针刺平行随机对照试验通常没有准确报告试验组和对照组的干预方法.为促进标准化,国际上有经验的针刺医师和研究者组成的小组制定了一些原则,即针刺临床对照试验中干预措施报告的标准(缩写为STRICTA).在征求意见过程中,一些期刊编辑协助对此标准进行了修改,使之与随机对照试验报告的标准(CON-SORT)格式一致,作为该指南对针剌研究报告的延伸.参与此事的杂志编辑已确定要发表该标准,建议其作者群按照此标准准备论文,并将邀请更多杂志采用该标准.目的是使针剌对照试验的干预措施充分报告,从而有利于对这些研究的严格评价、分析及这些措施的推广.
ObjectiveTo systematically evaluate the effectiveness of acupuncture combined with rehabilitation training compared with simple rehabilitation training or acupuncture treatment of dysphagia after stroke, and make clear whether the effect of acupuncture combined with rehabilitation training is better than simple rehabilitation training or acupuncture treatment.MethodsSix databases including China National Knowledge Infrastructure, Wanfang Data, Chongqing VIP, PubMed, Cochrance Library, and Embase were searched by computer for the randomized controlled trials on acupuncture combined with rehabilitation training treatment of post-stroke dysphagia, which were published from January 1st, 2010 to December 31st, 2018. After literature including, excluding, and screening, RevMan 5.3 software was used to conduct a meta-analysis.ResultsA total of 22 studies were included, including 1 987 patients. All the included studies took simple rehabilitation training or rehabilitation training combined with sham acupuncture as the control. Meta-analysis of efficiency and outcome measures for relevant studies showed that: compared with simple rehabilitation training, the effectiveness of acupuncture combined with rehabilitation training on post-stroke dysphagia was higher [17 studies included; odds ratio=3.66, 95% confidence interval (CI) (2.66, 5.05), P<0.000 01], the video fluoroscopy swallowing study score of acupuncture combined with rehabilitation training after treatment was higher [8 studies included; mean difference (MD)=2.31, 95%CI (1.75, 2.87), P<0.000 01], and the StandardizedSwallowing Assessment score of acupuncture combined with rehabilitation training after treatment was lower [6 studies included; MD=−3.20, 95%CI (−3.78, −2.61), P<0.000 01]; at the same time the Watian Drinking Water Test score of acupuncture combined with rehabilitation training after treatment was lower [6 studies included; MD=−0.65, 95%CI (−0.91, −0.39), P<0.000 01].ConclusionsAcupuncture combined with rehabilitation training is effective in dysphagia after stroke, and the combined effect is better than simple rehabilitation training. However, due to the limitations of quality of included literature and sample size, the above results and conclusions still require high quality and large sample studies to testify.
Objective To assess the efficacy of acupuncture versus western medicine in the treatment of depression in China. Methods Randomized controlled trials (RCTs) involving acupuncture versus western medicine in the treatment of depression in China were identified from CNKI (1979 to 2007), VIP (1989 to 2007), WANFANG Database (1998 to 2007) and CBM (1978 to 2007). We also hand searched relevant journals and conference proceedings. Data were extracted and evaluated by two reviewers independently with a specially designed extraction form. The Cochrane Collaboration’s RevMan4.2.8 software was used for data analyses. Results A total of 8 trials involving 619 patients were included. Meta-analyses showed that the total effective rate in the acupuncture group was similar when compared with fluoxetine (RR 1.03, 95%CI 0.94 to 1.14), doxepin (RR 1.14, 95%CI 0.91 to 1.43), amitriptyline (RR 0.95, 95%CI 0.70 to 1.29) and venlafaxine (RR 1.02, 95%CI 0.90 to 1.16). As for the HAMD score at week 2, no significant difference was noted between acupuncture and fluoxetine (WMD 0.03, 95%CI -1.26 to 1.31) or amitriptyline (WMD –?0.33, 95%CI –?1.88 to 1.23); for the HAMD score at week 4, no significant difference was observed between acupuncture and fluoxetine (WMD –?0.24, 95%CI –?1.85 to 1.37) or amitriptyline (WMD –?0.57, 95%CI –?2.02 to 0.88); for the HAMD score at week 6, acupuncture also had similar effects to fluoxetine (WMD –?0.19, 95%CI –?1.51 to 1.13). In terms of the SDS scores at week 2, 4, 6 and 8, no significant differences were noted between acupuncture and fluoxetine. Two trials reported adverse events and these observed no adverse events in the acupuncture group, but 31 and 25 patients experienced adverse events in the western medicine groups of these two trials. Conclusion Acupuncture is not inferior to western medicine, and it is worth noting that acupuncture is associated with few adverse reactions. Further large-scale trials are required to define the role of acupuncture in the treatment of depression.
ObjectiveTo select the key questions of the reporting quality of acupuncture therapy network meta-analysis. MethodsA question pool about reporting quality of acupuncture therapy network meta-analysis was conducted by preliminary literature research and qualitative systematic review. A correspondence questionnaire was designed and the selection of key questions was carried out through two rounds of expert consultation using the Delphi method. ResultsA total of 21 key questions were selected for the network meta-analysis report standard of acupuncture, including whether to report details of acupuncture interventions (e.g., needle type, acupoints used, number of needles inserted, depth of needle insertion, retention time, needling techniques, and treatment duration), diagnostic criteria for diseases or traditional Chinese medicine syndromes, and qualifications of acupuncture practitioners. Of these, the only three key questions answered by the preferred reporting items for systematic reviews and network meta-analysis (PRISMA-NMA) were summary, protocol and registration, and source of funding, while the remaining 19 were specific to acupuncture-related report standards. ConclusionThe conducted key question on reporting guideline of acupuncture network meta-analysis can improve the standardization and rigor of relevant research and better utilize its academic and clinical value.
