scholarly journals Acupuncture for Functional Dyspepsia: What Strength Does It Have? A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2016 ◽  
Vol 2016 ◽  
pp. 1-17 ◽  
Author(s):  
Bo Pang ◽  
Tao Jiang ◽  
Yuan-Hao Du ◽  
Jing Li ◽  
Bo Li ◽  
...  
Keyword(s):  
Acupuncture Therapy ◽  
Randomized Controlled Trials ◽  
Functional Dyspepsia ◽  
Short Form ◽  
Meta Analysis ◽  
Sham Acupuncture ◽  
Current Evidence ◽  
Controlled Trials ◽  
Postprandial Fullness ◽  
Randomized Controlled

Background. Although the effectiveness of acupuncture therapy on functional dyspepsia (FD) has been systematically reviewed, the available reports are still contradictive and no robust evidence has been provided to date. Objective. To assess the current evidence of high quality on the effects of acupuncture for patients with FD. Methods. A comprehensive literature database search was conducted to identify randomized controlled trials (RCTs) comparing acupuncture therapies (including manual acupuncture and electroacupuncture) to sham acupuncture and medication use. A meta-analysis was performed following a strict methodology. Results. 16 RCTs involving 1436 participants were included. The majority of the trials were determined to be of low quality. Positive results were found for acupuncture in improving the Nepean Dyspepsia Index (NDI) and scores of the MOS 36-Item Short-Form Health Survey (SF-36), as well as in alleviating relevant symptoms (especially postprandial fullness and early satiation) of FD patients. Conclusion. Based on current available evidence, acupuncture therapy achieves statistically significant effect for FD in comparison with sham acupuncture and is superior to medication (prokinetic agents) in improving the symptoms and quality of life of FD patients. Nonetheless, despite stringent methodological analyses, the conclusion of our review still needs to be strengthened by additional RCTs of higher quality.

scholarly journals Effectiveness of Acupuncture for Lateral Epicondylitis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Vol 2020 ◽  
pp. 1-10 ◽  
Author(s):  
Yumei Zhou ◽  
Yuebao Guo ◽  
Rui Zhou ◽  
Ping Wu ◽  
Fanrong Liang ◽  
...  
Keyword(s):  
Acupuncture Therapy ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Lateral Epicondylitis ◽  
Sham Acupuncture ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Efficacy Rate ◽  
Randomized Controlled

Objective. This study aimed at assessing the clinical effectiveness of acupuncture for lateral epicondylitis (LE). Methods. The following databases were systematically searched: China National Knowledge Infrastructure, Chinese Science and Technology Periodical Database, Wan Fang database, Chinese Biomedicine Literature, PubMed, EMBASE, and Cochrane Library from inception to May 2019. Randomized controlled trials (RCTs) meeting the inclusion criteria were included. RevMan 5.3 software was used to conduct meta-analyses. The study quality was evaluated with the Cochrane risk of bias. Results. Ten RCTs involving 796 individuals were included in this meta-analysis. Three studies reported randomized methods with a specific description. For the analyses of the clinical efficacy rate, acupuncture outperformed sham acupuncture (two RCTs, n = 130, P=0.15), medicine therapy (two RCTs, n = 124, P=0.02), and blocking therapy (four RCTs, n = 427, P=0.0001). For the analyses of the visual analog scale, acupuncture outperformed sham acupuncture (two RCTs, n = 92, P=0.18), medicine therapy (two RCTs, n = 144, P<0.00001), and blocking therapy (two RCTs, n = 132, P=0.03). The subgroup analyses comparing acupuncture with sham acupuncture therapy revealed heterogeneities. The follow-up information and adverse reactions were not analyzed because of the insufficient number of studies. Conclusions. Acupuncture appears to be superior to drug or blocking therapy or sham acupuncture therapy for LE. However, considering the low quality of the available trials, further large-scale RCTs with a low risk of bias are needed in the future.

scholarly journals Comparative Efficacy of Pharmacological and Nonpharmacological Interventions for Acne Vulgaris: A Network Meta-Analysis

2020 ◽  
Vol 11 ◽  
Author(s):  
Qingyang Shi ◽  
Lizi Tan ◽  
Zhe Chen ◽  
Long Ge ◽  
Xiaoyan Zhang ◽  
...  
Keyword(s):  
Adverse Events ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Physical Symptoms ◽  
Current Evidence ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Comparative Efficacy ◽  
Inflammatory Lesions ◽  
Randomized Controlled

