Jinhuan Yue

Traditional Chinese medicine for pressure ulcer: a meta‐analysis

To assess the effect of Traditional Chinese Medicine (TCM) [Chinese herbal medicine ointment (CHMO), acupuncture and moxibustion] on pressure ulcer. In this study, we searched MEDLINE, EMBASE, CENTER, CBM, CNKI, WAN FANG and VIP for articles published from database inception up to 4 April 2011. We included randomised controlled trials (RCTs), which compared the effects of TCM with other interventions. We assessed the methodological quality of these trials using Cochrane risk of bias criteria. Ten of 565 potentially relevant trails that enrolled a total of 893 patients met our inclusion criteria. All the included RCTs only used CHMO intervention, because acupuncture and moxibustion trials failed to meet the inclusive criteria. A meta‐analysis showed beneficial effects of CHMO for pressure ulcer compared with other treatments on the total effective rate [risk ratio (RR): 1·28; 95% confidence interval (CI): 1·20–1·36; P = 0·53; I2 = 0%), curative ratio (RR: 2·02; 95% CI: 1·73–2·35; P = 0·11; I2 = 37%) and inefficiency rate (RR: 0·16; 95% CI: 0·02–0·80; P = 0·84; I2 = 0%). However, the funnel plot indicated that there was publication bias in this study. The evidence that CHMO is effective for pressure ulcer is encouraging, but due to several caveats, not conclusive. Therefore, more rigorous studies seem warranted.

Acupuncture at Houxi (SI 3) acupoint for acute neck pain caused by stiff neck: study protocol for a pilot randomised controlled trial.

Introduction The use of acupuncture has been suggested for the treatment of acute neck pain caused by stiff neck in China. However, current evidence is insufficient to draw any conclusions about its efficacy. Therefore this pilot study was designed to evaluate the feasibility and efficacy of acupuncture at the Houxi (SI3) acupoint for treatment of acute neck pain. Methods/analysis This pilot study will be a two-parallel-group, assessor-blinded, randomised controlled trial. Thirty-six stiff neck participants with acute neck pain will be recruited and randomly divided into two groups in a 1:1 ratio. Participants in the control group will receive massage on the local neck region (5 min each session, three times a day for 3 days). In addition to massage, patients in the treatment group will receive acupuncture (one session a day for 3 days). Measures will be taken at 0, 3 and 15 days. The primary outcome is the Northwick Park Neck Pain Questionnaire (NPQ). The secondary outcome is the Short Form of the McGill Pain Questionnaire (SF-MPQ). Ethics/dissemination The protocol for this pilot randomised clinical trial has undergone ethics scrutiny and been approved by the ethics review boards of the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine (Permission number: HZYLL201303502). The findings of this study will provide important clinical evidence on the feasibility and efficacy of acupuncture treatment for stiff neck patients with acute neck pain. In addition, it will explore the feasibility of further acupuncture research. Trial registration number ChiCTR-TRC-13003911.

Electroacupuncture for pressure ulcer: a study protocol for a randomized controlled pilot trial

BackgroundPressure ulcers are one of the most common health complaints, which often take months or years to heal, and affect patients’ morbidity and quality of life. Medical options for pressure ulcers are limited. Electroacupuncture (EA) has been employed to relieve the symptoms for patients with pressure ulcers, but there is limited clinical evidence for its effectiveness.Methods/DesignThis study consists of a randomized controlled trial (RCT) with two parallel arms: a control group and an EA group. Both groups will receive standard wound care (including changing position, using mattresses and cushions, and a good diet) of five sessions per week for a total of 40 sessions during the 8-week treatment period. In addition, the EA group will receive the EA intervention. The following outcome measurements will be used in examination of participants: wound surface area (WSA), visual analogue scale (VAS), and the proportion of ulcers healed within trial period (PUHTP). All the outcomes will be evaluated at the start of the study, at the end of the fourth week, at 8 weeks after randomization, and 1 month after treatment cessation.DiscussionThe aim of this study is to evaluate the effectiveness of EA for the treatment of patients with pressure ulcers.Trial registrationChinese Clinical Trial Register: ChiCTR-TRC-11001693

