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Xiong Z, Ma P, Zhang H, Liu C, Liu B, Liu Z, Yan S. Placebo response to sham electroacupuncture in patients with chronic functional constipation: A secondary analysis. Neurogastroenterol Motil 2024; 36:e14770. [PMID: 38361038 DOI: 10.1111/nmo.14770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 01/30/2024] [Accepted: 02/08/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Chronic severe functional constipation is a common disease that requires novel and effective treatment strategies. Acupuncture might constitute a promising therapeutic approach for chronic constipation, but it reportedly engenders an enhanced placebo response. Herein, we aimed to determine the magnitude of the placebo responses to electroacupuncture for constipation and identify its influencing factors. METHODS In this secondary analysis of a multicenter randomized trial, patients were randomized to a sham electroacupuncture group, which was administered for 8 weeks in 24 sessions of superficial needling at nonacupoints. The placebo response rates were assessed using three responder criteria: ≥3 complete spontaneous bowel movements per week (CSBMs/week), overall CSBM, and sustained CSBM. Logistic regression with backward selection method was employed to identify the potential factors that affected the placebo response. KEY RESULTS Overall, 539 patients were included in the study. The placebo response rate was 10.58%, 9.46%, and 9.09% according to the three aforementioned criteria, respectively. Those who exhibited more CSBMs/week at baseline were more likely to respond to sham electroacupuncture. Among patients with more than one CSBM per week at baseline, the response rates for achieving the criteria of ≥3 CSBMs per week, overall CSBM, and sustained CSBM were 25.40%, 30.16%, and 22.22%. CONCLUSIONS AND INFERENCE Electroacupuncture did not demonstrate a large placebo response in functional constipation treatment. The number of CSBMs at baseline may be a moderator of the placebo response to sham electroacupuncture. Thus, superficial needling sham acupuncture may be considered an ideal sham control for clinical trials of chronic constipation.
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Affiliation(s)
- Zhiyi Xiong
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Peihong Ma
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Haoran Zhang
- College of Preschool Education, Beijing Youth Politics College, Beijing, China
| | - Cunzhi Liu
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Baoyan Liu
- China Academy of Chinese Medical Sciences, Beijing, China
| | - Zhishun Liu
- Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Shiyan Yan
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
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Gong C, Yang G, Wang S, Fan Y, Pan W, Li C, Su H, Gu X, Han S, Peng Z, Li Y. Discussion on Efficacy of intensive acupuncture versus sham acupuncture in knee osteoarthritis: a randomized controlled trial published in Arthritis & Rheumatology. Zhongguo Zhen Jiu 2024; 44:216-220. [PMID: 38373770 DOI: 10.13703/j.0255-2930.20221216-k0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
Professor LIU Cunzhi's team from Beijing University of Chinese Medicine published Efficacy of intensive acupuncture versus sham acupuncture in knee osteoarthritis: a randomized controlled trial in Arthritis & Rheumatology on November 10th, 2021, which demonstrates that three-session per week acupuncture is safe and effective for knee osteoarthritis patients. Experts from home and abroad discussed in depth the study design, acupuncture protocol, and interpretation of the results of the trial, emphasizing the importance of pretrial implementation, acupuncture dosage, reasonable setting of control group and assessing the efficacy of acupuncture, and pointed out that the mechanism of acupuncture for knee osteoarthritis still needs further study, and how to promote acupuncture for knee osteoarthritis according to the clinical practice abroad while ensuring the efficacy of acupuncture is worthwhile to explore.
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Affiliation(s)
| | - Guanhu Yang
- China-American Acupuncture and Rehabilitation Institute, Wenzhou Medical University, Wenzhou 325027, China
| | | | - Ying Fan
- McLean Center for Complementary and Alternative Medicine, Virginia VA 22182, USA
| | - Weixing Pan
- Howard Hughes Medical Institute, Maryland MD201 47, USA
| | - Canhui Li
- Humber College of Canada, Ontaria M4K3S5, Canada
| | - Hong Su
- American TCM Society, New York NY100 16, USA
| | - Xuming Gu
- Knox Chinese Healing and Myotherapy Center, Victoria 3152, Australia
| | - Songping Han
- Neuroscience Research Institute, Peking University, Beijing 100083, China
| | - Zengfu Peng
- Hong Kong Trigger Point Center, Hong Kong, China
| | - Yongming Li
- American TCM Society, New York NY100 16, USA.
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Liu J, Bai P. Elastic acupuncture needle: a set of one-piece elastic double-blind placebo acupuncture. Zhongguo Zhen Jiu 2024; 44:221-223. [PMID: 38373771 DOI: 10.13703/j.0255-2930.20230902-k0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
The Elastic acupuncture needle, a set of clinical device used in randomized controlled trials of acupuncture is developed, which may potentially obtain the double-blind placebo control. This kind of acupuncture device consists of a real needle and a sham one (placebo needle) with a identical appearance. Either of the needle is composed of an integrated cap-type handle and needle body, and a sterile double-sided adhesive pad is designed on the bottom for fixation. A spring with miniature low profile is built in sham needle. During operation, the real needle can be normally inserted, while the sham one be retracted because of the elasticity generated by the pressure on the skin, but deqi can still be felt by patients whenever the force difference between the skin and the spring reaches a certain balance. The rubber pad designed in this acupuncture needle can simulate the "resistance" felt by operators during needle insertion so that the double blinding is actualized in terms of the appearance and sensations.
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Affiliation(s)
- Jingyi Liu
- Third Affiliated Hospital of Beijing University of CM, Beijing 100029, China.
| | - Peng Bai
- Department of Acupuncture and Moxibustion, Third Affiliated Hospital of Beijing University of CM, Beijing 100029.
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Lee B, Kwon CY, Lee HW, Nielsen A, Wieland LS, Kim TH, Birch S, Alraek T, Lee MS. Different Outcomes According to Needling Point Location Used in Sham Acupuncture for Cancer-Related Pain: A Systematic Review and Network Meta-Analysis. Cancers (Basel) 2023; 15:5875. [PMID: 38136419 PMCID: PMC10741764 DOI: 10.3390/cancers15245875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 12/04/2023] [Accepted: 12/05/2023] [Indexed: 12/24/2023] Open
Abstract
Numerous acupuncture studies have been conducted on cancer-related pain; however, its efficacy compared to sham acupuncture remains controversial. We confirmed whether the outcome of acupuncture differs according to the needling points of sham acupuncture for cancer-related pain. We searched 10 databases on 23 May 2023 to screen acupuncture trials using sham acupuncture or waiting list as controls for cancer-related pain. Sham acupuncture was classified into two types, depending on whether the needling was applied at the same locations as verum acupuncture (SATV) or not (SATS). A network meta-analysis (NMA) was performed on the basis of a frequentist approach to assess pain severity. Eight studies (n = 574 participants) were included in the review, seven of which (n = 527 participants) were included in the NMA. The pain severity was not significantly different between SATV and verum acupuncture, but verum acupuncture significantly improved pain severity compared to SATS. The risk of bias affecting the comparisons between the verum and sham acupuncture was generally low. Previous acupuncture trials for cancer-related pain showed differing outcomes of sham and verum acupuncture, depending on the needling points of sham acupuncture. The application of SATV cannot be considered a true placebo, which leads to an underestimation of the efficacy of verum acupuncture.
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Affiliation(s)
- Boram Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea;
| | - Chan-Young Kwon
- Department of Oriental Neuropsychiatry, Dong-Eui University College of Korean Medicine, Busan 47227, Republic of Korea;
| | - Hye Won Lee
- KM Convergence Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea;
| | - Arya Nielsen
- Department of Family Medicine & Community Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
| | - L. Susan Wieland
- Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA;
| | - Tae-Hun Kim
- Korean Medicine Clinical Trial Center, Korean Medicine Hospital, Kyung Hee University, Seoul 02447, Republic of Korea;
| | - Stephen Birch
- Kristiania University College, School of Health Sciences, 0317 Oslo, Norway; (S.B.); (T.A.)
| | - Terje Alraek
- Kristiania University College, School of Health Sciences, 0317 Oslo, Norway; (S.B.); (T.A.)
- Department of Community Medicine, Faculty of Health Sciences, National Research Center in Complementary and Alternative Medicine (NAFKAM), Institute of Health Sciences, 9037 Tromsø, Norway
| | - Myeong Soo Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea;
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Yu C, Zhang R, Shen B, Li X, Fang Y, Jiang Y, Jian G. Effects of sham acupuncture for chronic musculoskeletal pain syndrome: A systematic review and network meta-analysis of randomized controlled trials. Medicine (Baltimore) 2023; 102:e35275. [PMID: 37986368 PMCID: PMC10659706 DOI: 10.1097/md.0000000000035275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/26/2023] [Accepted: 08/28/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Acupuncture has been widely used for chronic musculoskeletal pain syndrome (MPS). Due to the strong influence of sham acupuncture (SA) in clinical trials, the treatment of MPS by acupuncture remains controversial. Different types of SA procedures might produce different responses. The purpose of this systematic review was to assess the effect of SA on MPS. METHODS We searched 8 literature databases for randomized controlled trials (RCTs) on acupuncture for chronic MPS with SA as a control from database inception to November 29, 2022. SA included superficial acupuncture on non-acupoints (SANAs), non-penetration on acupoints (NPAs), and non-penetration on non-acupoints (NPNAs). Two independent reviewers assessed the risk of bias and conducted the research selection, data extraction, and quality assessment of the included RCTs. We conducted data analysis using the RevMan 5.3 and STATA 14 software packages, and traditional meta-analysis was adopted for direct comparison. A network meta-analysis (NMA) was executed using frequency models in which we combined all available direct and indirect evidence from RCTs. The pain-related indicators were set as primary outcomes, and GRADEpro online was implemented for the assessment of evidence quality. RESULTS Forty-two RCTs were included in this study, encompassing a total of 6876 patients and incorporating 3 types of SA procedures. In our traditional meta-analysis, true acupuncture (TA) was more effective than SANAs, NPAs, and NPANAs concerning MPS. In the NMA, TA was the most effective modality, followed by SANAs, NPAs and NPANAs, and then the blank control (BC). In this NMA and according to the therapeutic effects in the pain indicators, the rankings of SA were as follows: SANA (surface under the cumulative ranking curve [SUCRA], 65.3%), NPA (SUCRA, 46.2%), and NPANA (SUCRA, 34.2%). The quality of the evidence for outcomes ranged from "low" to "moderate." CONCLUSIONS Compared with SA, TA was effective in treating MPS. The effects produced by different SA procedures were different, and the order of effects from greatest to least was as follows: SANA, NPA, and NPANA.
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Affiliation(s)
- Chuan Yu
- Department of Acupuncture, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Dongcheng District, Beijing, China
| | - Rui Zhang
- Department of Acupuncture, Beijng Traditional Chinese Medicine Hospital Pinggu Hospital, Pinggu District, Beijing, China
| | - Bin Shen
- Department of Acupuncture, Beijng Traditional Chinese Medicine Hospital Pinggu Hospital, Pinggu District, Beijing, China
| | - Xiang Li
- Department of Acupuncture, Beijng Traditional Chinese Medicine Hospital Pinggu Hospital, Pinggu District, Beijing, China
| | - Yiyi Fang
- Department of Acupuncture, Beijng Traditional Chinese Medicine Hospital Pinggu Hospital, Pinggu District, Beijing, China
| | - Yiyun Jiang
- Department of Acupuncture, Beijng Traditional Chinese Medicine Hospital Pinggu Hospital, Pinggu District, Beijing, China
| | - Guofan Jian
- Department of Acupuncture, Beijng Traditional Chinese Medicine Hospital Pinggu Hospital, Pinggu District, Beijing, China
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Kim SA, Lee JS, Kim T, Kim TH, Kwon S, Kang JW. Efficacy and safety of acupuncture treatment for fatigue after COVID-19 infection: study protocol for a pilot randomized sham-controlled trial. Front Neurol 2023; 14:1302793. [PMID: 38033774 PMCID: PMC10684676 DOI: 10.3389/fneur.2023.1302793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 10/31/2023] [Indexed: 12/02/2023] Open
Abstract
Background As the coronavirus disease 2019 (COVID-19) pandemic has spread globally, its sequelae, called Long COVID, have persisted, troubling patients worldwide. Although fatigue is known to be the most frequent among Long COVID symptoms, its mechanism and treatment have not been clearly demonstrated. In 2022, we conducted a preliminary prospective case series and found that acupuncture and moxibustion were feasible interventions for fatigue. This study is a pilot patient-assessor-blinded randomized sham-controlled trial to evaluate the efficacy and safety of acupuncture treatment for patients with fatigue that has persisted for at least 4 weeks after recovery from COVID-19. Methods Thirty patients will be recruited and randomly assigned to either the acupuncture or sham acupuncture treatment groups. Treatment will be conducted thrice a week for both groups during 4 weeks. The primary outcome will be the efficacy and safety of acupuncture, including numeric rating scale (NRS), brief fatigue inventory (BFI), fatigue severity scale (FSS), and adverse event evaluation. Secondary outcomes will be evaluation of improvement in the comorbid symptoms of fatigue and feasibility variables. Outcome variables will be assessed before treatment, 4 weeks after treatment, and 8 weeks after treatment completion. Discussion The results of this study will be used to clarify the efficacy and safety of acupuncture treatment for persistent fatigue in patients with Long COVID. Additionally, the feasibility of the study design was validated to provide evidence for future full-scale randomized controlled trials.Clinical trial registration: identifier: KCT0008656 https://cris.nih.go.kr/cris/search/detailSearch.do?seq=24785&search_page=L.