Acne has several effects on physical symptoms, but the main impacts are on the quality of life, which can be improved by treatment. There are several acne treatments but less evidence comparing their relative efficacy. Thus, we assessed the comparative efficacy of pharmacological and nonpharmacological interventions for acne. We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials from inception to April 2019, to include randomized controlled trials for acne that compared topical antibiotics (TA), benzoyl peroxide (BPO), topical retinoids (TR), oral antibiotics (OA), lasers, light devices including LED device (LED), photodynamic therapy (PDT), and intense pulsed light, chemical peels (CP), miscellaneous therapies or complementary and alternative medicine (MTCAM), or their combinations. We performed Bayesian network meta-analysis with random effects for all treatments compared with placebo and each other. Mean differences (MDs) of lesions count and risk ratios of adverse events with their 95% credible intervals (CrIs) were calculated, and all interventions were ranked by the Surface Under the Cumulative Ranking (SUCRA) values. Additional frequentist additive network meta-analysis was performed to detect the robustness of results and potential interaction effects. Sensitivity analyses were carried out with different priors, and metaregression was to adjust for nine potential effect modifiers. In the result, seventy-three randomized controlled trials (27,745 patients with mild to moderate acne), comparing 30 grouped intervention categories, were included with low to moderate risk of bias. For adverse effects, OA had more risk in combination treatment with others. For noninflammatory lesions reduction, seventeen interventions had significant differences comparing with placebo and three interventions (TR+BPO: MD = −21.89, 95%CrI [−28.97, −14.76]; TR+BPO+MTCAM: −22.48 [−34.13, −10.70]; TA+BPO+CP: −20.63 [−33.97, −7.13]) were superior to others with 94, 94, and 91% SUCRA values, respectively. For inflammatory lesions reduction, nineteen interventions were significantly better than placebo, and three interventions (TR+BPO: MD = −12.13, 95%CrI [−18.41, −5.80]; TR+BPO+MTCAM: −13.21 [−.39, −3.04]; LED: −11.30 [−18.34, −4.42]) were superior to others (SUCRA: 81, 81, and 77%, respectively). In summary of noninflammatory and inflammatory lesions results, TR+BPO and TA+BPO were the best options compared to others. The frequentist model showed similar results as above. In summary, current evidence supports the suggestion that TR+BPO and TA+BPO are the best options for mild to moderate acne. LED is another option for inflammatory lesions when drug resistance occurs. All the combinations involved with OA showed more risk of adverse events than others. However, the evidence of this study should be cautiously used due to the limitations.

scholarly journals Acupuncture therapy for fibromyalgia: a systematic review and meta-analysis of randomized controlled trials

2019 ◽  
Vol Volume 12 ◽  
pp. 527-542 ◽  
Author(s):  
Xin-chang Zhang ◽  
Hao Chen ◽  
Wen-tao Xu ◽  
Yang-yang Song ◽  
Ya-hui Gu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Acupuncture Therapy ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled

scholarly journals Acupuncture Treatment for Chronic Pelvic Pain in Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Soo-Hyun Sung ◽  
Angela-Dong-Min Sung ◽  
Hyun-Kyung Sung ◽  
Tteul-E-Bom An ◽  
Kyeong Han Kim ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Acupuncture Treatment ◽  
Meta Analysis ◽  
Modern Technology ◽  
Current Evidence ◽  
Controlled Trials ◽  
Randomized Controlled

Aim of the Study. This systematic review and meta-analysis aims to evaluate the current evidence from randomized controlled trials (RCTs) related to the effectiveness and safety of acupuncture treatment (AT), including electroacupuncture or thread-embedding therapy in combination with modern technology, for chronic pelvic pain (CPP) in women. Materials and Methods. We searched 12 electronic databases up to December 2017. All randomized controlled trials evaluating the effect of AT for CPP were considered. Results. Four RCTs with 474 participants were included. The methodological quality of included studies was generally low. The results of meta-analysis of two studies showed that AT combined with conventional treatment (CT) was associated with significantly reduced CPP, based on the total effectiveness rate (n=277, mean difference = 1.29, confidence interval = 1.13 to 1.47, P=0.0001, I2 = 0%). Conclusions. This review suggests the potential of AT combined with CT compared to CT alone for treating female CPP. However, there is insufficient evidence to conclude that AT can be recommended as a complementary and alternative (CAM) treatment for women with CPP. To draw a firm conclusion, future studies should require not only lager, more rigorously designed RCTs but also research on different AT types. Protocol Registration Number. This study is registered with PROSPERO 2018 (CRD42018088627).

