World Journal of Acupuncture-Moxibustion最新文献

Clinical Practice Guideline on Acupuncture and Moxibustion: Allergic Rhinitis was revised and released by the Standards Working Committee of World Federation of Acupuncture-Moxibustion Societies (WFAS) on October 9, 2023. This is the first clinical practice guideline (CPG) on acupuncture and moxibustion for allergic rhinitis approved by an international academic organization, which provides evidence-based recommendations and the practical therapeutic protocols for acupuncture practitioners globally. This CPG was developed by following Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) methodology, and the principles of the World Health Organization Handbook for Guideline Development. The members in the guideline development group (GDG) were from different countries, with different professions, and they played a critical role in the development of clinical questions, recommendations, and therapeutic protocols. Recommendations are the core of a CPG and the direct answers to clinical questions, due to which this article focuses on the recommendations of this CPG. The recommendations were developed by using the modified Delphi method and the GRADE grid rules, based on the updated systematic reviews of clinical evidence. A total of 15 recommendations for 15 clinical questions were developed in this CPG, including one strong recommendation for intervention based on high-quality evidence, three conditional recommendations for either the intervention or the comparison based on very low quality of evidence, and 11 conditional recommendations for the intervention based on very low quality of evidence.

World Federation of Acupuncture-Moxibustion Societies (WFAS) Technical Benchmark of Acupuncture and Moxibustion: Electroacupuncture, developed under the leadership of Shanghai University of Traditional Chinese Medicine, was approved by WFAS. This technical benchmark was issued on October 9, 2023, and implemented on December 31, 2023. The main contents include the scope, normative references, terms and definitions, acupuncture and moxibustion procedures and rules, and safety. This article focuses on the above contents. An outlook on the application, popularization, and update plan of this technical benchmark is proposed.

Objective

To evaluate the clinical effect of acupuncture- moxibustion as the adjuvant therapy on frozen-thawed embryo transfer (FET) using network meta-analysis.

Methods

In PubMed, Embase, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI), Wanfang database (WanFang), VIP database and Chinese Biomedical Literature Database (SinoMed), the randomized controlled trials (RCTs) of the adjuvant therapy of acupuncture-moxibustion for FET were retrieved, from database inception to April 1, 2021. Cochrane risk of bias assessment tool was used to screen and evaluate the quality of the included studies, and RevMan 5.3, GeMTC0.14.3 and Stata16.0 software were adopted to complete the network meta-analysis.

Results

Twenty-nine RCTs comprising 2880 patients were finally included, involving 17 interventions and 4 outcome measures. The results of network meta-analysis showed that the top three therapies under each outcome based on the magnitude of SUCRA values were: ① Clinical pregnancy rate (CPR, %): “transcutaneous electrical acupoint stimulation + herbal medicine” (76.4), “moxibustion + herbal medicine” (74.7), “acupuncture + moxibustion” (73.3); ②Biochemical pregnancy rate (BPR): “moxibustion + herbal medicine” (89.3), “acupuncture + moxibustion” (82.1), “acupuncture + herbal medicine” (78.7); ③Endometrial thickness: “acupoint injection + Western medicine” (87.2), auricular therapy (76.8), “acupuncture + herbal medicine” (73.5); ④Type A endometrial morphology rate: “acupoint injection + Western medicine ”(78.3), “moxibustion + herbal medicine” (58.0) and “acupuncture + moxibustion” (52.6).

Conclusion

The combined treatment of acupuncture-moxibustion was superior to single therapy for FET patients. The combined therapy of transcutaneous electrical acupoint stimulation and herbal medicine had the best effect for improving CPR, “moxibustion + herbal medicine” obtained the best average comprehensive effect, and “acupoint injection + Western medicine” was conductive to ameliorate the endometrial thickness and morphology. Due to the limitations of existing studies, more high-quality RCTs are needed in the future to further verify these conclusions.

Background

Acupuncture has been proven to improve the pregnancy rate in infertile women. Endometriosis is a common cause of infertility. So far, there are no studies of the efficacy of acupuncture on endometriosis-associated infertility (EAI). Therefore, we will conduct a randomized controlled trial (RCT) to investigate whether acupuncture could have higher pregnancy rates in patients with EAI compared with sham acupuncture. The study protocol is reported in this paper.

Methods/design

The current trial is a multicenter randomized controlled study undergoing in Shanghai, China. About 224 eligible patients with EAI will be randomly assigned into the acupuncture group and the sham acupuncture group in a 1:1 ratio. In the acupuncture group, patients will be treated with acupuncture on Guanyuan (CV4), Zhongji (CV3), Zigong (EX-CA1), Xuehai (SP10), Zusanli (ST36), Sanyinjiao (SP6), and Taichong (LR3), twice a week, for 3 menstrual cycles, and 12 menstrual cycles will be followed up. The Park sham device will be used to perform non-transdermal acupuncture in the sham acupuncture group. The operation points will be located at 1.5 cm away beside these acupoints in the acupuncture group. The intervention period is the same as that in the acupuncture group. The primary outcome will be pregnancy rate. Secondary outcomes will include ultrasound results, cancer antigen 125 (CA125), anti-Müllerian hormone (AMH), sex hormones, and the Endometriosis Health Profile-5 (EHP-5). Outcomes will be collected at baseline, the end of treatment, and follow-up visits at 3, 6, and 12 menstrual cycles. All data, including major adverse events, will be recorded in electronic case report forms and analyzed using SPSS V.25.0.

Discussion

This study will help to evaluate whether acupuncture is effective in increasing the pregnancy rate of infertile women with endometriosis.

Trial registration

http://www.chictr.org.cn/ Identifier: ChiCTR2100047662. Registered 21 June 2021.

The paper reports a successful case of unilateral oculomotor palsy treated with acupuncture in a Chinese boy aged 5 years and 3 months. Filiform needles were applied for ptosis, ocular motility impairment and blurred vision of the left oculomotor palsy after arachnoid cyst surgery. Two stages of treatment with acupuncture were composed. Acupuncture in the first stage focused on resolving stasis, unblocking meridians and activating qi and blood circulation, especially at the acupoints around the eye, combined with the distal points (four gate points) to enhance qi movement and activate blood circulation, once daily. Besides, the western medicines for nerve nutrition were added. One month later, all the symptoms were alleviated, and the eyelid could be lifted. Then, the second stage of acupuncture started, during which, the western medicine for nerve nutrition was withdrawal, acupuncture was continued with the same acupoints as the first stage, once every two days. Besides, the thumb-tack needle was used to maintain the effect of filiform needle, and Zusanli (ST36) was added to replenish qi of spleen and stomach and promote circulation of meridians. Another month later, the lift of the left eyelid and the ocular motility were basically symmetrical to the right eye, and the left eye vision returned normal. Follow-up until the time of publication, the motility and function of the affected eye were basically the same as those of the healthy side. This case suggests that the staged intervention with acupuncture could be effective in child with unilateral oculomotor palsy after arachnoid cyst surgery and were acceptable for child. Further studies are needed to confirm the effect and mechanism of acupuncture intervention on postoperative oculomotor palsy.