Objective To compare the effectiveness of P6 stimulation and sham stimulation/ drug intervention on prevention of postoperative nausea and vomiting (PONV). Methods We searched PubMed (1990 to 2010), OVID (1990 to 2010), EBSCO (1990 to 2010), The Cochrane Library (1996 to 2010), PNAI (1990 to 2010), Hight Wirepres (1990 to 2010), and Chinese Digital Hospital Library (www.chkd.cnki.net) (1999 to 2010) to identify randomized controlled trials (RCTs) about P6 stimulation and sham stimulation/drug intervention on prevention of PONV. The methodological quality of the included studies was assessed and the data was extracted according to the Cochrane Reviewer’s Handbook 4.2.2. Meta-analyses were performed using RevMan 4.2 software. Results A total of 21 studies were included. The results of meta-analyses indicated that: (1) Compared with sham stimulation, P6 stimulation could be effective in preventing postoperative nausea (beginning to termination) (Plt;0.000 01), postoperative early nausea (lt;after surgery 6 h) (P=0.000 6) and postoperative late nausea (gt;after surgery 6 h) (P=0.001). (2) Compared with sham stimulation, P6 stimulation could be effective in preventing postoperative vomiting (beginning to termination) (Plt;0.0.000 1) and postoperative early vomiting (P=0.002), but as to postoperative late vomiting (gt;after surgery 6 h), P6 stimulation had no effective preventive effect (P=0.08). (3) Compared with the drug intervention, P6 stimulation had little effect on preventing postoperative nausea (P=0.29) and vomiting (P=0.15). Conclusion Compared with sham stimulation, P6 stimulation can be effective in preventing postoperative early nausea and vomiting as well as postoperative late nausea, but not effective in preventing postoperative late vomiting. In comparison with drugs, a large number of clinical trials are needed to prove P6 stimulation can replace drugs to prevent postoperative nausea and vomiting.
目的 评价B超引导下核心针活检术（CNB）对不可触及的乳腺病变（NPBL）的诊断价值。方法 采用18G Tru-cut针结合活检枪对88例患者的96个NPBL行B超引导下CNB，并与切除活检病理结果比较。结果 NPBL大小4～23mm（平均13.1mm）。在CNB中，86个为良性，2个为可疑恶性，6个为恶性，2个取材不良。在切除活检中9个为恶性，87个为良性。CNB可疑恶变的2个NPBL均为恶性，1个恶性NPBL误诊为乳腺腺病，取材不良的2个NPBL均为良性。本组NPBL中恶性病变占9.38%（9/96），B超引导下CNB对NPBL的良恶性诊断正确率为98.94%（93/94），诊断乳腺癌的敏感性为88.89%（8/9），特异性为100%（8/8），良性病变的病理诊断符合率为97.70%（85/87），取材不良为2.08%（2/96）。结论 B超引导下CNB对NPBL的诊断具有较高的敏感性和特异性，结果准确可靠。
目的:比较针刺配合中国灸穴位贴敷与单纯针刺治疗膝骨关节的临床疗效。方法:将60例符合膝骨关节炎诊断的病员随机分为针刺加中国灸治疗组和单纯针刺对照组,两组均取穴血海、梁丘、犊鼻、膝眼、鹤顶、阳陵泉治疗,治疗组每天加用中国灸穴位贴敷治疗。10次一疗程,2个疗程后观察疗效。结果:治疗组30例中显效20例,好转8例,无效2例,总有效率为93.3%。对照组30例中显效9例,好转16例,无效5例,总有效率为83.3%。两组有效率有显著性差异（Plt;0.05）。结论:针刺配合中国灸穴位贴敷治疗膝骨关节疗效优于单纯针刺。
Objectives We aimed to assess the methodological qual ity of RCT on acupuncture for migraine prophylaxis. Methods With the searching terms including acupuncture, migraine, prophylaxis and prevent, etc, the database of the Cochrane Library (Issue 4, 2007), MEDLINE (1966-2007), EMBase (1966-2007), CBM (1978-2007) and CMCC (1994-2007) were searched from their date of start publ ication. Chinese medical journals and relevant academic conference proceedings were hand searched as well. Several items in included trials were assessed, including methodology, diagnostic criteria, inclusion/exclusion criteria, acupuncture/control interventions, outcome measures and follow-up, etc. Result Among the 12 included trials, 9 trials overseas were high-qual ity and 3 in China were low-quality. Frequency or days of migraine attacks and SF-36/SF-12 were often evaluated as outcome measures in western countries, while headache index was used in China. Among the 12 trials, 9 reported the follow-up outcomes and 8 mentioned adverse events. Conclusion There was no high qual ity trial on acupuncture for migraine prophylaxis in China. The outcome measures in trials published in China by now can not evaluate the outcomes of acupuncture for migraine prophylaxis accurately. To study designs, advantages of trials oversea can be used for reference. To Chinese cl inical physicians, prophylactic therapy and abortive therapy of migraine should be distinguished in order to design high-qual ity study on acupuncture for migraine prophylaxis.