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Affiliation(s)
- Sung-A. Kim
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Ji-Su Lee
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Taegon Kim
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Tae-Hun Kim
- Korean Medicine Clinical Trial Center, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Sunoh Kwon
- Korean Medicine Convergence Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Jung Won Kang
- Department of Acupuncture & Moxibustion, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
- Department of Acupuncture and Moxibustion, Kyung Hee University Medical Center, Seoul, Republic of Korea
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7
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Wang XY, Liu W, Li H, Rong MY, Li JY, Wang SK, Du YZ, Zhao Q. Effectiveness of acupuncture treatment for stroke and stroke complications: a protocol for meta-analysis and systematic review based on randomized, single-blind, controlled trials. Front Neurol 2023; 14:1255999. [PMID: 38020598 PMCID: PMC10651727 DOI: 10.3389/fneur.2023.1255999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 09/28/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction The treatment and rehabilitation of stroke and its complications have become major global health issues. Acupuncture is widely used as a complementary and alternative treatment for stroke. Many clinical studies have evaluated the efficacy and safety of acupuncture, but the research results need to be more consistent. The quality of research based on previously published meta-analyzes is uneven, leading to unstable conclusions. This study aims to provide a comprehensive and systematic analysis of the efficacy of high-quality, randomized controlled trials (RCTs) based on blinded designs for treating stroke and its complications. It also aims to review the characteristics of blinded designs and the current use of sham/placebo acupuncture controls in treating stroke. Methods and analysis This study will be conducted under the reporting guidelines for systematic reviews and meta-analyzes. Randomized controlled trials using acupuncture as the primary measure for stroke will be searched in databases such as China National Knowledge Infrastructure (CNKI), Chongqing VIP (CQVIP), Wan-fang, PubMed, Embase, Cochrane Library, and Web of Science. To evaluate high-quality research based on a blind design, if the trial evaluates the efficacy of any acupuncture intervention by including a sham/placebo acupuncture control, it will be included. The primary outcome indicator will be the ability to perform daily activities. Secondary outcome indicators include evaluating quality of life and related functions in stroke-related sequelae. We will assess the quality of evidence, reporting quality, and risk of bias for the acupuncture intervention in the literature included in this study using the GRADE system, the STRICTA 2010 checklist, and ROB2.0, respectively. RevMan 5.4 software will be used to conduct the meta-analysis, and Stata 15.0 software will be used for sensitivity analysis and publication bias testing. Discussion By analyzing high-quality, well-designed, randomized controlled trials of acupuncture, the results of this study may contribute to a more objective and standardized evaluation of acupuncture efficacy in treating stroke and its complications.Systematic review registration: PROSPERO, Identifier (CRD42023378930).
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Affiliation(s)
- Xiao-Yu Wang
- Acupuncture Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Wei Liu
- Acupuncture Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Huan Li
- Acupuncture Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Meng-Ying Rong
- Acupuncture Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Jing-Yu Li
- Acupuncture Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Shao-Kang Wang
- Acupuncture Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Yu-Zheng Du
- Acupuncture Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Qi Zhao
- Acupuncture Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
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Yu LL, Li CN, Fang MY, Ma Y, Wang B, Lin FP, Liu WH, Tu SH, Chen Z, Xie WX, Zhang RY, Huang Y, Zheng CH, Wang Y. Evaluating the effectiveness and safety of acupuncture on serum uric acid in asymptomatic hyperuricemia population: a randomized controlled clinical trial study protocol. Front Endocrinol (Lausanne) 2023; 14:1218546. [PMID: 37900149 PMCID: PMC10611493 DOI: 10.3389/fendo.2023.1218546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 09/01/2023] [Indexed: 10/31/2023] Open
Abstract
Background The clinical dangers of asymptomatic hyperuricemia to human health have become increasingly prominent over the past 20 years. Previous studies have shown the potential benefits of acupuncture on uric acid levels in the body. However, definitive evidence is lacking. Our objective is to evaluate the efficacy and safety of acupuncture on serum uric acid (SUA) in individuals with asymptomatic hyperuricemia. Methods This is a randomized, single-blind, sham-controlled trial. A total of 180 eligible patients with asymptomatic hyperuricemia will be recruited at three hospitals in China. Patients will be randomly assigned in a 1:1 ratio to receive 16 sessions of manual acupuncture or sham acupuncture for 8 weeks. Patients will be followed up for 12 weeks. The primary outcome will be the change in SUA levels at week 8 after randomization. Secondary outcomes will include dynamic changes in SUA levels, efficacy rates, proportion of gout flare, body weight, and acute medication intake. The MGH Acupuncture Sensation Scale and adverse events related to acupuncture will be measured after each treatment. A blinding assessment will be performed on patients who receive at least one session of acupuncture. Data analyses will be performed on a full analysis set and a per-protocol set. Ethics and dissemination Ethics approval has been obtained from the Clinical Trial Ethics Committee of Tongji Medical College, Huazhong University of Science and Technology (approval no. 2021-S135). Written informed consent will be obtained from enrolled patients. The findings will be disseminated in a peer-reviewed journal. Clinical trial registration ClinicalTrials.gov identifier, NCT05406830.
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Affiliation(s)
- Ling-ling Yu
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chen-nan Li
- The Second School of Clinical Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Meng-yue Fang
- The Second School of Clinical Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yan Ma
- Department of Rehabilitation Medicine, Wuhan No.1 Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Bo Wang
- Department of Rehabilitation Medicine, Wuhan No.1 Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Feng-ping Lin
- Department of Endocrinology, Xianning Central Hospital, Hubei University of Science and Technology, Xianning, Hubei, China
| | - Wen-hua Liu
- Clinical Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Sheng-hao Tu
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhe Chen
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Wen-xi Xie
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Rui-yuan Zhang
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yao Huang
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Cui-hong Zheng
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yu Wang
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Xiong ZY, Liu XY, Ma PH, Sun CY, Sun CY, Liu TL, Liu BY, Liu CZ, Yan SY. Placebo Response among Different Types of Sham Acupuncture for Low Back Pain: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Chin J Integr Med 2023; 29:941-950. [PMID: 37580465 DOI: 10.1007/s11655-023-3608-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND Low back pain (LBP) is a prevalent and debilitating condition that poses a significant burden on healthcare systems. Acupuncture has been proposed as a promising intervention for LBP, but the evidence supporting its specific effect is insufficient, and the use of sham acupuncture as a control in clinical trials presents challenges due to variations in sham acupuncture techniques and the magnitude of the placebo effect. OBJECTIVE To investigate the magnitude of the placebo response of sham acupuncture in trials of acupuncture for nonspecific LBP, and to assess whether different types of sham acupuncture are associated with different responses. METHODS Four databases including PubMed, EMBASE, MEDLINE, and the Cochrane Library were searched through April 15, 2023, and randomized controlled trials (RCTs) were included if they randomized patients with LBP to receive acupuncture or sham acupuncture intervention. The main outcomes included the placebo response in pain intensity, back-specific function and quality of life. Placebo response was defined as the change in these outcome measures from baseline to the end of treatment. Random-effects models were used to synthesize the results, standardized mean differences (SMDs, Hedges'g) were applied to estimate the effect size. RESULTS A total of 18 RCTs with 3,321 patients were included. Sham acupuncture showed a noteworthy pooled placebo response in pain intensity in patients with LBP [SMD -1.43, 95% confidence interval (CI) -1.95 to -0.91, I2=89%]. A significant placebo response was also shown in back-specific functional status (SMD -0.49, 95% CI -0.70 to -0.29, I2=73%), but not in quality of life (SMD 0.34, 95% CI -0.20 to 0.88, I2=84%). Trials in which the sham acupuncture penetrated the skin or performed with regular needles had a significantly higher placebo response in pain intensity reduction, but other factors such as the location of sham acupuncture did not have a significant impact on the placebo response. CONCLUSIONS Sham acupuncture is associated with a large placebo response in pain intensity among patients with LBP. Researchers should also be aware that the types of sham acupuncture applied may potentially impact the evaluation of the efficacy of acupuncture. Nonetheless, considering the nature of placebo response, the effect of other contextual factors cannot be ruled out in this study. (PROSPERO registration No. CRD42022304416).
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Affiliation(s)
- Zhi-Yi Xiong
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Xiao-Yu Liu
- School of Acupuncture-Moxibustion and Tuina, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
| | - Pei-Hong Ma
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Chong-Yang Sun
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Cheng-Yi Sun
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Ting-Lan Liu
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Bao-Yan Liu
- China Academy of Chinese Medical Sciences, Beijing, 100007, China
| | - Cun-Zhi Liu
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Shi-Yan Yan
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China.
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Shi YZ, Yu SG, Zheng H, Zheng QH, Zhou SY, Huang Y, Zhang LX, Xiao XJ, Cao W, Li Y. Acupuncture for Patients with Chronic Spontaneous Urticaria: A Randomized, Sham-Controlled Pilot Trial. Chin J Integr Med 2023; 29:924-931. [PMID: 37561282 DOI: 10.1007/s11655-023-3741-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2023] [Indexed: 08/11/2023]
Abstract
OBJECTIVE To determine the feasibility of conducting a full-scale randomized controlled trial (RCT) and investigate the basic information and safety of acupuncture for patients with chronic spontaneous urticaria (CSU). METHODS A total of 80 participants with CSU from July 2018 to July 2019 were randomly assigned to receive active acupuncture (n=41) on a fixed prescription of acupoints or sham acupuncture (n=39) with superficial acupuncture on non-acupuncture points through the completely randomized design. Patients in both groups received 5 sessions per week for 2 weeks, and participants were followed for a further 2 weeks. Feasibility was assessed by recruitment and randomization rates, retention of participants, treatment protocol adherence, and the incidence of adverse events (AEs). The clinical primary outcome was the changes from baseline weekly urticaria activity scores (UAS7) after treatment at 2 weeks. Secondary outcomes included the Visual Analogue Scale (VAS) score of itching intensity, Dermatology Life Quality Index (DLQI), Hamilton Depression Scale (HAMD), and Hamilton Anxiety Scale (HAMA). RESULTS A total of 80 participants were enrolled. The recruitment rate of 24.02%, randomization rate of 100%, a loss rate of 6.25%, and no obvious AEs were observed in either group. The decrease from baseline in the mean UAS7 total score at week 2 in the active acupuncture group was -8.63 (95%CI, -11.78 to -5.49) and -6.21 (95%CI, -9.43 to -2.98) in the sham acupuncture group for a between-group difference of -2.42 (95% CI, -6.93 to 2.07). The change in the DLQI, VAS of itching intensity, HAMA, and HAMD were a slightly better improvement trend in the active acupuncture group than the sham acupuncture group, but the between-group difference was not significant. CONCLUSIONS Active acupuncture had a better improvement trend in alleviating symptoms, improving quality of life and regulating the mood of anxiety and depression in patients with CSU than sham acupuncture. (Registration Nos. AMCTR-ICR-18000190 and ChiCTR2100054776).
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Affiliation(s)
- Yun-Zhou Shi
- Department of Acupuncture and Moxibustion, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Shu-Guang Yu
- Department of Acupuncture and Moxibustion, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Hui Zheng
- Department of Acupuncture and Moxibustion, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Qian-Hua Zheng
- Department of Acupuncture and Moxibustion, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Si-Yuan Zhou
- Department of Acupuncture and Moxibustion, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Ying Huang
- Dermatology Department of Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Lei-Xiao Zhang
- Department of Acupuncture and Moxibustion, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Xian-Jun Xiao
- Department of Acupuncture and Moxibustion, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Wei Cao
- Department of Acupuncture and Moxibustion, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Ying Li
- Department of Acupuncture and Moxibustion, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China.
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11
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Huo YS, Chen ZY, Yin XJ, Jiang TF, Wang GL, Cui YX, Guo J. [ Tiaoshen acupuncture for primary insomnia: a pilot randomized controlled trial]. Zhongguo Zhen Jiu 2023; 43:1008-13. [PMID: 37697874 DOI: 10.13703/j.0255-2930.20221120-0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
OBJECTIVE To observe the effects of Tiaoshen (regulating the spirit) acupuncture on cognitive function and sleep quality in patients with primary insomnia (PI). METHODS Sixty patients with PI were randomly divided into an observation group (30 cases, 2 cases dropped off) and a control group (30 cases, 2 cases dropped off, 1 case was excluded). The patients in the observation group were treated with acupuncture at Baihui (GV 20), Shenting (GV 24), Sishencong (EX-HN 1), and bilateral Benshen (GB 13), Shenmen (HT 7), Neiguan (PC 6), Sanyinjiao (SP 6). The patients in the control group were treated with shallow needling at non-effective points. Each treatment was provided for 30 min, once every other day, 3 treatments per week for 4 weeks. The Montreal cognitive assessment (MoCA), digit span test (DST), trail making test (TMT)-A, Pittsburgh sleep quality index (PSQI), and fatigue scale-14 (FS-14) were used to assess cognitive function and sleep quality before and after treatment, as well as in follow-up of 4-week after treatment completion. Correlation analysis was conducted between the differences in PSQI scores and differences in MoCA scores before and after treatment in the observation group. RESULTS Compared with before treatment, the total score, visuospatial and executive function score and delayed memory score of MoCA as well as DST backward score were increased (P<0.01), while TMT-A time, PSQI and FS-14 scores were significantly reduced (P<0.01) after treatment and in follow-up in the observation group. Compared with before treatment, the PSQI score in the control group was reduced (P<0.01, P<0.05). After treatment and in follow-up, the observation group had significantly higher total score, visuospatial and executive function score, delayed memory score of MoCA, and DST backward score compared to the control group (P<0.05, P<0.01). In the observation group, the TMT-A time was significantly shorter than that in the control group (P<0.05, P<0.01), and the PSQI and FS-14 scores were significantly lower than those in the control group (P<0.01). In the observation group, there was a negative correlation between the difference in PSQI scores (post-treatment minus pre-treatment) and the difference in MoCA scores (post-treatment minus pre-treatment) (r=-0.481, P<0.01). A similar negative correlation was found between the difference in PSQI scores (follow-up minus pre-treatment) and the difference in MoCA scores (follow-up minus pre-treatment) (r=-0.282, P<0.05). CONCLUSION Tiaoshen acupuncture could improve cognitive function, enhance sleep quality, and alleviate daytime fatigue in patients with PI. The improvement in cognitive function in patients with PI is correlated with the improvement in sleep quality.
