A Systematic Review and Meta-Analysis of Moxibustion Treatment for Knee Osteoarthritis

The purpose of this study was to evaluate the evidence supporting the effectiveness of moxibustion treatment for osteoarthritis. There were 9 databases used to retrieve randomized controlled trials (RCTs) that used moxibustion as treatment for osteoarthritis. The quality of methodology for the RCTs was assessed using the Cochrane Risk of Bias tool [Review Manager (RevMan) Version 5.3 Windows, The Nordic Cochrane Centre, Copenhagen, Denmark]. The inclusion criteria for this review was met by 27 RCTs. All studies were conducted in China. A 4-week moxibustion treatment period was the most common. EX-LE4 and SP10 and GB34 acupoints were most frequently selected in the treatment of osteoarthritis. The most commonly used evaluation index was the visual analog scale (VAS). All studies, including a meta-analysis showed that moxibustion treatments were statistically significantly effective at treating knee osteoarthritis. However, welldesigned randomized RCTs without a high risk of bias should be designed in the future.

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Moxibustion for the Correction of Nonvertex Presentation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2013/241027 ◽

2013 ◽

Vol 2013 ◽

pp. 1-10 ◽

Cited By ~ 9

Author(s):

Qin-hong Zhang ◽

Jin-huan Yue ◽

Ming Liu ◽

Zhong-ren Sun ◽

Qi Sun ◽

...

Keyword(s):

Systematic Review ◽

Randomized Controlled Trials ◽

Meta Analysis ◽

Risk Of Bias ◽

Controlled Trials ◽

Inclusion Criteria ◽

Randomized Controlled ◽

Significant Difference ◽

Cessation Of Treatment

Objectives. This study aims to assess the effectiveness and safety of moxibustion for the correction of nonvertex presentation.Methods. Records without language restrictions were searched up to February 2013 for randomized controlled trials (RCTs) comparing moxibustion with other therapies in women with a singleton nonvertex presentation. Cochrane risk of bias criteria were used to assess the methodological quality of the trials.Results. Seven of 392 potentially relevant studies met the inclusion criteria. When moxibustion was compared with other interventions, a meta-analysis revealed a significant difference in favor of moxibustion on the correction of nonvertex presentation at delivery (risk ratio (RR) 1.29, 95% confidence interval (CI) 1.12 to 1.49, andI2=0). The same findings applied to the cephalic presentation after cessation of treatment (RR 1.36, 95% CI 1.08 to 1.71, andI2=80%). A subgroup analysis that excluded two trials with a high risk of bias also indicated favorable effects (RR 1.63, 95% CI 1.42 to 1.86, andI2=0%). With respect to safety, moxibustion resulted in decreased use of oxytocin.Conclusion. Our systematic review and meta-analysis suggested that moxibustion may be an effective treatment for the correction of nonvertex presentation. Moreover, moxibustion might reduce the need for oxytocin.

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Quality and Risk of Bias in Panax ginseng Randomized Controlled Trials: A Review

The American Journal of Chinese Medicine ◽

10.1142/s0192415x13500171 ◽

2013 ◽

Vol 41 (02) ◽

pp. 231-252 ◽

Cited By ~ 25

Author(s):

Johannah L. Shergis ◽

Anthony L. Zhang ◽

Wenyu Zhou ◽

Charlie C. Xue

Keyword(s):

