Wrist-Ankle Acupuncture for the Treatment of Pain Symptoms: A Systematic Review and Meta-Analysis

Routine acupuncture incorporates wrist-ankle acupuncture (WAA) for its analgesic effect, but WAA is not widely used in clinics due to incomplete knowledge of its effectiveness and concerns about less clinical research and because less people know it. This study aimed to assess the efficacy and possible adverse effects of WAA or WAA adjuvants in the treatment of pain symptoms. This study compared WAA or WAA adjuvant with the following therapies: western medication (WM), sham acupuncture (SA), or body acupuncture (BA). Randomized controlled trials (RCTs) were searched systematically in related electronic databases by two independent reviewers. 33 RCTs were finally included, in which 7 RCTs were selected for meta-analysis. It was found that WAA or WAA adjuvant was significantly more effective than WM, SA, or BA in pain relief. There was nothing different between WAA and SA in adverse events, but WAA was marginally significantly safer than WM. Although both WAA and WAA adjuvant appeared to be more effective than WM, SA, or BA in the treatment of pain symptoms with few side effects, further studies with better and more rigorously designed are still necessary to ensure the efficacy and safety issue of WAA due to the poor methodology and small sample size of previous studies.

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Efficacy and safety of colistin loading dose: a meta-analysis

Journal of Antimicrobial Chemotherapy ◽

10.1093/jac/dkaa064 ◽

2020 ◽

Vol 75 (7) ◽

pp. 1689-1698

Author(s):

Ioannis Bellos ◽

Vasilios Pergialiotis ◽

Maximos Frountzas ◽

Konstantinos Kontzoglou ◽

Georgios Daskalakis ◽

...

Keyword(s):

Small Sample Size ◽

Meta Analysis ◽

Treatment Success ◽

Small Sample ◽

High Dose ◽

Loading Dose ◽

Efficacy And Safety ◽

Optimal Dosing ◽

Retrospective Cohort Studies ◽

Dosing Strategy

Abstract Objectives Colistin represents a polypeptide used for the treatment of MDR microorganisms, although the optimal dosing strategy is under investigation. The present meta-analysis aims to determine whether the administration of a colistin loading dose in patients receiving high-dose maintenance regimens changes the rates of treatment success and the risk of nephrotoxicity. Methods Medline, Scopus, CENTRAL, Clinicaltrials.gov and Google Scholar were systematically searched from inception to 18 November 2019. Studies were considered eligible if they reported clinical outcomes among patients receiving high-dose colistin therapy with and without the administration of a loading dose. Meta-analysis was performed by fitting a random-effects model. Results Eight (three prospective and five retrospective cohort) studies were included, comprising 1115 patients. The administration of a colistin loading dose was associated with significantly higher microbiological [risk ratio (RR) = 1.23, 95% CI = 1.10–1.39] but not clinical (RR = 1.04, 95% CI = 0.87–1.24) success. No significant associations were calculated for nephrotoxicity (RR = 1.31, 95% CI = 0.90–1.91) and mortality (RR = 1.03, 95% CI = 0.82–1.29) risk. The results remained stable after adjustments for small sample size, credibility ceilings, publication bias and risk of bias. Conclusions Observational evidence suggests that the administration of a colistin loading dose in patients receiving high maintenance dosage regimens is significantly associated with higher rates of microbiological response, but does not change clinical cure, mortality or nephrotoxicity risk. The dosing regimen that would provide the optimal balance between treatment efficacy and safety needs to be determined by future randomized controlled trials.

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Acupuncture for Chronic Pain-Related Insomnia: A Systematic Review and Meta-Analysis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2019/5381028 ◽

2019 ◽

Vol 2019 ◽

pp. 1-10

Author(s):

Fushui Liu ◽

Jianyu You ◽

Qi Li ◽

Ting Fang ◽

Mei Chen ◽

...