A case of electroacupuncture therapy for pressure ulcer

Pressure ulcers (also known as bedsores or decubitus ulcers) are areas of localised injury to the skin and underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear forces. This type of ulcer is one of the most common complications in patients with spinal cord injury. Treatment with transcutaneous electrical stimulation, and with acupuncture combined with moxibustion, have been reported to be effective for pressure ulcers.1 ,2 The use of electroacupuncture (EA) specifically for pressure ulcers has not been reported.3 Here, we report a case of the successful use of EA to promote wound healing of pressure ulcers. A 42-year-old woman was admitted to our acupuncture department with a …

Moxibustion for the correction of nonvertex presentation: a systematic review and meta-analysis of randomized controlled trials.

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, and I 2 = 0). The same findings applied to the cephalic presentation after cessation of treatment (RR 1.36, 95% CI 1.08 to 1.71, and I 2 = 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, and I 2 = 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.

Acupuncture for chronic knee pain: a protocol for an updated systematic review.

Introduction The aim of this study is to evaluate the efficacy and safety of acupuncture for patients with chronic knee pain. Methods and analysis MEDLINE, EMBASE, CENTERAL, CINAHL and four Chinese medical databases will be searched from their inception to present. We will also manually retrieve eligible studies. Randomised controlled trials (RCTs) in which acupuncture is assessed as the sole treatment or as an adjunct treatment for chronic knee pain will be included. The primary outcome of our analysis is pain measured by the visual analogue scale (VAS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale or the 11-point numeric rating scale (NRS). The secondary outcomes will include the quality of life, measured by the 36-item Short-Form Health Survey (SF-36) and adverse events. Two researchers will conduct the study selection, data extraction and quality assessment independently. Any disagreement will be resolved through discussion with a third reviewer. The Cochrane risk-of-bias criteria and the Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA) checklist will be used to assess the methodological quality of the trials. Dissemination This systematic review will assess the current evidence on acupuncture therapy for chronic knee pain. It uses aggregated published data instead of individual patient data and does not require an ethical board review and approval. The findings will be published in a peer-reviewed journal and disseminated in conference presentations. It will provide the latest analysis of the currently available evidence for acupuncture treating chronic knee pain. Trial registration number CRD42014015514.

Acupuncture for the treatment of hiccups following stroke: a systematic review and meta-analysis

Objectives To assess the effectiveness and safety of acupuncture for hiccups following stroke. Methods Medline, Embase, CENTRAL, CINAHL, and four Chinese medical databases were searched from their inception to 1 June 2015. The dataset included randomised controlled trials (RCTs) with no language restrictions that compared acupuncture as an adjunct to medical treatment (effectiveness) or acupuncture versus medical treatment (comparative effectiveness) in stroke patients with hiccups. The Cochrane risk of bias tool was used to assess the methodological quality of the trials. Results Out of 436 potentially relevant studies, five met the inclusion criteria. When acupuncture was compared with other interventions (as sole or adjunctive treatment), meta-analysis revealed a significant difference in favour of cessation of hiccups within a specified time period (CHWST) following intervention when used as an adjunct (risk ratio (RR) 1.59, 95% CI 1.16 to 2.19, I2=0%), but not when used alone (RR 1.40, 95% CI 0.79 to 2.47, I2=65%, ie, high heterogeneity). No safety information was reported in these studies. Conclusions Our systematic review and meta-analysis suggests that acupuncture may be an effective treatment for patients suffering from hiccups following stroke when used as an adjunct to medical treatment. However, due to the limited number of RCTs and poor methodology quality, we cannot reach a definitive conclusion, hence further large, rigorously designed trials are needed.