Randomized Controlled Trials ◽

Panax Ginseng ◽

Methodological Quality ◽

Risk Of Bias ◽

Controlled Trials ◽

Publication Date ◽

Inclusion Criteria ◽

Randomized Controlled ◽

Clinical Benefits

Panax ginseng is one of the most frequently used herbs in the world. Numerous trials have evaluated its clinical benefits. However, the quality of these studies has not been comprehensively and systematically assessed. We reviewed randomized controlled trials (RCTs) of Panax ginseng to evaluate their quality and risk of bias. We searched four English databases, without publication date restriction. Two reviewers extracted details about the studies' methodological quality, guided by the Consolidated Standards of Reporting Trials (CONSORT) checklist and its extension for herbal interventions. Risk of bias was determined using the Cochrane Risk of Bias tool. Of 475 potentially relevant studies, 58 met our inclusion criteria. In these 58 studies, 48.3% of the suggested CONSORT checklist items and 35.9% of the extended herbal items were reported. The quality of RCTs published after the CONSORT checklist improved. Until 1995 (before CONSORT) (n = 4), 32.8% of the items were reported in studies. From 1996–2006 (CONSORT published and revised) (n = 30), 46.1% were reported, and from 2007 (n = 24), 53.5% were reported (p = 0.005). After the CONSORT extension for herbal interventions was published in 2006, RCT quality also improved, although not significantly. Until 2005 (n = 34), 35.2% of the extended herbal items were reported in studies; and from 2006 onwards (n = 24), 37.3% were reported (p = 0.64). Most studies classified risk of bias as "unclear". Overall, the quality of Panax ginseng RCT methodology has improved since the CONSORT checklist was introduced. However, more can be done to improve the methodological quality of, and reporting in, RCTs.

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Efficacy and Safety of Fuzi Formulae on the Treatment of Heart Failure as Complementary Therapy: A Systematic Review and Meta-Analysis of High-Quality Randomized Controlled Trials

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2019/9728957 ◽

2019 ◽

Vol 2019 ◽

pp. 1-21

Author(s):

Meng-Qi Yang ◽

Yong-Mei Song ◽

Huan-Yu Gao ◽

Yi-Tao Xue

Keyword(s):

Heart Failure ◽

Randomized Controlled Trials ◽

Meta Analysis ◽

Risk Of Bias ◽

Controlled Trials ◽

Efficacy And Safety ◽

High Quality ◽

Randomized Controlled ◽

Link Type

Objective. Heart failure is a major public health problem worldwide nowadays. However, the morbidity, mortality, and awareness of heart failure are not satisfied as well as the status of current treatments. According to the standard treatment for chronic heart failure (CHFST), Fuzi (the seminal root of Aconitum carmichaelii Debx.) formulae are widely used as a complementary treatment for heart failure in clinical practice for a long time. We are aiming to assess the efficacy and safety of Fuzi formulae (FZF) on the treatment of heart failure according to high-quality randomized controlled trials (RCTs). Methods. RCTs in PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journals Database (VIP), and Wanfang Database were searched from their inception until June 2019. In addition, the U.S. National Library of Medicine (clinicaltrials.gov) and the Chinese Clinical Trial Registry (http://www.chictr.org.cn) were also searched. We included RCTs that test the efficacy and safety of FZF for the treatment of heart failure, compared with placebo, CHFST, or placebo plus CHFST. The methodological quality of included studies were evaluated by the Cochrane Collaboration’s tool for assessing risk of bias. RCTs with Cochrane risk of bias (RoB) score ≥4 were included in the analysis. The meta-analysis was conducted through RevMan 5.2 software. The GRADE approach was used to assess the quality of the evidence. Results. Twelve RCTs with 1490 participants were identified. The studies investigated the efficacy and safety of FZF, such as FZF plus the CHFST vs placebo plus CHFST (n = 4), FZF plus CHFST vs CHFST (n = 6), FZF plus digoxin tablets (DT) plus CHFST vs placebo plus DT plus CHFST (n = 1), and FZF plus placebo plus CHFST vs placebo plus DT plus CHFST (n = 1). Meta-analysis indicated that FZF have additional benefits based on the CHFST in reducing plasma NT-proBNP level, MLHFQ scores, Lee’s heart failure scores (LHFs), and composite cardiac events (CCEs). Meanwhile, it also improved the efficacy on TCM symptoms (TCMs), NYHA functional classification (NYHAfc), 6MWD, and LVEF. Adverse events were reported in 6 out of 12 studies without significant statistical difference. However, after assessing the strength of evidence, it was found that only the quality of evidence for CCEs was high, and the others were either moderate or low or very low. So we could not draw confirmative conclusions on its additional benefits except CCEs. Further clinical trials should be well designed to avoid the issues that were identified in this study. Conclusion. The efficacy and additional benefits of FZF for CCEs were certain according to the high-quality evidence assessed through GRADE. However, the efficacy and additional benefits for the other outcomes were uncertain judging from current studies. In addition, the safety assessment has a great room for improvement. Thus, further research studies are needed to find more convincing proofs.