Keyword(s):

Chronic Pain ◽

Sample Size ◽

Small Sample Size ◽

Meta Analysis ◽

Sham Acupuncture ◽

Small Sample ◽

Control Group ◽

Large Sample Size ◽

Cure Rate ◽

Significant Difference

Objectives. Acupuncture has been widely used to relieve chronic pain-related insomnia (CPRI). However, the efficacy of acupuncture for CPRI is uncertain. The purpose of this study was to evaluate the efficacy of acupuncture for CPRI. Methods. Seven electronic databases were searched from inception to December 2018. Randomized controlled trials (RCTs) were included if acupuncture was compared to sham acupuncture or conventional drug therapies for treating CPRI. Two reviewers screened each study and extracted data independently. Statistical analyses were conducted by RevMan 5.3 software. Results. A total of nine studies involving 944 patients were enrolled. The pooled analysis indicated that acupuncture treatment was significantly better than control group in improving effective rate (OR = 8.09, 95%CI = [4.75, 13.79], P < 0.00001) and cure rate (OR = 3.17, 95%CI = [2.35, 4.29], P < 0.00001), but subgroup analysis showed that there was no statistically significant difference between acupuncture and sham acupuncture in improving cure rate (OR =10.36, 95% CI [0.53, 201.45], P=0.12) based on one included study. In addition, meta-analysis demonstrated that acupuncture group was superior to control group in debasing PSQI score (MD = -2.65, 95%CI = [-4.00, -1.30], P = 0.0001) and VAS score (MD = -1.44, 95%CI = [-1.58, -1.29], P < 0.00001). And there was no significant difference in adverse events (OR =1.73, 95%CI = [0.92, 3.25], P =0.09) between the two groups. Conclusions. Acupuncture therapy is an effective and safe treatment for CPRI, and this treatment can be recommended for the management of patients with CPRI. Due to the low quality and small sample size of the included studies, more rigorously designed RCTs with high quality and large sample size are recommended in future.

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Efficacy and safety of therapeutic anticoagulation for the treatment of isolated calf muscle vein thrombosis - a systematic review and meta-analysis

VASA ◽

10.1024/0301-1526/a000569 ◽

2016 ◽

Vol 45 (6) ◽

pp. 478-485 ◽

Cited By ~ 3

Author(s):

Xu-Chen Huang ◽

Xu-Hua Hu ◽

Xiao-Ran Wang ◽

Chao-Xi Zhou ◽

Gui-Ying Wang

Keyword(s):

Randomized Controlled Trial ◽

Controlled Trial ◽

Meta Analysis ◽

Small Sample ◽

Calf Muscle ◽

Cochrane Library ◽

Efficacy And Safety ◽

Vein Thrombosis ◽

Randomized Controlled ◽

Therapeutic Anticoagulation

Abstract. Background: Diverse treatment suggestions range from monitoring with duplex examinations to therapeutic anticoagulation (TA) for managing isolated calf muscle vein thrombosis (ICMVT). However, the small sample sizes and low-level evidence provided by most studies in the literature mean that the benefits of promising new treatment protocols are unclear. Hence, this meta-analysis is intended to assess the efficacy and safety of TA for patients with ICMVT. Patients and methods: Articles comparing TA with no anticoagulation (NA) or no therapeutic anticoagulation (NTA) in patients with ICMVT were collected from PubMed, the Cochrane Library, EMBASE, and Web of Science. The risk ratio (RR) and 95 % confidence interval (95 % CI) were generated for each outcome of interest. The data were pooled using a random-effects or fixed-effects model to evaluate differences in outcomes between the TA and control groups. Results: Five of 377 initially identified papers were included. One randomized controlled trial, one non-randomized controlled trial and three retrospective cohort studies (a total of 744 patients, 390 in the TA group and the remaining 354 in the NA or NTA group) were included in this meta-analysis. The occurrence of thrombosis progression was significantly less frequent in those who received TA compared with those receiving NTA (RR = 0.33, 95 % CI 0.20 to 0.54, p < 0.01). The rate of complete recanalization was higher, albeit not significantly, in the TA group than in the NTA group (RR = 1.96, 95 % CI 1.01 to 3.80, p = 0.05). None of the pooled outcomes were significantly different when comparing the TA and NA groups. Conclusions: This study suggests that TA may result in a significant reduction in the rate of thrombosis progression and a marginally significant increase in the rate of complete recanalization for patients with ICMVT. Further studies are needed to confirm these findings and clarify whether the benefits of TA outweigh the potential harm.

