Acupuncture for refractory gastro-oesophageal reflux disease: a systematic review and meta-analysis protocol

IntroductionRefractory gastro-oesophageal reflux disease (rGORD) is a common disease, affecting patients’ quality of life. Since conventional medicines have limitations, like low effective rates and adverse events, acupuncture may be a promising therapy for rGORD. While no related systematic review has been published, the present study is designed to evaluate the efficacy and safety of acupuncture for rGORD.Methods and analysisPubMed, the Cochrane Central Register of Controlled Trials and Chinese electronic databases, including China National Knowledge Infrastructure, Wan Fang database, VIP, SinoMed and the Chinese Clinical Trial Registry, will be searched from establishment of the database to 31 August 2019. There will be no limitations on language, and all articles will be screened and collected by two reviewers independently. RevMan V.5.3.5 software will be used for meta-analysis, and the conduction of study will refer to the Cochrane Handbook for Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol guidelines. The efficacy and safety of acupuncture for rGORD will be evaluated based on outcomes, including global symptom improvement, oesophageal sphincter function test measured by high-resolution manometry, quality of life, recurrence rate and adverse events.Ethics and disseminationThere is no necessity for this study to acquire an ethical approval, and this review will be disseminated in a peer-reviewed journal or conference presentation.Trial registration numberCRD42018111912.

Download Full-text

Acupuncture for the Treatment of Gastro-Oesophageal Reflux Disease: A Systematic Review and Meta-Analysis

Acupuncture in Medicine ◽

10.1136/acupmed-2016-011205 ◽

2017 ◽

Vol 35 (5) ◽

pp. 316-323 ◽

Cited By ~ 11

Author(s):

Jiajie Zhu ◽

Yu Guo ◽

Shan Liu ◽

Xiaolan Su ◽

Yijie Li ◽

...

Keyword(s):

Systematic Review ◽

Reflux Disease ◽

Small Sample Size ◽

Meta Analysis ◽

Small Sample ◽

Oesophageal Reflux ◽

Symptom Improvement ◽

Significant Heterogeneity ◽

Oesophageal Reflux Disease

Background Gastro-oesophageal reflux disease (GORD) is one of the most common diseases presenting to gastroenterology clinics. Acupuncture is widely used as a complementary and alternative treatment for patients with GORD. Objective To explore the effectiveness of acupuncture for the treatment of GORD. Methods Four English and four Chinese databases were searched through June 2016. Randomised controlled trials investigating the effectiveness of manual acupuncture or electroacupuncture (MA/EA) for GORD versus or as an adjunct to Western medicine (WM) were selected. Data extraction and quality evaluation were performed by two authors independently and RevMan 5.2.0 was used to analyse data. Results A total of 12 trials involving 1235 patients were included. Meta-analyses demonstrated that patients receiving MA/EA combined with WM had a superior global symptom improvement compared with those receiving WM alone (relative risk (RR) 1.17, 95% CI 1.09 to 1.26; p=0.03; six studies) with no significant heterogeneity (I2=0%, p=0.41). Recurrence rates of those receiving MA/EA alone were lower than those receiving WM (RR 0.42,95% CI 0.29 to 0.61; p<0.001; three studies) with low heterogeneity (I2=7%, p=0.34), while global symptom improvement (six studies) and symptom scores (three studies) were similar (both p>0.05). Descriptive analyses suggested that acupuncture also improves quality of life in patients with GORD. Conclusion This meta-analysis suggests that acupuncture is an effective and safe treatment for GORD. However, due to the small sample size and poor methodological quality of the included trials, further studies are required to validate our conclusions. Trial registration number PROSPERO Systematic review registration no. CRD42016041916.

Download Full-text

Probiotics for preventing and treating gastro-oesophageal reflux/gastro-oesophageal reflux disease in infants: A systematic review and meta-analysis

10.21203/rs.2.13660/v1 ◽

2019 ◽

Author(s):

Jann Foster ◽

Hannah Dahlen ◽

Sabina Fijan ◽

Nadia Badawi ◽

Viginia Schmied ◽

...

Keyword(s):

Systematic Review ◽

Placebo Group ◽

Reflux Disease ◽

Meta Analysis ◽

Mean Difference ◽

Oesophageal Reflux ◽

Controlled Trials ◽

Cochrane Central Register ◽

Probiotic Group ◽

Oesophageal Reflux Disease

Abstract Background Gastro-oesophageal reflux (GOR) and Gastro-oesophageal reflux disease (GORD) are common during infancy and can cause substantial discomfort in infants, parental distress and financial burden on parents and the health care system. Effective treatment regimens, however, remain elusive. Probiotics given to women during pregnancy and lactation, and babies may have therapeutic effects when it comes to GOR/GORD. The objective of this systematic review and meta-analysis is to evaluate the efficacy of probiotic supplementation for the prevention and treatment of GOR/GORD in infants.Methods Literature searches were conducted using MEDLINE, EMBASE and the Cochrane Central Register of Controlled trials. Only randomised controlled trials (RCTs) were included. A meta-analysis of included trials was performed using the Cochrane Collaboration methodology where possible. Results Six RCTs examined the prevention or treatment with probiotics on GOR. There were no studies examining probiotics for GORD. A meta-analysis of 3 studies showed a statistically significant reduction in regurgitation episodes for the probiotic group compared to the placebo group [mean difference -1.44 episodes/day; 95% CI -1.71 to -1.17] but there was high heterogeneity (96%). Meta-analysis of two studies found a statistically significant increased number of stools per day in the probiotic group compared to the placebo group [mean difference 1.26, 95% CI 1.12 to 1.41]. However, there was moderate heterogeneity (69%). Individual studies reported: a decrease in crying time, increased gastric emptying rate, infant length and head circumference, visits to an emergency department or health professional, and loss of parent working days were significantly less with infants receiving probiotic compared to a placebo but more research is needed. Meta-analysis of two studies showed no difference in body weight between the two groups (minimal heterogeneity 23%). None of the studies reported any adverse effects for the women or infants. Conclusions Probiotic therapy appears promising with some evidence of benefit but most studies are small and there was high heterogeneity between the studies. The use of probiotics could potentially be a non-invasive, cost effective and preventative positive health strategy for both women and their babies. Further well controlled RCTs examining the effect of probiotics for GOR /GORD are warranted.

Download Full-text