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Comparison of Animal Models for Premature Ovarian Insufficiency Induced by Different Doses of Cyclophosphamide: a Network Meta‑analysis

10.21203/rs.3.rs-1243777/v1 ◽

2022 ◽

Author(s):

Yiwen Qi ◽

Yue-meng Zhu ◽

Bin Li

Keyword(s):

Hormone Level ◽

Morphological Changes ◽

Meta Analysis ◽

Risk Of Bias ◽

Controlled Trials ◽

Loading Dose ◽

Inclusion Criteria ◽

Ovarian Insufficiency ◽

Review Manager ◽

Different Doses

Abstract IntroductionCyclophosphamide (CTX), is reported to be extensively used to establish POI animal model. But the most effective dose has not been systematically concluded yet. This systematic review and network meta-analysis is aimed to compare and rank the different doses of cyclophosphamide in the CTX-induced POI rat model.MethodsRandomized controlled trials of CTX-induced rat POI model were searched in four databases from inception to December, 2021. A network meta-analysis was conducted to analyze the data of included publications. The quality assessment was assessed by SYRCLE’s risk of bias tool. Data were analyzed with STATA 15.0 and Review Manager 5.3.Result205 records were searched and a total of 14 articles met inclusion criteria, Compared by Ovarian morphological changes, estrous cycle and hormone level (FSH, E2, AMH), the loading dose of 200mg/kg CTX with the maintenance dose of 8mg/kg CTX for consecutive 14 days showed the best efficacy in inducing rat POI model.

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The Efficacy of Preoperative Gabapentin in Spinal Surgery: A Meta-Analysis of Randomized Controlled Trials

January 2018 - Pain Physician ◽

10.36076/ppj/2017.7.649 ◽

2017 ◽

Vol 7 (20;7) ◽

pp. 649-661

Author(s):

Xin-long Ma

Keyword(s):

Adverse Effects ◽

Randomized Controlled Trials ◽

Incidence Rate ◽

Spinal Surgery ◽

Meta Analysis ◽

Controlled Trials ◽

Inclusion Criteria ◽

Analog Scale ◽

Randomized Controlled ◽

Vas Scores

Background: Pain management after spinal surgery has been studied for years. Gabapentin is a third-generation antiepileptic drug that selectively affects the nociceptive process and has been used for pain relief after surgery. However, the relationship between gabapentin and postoperative pain in spinal surgery is still controversial. Objective: To assess the efficacy of the pre-emptive use of gabapentin in spinal surgery. Study Design: A meta-analysis of randomized controlled studies. Setting: The MEDLINE, EMBASE, ClinicalTrials.gov, and Web of Science databases were systematically searched. Methods: This meta-analysis of randomized controlled trials (RCTs) was performed to compare the use of gabapentin with placebo in spinal surgery regarding to the following: the mean difference (MD) of postoperative opioid requirements, the changes of visual analog scale (VAS) scores in 2 groups, and the incidence rate of adverse effects. An electronic-based search of all related literatures was conducted, and only RCTs for spinal surgery were included. The MD of postoperative opioid requirements and VAS scores and the relative risk (RR) of the incidence rate of adverse effects in the gabapentin group versus the placebo group were extracted throughout the study. Results: Ten trials, involving 827 patients, met the inclusion criteria and were included in this meta-analysis. The total morphine consumption was significantly lower over the first 24 hours postoperatively in the gabapentin group (P < 0.05). The VAS scores at 2, 4, 6, 12, and 24 hours were less in the gabapentin group (P < 0.05). The incidence rate of vomiting, pruritus, and urinary retention was significantly less in the gabapentin groups (RR = 0.53, 95% CI 0.32–0.86, P < 0.05; RR = 0.38, 95% CI 0.22–0.66, P < 0.05; RR = 0.57, 95% CI 0.34–0.98, P < 0.05, respectively). Limitations: All of the studies we screened were published online except for unpublished articles. Only 10 RCTs met our inclusion criteria, so the sample size was still relatively small. Conclusion: This meta-analysis suggests that the administration of gabapentin is effective in reducing postoperative opioid consumption, VAS scores, and some side effects after spinal surgery. Key words: Gabapentin, analgesia, spinal surgery, meta-analysis, randomized controlled trials, visual analog scale score, side effect