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Nasogastric Nutrition versus Nasojejunal Nutrition in Patients with Severe Acute Pancreatitis: A Meta-Analysis of Randomized Controlled Trials

Gastroenterology Research and Practice ◽

10.1155/2016/6430632 ◽

2016 ◽

Vol 2016 ◽

pp. 1-8 ◽

Cited By ~ 11

Author(s):

Youfeng Zhu ◽

Haiyan Yin ◽

Rui Zhang ◽

Xiaoling Ye ◽

Jianrui Wei

Keyword(s):

Acute Pancreatitis ◽

Randomized Controlled Trials ◽

Severe Acute Pancreatitis ◽

Small Sample Size ◽

Meta Analysis ◽

Small Sample ◽

Controlled Trials ◽

Cochrane Central Register ◽

China National Knowledge Infrastructure ◽

Randomized Controlled

Introduction.Previous studies have shown that the nasogastric (NG) route seems equivalent to the nasojejunal (NJ) route in patients with severe acute pancreatitis (SAP). However, these studies used a small sample size and old criteria for diagnosing SAP, which may include some patients with moderate SAP, according to the newly established SAP criteria (Atlanta 2012 classification). Based on the changes in the criteria for classifying SAP, we performed an up-to-date meta-analysis.Method.We reviewed the PubMed, EMbase, China National Knowledge Infrastructure, Wanfang Database, and Cochrane Central Register of Controlled Trials electronic databases. We included randomized controlled trials comparing NG and NJ nutrition in patients with SAP. We performed the meta-analysis using the Cochrane Collaborations’ RevMan 5.3 software.Results.We included four randomized controlled trials involving 237 patients with SAP. There were no significant differences in the incidence of mortality, infectious complications, digestive complications, achievement of energy balance, or length of hospital stay between the NG and NJ nutrition groups.Conclusions.NG nutrition was as safe and effective as NJ nutrition in patients with SAP. Further studies are needed to confirm our results.

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Acupotomy for Osteoarthritis of the Knee; A Systematic Review and Meta-Analysis

Journal of Acupuncture Research ◽

10.13045/jar.2020.00339 ◽

2021 ◽

Vol 38 (2) ◽

pp. 96-109

Author(s):

Seung Min Lee ◽

Cham Kyul Lee ◽

Kyung Ho Kim ◽

Eun Jung Kim ◽

Chan Yung Jung ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Western Medicine ◽

Small Sample Size ◽

Meta Analysis ◽

Intervention Group ◽

Effective Rate ◽

Small Sample ◽

Control Group ◽

Osteoarthritis Of The Knee ◽

Randomized Controlled

The purpose of this study was to evaluate the effectiveness and safety of acupotomy for the treatment of patients with knee osteoarthritis. There were 9 databases searched to retrieve randomized controlled trials until August 3, 2019 regarding acupotomy versus conventional Western medicine, conventional Western medicine treatment with and without acupotomy, and Korean medicine treatment with and without acupotomy, and meta-analysis was performed. Of 303 potentially relevant studies retrieved, 43 were systematically reviewed. All studies were conducted in China. Effective rate, visual analogue scale, and Western Ontario and McMaster Universities Osteoarthritis index were used as the evaluation scales. The Ashi point was selected most frequently. In all studies, the intervention group was more effective than the control group. Meta-analysis revealed that acupotomy showed statistically significant beneficial results. Although acupotomy had a beneficial effect on knee osteoarthritis, the risk of bias of the included studies was not low. The majority of the results from the evaluation scales used were highly heterogeneous (> 50%) which reduced confidence in the estimation of effect, or had a small sample size. Further clinical research and development is required in the future.

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Clinical Efficacy and Safety of Shashen Maidong Decoction in the Treatment of Pediatric Mycoplasma Pneumonia: A Systematic Review and Meta-Analysis

Frontiers in Pharmacology ◽

10.3389/fphar.2021.765656 ◽

2021 ◽

Vol 12 ◽

Author(s):

Jiawei Wang ◽

Xiao Ma ◽

Shizhang Wei ◽

Tao Yang ◽

Yuling Tong ◽

...

