World Journal of Acupuncture-Moxibustion最新文献

Objective

To explore the influence of acupuncture duration on the effect of acupuncute for patients with knee osteoarthritis (KOA).

Methods

This secondary analysis was conducted based on the data of a randomized controlled trial about acupuncture on KOA. A total of 480 patients were recruited at nine centers. Only data from the manual acupuncture (MA) group and electroacupuncture (EA) group were included in this secondary analysis. The needles were retained for 30-min each time and treatment was given three times a week for 8 weeks. The follow-up visit lasted until week 26. Outcomes were numerical rating scale (NRS) on pain, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) function and the response rate.

Results

The NRS and WOMAC function at week 8 were lower than those at week 4 (P<0.05), and were no significant difference compared with those at week 26 in MA and EA groups (P>0.05). Greater changes were observed in NRS and WOMAC function during 0–4 weeks compared with those during 4–8 weeks (P<0.05) in both groups. The response rate at week 8 was higher than it at week 4 (P<0.05), and was no significant difference compared with it at week 26 (P>0.05) in both groups. Association was found between BMI and changes of NRS (P<0.05), but not between BMI and WOMAC function (P>0.05) in MA group, while no asscoaition was found between BMI and NRS or WOMAC function in EA group (P>0.05). There was no association found between other factors and NRS or WOMAC function in both groups (P>0.05).

Conclusion

For KOA patients, 8-week acupuncture was more effective than 4-week acupuncture in relieving pain and improving joint function, but growth rate of the effect slowed down with increasing duration of intervention. It was uncertain whether the long-term effect of 8-week acupuncture was better than that of 4-week acupuncture. Further studies are required to further determine the effect of duration of intervention.

Acupuncture and moxibustion, which are important treatment modalities in traditional Chinese medicine, have gained global recognition and research interest due to their effectiveness. While the number of acupuncture and moxibustion studies continues to increase, the quality vary widely. This inconsistency can have a negative effect on production of high-quality evidence and development of acupuncture and moxibustion science. In 2022, the China Association of Acupuncture-Moxibustion published the Guideline for Acupuncture-Moxibustion Clinical Research Registration. This guideline standardizes methods and approaches used in the clinical research of acupuncture and moxibustion in China, and aims at improving data quality and enhancing transparency, thereby promoting the normalization of clinical studies on acupuncture and moxibustion and improving the quality of evidence. This study aimed to present interpretations of the contents of the Guideline for Acupuncture-Moxibustion Clinical Research Registration to facilitate a better understanding and application among researchers.

Placebo control is designed to evaluate the specific effect of one intervention. Relevant studies showed that acupuncture has a considerable placebo effect affected by many factors. In this paper, the relevant articles of acupuncture placebo studies all around the world were reviewed comprehensively to clarify the definition of acupuncture placebo effect and its psychological mechanism. The factors of acupuncture placebo effect were discussed in view of three aspects, i.e. types of sham acupuncture as control, patient-doctor interaction and outcome types. Eventually, the issues encountered in current studies of acupuncture placebo effect were described, e.g. lack of relevant studies especially with systematic and in-depth approaches in this field, inappropriate classification of specific non-needling effect relevant with acupuncture theory, and inaccurate assessment of acupuncture placebo effect due to the difficulty of sham-acupuncture design. In order to drive the future research direction of acupuncture placebo effect, it is suggested that more attention should be paid on the topic, including but not limited to correct recognition of the holistic effect of acupuncture, the appropriate design of sham acupuncture and in-depth research of mechanism of acupuncture placebo effect and its contributing factors.

Objective

As a popular complementary therapy, the safety of acupuncture must be considered. Acupuncture case reports of adverse events (ACR-AEs) significantly contribute to the assessment of acupuncture safety. However, the reporting quality of ACR-AEs remains unclear. We aimed to promote the application of the CARE (case report) guidelines and improve the reporting quality of ACR-AEs.

Methods

We systematically searched for ACR-AE from six databases: Medline, Embase, Chinese Biomedical Literature Service System, China National Knowledge Infrastructure, Wanfang Data, and VIP, and collected published ACR-AEs from January 1, 2016, to December 31, 2020. We included only case reports of adverse events related to acupuncture therapy. The retrieved case reports were screened and filtered by two reviewers independently. Then, basic information extraction and CARE evaluation of the included ACR-AEs were performed.

Results

A total of 56 ACR-AE were included, 15 of which were from China. The top two major diseases were nervous system diseases (28.6%) and infections (21.4%). For all ACR-AEs, seven of 30 CARE subordinate items were reported in 30% or less, seven items were reported in 30–60%, and only five items got reporting proportion over 90%. In Chinese ACR-AE, only three items, “the main concerns and symptoms of the patient(5b)”, “types of intervention(9a)” and “adverse and unanticipated events (10d)” were sufficiently reported. In English ACR-AE, item “the main concerns and symptoms of the patient(5b)” and item “the primary takeaway lessons(11d)” were also generally reported.

Conclusion

Overall, the reporting quality of ACR-AE was unsatisfactory, and we believe that a special reporting guideline for clinical cases targeted at acupuncture should be extended in future studies.

Objectives

To summarize the available evidence of acupuncture for pain relief in the patients with postherpetic neuralgia (PHN) using a scoping review.

Methods

Seven electronic databases of the original studies of acupuncture on PHN were retrieved. The search time was from the inception to May 1, 2021. Two researchers screened the title, abstract and full text of each article independently. The original studies that was met the inclusion criteria were collected and analyzed, and finally presented with a qualitative description.

Results

A total of 216 original studies were eligible and all of them were randomized controlled trials. The acupuncture therapies with the highest use frequency included manual acupuncture, pricking and cupping and electroacupuncture. Acupuncture therapies were mostly combined with other interventions in studies. There were large differences in acupoint selection, time duration for single treatment and the total treatment times. It was believed in all of the included studies that acupuncture was effective of pain relief in PHN and 85.65% of the studies obtained the minimum clinical importance difference (MCID), suggesting the clinical effectiveness. The adverse reaction of acupuncture was low in its incidence, and mostly transient in occurrence.

Conclusion

The study type of acupuncture for PHN is relatively simple. Most studies show the advantages of acupuncture in pain relief of PHN. The quality of study needs to be improved.

Randomized controlled trial (RCT) is the golden standard for evaluation of clinical evidence. To assess the effect of acupuncture, due to the specificity of acupuncture intervention, the blinding and control methods are the difficulties in study design. It is not practical to blind investigators, participants and evaluators simultaneously. At present, blinding is generally conducted for the participants and evaluators in clinical trial. We took a comparative study of manual acupuncture and electroacupuncture for menopausal hot flush as an example to explore a new way with the reference of double-dummy design in new drug study. A single-blind and double-dummy clinical trial model of acupuncture was established. Based on individual acupuncture intervention in each group, the placebo intervention was combined to ensure the form consistency of two groups. Such a study design may eliminate non-specific effect of acupuncture, and can be conductive to comparing the specific effect of acupuncture and can provide the references and regimens for study design.