scholarly journals Acupuncture for Improving Cognitive Impairment After Stroke: A Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Vol 11 ◽  
Author(s):  
Liang Zhou ◽  
Yao Wang ◽  
Jun Qiao ◽  
Qing Mei Wang ◽  
Xun Luo
Keyword(s):  
Cognitive Impairment ◽  
Randomized Controlled Trials ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Sham Acupuncture ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Post Stroke ◽  
Randomized Controlled ◽  
Therapeutic Benefits

Objective: This meta-analysis evaluated the efficacy of acupuncture in improving cognitive impairment of post-stroke patients.Design: Randomized controlled trials (RCTs) investigating the effects of acupuncture compared with no treatment or sham acupuncture on post-stroke cognitive impairment (PSCI) before December 2019 were identified from databases (PubMed, EMBASE, Ovid library, Cochrane Library, Chinese National Knowledge Infrastructure, VIP Chinese Periodical Database, Wanfang Database, and SinoMed). The literature searching and data extracting were independently performed by two investigators. Study quality was assessed using the Cochrane Handbook for Systematic Reviews of Interventions. Meta-analyses were performed for the eligible RCTs with Revman 5.3 software.Results: Thirty-seven RCTs (2,869 patients) were included in this meta-analysis. Merged Random-effects estimates of the gain of MMSE (Mini-Mental State Examination) or MoCA (Montreal Cognitive Assessment) were calculated for the comparison of acupuncture with no acupuncture or sham acupuncture. Following 2–8 weeks of intervention with acupuncture, pooled results demonstrated significant effects of acupuncture in improving PSCI assessed by MMSE (MD [95% CI] = 2.88 [2.09, 3.66], p &lt; 0.00001) or MoCA (MD [95% CI] = 2.66 [1.95, 3.37], p &lt; 0.00001).Conclusion: The results suggest that acupuncture was effective in improving PSCI and supported the needs of more rigorous design with large-scale randomized clinical trials to determine its therapeutic benefits.

scholarly journals Effect of Intermittent Fasting Strategies on Cardiometabolic Risk Factors: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 1091-1091
Author(s):  
Zhila Semnani-Azad ◽  
Tauseef Khan ◽  
Stefan Kabisch ◽  
Hana Kahleova ◽  
Cyril Kendall ◽  
...  
Keyword(s):  
Body Weight ◽  
Randomized Controlled Trials ◽  
Ldl Cholesterol ◽  
Fasting Glucose ◽  
Meta Analysis ◽  
Current Evidence ◽  
Intermittent Fasting ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Ad Libitum

Abstract Objectives Intermittent fasting (IF) is a popular trending diet, yet there is limited evidence-based support considering its clinical impact on cardiometabolic outcomes. In an effort to inform the European Association for the Study of Diabetes (EASD) clinical practice guidelines for nutrition therapy, we conducted a network meta-analysis of randomized controlled trials (RCTs) comparing IF strategies and continuous energy restriction (CER) on cardiometabolic outcomes using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. Methods MEDLINE, EMBASE, and Cochrane databases were searched through Nov 2020. We included RCTs assessing the effect of IF strategies (alternate-day fasting (ADF), whole-day periodic fasting (WDF), time-restricted feeding (TRF)), CER, and ad libitum diet. Outcomes included body weight, fasting glucose and LDL-cholesterol. Two independent researchers extracted data and assessed risk of bias. A network meta-analysis was performed and data were expressed as mean differences (MD) with 95% confidence intervals (CI). The certainty of the evidence was assessed using GRADE. Results We identified 19 RCTs (n = 590) including adults of varying health backgrounds. ADF and CER both showed a benefit for body weight reduction compared to ad libitum diet (18 trials, n = 520; MD −3.95 kg [95% CI −6.09, −1.81] and MD −2.85 kg [95% CI −4.99, −0.71], respectively). For fasting glucose (17 trials, n = 590), TRF showed a benefit compared to ad libitum diet (MD −0.39 mmol/L [95% CI −0.59, −0.20]), to CER (MD −0.25 mmol/L [95% CI, −0.45 to −0.06]) and to WDF (MD −0.20 mmol/L [95% CI, −0.45, −0.05]). Furthermore, ADF showed a benefit in reducing LDL-cholesterol (17 trials, n = 590) compared to ad libitum diet (MD −0.21 mmol/L [95% CI −0.40, −0.1]), and to CER (MD −0.15 mmol/L [95% CI −0.31, −0.01]). The certainty of the evidence ranged from high to moderate due to variable downgrades for imprecision. Conclusions Current evidence provides a good indication that IF strategies have similar benefits to CER for weight loss but may have additional benefits for fasting glucose and LDL-cholesterol. Long-term high quality RCTs are needed to clarify the effect of different IF strategies on cardiometabolic outcomes. Funding Sources Diabetes and Nutrition Study Group of the EASD, Canadian Institutes of Health Research (CIHR), Diabetes Canada.