Keyword(s):

Randomized Controlled Trials ◽

Small Sample Size ◽

Meta Analysis ◽

Lymphocyte Subpopulation ◽

Small Sample ◽

Systematic Evaluation ◽

Controlled Trials ◽

Randomized Controlled ◽

Mycoplasma Pneumonia ◽

Factor Α

Objective: This study was intended to provide data to support the effect of Shashen Maidong Decoction in improving mycoplasma pneumonia in pediatric patients through systematic evaluation.Methods: PubMed, the Web of Science, EMbase, CNKI, CQVIP, Wan-Fang, and CBM databases were comprehensively searched from established in June 2021. Randomized controlled trials of TRQI were selected by screening the literature and extracting information. The Cochrane RCT Evaluation Manual was used to evaluate the methodological quality of all included studies, and Meta-analysis was performed using Stata 14.0 and Review Manager 5.4 software.Results: A total of 1,127 patients from 12 clinical studies met the inclusion criteria. Meta-analysis results showed that the treatment group of Shashen Maidong Decoction was able to significantly increase the overall efficiency level and significantly reduce the incidence of adverse reactions, time for disappearance of cough, time for relief of cough, time for defervescence, time for disappearance of lung rales, time for return to normal of chest X-ray, T lymphocyte subpopulation (CD3+) and tumor necrosis factor-α (TNF-α) and other index levels (p < 0.05).Conclusion: Shashen Maidong Decoction has a significant improvement in the levels of relevant indexes in pediatric mycoplasma pneumonia, which provides a basis for the safety and efficacy of pediatric mycoplasma pneumonia. However, due to the small sample size included in the study, the study quality was not high, and more randomized controlled trials of high quality are required for further validation.

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Herbal Medicine for Dumping Syndrome: A Systematic Review and Meta-Analysis

Integrative Cancer Therapies ◽

10.1177/1534735419873404 ◽

2019 ◽

Vol 18 ◽

pp. 153473541987340 ◽

Cited By ~ 1

Author(s):

Seungcheol Hong ◽

Bongki Park ◽

Hyeonseok Noh ◽

Dong-Jun Choi

Keyword(s):

Herbal Medicine ◽

Clinical Evidence ◽

Small Sample Size ◽

Meta Analysis ◽

Small Sample ◽

Dumping Syndrome ◽

Improvement Rate ◽

Randomized Controlled ◽

Symptom Response

Background: Dumping syndrome is a common complication of surgical treatment of gastric cancer, but conventional therapy has limitations related to symptom care due to its structural cause and the decreased quality of life. Objectives: The objective of this review was to assess the clinical evidence for the effectiveness of herbal medicine as a treatment for dumping syndrome. Methods: A literature review was conducted using 16 databases from their inceptions to March 2018. All randomized controlled trials (RCTs) of herbal medicine used to treat dumping syndrome patients were included and meta-analyzed. Methodological quality was assessed using the Cochrane Handbook for Systematic Reviews of Interventions. Results: A total of 174 dumping syndrome patients of 3 trials met all inclusion criteria. Two trials assessed the effectiveness of herbal medicine on the symptom response rate compared with conventional pharmacotherapy. Their results suggested significant effects in favor of herbal medicine (risk ratio [RR] = 1.37, 95% confidence interval [CI] = 1.16-1.63, P = .0003, heterogeneity τ2 = 0, χ2 = 0.02, P = .88, I2 = 0%). One trial assessed its effectiveness on the improvement rate of overall symptoms compared with conventional conservative complex therapy, such as postural management, diet regulation, and counseling (RR = 1.23, 95% CI = 0.96-1.58). Conclusions: Due to the small sample size, scarcity of reported articles, and lack of quality of the current RCTs, it was concluded that the effectiveness of herbal medicine in treating dumping syndrome is unclear.

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Yiqi Fumai Injection for patients with Septic Shock: study protocol for a randomized controlled trial1

10.21203/rs.2.21820/v1 ◽

2020 ◽

Author(s):

jing zeng ◽

Hai-rong Cai ◽

Shu-ling Liu ◽

Shuai Zhao ◽

Zhi-shang Li ◽

...

Keyword(s):