Updated systematic review and meta-analysis of acupuncture for chronic knee pain

Objective To assess the effectiveness and safety of acupuncture for the treatment of chronic knee pain (CKP). Methods We searched the MEDLINE, EMBASE, Cochrane CENTERAL, CINAHL and four Chinese medical databases from their inception to June 2017. We included randomised controlled trials of acupuncture as the sole treatment or as an adjunctive treatment for CKP. The primary outcome was pain intensity measured by visual analogue scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale and 11-point numeric rating scale. Secondary outcome measurements included the 36-Item Short Form Health Survey and adverse events. The quality of all included studies was evaluated using the Cochrane risk-of-bias criteria and the STRICTA (Standards for Reporting Interventions in Controlled Trials of Acupuncture) checklist. Results Nineteen trials were included in this systematic review. Of these, data from 17 studies were available for analysis. Regarding the effectiveness of acupuncture alone or combined with other treatment, the results of the meta-analysis showed that acupuncture was associated with significantly reduced CKP at 12 weeks on WOMAC pain subscale (mean difference (MD) −1.12, 95% confidence interval (CI) −1.98 to −0.26, I2=62%, 3 trials, 608 participants) and VAS (MD −10.56, 95% CI −17.69 to −3.44, I2=0%, 2 trials, 145 patients). As for safety, no difference was found between the acupuncture and control groups (risk ratio 1.08, 95% CI 0.54 to 2.17, I2=29%). Conclusion From this systematic review, we conclude that acupuncture may be effective at relieving CKP 12 weeks after acupuncture administration, based on the current evidence and our protocol. However, given the heterogeneity and methodological limitations of the included trials, we are currently unable to draw any strong conclusions regarding the effectiveness of acupuncture for chronic knee pain. In addition, we found that acupuncture appears to have a satisfactory safety profile, although further studies with larger numbers of participants are needed to confirm the safety of this technique. Strengths Systematic review without language restrictions. Limitations Only a few high-quality and consistent trials could be included in this review.

Acupuncture for urinary incontinence after stroke: a protocol for systematic review

Introduction The aim of this study, which will include randomised controlled trials (RCTs), is to assess the efficacy and safety of acupuncture for patients with stroke and urinary incontinence. Methods and analysis RCTs will be searched electronically in the MEDLINE, EMBASE, Cochrane CENTRAL, CINAHL and four Chinese medical databases from their inception to present. Manual retrieval will also be conducted. RCTs will be included if acupuncture was evaluated as the sole or adjunct treatment for patients with stroke and urinary incontinence. The primary outcome will be measured by using the pad-weighing test. The secondary outcomes will include urination diary, bladder capacity, clinical symptom scores, the number of patients healed completely in trial follow-up period and adverse events. The study selection, data extraction and evaluation of study quality will be performed independently by two researchers. The methodological quality of the included trials will be assessed by using the Cochrane risk-of-bias criteria and the Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA) checklist. Dissemination This systematic review will assess the current evidence of acupuncture treatment for patients with stroke and urinary incontinence. The findings of this study will be published through a peer-reviewed journal and presented at a relevant conference. Trial registration number CRD42014015611.

Moxibustion for the treatment of pressure ulcers: study protocol for a pilot, multicentre, randomised controlled trial

Introduction Pressure ulcers are common in the elderly and immobile. Currently, there are few proven effective treatments for pressure ulcers. This trial aims to evaluate the feasibility, efficacy and safety of moxibustion for pressure ulcers. Methods/analysis This is a multicentre, two-armed, parallel-design randomised controlled trial (RCT). 30 eligible patients with pressure ulcers will be randomised in a ratio of 1:1 to the treatment group and control group. The participants in the treatment group will undergo indirect moxibustion for 30 min before application of a dressing, one session daily, five sessions weekly for 4 weeks. The patients in the control group will only receive a dressing, applied in the same way as in the treatment group. Both groups will be followed up for 3 months. The primary outcome measures will be wound surface area (WSA) and proportion of ulcers healed within trial period (PUHTP). The secondary outcomes will be the Pressure Ulcer Scale for Healing (PUSH Tool), visual analogue scale (VAS) and adverse events. All outcomes will be evaluated at the beginning of the study, at the end of the second week, at 4 weeks after randomisation and at 1 and 3 months after treatment cessation. Ethics/dissemination This trial has undergone ethical scrutiny and been approved by the ethics review boards of First Affiliated Hospital of Heilongjiang University of Chinese Medicine and Second Affiliated Hospital of Heilongjiang University of Chinese Medicine (Permission number: HZYEYLP2014). The results of this study will provide clinical evidence for the feasibility, efficacy and safety of moxibustion for pressure ulcers. Trial registration number ChiCTR-TRC-13003959.