scholarly journals Effect of sildenafil citrate in women undergoing assisted reproduction: a meta-analysis based on randomized controlled trials

2020 ◽  
Author(s):  
Safoura Rouholamin ◽  
Mahdi Sepidarkish ◽  
Maryam Razavi ◽  
Azar Nabati ◽  
Saman Maroufizadeh ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Assisted Reproduction ◽  
Meta Analysis ◽  
Clomiphene Citrate ◽  
Clinical Pregnancy ◽  
Sildenafil Citrate ◽  
Current Evidence ◽  
Estradiol Valerate ◽  
Controlled Trials ◽  
Randomized Controlled

Abstract Background to evaluate whether the sildenafil citrate in women undergoing assisted reproduction ameliorate the clinical outcomes. Methods We performed a comprehensive literature search for published randomized controlled trials (RCT) in Medline, Embase, Scopus, Web of Science and Cochrane Central Register of Controlled Trials from inception to 25 Jun 2020. Literature screening, selection of relevant studies, assessment risk of bias and data extraction was conducted independently by two reviewers. We combined study data using the random-effects model. Results Sixteen trials including 1,589 women (771 cases and 818 controls) were included in meta-analysis. Pooling results from five trials, which compared clinical pregnancy between sildenafil citrate and placebo, showed a significantly higher probability of clinical pregnancy in sildenafil citrate group (RR: 1.57, 95% CI: 1.05, 2.36, I2 = 0%). The probability of clinical pregnancy was significantly higher in women who received the combination of sildenafil citrate and clomiphene citrate compared with clomiphene citrate alone (RR: 1.31, 95% CI: 1.12, 1.53, I2 = 0%). Following the intervention, clinical pregnancy significantly increased in women who received the combination of estradiol valerate and sildenafil citrate compared to estradiol valerate (RR: 1.59, 95% CI: 1.05, 2.43, I2 = 0%). Following the intervention, endometrial thickness (ET) increased in women who received sildenafil citrate compared to women who received placebo (SMD: 1.32, 95% CI: 0.30, 2.34, I2 = 92.41%). The mean of ET was significantly higher in women who received the combination of sildenafil citrate and clomiphene citrate compared to women who received clomiphene citrate (SMD: 0.92, 95% CI: 0.49, 1.36). Conclusion Our systematic review and meta-analysis showed that luteal supplementation of sildenafil citrate (oral or vaginal), alone or adjuvant therapy can be used for improving the EM and clinical pregnancy rate in women undergoing assisted reproduction. However, given the methodological limitations the current evidence does not support its use in clinical practice yet.

Evidence from systematic reviews of randomized trials on enteral lactoferrin supplementation in preterm neonates

2020 ◽  
Author(s):  
Mohan Pammi ◽  
Geoffrey A. Preidis ◽  
William O Tarnow-mordi
Keyword(s):  
Randomized Controlled Trials ◽  
Late Onset ◽  
Meta Analysis ◽  
Current Evidence ◽  
Preterm Neonates ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Late Onset Sepsis ◽  
Statistical Heterogeneity ◽  
Tract Infections

In this commentary, we summarize the current evidence from randomized controlled trials on enteral lactoferrin supplementation in preterm neonates. Our recently completed systematic review includes 12 randomized controlled trials performed all over the world. Our meta-analysis suggests clinical benefit in decreasing late-onset sepsis, late-onset fungal sepsis, length of stay in the hospital and urinary tract infections. There were no adverse effects. There was no statistically significant decrease in necrotizing enterocolitis, mortality or neurodevelopmental impairment in lactoferrin supplemented preterm infants. There was significant statistical heterogeneity in the effects of lactoferrin on late-onset sepsis between larger and smaller studies, which may reflect either small study biases, differences in the effectiveness, dose or duration of supplemental lactoferrin products, or differences in underlying population risk, or any or all of these.

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