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Affiliation(s)
- Yi-Shan Huo
- Acupuncture-Moxibustion Center, Beijing Hospital of TCM Affiliated to Capital Medical University, Beijing 100010, China; Department of TCM, First Affiliated Hospital of Tsinghua University, Beijing 100016
| | - Zhao-Yi Chen
- Acupuncture-Moxibustion Center, Beijing Hospital of TCM Affiliated to Capital Medical University, Beijing 100010, China
| | - Xue-Jiao Yin
- Acupuncture-Moxibustion Center, Beijing Hospital of TCM Affiliated to Capital Medical University, Beijing 100010, China
| | - Tong-Fei Jiang
- Acupuncture-Moxibustion Center, Beijing Hospital of TCM Affiliated to Capital Medical University, Beijing 100010, China
| | - Gui-Ling Wang
- Acupuncture-Moxibustion Center, Beijing Hospital of TCM Affiliated to Capital Medical University, Beijing 100010, China
| | - Ying-Xue Cui
- Acupuncture-Moxibustion Center, Beijing Hospital of TCM Affiliated to Capital Medical University, Beijing 100010, China
| | - Jing Guo
- Acupuncture-Moxibustion Center, Beijing Hospital of TCM Affiliated to Capital Medical University, Beijing 100010, China
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12
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Liu XY, Yan SY, Liu BY. [ Sham acupuncture and placebo acupuncture in clinical trials]. Zhongguo Zhen Jiu 2023; 43:821-4. [PMID: 37429663 DOI: 10.13703/j.0255-2930.20221226-k0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
The commonly used terms "sham acupuncture" and "placebo acupuncture" in clinical acupuncture research is compared and analyzed in this article. In terms of their respective characteristics, sham acupuncture has a wider scope, including various types of acupoints, needle insertion at non-acupoint or non-insertion at acupoints, while placebo acupuncture mainly focuses on non-insertion at acupoints. Sham acupuncture mainly emphasizes the appearance similarity to real acupuncture, while placebo acupuncture emphasizes both similarity in appearance and the absence of therapeutic effects. Properly distinguishing and applying sham acupuncture and placebo acupuncture can help standardize their usage in terminology. Considering the difficulty in setting up qualified placebo acupuncture, it is suggested that researchers use the term "sham acupuncture" to describe the acupuncture control methods used in clinical research.
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Affiliation(s)
- Xiao-Yu Liu
- College of Acupuncture-Moxibustion and Tuina, Tianjin University of TCM, Tianjin 301617, China
| | - Shi-Yan Yan
- College of Acupuncture-Moxibustion and Tuina, Beijing University of CM, Beijing 100105
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Gao S, Sun Y, Shi H, Fang J, Liu Z. Efficacy and Safety of Acupuncture for Cyclic Mastalgia: Study Protocol for a Randomized, Sham-Controlled Trial. Int J Womens Health 2023; 15:845-855. [PMID: 37275513 PMCID: PMC10237189 DOI: 10.2147/ijwh.s410000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 05/16/2023] [Indexed: 06/07/2023] Open
Abstract
Purpose Cyclic mastalgia is prevalent among women and negatively impairs their daily life and work. There is still a lack of effective therapies for mastalgia, and acupuncture may be a promising method. We design this multicenter randomized trial to evaluate the efficacy and safety of acupuncture on cyclic mastalgia. Study Design and methods Sixty participants with moderate-to-severe cyclic breast pain (with a duration of 5-21 days and the worst pain scoring 5 points or more on Numerical Rating Scale [NRS]) will be recruited at three hospitals in China. They will be randomly assigned to acupuncture group or sham-acupuncture group at 1:1 ratio to receive 16-session treatment during 3 consecutive menstrual cycles, and follow-up for 6 menstrual cycles after treatment. The primary outcome is the change from baseline in the NRS score on the worst breast pain during the third cycle of treatment period. All statistical tests will be two-sided and P value <0.05 will be considered statistically significant.
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Affiliation(s)
- Shuai Gao
- Department of Acupuncture, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China
| | - Yuanjie Sun
- Department of Acupuncture, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China
| | - Hangyu Shi
- Department of Acupuncture, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China
- Graduate School, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Jiufei Fang
- Department of Acupuncture, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China
| | - Zhishun Liu
- Department of Acupuncture, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China
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14
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Abstract
OBJECTIVE To promote better reporting quality regarding sham acupuncture in clinical trials for a precise appraisal of the adequacy of the sham acupuncture procedure. METHODS A three-stage online Delphi survey was conducted to a group of experts. Items with higher than 80% consensus from the initial checklist were selected as the final candidates. Further discussion among the working group was convened to preclude potential redundancy among the items. RESULTS A total of 23 experts out of 35 (66%) responded to the Delphi process. The final checklist consists of 23 items in six categories: type of sham acupuncture, details of sham acupuncture manipulation, location of sham acupuncture, treatment regimen, practitioner, and protocol and settings. CONCLUSION This paper presents the Acupuncture Controls gUideline for Reporting humAn Trials and Experiments (ACURATE) checklist, an extension of The Consolidated Standards for Reporting of Trials (CONSORT) and to be used along with STandards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) when sham acupuncture needles are used in the study. This checklist focuses on a clear depiction of sham needling procedures to enhance replicability and enable a precise appraisal. We encourage researchers to use ACURATE in trials and reviews involving sham acupuncture to assist reporting sham acupuncture procedures and the related components.
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Affiliation(s)
- Ye-Seul Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Song-Yi Kim
- Department of Anatomy and Acupoint, College of Korean Medicine, Gachon University, Seongnam, Republic of Korea
| | - Hyangsook Lee
- Department of Science in Korean Medicine, College of Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Younbyoung Chae
- Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Myeong Soo Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
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15
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Li YJ, Leong II, Fan JQ, Yan MY, Liu X, Lu WJ, Chen YY, Tan WQ, Wang YT, Zhuang LX. Efficacy of acupuncture for the treatment of Parkinson's disease-related constipation (PDC): A randomized controlled trial. Front Neurosci 2023; 17:1126080. [PMID: 36866329 PMCID: PMC9972583 DOI: 10.3389/fnins.2023.1126080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 01/30/2023] [Indexed: 02/16/2023] Open
Abstract
Objective To evaluate the efficacy of acupuncture in treating Parkinson's disease-related constipation (PDC). Materials and methods This was a randomized, controlled trial in which patients, outcome assessors, and statisticians were all blinded. Seventy-eight eligible patients were randomly assigned to either the manual acupuncture (MA) or sham acupuncture (SA) groups and received 12 sessions of treatment over a 4-week period. Following treatment, patients were monitored until the eighth week. The primary outcome was the change in weekly complete spontaneous bowel movements (CSBMs) from baseline after treatment and follow-up. The Constipation Symptom and Efficacy Assessment Scale (CSEAS), the Patient-Assessment of Constipation Quality of Life questionnaire (PAC-QOL), and the Unified Parkinson's Disease Rating Scale (UPDRS) were used as secondary outcomes. Results In the intention-to-treat analysis, 78 patients with PDC were included, with 71 completing the 4-week intervention and 4-week follow-up. When compared to the SA group, weekly CSBMs were significantly increased after treatment with the MA group (P < 0.001). Weekly CSBMs in the MA group were 3.36 [standard deviation (SD) 1.44] at baseline and increased to 4.62 (SD, 1.84) after treatment (week 4). The SA group's weekly CSBMs were 3.10 (SD, 1.45) at baseline and 3.03 (SD, 1.25) after treatment, with no significant change from baseline. The effect on weekly CSBMs improvement in the MA group lasted through the follow-up period (P < 0.001). Conclusion Acupuncture was found to be effective and safe in treating PDC in this study, and the treatment effect lasted up to 4 weeks. Clinical trial registration http://www.chictr.org.cn/index.aspx, identifier ChiCTR2200059979.
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Affiliation(s)
- Ying-Jia Li
- Clinical Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ian-I Leong
- The First Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jing-Qi Fan
- Clinical Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ming-Yue Yan
- Clinical Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xin Liu
- The First Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wei-Jing Lu
- The First Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yuan-Yuan Chen
- Clinical Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wei-Qiang Tan
- Clinical Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yu-Ting Wang
- Clinical Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Li-Xing Zhuang
- Department of Acupuncture and Moxibustion, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China,*Correspondence: Li-Xing Zhuang,
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16
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Li X, Zhou J, He R, Lian J, Jia J, Hsu C, Yuan S, Chen Z. A study on the effects of the Qihuang Needle therapy on patients with Parkinson's disease. Front Neurol 2023; 13:1022057. [PMID: 36776577 PMCID: PMC9912771 DOI: 10.3389/fneur.2022.1022057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 12/30/2022] [Indexed: 01/28/2023] Open
Abstract
Objective This study aimed to evaluate the effectiveness of the Qihuang Needle (QHN) in treating Parkinson's disease (PD). Design setting and participants The trial was an 8-week randomized clinical trial (4 weeks of treatment followed by 4 weeks of follow-up) conducted from January 2021 to July 2022 in outpatient settings at three clinical sites in Guangzhou, China. Thirty-four participants with PD were diagnosed based on the diagnostic criteria formulated by the brain bank of the British Parkinson's Disease Society in 1992. Interventions Patients in the treatment and control groups received six sessions within 4 weeks of the QHN therapy or the sham acupuncture therapy (two times per week for the first two consecutive weeks and one time per week for the following two consecutive weeks). Main outcomes and measures The primary outcome measure was the change in the Parkinson's Disease Rating Scale-Part III Motor Examination (UPDRS III) between baseline and 8 weeks after treatments. Secondary outcome measures were the Non-Motor Symptoms Scale for Parkinson's Disease (NMSS) and Parkinson's Disease Daily Quality of Life-39 (PDQ-39). Real-time shear wave elastography (SWE) was assessed for each patient at baseline and during the 4-week period as the third outcome measure. Results A more significant reduction of UPDRS III score, PDQ-39, NMSS, and SWE was observed in the QHN group than in the sham acupuncture group. Conclusions The QHN therapy consistently demonstrated superiority and produced clinically meaningful benefits in reducing motor and non-motor symptoms, as well as significantly improving muscle stiffness, in patients with PD.
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Affiliation(s)
- Xinyu Li
- Medical College of Acupuncture, Moxibustion, and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Jingpei Zhou
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Renxiu He
- Baiyun Branch of Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Jiahui Lian
- The Affiliated Traditional Chinese Medicine Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jie Jia
- Department of Ultrasound, The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Chialin Hsu
- International College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Shihua Yuan
- International College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Zhenhu Chen
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China,*Correspondence: Zhenhu Chen ✉
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17
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Li X, Zhi L, Han KY, Li SQ, Ahmad K, Seluzicki C, Wang R, Bao T. Impact of Baseline Expectancy on Outcome Prediction of Real and Sham Acupuncture for Persistent Chemotherapy-Induced Peripheral Neuropathy Pain in Solid Tumor Survivors: A Secondary Analysis of a Randomized Clinical Trial. Integr Cancer Ther 2023; 22:15347354221149992. [PMID: 36691937 PMCID: PMC9893060 DOI: 10.1177/15347354221149992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Chemotherapy-induced peripheral neuropathy (CIPN) pain significantly worsens cancer survivors' quality of life. Expectancy may play an important role in acupuncture response. We sought to explore whether expectancy predicts pain outcome in real acupuncture (RA) and sham acupuncture (SA) in cancer survivors. METHODS We analyzed data from a randomized clinical trial that evaluated the effect of RA on CIPN symptoms compared to SA and wait list control (WLC) in 75 cancer survivors. This secondary analysis was limited to CIPN pain measured by the Numeric Rating Scale (NRS), graded from 0 to 10. Interventions were delivered over 8 weeks. SA was implemented using a combination of non-acupuncture points and a non-insertion procedure. Patient expectancy was measured by the Acupuncture Expectancy Scale (AES) 3 times during the study. We used a linear regression model to evaluate if the NRS score was associated with the baseline AES score at the end of treatment (week 8), adjusting for baseline NRS score. RESULTS AES was similar among 3 groups at baseline (RA: 11.8 ± 2.7; SA: 12.1 ± 3.8.; WLC: 14.6 ± 4.2; P = .062). Baseline AES was not found to be significantly associated with the week 8 NRS score among patients in all RA, SA, and WLC groups (all P > .05). However, we found a trend that higher baseline AES predicted lower NRS score at week 8 in the SA group: a one-point higher score on baseline expectancy was associated with a 0.3-point reduction in NRS pain score (P = .059) at week 8. CONCLUSIONS The association of baseline expectancy and acupuncture response was similar between RA and SA. However, SA seemed to rely more on expectancy than RA. Further studies with larger sample sizes are needed to confirm this finding.
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Affiliation(s)
- Xiaotong Li
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Lilly Zhi
- Ward Melville High School, East Setauket, NY, USA
| | | | - Susan Q. Li
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Khalada Ahmad
- AdventHealth Cancer Institute Clinical Research, AdventHealth Great Lakes Region, Hinsdale, IL, USA
| | | | - Rui Wang
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ting Bao
- Memorial Sloan Kettering Cancer Center, New York, NY, USA,Ting Bao, Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 321 East 61st Street, 4th Floor, New York, NY 10065, USA.