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Were Traditional Chinese Medicine Injections Efficacious for Angina Pectoris? A Frequentist Network Meta-Analysis of Randomized Controlled Trials

10.21203/rs.3.rs-137394/v1 ◽

2020 ◽

Author(s):

Guoying Gao ◽

Siu-wai Leung ◽

Yongliang Jia

Keyword(s):

Chinese Medicine ◽

Angina Pectoris ◽

Traditional Chinese Medicine ◽

Meta Analysis ◽

Risk Of Bias ◽

Controlled Trials ◽

Quality Of Evidence ◽

Randomized Controlled ◽

Grade Approach

Abstract Background: The efficacy of traditional Chinese medicine injections (TCMIs) for angina pectoris has never been well investigated for lacking quality assessment of evidence. This study aimed to conduct a comprehensive and rigorous network meta-analysis and assess the quality of evidence according to the Grading of Recommendations and Assessment, Development, and Evaluation (GRADE) approach to compare the efficacy of all TCMIs in treating angina pectoris.Methods: Following the protocol (reference: CRD42018117720), randomized controlled trials (RCTs) which compared one TCMI with another TCMI or conventional treatments on anginal outcome measures (i.e. symptomatic improvement, electrocardiography improvement, symptomatic recovery, and electrocardiography recovery) were included. The risk of bias among included RCTs was assessed with the revised Cochrane’s risk of bias tool 2. Frequentist statistical analyses including subgroup analysis, sensitivity analysis, meta-regression and publication bias analysis were performed. The certainty of evidence was assessed with the GRADE approach.Results: Totally, 475 RCTs including all 24 TCMIs were identified, while the quality of all but two included RCTs was poor. According to the network meta-analysis, Honghua (Safflower) injection were preferable both in improving symptoms and electrocardiography. However, significant inconsistency showed the intransitivity among indirect comparisons, results in network meta-analysis seemed thus not trustworthy. The quality of evidence was assessed as low or very low.Conclusions: The low-quality evidence reduced the confidence in the efficacious results. Current evidence hardly supports the beneficial effects of TCMIs in treating angina pectoris.

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Meta-analysis Comparing Celecoxib with Diclofenac Sodium in Patients with Knee Osteoarthritis

Pain Medicine ◽

10.1093/pm/pnaa230 ◽

2020 ◽

Author(s):

Hetao Huang ◽

Minghui Luo ◽

Haodong Liang ◽

Jianke Pan ◽

Weiyi Yang ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Complication Rate ◽

Meta Analysis ◽

Diclofenac Sodium ◽

Controlled Trials ◽

Reactive Protein ◽

Randomized Controlled ◽

Vas Score ◽

Online Databases ◽

Review Manager

Abstract Objective To compare the efficacy and safety of celecoxib and diclofenac sodium in patients with knee osteoarthritis (KOA). Methods Clinical controlled trials (CCTs) and randomized controlled trials (RCTs) from online databases comparing the efficacy of celecoxib and diclofenac sodium in the treatment of KOA were retrieved. The main outcomes included the treatment effect, C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), visual analog scale (VAS) score, and complication rate. The Cochrane risk of bias (ROB) tool in Review Manager 5.3.5 was used to assess methodological quality. Results Twelve studies (N = 2,350) were included in this meta-analysis. The meta-analysis indicated that celecoxib reduced pain more effectively than diclofenac sodium in patients with KOA, as evaluated by the VAS score. In addition, celecoxib has certain advantages in terms of better treatment effects and greater reductions in the ESR, CRP level, and complication rate. Conclusions Celecoxib is superior to diclofenac sodium in the treatment of KOA. However, well-designed and high-quality RCTs are still needed.