Septic Shock ◽

Conventional Treatment ◽

Small Sample Size ◽

Controlled Trial ◽

Small Sample ◽

Control Group ◽

Controlled Clinical Trial ◽

Efficacy And Safety ◽

Double Blind ◽

Randomized Controlled

Abstract Background Septic shock is an important problem in critical care medicine and one of the leading causes of death in intensive care units (ICU). In China, Traditional Chinese medicine ( TCM) has been widely used as the adjuvant treatment to improve the symptoms and prognosis in patients with septic shock. Yiqi Fumai Injection (YFI) is one of the most important proprietary TCM for septic shock, previous studies have demonstrated its efficacy and safety. However, these conclusions were limited due to the small sample size and low quality of methodologies of these studies. Therefore, we designed this study to evaluate the efficacy and safety of using YFI as an adjunct treatment for septic shock.Methods This is a double-blind, randomized, parallel, placebo-controlled clinical trial. A total of 800 participants will be randomly assigned to receive either treatment or placebo in a 1:1 ratio. The treatment group will receive YFI combined with conventional treatment, and the control group will receive 0.9% sodium chloride injection combined with conventional treatment for 2 weeks. The primary outcome is the 28- days mortality. Secondary outcomes are blood lactate levels, hemodynamics , blood gas analysis, immune function indicators, inflammatory indicators, acute physiology improvement and chronic health assessment (APACHE) II scores, and sepsis-related organ failure score (SOFA). Adverse events will be observed and recorded at the same time for safety assessment.Discussion This randomized controlled trial will help evaluate the efficacy and safety of YFI for the treatment of septic shock. The results of this trial will provide recommendations for the management of septic shock.

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Acupoint Injection for Alleviating Side Effects of Chemotherapy in People with Cancer: A Systematic Review and Meta-Analysis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2021/9974315 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Yulan Yang ◽

Hairong Su ◽

Jian Wen ◽

Jianyun Hong

Keyword(s):

Side Effects ◽

Adverse Reactions ◽

Small Sample Size ◽

Meta Analysis ◽

Small Sample ◽

Risk Of Bias ◽

Cochrane Library ◽

Randomized Controlled ◽

Acupoint Injection ◽

Review Manager

Objective. This study aimed to investigate the efficacy of acupoint injection for alleviating side effects of chemotherapy in people with cancer. Methods. PubMed, EMBASE, Cochrane library databases, CNKI, VIP, WanFang Date, and CBM were searched for randomized controlled trials (RCTs) from inception through December 28, 2020. This meta-analysis was performed using Review Manager 5.3. Results. A total of 8 RCTs including 557 participants were eligible and included in the meta-analysis. The selected RCTs studied acupoint injection for alleviating side effects of chemotherapy in people with cancer. Statistically significant improvements were observed for the incidence of nausea and vomiting (RR = 0.39; 95% CI 0.26, 0.58; P < 0.00001), the number of leukocyte (MD = 1.89; 95%CI 0.74, 3.03; P = 0.001), and the number of platelet (MD = 28.82; 95%CI 19.33, 38.30; P < 0.00001). Two of these studies suggested that acupoint injection can also reduce some other adverse reactions, which showed a statistical difference (RR = 0.29; 95% CI 0.11, 0.75; P = 0.01). Conclusion. The analysis indicated that acupoint injection can alleviate side effects of chemotherapy in people with cancer. However, due to the high risk of bias and small sample size in the included studies, the results need to be further confirmed by further large, rigorously designed trials.

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Punch Incision versus Elliptical Excision for Epidermal Inclusion Cysts: Systematic Review and Meta-Analysis

Surgeries ◽

10.3390/surgeries2030033 ◽

2021 ◽

Vol 2 (3) ◽

pp. 335-346

Author(s):

Kengo Mukuda ◽

Jun Watanabe

Keyword(s):

Operative Time ◽

Small Sample Size ◽

Meta Analysis ◽

Small Sample ◽

Postoperative Wound ◽

Randomized Controlled ◽

Clinical Registries ◽

The Mean ◽

Wound Length ◽

Review Manager

Punch incision is an alternative to elliptical excision for treating epidermal inclusion cysts, but its efficacy has not been systematically reviewed. This study assessed the efficacy and safety of punch incision versus elliptical excision for epidermal inclusion cysts. Randomized controlled trials published through January 2021 that evaluated the performance of punch incision versus elliptical excision on epidermal inclusion cysts were identified through electronic databases and clinical registries. Version 2 of the Cochrane risk-of-bias tool for randomized trials tool was used. Review Manager software was used for the meta-analysis. Two trials (100 participants) were identified. The primary outcomes were recurrence rate (risk ratio, 2.40; 95% confidence interval [CI], 0.37–15.60 [favoring elliptical excision]), mean operative time (mean difference [MD], −5.28; 95% CI, −12.72 to 2.16 [favoring punch incision]), and mean postoperative wound length (MD, −11.67; 95% CI, −20.59 to −2.76 [favoring punch incision]). The evidence was low to moderate due to the small sample size and its considerable heterogeneity. The use of punch incision shortened the mean postoperative wound length and had comparable safety to that of elliptical excision.

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