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Zhang L, Deng Y, Hui R, Tang Y, Yu S, Li Y, Hu Y, Li N. The effects of acupuncture on clinical efficacy and steady-state visual evoked potentials in insomnia patients with emotional disorders: A randomized single-blind sham-controlled trial. Front Neurol 2023; 13:1053642. [PMID: 36742043 PMCID: PMC9889562 DOI: 10.3389/fneur.2022.1053642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 12/13/2022] [Indexed: 01/20/2023] Open
Abstract
The aim of this study was to observe the clinical effects and brain electrical potential changes following acupuncture in the treatment of insomnia patients with mood disorders. Ninety patients with insomnia who met the inclusion criteria were randomly divided into the active acupuncture group (AA group, n = 44) and sham acupuncture group (SA group, n = 46) at a ratio of 1:1. The primary outcome was the total score of the Pittsburgh Sleep Quality Index (PSQI), and the secondary outcomes were the total effective rate, Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS) scores, and values of steady-state visual evoked potentials (SSVEP). The two groups received acupuncture or sham acupuncture 10 times (2 weeks). Finally, the total PSQI scores of the AA group and SA group were significantly different (p < 0.05) at 2 weeks (6.11 ± 2.33 vs. 10.37 ± 4.73), 6 weeks (6.27 ± 1.39 vs. 11.93 ± 3.07), 18 weeks (6.32 ± 2.84 vs. 11.78 ± 2.95) and 42 weeks (8.05 ± 3.14 vs. 12.54 ± 2.81). Further analysis found that AA group patients received acupuncture treatment at any age after the same effect (p > 0.05). The SAS and SDS scores of the AA group were also significantly different from those of the SA group at each assessment time point (p < 0.05). The total effective rate of the AA group was 81.82%, while that of the SA group was 30.43% (p < 0.05). There was no significant difference between the AA group and SA group only in the brain potential of the parietal lobe (F4), left temporal lobe (C3) and right temporal lobe (T8) (P > 0.05), but there was a significant difference between other brain regions (P < 0.05). In addition, correlation analysis showed that there was a certain positive correlation between the total PSQI score, SAS score, efficacy level, and SSVEP value in the AA group as follows: C4 and the total PSQI score (r = 0.595, P = 0.041), F3 and SAS score (r = 0.604, P = 0.037), FPz and efficiency level of the frontal lobe (r = 0.581, P = 0.048), and O2 and efficiency level of the occipital lobe (r = 0.704, P = 0.011). Therefore, acupuncture have a good clinical effect on patients with insomnia and emotional disorders and have a significant regulatory effect on abnormally excited brain potentials.
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Affiliation(s)
- Leixiao Zhang
- Department of Integrated Traditional and Western Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Yanli Deng
- Sichuan Second Chinese Medicine Hospital, Chengdu, China
| | - Ruting Hui
- Chengdu First People's Hospital, Chengdu, China
| | - Yu Tang
- Chongqing Emergency Medical Center, Chongqing, China
| | - Siyi Yu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ying Li
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Youping Hu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China,*Correspondence: Youping Hu ✉
| | - Ning Li
- Department of Integrated Traditional and Western Medicine, West China Hospital, Sichuan University, Chengdu, China,Ning Li ✉
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Liu J, Li L, Luo X, Qin X, Zhao L, Zhao J, Zhou X, Liu Y, Deng K, Ma Y, Zou K, Sun X. Specification of interventions and selection of controls in randomized controlled trials of acupuncture: a cross-sectional survey. Acupunct Med 2022; 40:524-537. [PMID: 36039602 DOI: 10.1177/09645284221117848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Specification of interventions and selection of controls are two methodological determinants for a successful acupuncture trial. However, current practice with respect to these two determinants is not fully understood. Thus, we conducted a cross-sectional survey to examine the specification of interventions and selection of controls among published randomized controlled trials (RCTs) of acupuncture. STUDY DESIGN AND SETTING We searched PubMed for acupuncture RCTs published in core clinical journals and complementary and alternative medicine (CAM) journals from January 2010 to December 2019 (10 years) and included RCTs that assessed treatment effects of acupuncture versus any type of control. We used network meta-analyses to explore whether there were differential treatment effects in patients with chronic pain when using sham acupuncture as a control versus using waiting list or no treatment. RESULTS Most of the 319 eligible RCTs specified well the style of acupuncture (86.8%), traditional acupuncture point locations (96.2%), type of needle stimulation (90.3%) and needle retention time (85.6%). However, other acupuncture details were less-frequently specified, including response sought (65.5%), needle manipulation (50.5%), number of needle insertions (21.9%), angle and direction of insertion (31.3%), patient posture (32.3%) and co-interventions (22.9%). Sham acupuncture (41.4%) was the most frequently used control, followed by waiting list or no treatment (32.9%). There was no differential treatment effect when using sham acupuncture versus waiting list/no treatment as a control (standardized mean difference = -0.15, 95% confidence interval: -0.91 to 0.62). CONCLUSION Over a decade of research practice, important gaps have remained in the specification of acupuncture interventions, including response sought, needle manipulation, and co-interventions. While sham acupuncture has been widely used, waiting list or no treatment may also be considered as an appropriate control.
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Affiliation(s)
- Jiali Liu
- Chinese Evidence-based Medicine Center and Cochrane China Center, West China Hospital, Sichuan University, Chengdu, China.,NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, China.,Sichuan Center of Technology Innovation for Real World Data, Chengdu, China
| | - Ling Li
- Chinese Evidence-based Medicine Center and Cochrane China Center, West China Hospital, Sichuan University, Chengdu, China.,NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, China.,Sichuan Center of Technology Innovation for Real World Data, Chengdu, China
| | - Xiaochao Luo
- Chinese Evidence-based Medicine Center and Cochrane China Center, West China Hospital, Sichuan University, Chengdu, China.,NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, China.,Sichuan Center of Technology Innovation for Real World Data, Chengdu, China
| | - Xuan Qin
- Chinese Evidence-based Medicine Center and Cochrane China Center, West China Hospital, Sichuan University, Chengdu, China.,NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, China.,Sichuan Center of Technology Innovation for Real World Data, Chengdu, China
| | - Ling Zhao
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jiping Zhao
- Department of Acupuncture and Moxibustion, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Xu Zhou
- Evidence-based Medicine Research Center, School of Basic Science, Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Yanmei Liu
- Chinese Evidence-based Medicine Center and Cochrane China Center, West China Hospital, Sichuan University, Chengdu, China.,NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, China.,Sichuan Center of Technology Innovation for Real World Data, Chengdu, China
| | - Ke Deng
- Chinese Evidence-based Medicine Center and Cochrane China Center, West China Hospital, Sichuan University, Chengdu, China.,NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, China.,Sichuan Center of Technology Innovation for Real World Data, Chengdu, China
| | - Yu Ma
- Chinese Evidence-based Medicine Center and Cochrane China Center, West China Hospital, Sichuan University, Chengdu, China.,NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, China.,Sichuan Center of Technology Innovation for Real World Data, Chengdu, China
| | - Kang Zou
- Chinese Evidence-based Medicine Center and Cochrane China Center, West China Hospital, Sichuan University, Chengdu, China.,NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, China.,Sichuan Center of Technology Innovation for Real World Data, Chengdu, China
| | - Xin Sun
- Chinese Evidence-based Medicine Center and Cochrane China Center, West China Hospital, Sichuan University, Chengdu, China.,NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, China.,Sichuan Center of Technology Innovation for Real World Data, Chengdu, China.,Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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20
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Abstract
BACKGROUND Acupuncture is widely used for treating migraine; however, evidence of its efficacy when compared with sham acupuncture is equivocal. This study aimed to compare the evaluate efficacy of acupuncture versus sham acupuncture in migraine treatment. METHODS We searched PubMed, the Cochrane Library, Web of Science, and EMBASE databases from their inception to April 25, 2021, for randomized controlled trials. The outcome measurement included response rate, migraine days, intensity, and frequency. RESULTS Twenty randomized controlled trials involving 2725 patients were included. Pooled data suggested that acupuncture was superior to sham acupuncture [mean difference (MD)=-0.52, 95% confidence interval (CI): -0.71 to -0.34, P<0.00001] in reducing the migraine frequency after treatment and follow-up (MD=-0.51, 95% CI: -0.70 to -0.32, P<0.00001). In reducing Visual Analog Scale, acupuncture was superior to sham acupuncture (MD=-0.72, 95% CI: -1.17 to -0.27, P=0.002) after treatment, and also superior to sham acupuncture (MD=-0.82, 95% CI: -1.31 to -0.33, P=0.001) on the follow-up. As for responder rate, acupuncture's efficacy was better than sham acupuncture (relative risk=1.28, 95% CI: 1.00-1.64, P=0.05). However, the reduction of migraine days in the acupuncture group was not significantly different from that in the sham acupuncture group after treatment (MD=-0.62; 95% CI: -1.31 to 0.08; P=0.08) and on the follow-up (MD=-0.68; 95% CI: -1.52 to 0.17; P=0.12). CONCLUSIONS Acupuncture appears to be an effective treatment modality for migraine. Compared with sham acupuncture, acupuncture had greater improvements in migraine frequency, Visual Analog Scale, and responder rate, but there was no statistically significant difference for the number of migraine days.
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21
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Feng S, Li B, Zhang HN, Ma JZ, Fu YB, Zhang T, Hu J. [Placebo control and its methodological issues on clinical trials of acupuncture therapy]. Zhongguo Zhen Jiu 2022; 42:437-441. [PMID: 35403406 DOI: 10.13703/j.0255-2930.20210204-0002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The paper introduces the placebo acupuncture simulation devices commonly used in clinical trial of acupuncture therapy. These devices are composed of Streitberger, Park, Takakura, Foam and Phantom acupuncture. Because acupuncture therapy is a kind of complex intervention, there are the controversies in methodology for the acupuncture placebo control of clinical trial. Placebo acupuncture may be an effective control, with a certain of specific therapeutic effect. The blinding effect of placebo acupuncture is highly questioned, specially, the sensation of deqi is hardly imitated during acupuncture. On these grounds, in this research, the suggestions has been proposed on the selection and the setting of placebo control in clinical trial of acupuncture therapy.
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Affiliation(s)
- Shuo Feng
- Clinical Epidemiology and Evidence-Based Medicine Center of Beijing Hospital of TCM, Capital Medical University, Beijing 100010, China; Clinical Epidemiology and Evidenced-Based Medicine Center, Beijing Institute of TCM, Beijing 100010
| | - Bo Li
- Clinical Epidemiology and Evidence-Based Medicine Center of Beijing Hospital of TCM, Capital Medical University, Beijing 100010, China; Clinical Epidemiology and Evidenced-Based Medicine Center, Beijing Institute of TCM, Beijing 100010
| | - Hui-Na Zhang
- Clinical Epidemiology and Evidence-Based Medicine Center of Beijing Hospital of TCM, Capital Medical University, Beijing 100010, China; Clinical Epidemiology and Evidenced-Based Medicine Center, Beijing Institute of TCM, Beijing 100010
| | - Ji-Zheng Ma
- Department of Spleen and Stomach Disorders, Guang'anmen Hospital, China Academy of Chinese Medical Sciences
| | - Yuan-Bo Fu
- Department of Acupuncture-Moxibustion, Beijing Hospital of TCM, Capital Medical University
| | - Tao Zhang
- Department of Acupuncture-Moxibustion, Beijing Hospital of TCM, Capital Medical University
| | - Jing Hu
- Clinical Epidemiology and Evidence-Based Medicine Center of Beijing Hospital of TCM, Capital Medical University, Beijing 100010, China; Clinical Epidemiology and Evidenced-Based Medicine Center, Beijing Institute of TCM, Beijing 100010
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22
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Zeng D, Yan X, Deng H, Li J, Xiao J, Yuan J, Huang J, Xu N, Fu W, Jianhua L. Placebo response vary between different types of sham acupuncture: A randomized double-blind trial in neck pain patients. Eur J Pain 2022; 26:1006-1020. [PMID: 35129852 PMCID: PMC9305463 DOI: 10.1002/ejp.1924] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 08/31/2021] [Accepted: 02/05/2022] [Indexed: 11/06/2022]
Abstract
Background In prospective experimental studies of neck pain patients, it is difficult to determine whether responses to sham acupuncture differ from responses to real acupuncture due to the heterogeneous methodologies in control/sham interventions. Here we aim to compare the specific and nonspecific effects of electroacupuncture with four types of sham acupuncture. Methods In this double‐blind, sham‐controlled study, we randomly assigned 175 patients with neck pain to receive 10 sessions of electroacupuncture, shallow puncture, nonacupoint deep puncture, nonacupoint shallow puncture, or nonpenetration acupuncture. We used the Northwick Park Neck Pain Questionnaire (NPQ) as our primary outcome, and Short‐form McGill Pain Questionnaire, visual analog scale (VAS), and Pain Threshold as secondary outcomes to measure the changes from baseline to a 3‐month follow up. Results All groups, except nonacupoint shallow puncture, had significant improvement in all outcome measurements. Electroacupuncture only showed superior improvements than the shallow puncture, nonacupoint shallow puncture, and nonpenetration groups when compared using the NPQ and VAS scale (*p < 0.001). Interestingly, the nonacupoint shallow puncture produced even less placebo response than nonpenetration acupuncture. Conclusion Our study demonstrates the high variability of placebo response among different types of sham controls depending on the depth of needle insertion and the puncture location. An important implication of our results is nonacupoint deep puncture produced similar analgesic effects as electroacupuncture. Our study may shed a new light on the predominant underlying mechanisms among different types of sham acupuncture controls, which can help with interpreting the effect of acupuncture in other studies. Trial registration Chinese clinical trial registry (ChiCTR‐IOR‐15006886). Significance This study compared the observed specific and nonspecific analgesia effect in four different types of sham acupuncture stimulation with neck pain patients, assessed by four outcomes. Although all of the sham controls produced significant reduction in neck pain, electroacupuncture had superior significant improvement. Importantly, placebo responses differed significantly between the sham controls and responses were inconsistent according to different outcome assessments. This study emphasizes the importance of taking into consideration which sham control and method of outcome measurement were used in a pain research study when evaluating its results.
