.83% funds in trials were originated from universities and hospitals. Type 2 diabetes, and chronic obstructive pulmonary disease were the most studied diseases in the registered trials. 90.08% trials were designed as randomised parallel control studies, and the sample sizes of trials were concentrated between 30 and 100 (71.07%), and the age of the subjects was distributed over 40 years old (46.15%). The average quality of registration completion of the two registries was 87.44%.ConclusionsAt present, the general trend of health Qigong clinical research is positive. However, these trials contain unbalanced attributes such as the research type of health Qigong, distribution of registration area and organization, allocation of funds, and age composition of subjects. The design of clinical trials and registration details are needed to be improved.
ObjectiveTo evaluate the quality of methodology and evidence of the systematic reviews and meta-analyses (SRs/MAs) of acupuncture therapy for bronchial asthma. MethodsCNKI, CBM, VIP, WanFang Data, PubMed, The Cochrane Library and Web of Science databases were electronically searched to collect SRs/MAs of acupuncture therapy for bronchial asthma from inception to October 31, 2021. Four reviewers independently screened literature, extracted data, and applied the AMSTAR 2 to evaluate the quality of methodology of the included studies and the GRADE system to assess the certainty of evidence for outcomes. ResultsA total of 14 SRs/MAs were included and their main conclusions were that acupuncture therapy was beneficial in improving the clinical efficacy of bronchial asthma treatment. The evaluation of AMSTAR 2 showed that the methodological quality of all studies was all extremely low. The evidence grading of GRADE system showed that, in the total of 59 outcomes, 7 were graded as medium-level, 24 as low-level, 28 as extremely low-level, and none was graded as high-level. ConclusionThe current evidence shows the advantages of acupuncture therapy for bronchial asthma but the reliability of SRs/MAs is low. High-quality clinical studies are still needed to verify the efficacy of acupuncture therapy for bronchial asthma.
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.
ObjectivesTo evaluate the quality of methodology and evidence of the exiting systematic reviews (SRs) of acupuncture therapy for post-stroke spastic paralysis.MethodsCNKI, CBM, The Cochrane Library, PubMed and EMbase databases were electronically searched to collect SRs of acupuncture therapy for post-stroke spastic paralysis from inception to December 16th, 2018. Two reviewers independently screened literature, extracted data, and evaluated the quality of methodology and evidence by AMSTAR 2 scale and GRADE system.ResultsA total of 7 SRs were included. The results showed that acupuncture therapy had obvious advantages in treating post-stroke spastic paralysis without obvious adverse reactions. The results of AMSTAR 2 scale showed that the failure of key items 2 and 7 resulted in extremely low methodological quality. The results of GRADE system showed that 46.15% of which were low-level evidence quality, 42.31% were medium, 11.54% were extremely low, and no evidence quality were high.ConclusionsCurrent evidence shows that acupuncture and moxibustion therapy is effective in treating spastic paralysis after stroke, however, the quality of the SRs is low. The studies are required to be standardized and combined with the characteristics of TCM to obtain high quality evidence in the future.
ObjectivesTo analyze the development of acupuncture registered trials based on WHO international clinical trial registration platform (ICTRP) in the past 5 years.MethodsWHO ICTRP database was electronically searched to collect acupuncture-related clinical trials registered from January 1st, 2014 to December 31st, 2018. Two reviewers independently screened items, extracted data, and descriptive analysis was performed for the included trials.ResultsThe results showed that there were 1 556 registered clinical trials on acupuncture, and the most registered year was 2017. China was in the main country in applying for acupuncture-related clinical trials, however, the most registered unit was Kyung Hee University in Korea. The trials were mainly interventional research, mostly used randomized, blinded methods, and design modes were mainly based on parallel trials. In clinical trial phase, the majority were in the clinical trial period of treatment of new technologies. The field of clinical research was expected to be on pain in the future.ConclusionsAlthough acupuncture research is currently in a good stage of development, it should still value on the quality and innovative training of relevant trials, strengthen Chinese ties with other countries, focus on regional, domestic and international cooperation, expand research types, and enhance acupuncture applicability.
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.