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Electro-Acupuncture is Beneficial for Knee Osteoarthritis: The Evidence from Meta-Analysis of Randomized Controlled Trials

The American Journal of Chinese Medicine ◽

10.1142/s0192415x17500513 ◽

2017 ◽

Vol 45 (05) ◽

pp. 965-985 ◽

Cited By ~ 43

Author(s):

Na Chen ◽

Jing Wang ◽

Attilio Mucelli ◽

Xu Zhang ◽

Changqing Wang

Keyword(s):

Knee Osteoarthritis ◽

Randomized Controlled Trials ◽

Physical Function ◽

Pharmacological Treatment ◽

Meta Analysis ◽

Risk Of Bias ◽

Cochrane Library ◽

Controlled Trials ◽

Great Opportunity ◽

Randomized Controlled

Knee osteoarthritis (KOA) is a common chronic degenerative disease of the elderly. Electro-acupuncture (EA) is considered as a beneficial treatment for KOA, but the conclusion is controversial. This systematic review compiled the evidence from 11 randomized controlled trials to objectively assess the effectiveness and safety of EA for KOA. Eight databases including PubMed, Cochrane Library, Clinic trials, Foreign Medical Literature Retrial Service (FMRS), Science Direct, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), and Wanfang Data were extensively searched up to 5 July 2016. The outcomes included the evaluation of effectiveness, pain and physical function. Risk of bias was evaluated according to the Cochrane risk of bias tool. Eleven RCTs with 695 participants were included. Meta-analysis indicated that EA was more effective than pharmacological treatment (RR [Formula: see text] 1.14; 95% CI [Formula: see text] 1.01,1.28; [Formula: see text]) and manual acupuncture (RR [Formula: see text] 1.12; 95% CI [Formula: see text] 1.02,1.22; [Formula: see text]). Also, EA had a more significant effect in reducing the pain intensity (SMD [Formula: see text]; 95% CI [Formula: see text]; [Formula: see text]) and improving the physical function in the perspective of WOMAC (MD [Formula: see text]; 95% CI [Formula: see text], 5.56; [Formula: see text]) and LKSS (pharmacological treatment: MD [Formula: see text]; 95% CI [Formula: see text], 6.64; [Formula: see text]). Furthermore, these studies implied that EA should be performed for at least 4 weeks. Conclusively, the results indicate that EA is a great opportunity to remarkably alleviate the pain and improve the physical function of KOA patients with a low risk of adverse reaction. Therefore, more high quality RCTs with rigorous methods of design, measurement and evaluation are needed to confirm the long-term effects of EA for KOA.

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The Effectiveness of Pump Techniques and Pompages: A Systematic Review

Applied Sciences ◽

10.3390/app11094150 ◽

2021 ◽

Vol 11 (9) ◽

pp. 4150

Author(s):

Carla Vanti ◽

Matteo Golfari ◽

Giacomo Pellegrini ◽

Alice Panizzolo ◽

Luca Turone ◽

...

Keyword(s):

Systematic Review ◽

Web Of Science ◽

Meta Analysis ◽

Risk Of Bias ◽

Walking Distance ◽

Blood Collection ◽

Controlled Trials ◽

Randomized Controlled ◽

Length Of Hospitalization

Background: Osteopathic manual procedures called pump techniques include thoracic, abdominal, and pedal pumps. Similar techniques, called pompages, are also addressed to joints and muscles. Despite their widespread use, no systematic review has been published on their effectiveness. (2) Methods: CINAHL, Cochrane Controlled Trials Register, ISI Web of Science, PEDro, PubMed, and Scopus databases were searched until July 2020. Randomized Controlled Trials (RCTs) on adults were included. Subjective (e.g., pain, physical function) and objective (e.g., pulmonary function, blood collection) outcomes were considered. The Risk of Bias tool (RoB 2) and the GRADE instrument were used to evaluate the quality of evidence. (3) Results: 25 RCTs were included: 20 concerning the pump techniques and five concerning pompages. Due to the extensive heterogeneity of such studies, it was not possible to perform a meta-analysis. The risk of bias resulted from moderate to high and the quality of the evidence was from very low to high. Singular studies suggested some effectiveness of pump techniques on pain and length of hospitalization. Pompage seems also to help improve walking distance and balance. (4) Conclusions: Although several studies have been published on manual pump techniques, the differences for population, modalities, dosage, and outcome measures do not allow definite conclusions of their effectiveness.

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