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Affiliation(s)
- Dian Zeng
- Acupuncture Research Team, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiaoxia Yan
- Acupuncture Research Team, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Hongmei Deng
- Acupuncture Research Team, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jiemei Li
- Acupuncture Research Team, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jiaxin Xiao
- Acupuncture Research Team, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jiawei Yuan
- Acupuncture Research Team, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jianpeng Huang
- Acupuncture Research Team, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Nenggui Xu
- South China Research Center for Acupuncture, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wenbin Fu
- Acupuncture Research Team, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Liu Jianhua
- Acupuncture Research Team, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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23
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Xian J, Wang L, Sun M, Wang X, Zang XM, Yu HJ, Zhang X, Cheng B, Tan QW. Acupuncture for Subthreshold Depression: Study Protocol for a Randomized Controlled Trial. Front Psychiatry 2022; 12:772360. [PMID: 35153851 PMCID: PMC8828975 DOI: 10.3389/fpsyt.2021.772360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 12/13/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Subthreshold depression refers to a state of mental sub-health that has depressive symptoms but does not meet the diagnostic criteria for major depressive disorder. It is a strong risk factor for depression and is related to an increase in suicide and mortality. Studies suggest that acupuncture may be effective in the treatment of subthreshold depression, but no evidence has proven that the efficacy of acupuncture for subthreshold depression is a specific therapeutic effect or a placebo effect. METHODS This will be a prospective, randomized, controlled, and double-blind study of 64 patients with subthreshold depression. They will be randomly assigned as verum or minimal acupuncture group members. Patients in the verum acupuncture group will receive acupuncture at the acupoints, and those in the minimal acupuncture group will receive minimal acupuncture at non-acupoints. The interventions will be delivered over an 8-week period. The primary outcome measure will be the Hamilton Depression Scale-17 (HAMD-17). The secondary outcome measures will be the 9-item Patient Health Questionnaire (PHQ-9), 7-item Generalized Anxiety Disorder (GAD-7), and SF-12v2 Health Survey. The assessments will occur at baseline, 4 weeks, 8 weeks, and during a follow-up period. DISCUSSION The protocol uses a randomized controlled trial to examine the effectiveness of acupuncture for subthreshold depression and to further study the mechanisms of its effect.
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Affiliation(s)
- Jin Xian
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
- Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Ling Wang
- Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Mi Sun
- Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xue Wang
- Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xiao-Ming Zang
- Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Hui-Juan Yu
- Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xin Zhang
- Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Bin Cheng
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Qi-Wen Tan
- Shandong University of Traditional Chinese Medicine, Jinan, China
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24
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Li M, Wang Y, Li K, Xu X, Zhuang L. The efficacy and safety of Jin's three-needle therapy vs. placebo acupuncture on anxiety symptoms in patients with post-stroke anxiety: A study protocol for a randomized controlled trial. Front Psychiatry 2022; 13:941566. [PMID: 36159932 PMCID: PMC9490304 DOI: 10.3389/fpsyt.2022.941566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/18/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND A large number of clinical RCTs have verified that Jin's three-needle therapy (JTNT) has a great contribution to promoting the function of paralyzed limbs and relieving anxiety disorders for patients with post-stroke anxiety (PSA). However, there is still a lack of sham needle control, and its placebo effect cannot be ruled out. This study firstly verifies the real effectiveness of JTNT. Besides, the changes in serum indexes on the hypothalamic-pituitary-adrenal axis (HPA axis) are observed dynamically by the Enzyme-Linked ImmunoSorbent Assay (ELISA). The activation of different brain regions by JTNT is recorded using resting functional magnetic resonance imaging (rs-fMRI). Therefore, we can provide more practical and powerful evidence-based medical evidence for clinical decisions. METHOD This is a 16 week parallel, single-blind, random, controlled trial, including baseline, 4 weeks of treatment, and 12 weeks of follow-up. A total of 114 participants will be randomly divided into three groups in the proportion of 1:1:1. Participants will receive Jin's three-needle therapy in the active acupuncture group and accept sham needle treatment in the sham acupuncture group. In the waitlist control group, patients will not receive any acupuncture treatment. Outcomes cover three types of indicators, including scale indicators, serum indicators, and imaging indicators. The primary outcome is the change in the performance of anxiety symptoms, which is estimated by the 14-item Hamilton Anxiety Rating Scale (HAMA-14) and the 7-item Generalized Anxiety Disorder scale (GAD-7). Secondary outcomes are physical recovery and daily quality of life, which are evaluated by the National Institute of Health stroke scale (NIHSS) and the Modified Barthel Index Score (MBI Scale). Therefore, the assessment of the scale is carried out at baseline, 2nd, 4th, 8, 12, and 16 weeks. Adrenocorticotropin and cortisol will be quantitatively detected by ELISA at baseline and 4 weeks after treatment. In addition, regional homogeneity analysis (ReHo) will be used to record the activity of brain regions at baseline and 4 weeks after intervention. DISCUSSION The study aims to provide high-quality clinical evidence on the effectiveness and safety of JTNT for patients with PSA. In addition, this trial explores a possible mechanism of JTNT for patients with PSA. CLINICAL TRIAL REGISTRATION Chinese Clinical Trial Registry, identifier [ChiCTR2200058992].
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Affiliation(s)
- Meichen Li
- Clinical Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yuting Wang
- Clinical Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Keyi Li
- The First Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiaoyan Xu
- The First Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Lixing Zhuang
- Department of Acupuncture and Moxibustion, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, China
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25
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Wen Q, Hu M, Lai M, Li J, Hu Z, Quan K, Liu J, Liu H, Meng Y, Wang S, Wen X, Yu C, Li S, Huang S, Zheng Y, Lin H, Liang X, Lu L, Mai Z, Zhang C, Wu T, Ng EHY, Stener-Victorin E, Ma H. Effect of acupuncture and metformin on insulin sensitivity in women with polycystic ovary syndrome and insulin resistance: a three-armed randomized controlled trial. Hum Reprod 2021; 37:542-552. [PMID: 34907435 PMCID: PMC8888993 DOI: 10.1093/humrep/deab272] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 11/15/2021] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION Does acupuncture improve insulin sensitivity more effectively than metformin or sham acupuncture in women with polycystic ovary syndrome (PCOS) and insulin resistance (IR)? SUMMARY ANSWER Among women with PCOS and IR, acupuncture was not more effective than metformin or sham acupuncture in improving insulin sensitivity. WHAT IS KNOWN ALREADY Uncontrolled trials have shown that acupuncture improved insulin sensitivity with fewer side effects compared with metformin in women with PCOS and IR. However, data from randomized trials between acupuncture and metformin or sham acupuncture are lacking. STUDY DESIGN, SIZE, DURATION This was a three-armed randomized controlled trial enrolling a total of 342 women with PCOS and IR from three hospitals between November 2015 and February 2018, with a 3-month follow-up until October 2018. PARTICIPANTS/MATERIALS, SETTING, METHODS Women aged from 18 to 40 years with PCOS and homeostasis model assessment of insulin resistance (HOMA-IR) ≥2.14 were randomly assigned (n = 114 per group) to receive true acupuncture plus placebo (true acupuncture), metformin plus sham acupuncture (metformin, 0.5 g three times daily) or sham acupuncture plus placebo (sham acupuncture) for 4 months, with an additional 3-month follow-up. True or sham acupuncture was given three times per week, and 0.5 g metformin or placebo was given three times daily. The primary outcome was change in HOMA-IR from baseline to 4 months after baseline visit. Secondary outcomes included changes in the glucose AUC during an oral glucose tolerance test, BMI and side effects at 4 months after baseline visit. MAIN RESULTS AND THE ROLE OF CHANCE After 4 months of treatment, the changes of HOMA-IR were -0.5 (decreased 14.7%) in the true acupuncture group, -1.0 (decreased 25.0%) in the metformin group and -0.3 (decreased 8.6%) in the sham acupuncture group, when compared with baseline. True acupuncture is not as effective as metformin in improving HOMA-IR at 4 months after baseline visit (difference, 0.6; 95% CI, 0.1-1.1). No significant difference was found in change in HOMA-IR between true and sham acupuncture groups at 4 months after baseline visit (difference, -0.2; 95% CI, -0.7 to 0.3). During the 4 months of treatment, gastrointestinal side effects were more frequent in the metformin group, including diarrhea, nausea, loss of appetite, fatigue, vomiting and stomach discomfort (31.6%, 13.2%, 11.4%, 8.8%, 14.0% and 8.8%, respectively). Bruising was more common in the true acupuncture group (14.9%). LIMITATIONS, REASONS FOR CAUTION This study might have underestimated the sample size in the true acupuncture group with 4 months of treatment to enable detection of statistically significant changes in HOMA-IR with fixed acupuncture (i.e. a non-personalized protocol). Participants who withdrew because of pregnancy did not have further blood tests and this can introduce bias. WIDER IMPLICATIONS OF THE FINDINGS True acupuncture did not improve insulin sensitivity as effectively as metformin in women with PCOS and IR, but it is better than metformin in improving glucose metabolism (which might reduce the risk of type 2 diabetes) and has less side effects. Metformin had a higher incidence of gastrointestinal adverse effects than acupuncture groups, and thus acupuncture might be a non-pharmacological treatment with low risk for women with PCOS. Further studies are needed to evaluate the effect of acupuncture combined with metformin on insulin sensitivity in these women. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by grants 2017A020213004 and 2014A020221060 from the Science and Technology Planning Project of Guangdong Province. The authors have no conflicts of interest. TRIAL REGISTRATION NUMBER Clinicaltrials.gov number: NCT02491333. TRIAL REGISTRATION DATE 8 July 2015. DATE OF FIRST PATIENT’S ENROLLMENT 11 November 2015.
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Affiliation(s)
- Qidan Wen
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Min Hu
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.,Institute of Integration of Traditional Chinese Medicine and Western Medicine, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Maohua Lai
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.,Institute of Integration of Traditional Chinese Medicine and Western Medicine, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Juan Li
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.,Institute of Integration of Traditional Chinese Medicine and Western Medicine, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Zhenxing Hu
- Department of Gynecology, Xuzhou Maternity and Child Health Care Hospital, Xuzhou, Jiangsu, China
| | - Kewei Quan
- Department of Obstetrics and Gynecology, Dongguan Hospital of Traditional Chinese Medicine, Dongguan, Guangdong, China
| | - Jia Liu
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Hua Liu
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.,Institute of Integration of Traditional Chinese Medicine and Western Medicine, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yanbing Meng
- Department of Traditional Chinese Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Suling Wang
- Department of Traditional Chinese Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xiaohui Wen
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Chuyi Yu
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Shuna Li
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Shiya Huang
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yanhua Zheng
- Department of Traditional Chinese Medicine, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Han Lin
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xingyan Liang
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Lingjing Lu
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Zhefen Mai
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Chunren Zhang
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Taixiang Wu
- Chinese Clinical Trial Registry, Shenzhen, China
| | - Ernest H Y Ng
- Department of Obstetrics and Gynecology, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Elisabet Stener-Victorin
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.,Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Hongxia Ma
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.,Institute of Integration of Traditional Chinese Medicine and Western Medicine, Guangzhou Medical University, Guangzhou, Guangdong, China
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26
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Wang TQ, Li LR, Tan CX, Yang JW, Shi GX, Wang LQ, Hu H, Liu ZS, Wang J, Wang T, Yuan Y, Jia WR, Li H, Wang XW, Wu B, Tu JF, Liu CZ. Effect of Electroacupuncture on Gut Microbiota in Participants With Knee Osteoarthritis. Front Cell Infect Microbiol 2021; 11:597431. [PMID: 34671567 PMCID: PMC8521167 DOI: 10.3389/fcimb.2021.597431] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 06/09/2021] [Indexed: 11/13/2022] Open
Abstract
A close relationship between knee osteoarthritis (KOA) and gut microbiota has recently been described. Herein, we aim to investigate the effect of electroacupuncture (EA) on gut microbiota in participants with KOA. We conducted a study of 60 participants with KOA and 30 matched healthy controls (HCs). Sixty participants were allocated to either EA group (n=30) or sham acupuncture (SA) group (n=30). Five obligatory acupoints and three adjunct acupoints were punctured in the EA group. Eight non-acupoints that were separated from conventional acupoints or meridians were used for the SA group. Participants in both groups received 24 sessions within eight weeks. Fecal microbial analyses by 16S ribosomal RNA gene sequencing were carried out after collecting stools at T0 and T8 weeks (Four samples with changed defecation habits were excluded). The results showed that both Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total score (P=0.043) and NRS score (P=0.002) decreased more in EA group than those in SA group. Moreover, EA could reverse more KOA-related bacteria including Bacteroides, [Eubacterium]_hallii_group, Agathobacter and Streptococcus. The number of significantly different genera between KOA patients and HCs were less after EA treatment than that after SA treatment. This meant that EA modified the composition of the gut microbiome, making it closer to healthy people, while not significantly affecting the microbial diversity. Two genera including Agathobacter (P=0.0163), Lachnoclostridium (P=0.0144) were statistically increased than baseline in EA group (paired Wilcoxon rank sum test). After EA treatment, Bacteroides (P=0.0394) was more abundant and Streptococcus (P=0.0306) was significantly reduced in patients who demonstrated adequate response than in those with inadequate response (Wilcoxon rank-sum test). Spearman correlation test between gut microbe and KOA clinical outcomes indicated that Bacteroides and Agathobacter was negatively correlated with NRS score, WOMAC total score, and WOMAC pain, stiffness and pain scores (P<0.001 or 0.05 or 0.01), while Streptococcus was positively correlated with them (P<0.05 or 0.01). Our study suggests that EA contributes to the improvement of KOA and gut microbiota could be a potential therapeutic target.
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Affiliation(s)
- Tian-Qi Wang
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Ling-Ru Li
- National Institute of Traditional Chinese Medicine Constitution and Preventive Treatment of Diseases, Beijing University of Chinese Medicine, Beijing, China
| | - Chun-Xia Tan
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Jing-Wen Yang
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Guang-Xia Shi
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Li-Qiong Wang
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Hui Hu
- Department of Acupuncture and Moxibustion, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Zhi-Shun Liu
- Department of Acupuncture and Moxibustion, Guang'an Men Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jun Wang
- Department of Acupuncture and Moxibustion, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Tong Wang
- Department of Orthopedics, Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yong Yuan
- Department of Orthopedics, Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Wen-Rui Jia
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Hua Li
- Department of Acupuncture and Moxibustion, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Xin-Wei Wang
- Department of Acupuncture and Moxibustion, Guang'an Men Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Bin Wu
- Department of Acupuncture and Moxibustion, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Jian-Feng Tu
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Cun-Zhi Liu
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
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Wang J, Wang IL, Hu R, Yao S, Su Y, Zhou S, Chen CH. Immediate Effects of Acupuncture on Explosive Force Production and Stiffness in Male Knee Joint. Int J Environ Res Public Health 2021; 18:9518. [PMID: 34574441 DOI: 10.3390/ijerph18189518] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/27/2021] [Accepted: 09/05/2021] [Indexed: 01/01/2023]
Abstract
Acupuncture can improve explosive force production and affect joint stiffness by affecting muscle activation levels. This study aims to explore the effects of true acupuncture (TA) compared with sham acupuncture (SA) on the explosive force production and stiffness of the knee joint in healthy male subjects. Twenty subjects were randomly divided into the TA group (n = 10) and SA group (n = 10) to complete isokinetic movement of the right knee joint at a speed of 240°/s before and after acupuncture. Futu (ST32), Liangqiu (ST34), Zusanli (ST36), Xuehai (SP10), and Chengshan (BL57) were selected for acupuncture. The intervention of SA is that needles with a blunt tip were pushed against the skin, giving an illusion of insertion. The results showed that acupuncture and the intervention time had a significant interaction effect on knee joint explosive force and joint stiffness (p < 0.05). The average maximum (max) torque, average work, average power, average peak power and total work of the TA group increased significantly after acupuncture (p < 0.05), while the SA group did not (p > 0.05). Therefore, true acupuncture can immediately improve the explosive force and joint stiffness of the male knee joint by inducing post-activation potentiation (PAP) and/or De-Qi.
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Zhang N, Tu JF, Lin Y, Li JL, Zou X, Wang Y, Li H, Wei XY, Wang LQ, Shi GX, Yan SY, Liu CZ. Overall Reporting Descriptions of Acupuncture for Chronic Pain in Randomized Controlled Trials in English Journals. J Pain Res 2021; 14:2369-2379. [PMID: 34393507 PMCID: PMC8354735 DOI: 10.2147/jpr.s319195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 07/08/2021] [Indexed: 11/29/2022] Open
Abstract
Background Whether the clinical effect of acupuncture in chronic pain is effective has always been a hot topic of research, which has a great relationship with the overall reporting descriptions of acupuncture, especially the sham acupuncture intervention. To confirm the effectiveness of acupuncture, more clinical studies are often required. Therefore, it is necessary to report high-quality and complete descriptions of acupuncture in clinical trials. This study aims to assess the overall reporting quality of acupuncture for chronic pain in randomized controlled trials (RCTs). Methods Three databases from inception to March 2020 were searched, to assess the quality of acupuncture reports included the RCTs based on the pain-specific supplement to Consolidated Standards for Reporting Trials (CONSORT) and Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA) guidelines. The quality of sham acupuncture descriptions was evaluated based on the Template for Intervention Description and Replication (TIDieR)-placebo checklist. Descriptive statistics and analysis of the results were carried out according to the percentage of each item. Results A total of 74 RCTs were included which met the inclusion criteria. Based on the pain-specific CONSORT, the reporting rates of “Statistical methods”, “Participant flow”, and “Blinding” were “52.70%”, “70.27%”, and “77.03%”, respectively. The weakest reported items in STRICTA were related to the depth of insertion (Item 2c, 54.05%) and the setting and context of treatment (Item 4b, 0.00%). Based on the TIDieR-placebo checklist, the reporting rates of “Item 12”, “Item 11”, “Item 13”, “Item 3”, and “Item 4” were “8.11%”, “10.81%”, “29.73%”, “ 44.59% ”, and “47.30%”, respectively. Conclusion At present, the overall report quality of acupuncture treatment for chronic pain in English journals is acceptable, but the report rate in some aspects is still low. In the future, researchers should report RCTs of acupuncture following cleaner checklists and guidelines.
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Affiliation(s)
- Na Zhang
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, People's Republic of China.,School of Acupuncture-Moxibustion and Tuina, Shandong University of Chinese Medicine, Shandong, People's Republic of China
| | - Jian-Feng Tu
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, People's Republic of China
| | - Ying Lin
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, People's Republic of China
| | - Jin-Ling Li
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, People's Republic of China
| | - Xuan Zou
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, People's Republic of China
| | - Yu Wang
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, People's Republic of China
| | - Hewen Li
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, People's Republic of China
| | - Xiao-Ya Wei
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, People's Republic of China
| | - Li-Qiong Wang
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, People's Republic of China
| | - Guang-Xia Shi
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, People's Republic of China
| | - Shi-Yan Yan
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, People's Republic of China
| | - Cun-Zhi Liu
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, People's Republic of China
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Dong HX, Wang Q, Wang Z, Wu XK, Cheng L, Zhou ZM, Yang L, Yi P, Huang DM. Impact of Low Frequency Electro-acupuncture on Glucose and Lipid Metabolism in Unmarried PCOS Women: A Randomized Controlled Trial. Chin J Integr Med 2021; 27:737-743. [PMID: 34319506 DOI: 10.1007/s11655-021-3482-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To explore the effect of electro-acupuncture (EA) on glucose and lipid metabolism in unmarried patients with polycystic ovary syndrome (PCOS). METHODS Fifty-four PCOS patients were equally randomized into true acupuncture group and sham acupuncture group (control) for totally 16 weeks of treatment by random method with a computerized randomization program. Patients in true acupuncture group accepted traditional acupuncture methods with EA and two sets of acupoint groups were used alternatively. The first set consisted of Zhongji (CV 3), Qihai (CV 6), Guilai (ST 29), Sanyinjiao (SP 6), Yinlingquan (SP 9), Hegu (LI4) and Baihui (GV 20), and the second set consisted of Tianshu (ST 25), ST 29, CV 3, CV 6, SP 6, Taichong (LR 3), Neiguan (PC) 6 and GV 20. Patients in the sham acupuncture group accepted shallow acupuncture methods through EA without electricity at 4 non-meridian points in each shoulder and upper arm. Outcome measures included body mass index (BMI), waist-hip-ratio (WHR), oral glucose tolerance test (OGTT), insulin release test, glucose and lipid metabolism indicators such as total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), adiponectin, leptin, visfatin, resistin, and interleukin (IL-6). RESULTS Twenty-six subjects in the true acupuncture group and 20 subjects in the sham group completed the clinical trial. After 16 weeks of treatment, no significant difference in the outcome measures were observed between the two groups (P>0.05). However, as compared with baseline data, a reduction in weight, BMI, hipline, WHR, fasting glucose, homeostatic model assessment of insulin sensitivity, visfatin and HDL-C, and an increase in resistin and IL-6 were observed in the true acupuncture group (P<0.05). In addition, a reduction in visfatin and an increase in TC were also observed in the sham group (P<0.05). CONCLUSIONS Acupuncture may have a beneficial effect in the treatment of PCOS by improving glucose and lipid metabolism. Moreover, the sham acupuncture may be not completely ineffective. Sham acupuncture may improve some of the aspects of the glucose and lipid metabolism of PCOS patients through a placebo effect. (Registration Nos. ChiCTR-TRC-12002529 and NCT01812161).
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Affiliation(s)
- Hao-Xu Dong
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, 430030, China.,Department of Traditional Chinese Medicine, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Qing Wang
- Department of Rehabilitation Center of Wuhan Puren Hospital, Affiliated Hospital of Wuhan University of Science and Technology, Wuhan, 430081, China
| | - Zhi Wang
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xiao-Ke Wu
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, 50040, China
| | - Ling Cheng
- Department of Acupuncture and Moxibustion, East Hospital, Tongji University, Shanghai, 200120, China
| | - Zhong-Ming Zhou
- Department of Obstetrics and Gynecology, Hubei University of Traditional Chinese Medicine, Wuhan, 430060, China
| | - Li Yang
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ping Yi
- Department of Rehabilitation Center of Wuhan Puren Hospital, Affiliated Hospital of Wuhan University of Science and Technology, Wuhan, 430081, China
| | - Dong-Mei Huang
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, 430030, China.
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30
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Lynning M, Hanehøj K, Westergaard K, Kjær Ersbøll A, Claesson MH, Boesen F, Skovgaard L. Effect of Acupuncture on Cytokine Levels in Persons with Multiple Sclerosis: A Randomized Controlled Trial. J Altern Complement Med 2021; 27:832-840. [PMID: 34265224 DOI: 10.1089/acm.2020.0510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background: Cytokines have been found to play a role in the disease activity of multiple sclerosis (MS). Previous studies indicate that acupuncture can affect cytokine levels in persons with other inflammatory diseases. Objectives: The aim of this study is to investigate the effect of acupuncture on cytokine levels and health-related quality of life (HRQoL) in persons with MS. Materials and Methods: A single-blind, randomized controlled trial was performed. Participants (n = 66) were randomized into three groups (real acupuncture, sham acupuncture, and reference). Participants in the real acupuncture and sham groups received six treatments during a period of 4 weeks. The serum levels of 11 pro- and anti-inflammatory cytokines (IFNγ, IL-1β, IL-6, IL-8, IL-12p70, IL-13, TNFα, IL-10, IL-4, IL-2, and IL-17A) were assessed at baseline, after 2 and 4 weeks of treatment, and 4 weeks after the final treatment. Changes in HRQoL were assessed using the Functional Assessment of Multiple Sclerosis questionnaire. Results: No statistically significant differences in plasma levels between the three groups were seen for either of the cytokines, nor were there any differences between the groups for HRQoL. Conclusions: In this study, the authors could not demonstrate that a 4-week acupuncture treatment had a measurable effect on the plasma levels of seven selected cytokines or on HRQoL among people with MS. The trial was registered with the ISRCTN registry as ISRCTN34352011.
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Affiliation(s)
| | | | | | - Annette Kjær Ersbøll
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Mogens Helweg Claesson
- Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
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Wei X, Liu B. Acupuncture is ineffective for chronic low back pain? A critical analysis and rethinking. Front Med 2021; 15:767-775. [PMID: 33870448 DOI: 10.1007/s11684-020-0785-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 03/27/2020] [Indexed: 12/29/2022]
Abstract
Acupuncture is a promising treatment for relieving pain and improving lower back function in clinical practice. However, evidence from randomized clinical trials (RCTs) remains controversial. Most RCTs conclude that acupuncture procedures for chronic low back pain (CLBP) had no significant difference in efficacy and belonged to placebo. We carefully reviewed and analyzed the methodology and implementation of sham acupuncture in RCTs. Controversial evidence of acupuncture for CLBP is only a microcosm of the evaluation methodological limitation of acupuncture. Inappropriate selection of sham acupuncture controls, rigorous RCT research models, and incorrect interpretation of results may contribute to negative evidence. Evaluating and disregarding the holistic efficacy of acupuncture with an explanatory RCT model based on evaluation drugs may be unwise. Moreover, sham acupuncture is often proven to be non-inert, unreasonable, and with low fidelity. Pitfalls of the explanatory RCT model and sham acupuncture design should be avoided. Establishing a new evaluation system that is in line with the clinical characteristics of acupuncture and obtaining high-quality evidence are difficult but promising tasks.
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Affiliation(s)
- Xuqiang Wei
- College of Acupuncture and Orthopedic, Hubei University of Chinese Medicine, Wuhan, 430065, China
| | - Baoyan Liu
- College of Acupuncture and Orthopedic, Hubei University of Chinese Medicine, Wuhan, 430065, China. .,Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, 100700, China.
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Tu JF, Wang LQ, Shi GX, Yang JW, Li JL, Li YT, Zhao JJ, Hou HK, Du Y, Liu CZ. [Effect of acupuncture on knee injury and osteoarthritis outcome score in patients with knee osteoarthritis]. Zhongguo Zhen Jiu 2021; 41:27-30. [PMID: 33559438 DOI: 10.13703/j.0255-2930.20191212-0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To verify the clinical effect of acupuncture on knee osteoarthritis (KOA). METHODS Forty-two patients with KOA were randomly divided into an acupuncture group (21 cases, 1 case dropped off) and a sham acupuncture group (21 cases, 1 case dropped off). The patients in the acupuncture group were treated with routine acupuncture at 5-6 local acupoints [Dubi (ST 35), Neixiyan (EX-LE 4), Heding (EX-LE 2), Yinlingquan (SP 9), Xuehai (SP 10), Zusanli (ST 36), etc.] and 3-4 distal acupoints [Fengshi (GB 31), Waiqiu (GB 36), Xuanzhong (GB 39), Zulinqi (GB 41), etc.]. The patients in the sham acupuncture group were treated with shallow needling technique at non-acupoint. The needles were retained for 30 min in both groups. All the treatment was given three times a week for 8 weeks. Knee injury and osteoarthritis outcome score (KOOS) were recorded before and after treatment and 18-week follow-up. RESULTS Compared before treatment, the scores of 5 dimensions of KOOS [pain, symptoms (except pain), daily activities, sports and entertainment, and quality of life] were increased after treatment and during follow-up in the two groups (P<0.05), and the scores of pain and daily activities in the acupuncture group were higher than those in the sham acupuncture group (P<0.05). CONCLUSION Acupuncture can reduce the pain symptoms and improve daily activities in patients with KOA.
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Affiliation(s)
- Jian-Feng Tu
- International Acupuncture and Moxibustion Innovation Institute, Beijing University of CM, Beijing 100029, China; School of Acupuncture-Moxibustion and Tuina, Beijing University of CM, Beijing 100029
| | - Li-Qiong Wang
- International Acupuncture and Moxibustion Innovation Institute, Beijing University of CM, Beijing 100029, China
| | - Guang-Xia Shi
- International Acupuncture and Moxibustion Innovation Institute, Beijing University of CM, Beijing 100029, China
| | - Jing-Wen Yang
- International Acupuncture and Moxibustion Innovation Institute, Beijing University of CM, Beijing 100029, China
| | - Jin-Ling Li
- International Acupuncture and Moxibustion Innovation Institute, Beijing University of CM, Beijing 100029, China
| | - Yong-Ting Li
- Department of Acupuncture and Moxibustion, Beijing Hospital of TCM, Capital Medical University
| | - Jing-Jie Zhao
- Department of TCM, Beijing Friendship Hospital, Capital Medical University
| | - Hai-Kun Hou
- Department of Acupuncture and Moxibustion, Beijing Jishuitan Hospital
| | - Yi Du
- Department of TCM, Beijing Friendship Hospital, Capital Medical University
| | - Cun-Zhi Liu
- International Acupuncture and Moxibustion Innovation Institute, Beijing University of CM, Beijing 100029, China; School of Acupuncture-Moxibustion and Tuina, Beijing University of CM, Beijing 100029
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33
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Lai X, Zhang J, Chen J, Lai C, Huang C. Is electroacupuncture safe and effective for treatment of stress urinary incontinence in women? A systematic review and meta-analysis. J Int Med Res 2020; 48:300060520948337. [PMID: 33045874 PMCID: PMC7570783 DOI: 10.1177/0300060520948337] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 07/09/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE Stress urinary incontinence (SUI) is prevalent worldwide, particularly among elderly women. Although electroacupuncture (EA) has been accepted by many patients and physicians in Asia, its efficacy for SUI has not been evaluated scientifically and systematically. We aimed to conduct a systematic evaluation of the efficacy and safety of EA treatment for women with SUI. METHODS We retrieved publications up to February 2019 from seven databases. Randomized controlled trials for women with SUI treated by EA were included. Therapeutic effect, 1-hour urine leakage and International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) scores were the primary outcomes. The Cochrane Collection's RevMan 5.3 software was used to pool data. RESULTS The 15 included articles demonstrated that EA for SUI was effective (odds ratio [OR], confidence interval [CI] = 5.64, 4.19-7.59; Ι2 = 22%). ICIQ-SF scores increased (standard mean difference, CI = -0.48, -0.62 to -0.33; Ι2 = 32%) and 1-hour urine leakage decreased (OR, CI = -4.14, -4.96 to -3.33; Ι2 = 78%) in patients undergoing EA compared with those receiving sham EA, physical exercise or medication. CONCLUSION EA for women with SUI exhibited significant efficacy and safety for key outcomes.
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Affiliation(s)
- Xiuhua Lai
- Meizhou People’s Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, Guangdong, P. R. China
| | - Jiapeng Zhang
- Medical College of Jiaying University, Meizhou, Guangdong, P. R. China
| | - Jing Chen
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P. R. China
| | - Cuiwei Lai
- Meizhou People’s Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, Guangdong, P. R. China
| | - Chunping Huang
- Meizhou People’s Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, Guangdong, P. R. China
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Abstract
Several control conditions, such as penetrating sham acupuncture and non-penetrating placebo needles, have been used in clinical trials on acupuncture effects in chronic pain syndromes. All these control conditions are surprisingly effective with regard to their analgesic properties. These findings have fostered a discussion as to whether acupuncture is merely a placebo. Meta-analyses on the clinical effectiveness of placebo revealed that placebo interventions in general have minor, clinically important effects. Only in trials on pain and nausea, including acupuncture studies, did placebo effects vary from negligible to clinically important. At the same time, individual patient meta-analyses confirm that acupuncture is effective for the treatment of chronic pain, including small but statistically significant differences between acupuncture and sham acupuncture. All acupuncture control conditions induce de qi, a distinct stimulation associated with pain and needling which has been shown to be a nociceptive/pain stimulus. Acupuncture therefore probably activates the pain matrix in the brain in a bottom-up fashion via the spino-thalamic tract. Central nervous system effects of acupuncture can be modulated through expectations, which are believed to be a central component of the placebo response. However, further investigation is required to determine how strong the influence of placebo on the attenuation of activity in the pain matrix really is. A meta-analysis of individual participant functional magnetic imaging data reveals only weak effects of placebo on the activity of the pain network. The clinical acupuncture setting is comprised of a combination of a distinct neurophysiological stimulus, the needling stimulus/experience, and a complex treatment situation. A broader definition of placebo, such as that proposed by Howick (2017) acknowledges a role for expectation, treatment context, emotions, learning, and other contextual variables of a treatment situation. The inclusion of particular treatment feature as a definitional element permits a contextual definition of placebo, which in turn can be helpful in constructing future clinical trials on acupuncture.
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Affiliation(s)
- Frauke Musial
- Department of Community Medicine, National Research Center in Complementary and Alternative Medicine, NAFKAM, Faculty of Health Science, UiT - The Arctic University of Norway, Tromsø, Norway
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35
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Zhong YM, Lai DL, Chen Y, Luo XC, Lu WT, Shang YN, Zhang LL, Zhou HY. Acupuncture vs sham acupuncture for simple obesity: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2019; 98:e17562. [PMID: 31626121 PMCID: PMC6824781 DOI: 10.1097/md.0000000000017562] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 09/19/2019] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Obesity is a growing chronic health problem worldwide. Studies about acupuncture for obesity treatment are many. But there are some doubts about the effectiveness of acupuncture vs sham acupuncture in treating obesity due to its lack of an evidence-based medical proof. Therefore, the aim of this study is to assess the efficacy of acupuncture for obesity treatment and provide clinic evidence. METHODS This protocol was based on the previous reporting items for systematic review and meta-analysis agreements. Four English databases (PubMed, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials) and 4 Chinese databases (China National Knowledge Infrastructure, Chinese BioMedical Database, Chinese Scientific Journal Database, Wan-Fang Data) will be searched from their receptions to August 2019. Randomized controlled trials (RCTs) using acupuncture compared sham acupuncture (or no treatment) to treat simple obesity will be included. The primary outcome of body mass index (BMI) and body weight (BW) will be used to measure the effect of acupuncture on obesity. According to the trial data extraction form based on the Cochrane Handbook, 2 reviewers will separately extract the data. Risk of bias of the RCTs will be assessed by the Cochrane Risk of Bias Tool. Publication bias will be assessed with funnel plots. RESULTS This study will be to evaluate whether acupuncture is an effective intervention for simple obesity when compared with sham acupuncture. CONCLUSION The conclusion of this study will help clinicians provide effective treatment options for obese patients. ETHICS AND DISSEMINATION Ethical approval is not required for systematic review and meta- analysis. The results of this review will be disseminated in a peer-review journal. PROSPERO REGISTRATION NUMBER PROSPERO CRD42019129825.
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Affiliation(s)
- Yu-Mei Zhong
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
| | - De-Li Lai
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
- The Affiliated Hospital, School of Medicine, UESTC, Chengdu Women's and Children's Central Hospital, Chengdu, China
| | - Yang Chen
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
| | - Xiao-Chao Luo
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
| | - Wen-Ting Lu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
| | - Ya-Nan Shang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
| | - Lin-Lin Zhang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
| | - Hai-Yan Zhou
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
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Dhaliwal DK, Zhou S, Samudre SS, Lo NJ, Rhee MK. Acupuncture and dry eye: current perspectives. A double-blinded randomized controlled trial and review of the literature. Clin Ophthalmol 2019; 13:731-740. [PMID: 31114151 PMCID: PMC6497118 DOI: 10.2147/opth.s175321] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 03/05/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose: Dry eye disease (DED) is a common disorder that negatively impacts quality of life and vision. Prior studies have shown some benefit of acupuncture for dry eye, but very few have included control group to mitigate placebo effect. This study was designed with a sham acupuncture control group to evaluate true acupuncture treatment effect. Methods: This is a prospective, randomized, double-blinded, sham-acupuncture-controlled trial. Acupuncture treatment for dry eye was performed as per the Niemtzow Protocol. Twenty-four patients received true acupuncture and twenty-five received sham acupuncture. Treatment efficacy was assessed by the Ocular Surface Disease Index (OSDI) Questionnaire, ocular surface staining, tear flow, tear film break-up time (TBUT), and a general questionnaire. Atmospheric data were collected to control for the effect of atmospheric conditions on symptoms of dry eye. Results: OSDI scores in the treatment group improved compared to baseline (1 week, p<0.01, 1 month p<0.05, 3 months p<0.05, and 6 months p<0.01). OSDI scores in the control group improved, but did not reach significance (p=0.09). Secondary outcome measures showed no significant improvement in TBUT, Schiermer’s Test, ocular surface grading, or artificial tear application. However, at 3 months, a significant reduction in the frequency of eye closing was observed among participants receiving true acupuncture treatment when compared to baseline (p=0.002). Furthermore, intragroup analysis showed significant reduction in symptoms of discomfort (p=0.01), dryness (p=0.001), scratchiness (p=0.001), and redness (p=0.01) in the true acupuncture group at 3 months. Conclusion: Both true and sham acupuncture improved OSDI at 1 week after treatment, however, the improvement in OSDI was significantly greater in the true treatment groups than the sham group at 6 months after acupuncture. True acupuncture treatment improved many subjective assessments of dry eye symptoms, however, other common indicators used to objectively assess dry eye (tear flow, corneal staining, TBUT) remained unchanged. While there were trends towards improvement in the sham acupuncture group, this did not reach statistical significant during the study period. This suggests a true treatment effect of acupuncture rather than a placebo effect. Acupuncture can, therefore, be an effective adjunct to routine clinical treatment of dry eye.
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Affiliation(s)
- Deepinder K Dhaliwal
- Department of Ophthalmology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Siwei Zhou
- Department of Ophthalmology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Sandeep S Samudre
- Department of Ophthalmology, Eastern Virginia Eye Institute, Norfolk, VA, USA
| | - Nathan J Lo
- Department of Medicine, Duke University Hospital, Durham, NC, USA
| | - Michelle K Rhee
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Lin LL, Li YT, Tu JF, Yang JW, Sun N, Zhang S, Wang TQ, Shi GX, Du Y, Zhao JJ, Xiong DC, Hou HK, Liu CZ. Effectiveness and feasibility of acupuncture for knee osteoarthritis: a pilot randomized controlled trial. Clin Rehabil 2018; 32:1666-1675. [PMID: 30037276 DOI: 10.1177/0269215518790632] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE: To evaluate the effectiveness of acupuncture for pain relief and function improvement in patients with knee osteoarthritis and to determine the feasibility of an eight-week acupuncture intervention. DESIGN: Pilot randomized controlled trial. SETTING: Three teaching hospitals in China. SUBJECTS: Patients with knee osteoarthritis (Kellgren grade II or III). INTERVENTIONS: Patients were randomly assigned to an eight-week (three sessions per week) intervention of either traditional Chinese acupuncture or sham acupuncture. MAIN MEASURES: The primary outcome was response rate-the proportion of patients achieving score ⩾36% decrease in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function at week 8 compared with baseline. Secondary outcomes included pain, function and quality of life. RESULTS: Of 42 patients randomized, 36 (85.7%) completed the study. There was no significant difference in response rate between the traditional Chinese acupuncture and control groups: 61.9% (13 of 21) versus 42.9% (9 of 21) achieved score ⩾36% decrease in WOMAC pain and function at week 8 ( P = 0.217). The sum of WOMAC pain and function scores at week 8 was 11.6 (9.1) in the traditional Chinese acupuncture group compared with 16.3 (10.9) in the control group ( P = 0.183). There was no significant difference between groups. Three adverse events were recorded and were classified as mild. CONCLUSION: It showed that three sessions per week acupuncture intervention of knee osteoarthritis was feasible and safe. No difference was observed between groups due to small sample size. Larger (sample size ⩾ 296) randomized controlled trials of this intervention appear justified.
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Affiliation(s)
- Lu-Lu Lin
- 1 Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China.,2 Department of Medicine, School of Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yong-Ting Li
- 3 Department of Acupuncture and Moxibustion, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Jian-Feng Tu
- 1 Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Jing-Wen Yang
- 1 Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Ning Sun
- 1 Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China.,2 Department of Medicine, School of Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Shuai Zhang
- 1 Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Tian-Qi Wang
- 1 Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Guang-Xia Shi
- 1 Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Yi Du
- 4 Department of Traditional Chinese Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Jing-Jie Zhao
- 4 Department of Traditional Chinese Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Da-Chang Xiong
- 5 Department of Acupuncture and Moxibustion, Beijing Jishuitan Hospital, Peking University, Beijing, China
| | - Hai-Kun Hou
- 5 Department of Acupuncture and Moxibustion, Beijing Jishuitan Hospital, Peking University, Beijing, China
| | - Cun-Zhi Liu
- 3 Department of Acupuncture and Moxibustion, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
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Gollub RL, Kirsch I, Maleki N, Wasan AD, Edwards RR, Tu Y, Kaptchuk TJ, Kong J. A Functional Neuroimaging Study of Expectancy Effects on Pain Response in Patients With Knee Osteoarthritis. J Pain 2018; 19:515-527. [PMID: 29325883 DOI: 10.1016/j.jpain.2017.12.260] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 12/01/2017] [Accepted: 12/13/2017] [Indexed: 12/18/2022]
Abstract
Placebo treatments and healing rituals share much in common, such as the effects of expectancy, and have been used since the beginning of human history to treat pain. Previous mechanistic neuroimaging studies investigating the effects of expectancy on placebo analgesia have used young, healthy volunteers. Using functional magnetic resonance imaging (fMRI), we aimed to investigate the neural mechanisms by which expectancy evokes analgesia in older adults living with a chronic pain disorder and determine whether there are interactions with active treatment. In this fMRI study, we investigated the brain networks underlying expectancy in participants with chronic pain due to knee osteoarthritis (OA) after verum (genuine) and sham electroacupuncture treatment before and after experiencing calibrated experimental heat pain using a well tested expectancy manipulation model. We found that expectancy significantly and similarly modulates the pain experience in knee OA patients in both verum (n = 21, 11 female; mean ± SD age 57 ± 7 years) and sham (n = 22, 15 female; mean ± SD age 59 ± 7 years) acupuncture treatment groups. However, there were different patterns of changes in fMRI indices of brain activity associated with verum and sham treatment modalities specifically in the lateral prefrontal cortex. We also found that continuous electroacupuncture in knee OA patients can evoke significant regional coherence decreases in pain associated brain regions. Our results suggest that expectancy modulates the experience of pain in knee OA patients but may work through different pathways depending on the treatment modality and, we speculate, on pathophysiological states of the participants. PERSPECTIVE To investigate the neural mechanisms underlying pain modulation, we used an expectancy manipulation model and fMRI to study response to heat pain stimuli before and after verum or sham acupuncture treatment in chronic pain patients. Both relieve pain and each is each associated with a distinct pattern of brain activation.
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Affiliation(s)
- Randy L Gollub
- Psychiatric Neuroimaging, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts.
| | - Irving Kirsch
- Program in Placebo Studies and Therapeutic Encounter, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Nasim Maleki
- Psychiatric Neuroimaging, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Ajay D Wasan
- Departments of Anesthesiology and Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Robert R Edwards
- Pain Management Center, Department of Anesthesiology, Perioperative and Pain Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Yiheng Tu
- Psychiatric Neuroimaging, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Ted J Kaptchuk
- Program in Placebo Studies and Therapeutic Encounter, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Jian Kong
- Psychiatric Neuroimaging, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts
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39
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Zheng Z, Wong Lit Wan D, Arendt-Nielsen L, Yao DY, Iversen G, Xue CC, Wang K. Being Adaptive to Pain Enhances Sham Acupuncture Analgesia: A Crossover Healthy Human Study. J Acupunct Meridian Stud 2017; 10:385-95. [PMID: 29275794 DOI: 10.1016/j.jams.2017.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 09/06/2017] [Accepted: 10/19/2017] [Indexed: 11/23/2022] Open
Abstract
We have reported a model that distinguishes pain adaptive individuals (PA) from those who are pain non-adaptive (PNA). The present randomised, cross-over, participant-assessor blinded study aimed to determine the impact of pain adaptability on individuals' response to real and sham acupuncture. Healthy volunteers (nine PA and 13 PNA) were randomly allocated to receive real and sham acupuncture on the left hand and forearm in two separate acupuncture sessions. Pressure pain thresholds (PPTs) were measured at bilateral forearms and right leg before, immediately after and 20 minutes after the end of acupuncture. Ratings to pinprick and suprathreshold PPT were also recorded. The two groups were comparable in their demographic and baseline data. Analgesia induced by real or sham acupuncture did not differ on any outcome measures. PA responded to acupuncture needling better than PNA, and to sham needling (20% increase in PPT) better than to real acupuncture (7.9%). Those differences were at 20 min after end of acupuncture in the areas distant to the needling sites. PNA reported little changes in PPT. Being adaptive to pain was associated with enhanced distant analgesia in response to sham acupuncture. Our finding might partly explain varied acupuncture analgesia in clinical practice and trials.
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40
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Liu J, Mu J, Liu Q, Dun W, Zhang M, Tian J. Brain structural properties predict psychologically mediated hypoalgesia in an 8-week sham acupuncture treatment for migraine. Hum Brain Mapp 2017; 38:4386-4397. [PMID: 28608601 DOI: 10.1002/hbm.23667] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 04/28/2017] [Accepted: 05/19/2017] [Indexed: 01/17/2023] Open
Abstract
Neuroimaging studies described brain structural changes that comprise the mechanisms underlying individual differences in migraine development and maintenance. However, whether such interindividual variability in migraine was observed in a pretreatment scan is a predisposition for subsequent hypoalgesia to placebo treatment that remains largely unclear. Using T1-weighted imaging, we investigated this issue in 50 healthy controls (HC) and 196 patients with migraine without aura (MO). An 8-week double-blinded, randomized, placebo-controlled acupuncture was used, and we only focused on the data from the sham acupuncture group. Eighty patients participated in an 8-weeks sham acupuncture treatment, and were subdivided (50% change in migraine days from baseline) into recovering (MOr) and persisting (MOp) patients. Optimized voxel-based morphometry (VBM) and functional connectivity analysis were performed to evaluate brain structural and functional changes. At baseline, MOp and MOr had similar migraine activity, anxiety and depression; reduced migraine days were accompanied by decreased anxiety in MOr. In our findings, the MOr group showed a smaller volume in the left medial prefrontal cortex (mPFC), and decreased mPFC-related functional connectivity was found in the default mode network. Additionally, the reduction in migraine days after placebo treatment was significantly associated with the baseline gray matter volume of the mPFC which could also predict post-treatment groups with high accuracy. It indicated that individual differences for the brain structure in the pain modulatory system at baseline served as a substrate on how an individual facilitated or diminished hypoalgesia responses to placebo treatment in migraineurs. Hum Brain Mapp 38:4386-4397, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Jixin Liu
- Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, People's Republic of China.,Engineering Research Center of Molecular and Neuro Imaging, Ministry of Education, Xi'an, People's Republic of China
| | - Junya Mu
- Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, People's Republic of China.,Engineering Research Center of Molecular and Neuro Imaging, Ministry of Education, Xi'an, People's Republic of China
| | - Qianqian Liu
- Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, People's Republic of China.,Engineering Research Center of Molecular and Neuro Imaging, Ministry of Education, Xi'an, People's Republic of China
| | - Wanghuan Dun
- Department of Medical Imaging, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Ming Zhang
- Department of Medical Imaging, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Jie Tian
- Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, People's Republic of China.,Engineering Research Center of Molecular and Neuro Imaging, Ministry of Education, Xi'an, People's Republic of China
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Zhang LL, Chu Q, Wang S, Lai H, Xie BB. Is sham acupuncture as effective as traditional Chinese acupuncture? It's too early to say. Chin J Integr Med 2016; 22:483-9. [PMID: 27081001 DOI: 10.1007/s11655-016-2458-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Indexed: 10/22/2022]
Abstract
Many clinical trials and experimental studies claim that sham acupuncture is as effective as traditional Chinese acupuncture. However, these studies have no standard sham acupuncture control and many other factors can affect the clinical effect. These factors include needle retention time, treatment frequency, and the total number of treatments needed for satisfactory results, and all can change the clinical effect. The majority of existing acupuncture treatment studies do not consider these factors and lack standard dosage criteria. Therefore, it is still too early to conclude that sham acupuncture is as effective as traditional Chinese acupuncture. This article investigates the factors that influence the curative effect of acupuncture as to help set a standard for acupuncture studies in the future.
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Bertisch SM, Legedza ART, Phillips RS, Davis RB, Stason WB, Goldman RH, Kaptchuk TJ. The impact of psychological factors on placebo responses in a randomized controlled trial comparing sham device to dummy pill. J Eval Clin Pract 2009; 15:14-9. [PMID: 19239577 PMCID: PMC4462242 DOI: 10.1111/j.1365-2753.2008.00942.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To explore to what extent psychological factors such as expectation, depression, anxiety and belief in alternative medicine impact placebo response and differential responses to separate placebo interventions. METHODS We analysed data from a randomized controlled trial designed to compare the clinical response of two distinct placebo treatments (sham acupuncture device and placebo pill) in 119 participants with persistent distal upper arm pain due to repetitive stress injury. We used a multivariable linear regression model to identify potential correlates of self-reported upper extremity pain at the end of treatment in both placebo arms of the study combined. We also performed stratified analyses by placebo treatment. RESULTS We did not find any of the psychological factors of interest to be associated with pain at the end of treatment in our combined analysis. We found higher baseline pain score and pain for longer than 1 year's duration to be significantly associated with higher pain scores at the end of treatment for the placebo treatments combined. In stratified analyses, for the sham acupuncture group, we found higher baseline depression score, higher baseline pain score and younger age to be independently correlated with higher pain score at the end of treatment. For the placebo pill group, only baseline pain was significantly correlated to pain score at the end of treatment. CONCLUSION In this trial, neither expectancy nor psychological states were associated with response to placebo, with the exception of baseline depression score for the sham acupuncture arm.
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Affiliation(s)
- Suzanne M Bertisch
- Division for Research and Education in Complementary and Integrative Medical Therapies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.
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Wayne PM, Kerr CE, Schnyer RN, Legedza ATR, Savetsky-German J, Shields MH, Buring JE, Davis RB, Conboy LA, Highfield E, Parton B, Thomas P, Laufer MR. Japanese-style acupuncture for endometriosis-related pelvic pain in adolescents and young women: results of a randomized sham-controlled trial. J Pediatr Adolesc Gynecol 2008; 21:247-57. [PMID: 18794019 PMCID: PMC2610346 DOI: 10.1016/j.jpag.2007.07.008] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2007] [Revised: 07/16/2007] [Accepted: 07/17/2007] [Indexed: 11/17/2022]
Abstract
STUDY OBJECTIVE To assess feasibility, and collect preliminary data for a subsequent randomized, sham-controlled trial to evaluate Japanese-style acupuncture for reducing chronic pelvic pain and improving health-related quality of life (HRQOL) in adolescents with endometriosis. DESIGN Randomized, sham-controlled trial. SETTINGS Tertiary-referral hospital. PARTICIPANTS Eighteen young women (13-22y) with laparoscopically-diagnosed endometriosis-related chronic pelvic pain. INTERVENTIONS A Japanese style of acupuncture and a sham acupuncture control. Sixteen treatments were administered over 8 weeks. MAIN OUTCOME MEASURES Protocol feasibility, recruitment numbers, pain not associated with menses or intercourse, and multiple HRQOL instruments including Endometriosis Health Profile, Pediatric Quality of Life, Perceived Stress, and Activity Limitation. RESULTS Fourteen participants (out of 18 randomized) completed the study per protocol. Participants in the active acupuncture group (n = 9) experienced an average 4.8 (SD = 2.4) point reduction on a 11 point scale (62%) in pain after 4 weeks, which differed significantly from the control group's (n = 5) average reduction of 1.4 (SD = 2.1) points (P = 0.004). Reduction in pain in the active group persisted through a 6-month assessment; however, after 4 weeks, differences between the active and control group decreased and were not statistically significant. All HRQOL measures indicated greater improvements in the active acupuncture group compared to the control; however, the majority of these trends were not statistically significant. No serious adverse events were reported. CONCLUSION Preliminary estimates indicate that Japanese-style acupuncture may be an effective, safe, and well-tolerated adjunct therapy for endometriosis-related pelvic pain in adolescents. A more definitive trial evaluating Japanese-style acupuncture in this population is both feasible and warranted.
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Affiliation(s)
- Peter M Wayne
- Harvard Medical School, Osher Research Center, Boston, Massachusetts 02215, USA.
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Lee SW, Liong ML, Yuen KH, Leong WS, Chee C, Cheah PY, Choong WP, Wu Y, Khan N, Choong WL, Yap HW, Krieger JN. Acupuncture versus sham acupuncture for chronic prostatitis/chronic pelvic pain. Am J Med 2008; 121:79.e1-7. [PMID: 18187077 DOI: 10.1016/j.amjmed.2007.07.033] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2007] [Revised: 07/16/2007] [Accepted: 07/18/2007] [Indexed: 01/09/2023]
Abstract
BACKGROUND Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) afflicts 2%-10% of adult men. Available therapies offer little or no proven benefit. Because acupuncture represents an attractive "natural" therapy, we compared the efficacy of acupuncture to sham acupuncture for CP/CPPS. METHODS Participants met US National Institutes of Health (NIH) consensus criteria for CP/CPPS, were aged > or = 20 years old, and had a total score > or = 15 on the NIH Chronic Prostatitis Symptom Index (NIH-CPSI) and symptoms for at least 3 of the preceding 6 months. They were randomized 1:1 to acupuncture or sham acupuncture. Treatment consisted of twice-weekly 30-minute sessions for 10 weeks (20 sessions total) without needle stimulation, herbs, or adjuvants. The primary response criterion was a 6-point decrease from baseline to week 10 in NIH-CPSI total score (range 0-43). RESULTS Thirty-two (73%) of 44 participants responded in the acupuncture group compared with 21 (47%) of 45 sham group participants (relative risk 1.81, 95% confidence interval, 1.3-3.1, P = .02). Long-term responses 24 weeks after completing therapy without additional treatment occurred in 14 (32%) of 44 acupuncture group participants and in 6 (13%) of 45 sham group participants (relative risk 2.39, 95% confidence interval, 1.0-5.6, P = .04). CONCLUSIONS After 10 weeks of treatment, acupuncture proved almost twice as likely as sham treatment to improve CP/CPPS symptoms. Participants receiving acupuncture were 2.4-fold more likely to experience long-term benefit than were participants receiving sham acupuncture.
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Abstract
BACKGROUND AND AIMS Despite occasional positive reports on the efficacy of acupuncture (AC) on functions of the gastrointestinal tract, there is no conclusive evidence that AC is effective in the treatment of irritable bowel syndrome (IBS). PATIENTS AND METHODS Forty three patients with IBS according to the Rome II criteria were randomly assigned to receive either AC (n = 22) or sham acupuncture (SAC) (n = 21) using the so-called "Streitberger needle". Treatment duration was 10 sessions with an average of two AC sessions per week. The primary end point was improvement in quality of life (QOL) using the functional digestive diseases quality of life questionnaire (FDDQL) and a general quality of life questionnaire (SF-36), compared with baseline assessments. QOL measurements were repeated three months after treatment. RESULTS Both the AC and SAC groups improved significantly in global QOL, as assessed by the FDDQL, at the end of treatment (p = 0.022), with no differences between the groups. SF-36 was insensitive to these changes (except for pain). This effect was partially reversed three months later. Post hoc comparison of responders and non-responders in both groups combined revealed a significant prediction of the placebo response by two subscales of the FDDQL (sleep, coping) (F = 6.746, p = 0.003) in a stepwise regression model. CONCLUSIONS Acupuncture in IBS is primarily a placebo response. Based on the small differences found between the AC and SAC groups, a study including 566 patients would be necessary to prove the efficacy of AC over SAC. The placebo response may be predicted by high coping capacity and low sleep quality in individual patients.
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Affiliation(s)
- A Schneider
- Department of General Practice and Health Services Research, University Medical Hospital, University of Heidelberg, Vossstrasse 2, 69120 Heidelberg, Germany.
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Abstract
Patients suffering from functional gastrointestinal disorders are likely to search elsewhere when conventional therapies fail them. Enthusiasm for complementary and alternative medicine use and research is clearly growing. Studies of acupuncture and herbal therapy for functional gastrointestinal disorders in the Western literature have often been limited by poor study design but these interventions may have promise and are discussed here.
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Affiliation(s)
- K Tillisch
- Division of Digestive Diseases, David Geffen School of Medicine at UCLA, 100 UCLA Medical Plaza, Suite 700, Los Angeles, CA 90095, USA.
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