RESUMO
OBJECTIVE: The efficacy of auricular acupressure in patients with hypertension and insomnia is controversial. This systematic review aims to explore the effectiveness of auricular acupressure in reducing blood pressure and improving sleep in this population. METHODS: We conducted an extensive database search in Cochrane Central Register of Controlled Trials, PubMed, Ovid LWW, Web of Science, Chinese Biomedical Literature Database, China Knowledge Resource Integrated Database, Wanfang Data, and China Science and Technology Journal Database on randomized controlled trials published from inception to November 2019 that compared auricular acupressure with a control or comparison group on blood pressure control and sleep improvement. Two reviewers independently conducted data screening and extraction. Study quality was evaluated using the Cochrane Handbook for Systematic Reviews of Interventions. Meta-analyses were performed on blood pressure, Pittsburgh Sleep Quality Index (PSQI), the efficacy rate of diagnostic and therapeutic criteria for traditional Chinese medicine syndromes (DTCTCMS), and the efficacy rate of guidelines for traditional Chinese medicine (new drug) clinical research (GTCMCR) by Revman 5.3.0. RESULTS: A total of 18 randomized controlled trials with 1685 patients were identified. Compared with a control or comparison group, pooled meta-analyses showed that auricular acupressure significantly improved systolic blood pressure (MD = -15.05, 95% CI (-18.49, -11.61), P < 0.00001), diastolic blood pressure (MD = -8.41, 95% CI (-11.33, -5.48), P < 0.00001), PSQI (MD = -2.37, 95% CI (-4.64, -0.10), P=0.04), the efficacy rate of DTCTCMS (RR = 1.63, 95% CI (1.16, 2.28), P=0.004), and the efficacy rate of GTCMCR (RR = 1.25, 95% CI (1.12, 1.38)). CONCLUSIONS: The results demonstrated a favorable effect of auricular acupressure to reduce blood pressure and improve sleep in patients with hypertension and insomnia. Further studies to better understand the acupoints and intervention times of auricular acupressure are warranted.
RESUMO
BACKGROUND: Physical activity is an important part of the diabetes management plan. However, the effects caused by different training durations and styles of Tai Chi have not been evaluated. We conducted an updated systematic review of the effects of Tai Chi on patients with type 2 diabetes based on different training durations and styles. METHODS: We performed a search for Chinese and English studies in 8 databases. Two reviewers independently selected the eligible trials and conducted a critical appraisal of the methodological quality. RESULTS: Seventeen trials were included. Tai Chi was found to have reduced fasting blood glucose (FBG) [SMD = - 0.54, 95% CI (- 0.91, - 0.16), P = 0.005] and HbA1c [SMD = - 0.68, 95% CI (- 1.17, - 0.19), P = 0.006] overall, compared with a control group. Considering the subgroup analysis, the pooled results showed that 24 movements or Yang-style Tai Chi did not significantly reduce FBG after a duration of ≤3 months [SMD = - 0.46, 95% CI (- 1.42, 0.50), P = 0.35] or > 3 months [SMD = - 0.50, 95% CI (- 1.49, 0.49), P = 0.32], nor did it reduce HbA1c [SMD = - 1.22, 95% CI (- 2.90, 0.47), P = 0.16] after a duration > 3 months in all studies. However, other styles of Tai Chi significantly reduced FBG [SMD = - 0.90, 95% CI (- 1.28, - 0.52), P < 0.00001] and HbA1c [SMD = - 0.90, 95% CI (- 1.28, - 0.52), P < 0.00001] after a duration > 3 months, while no significant reduction in FBG [SMD = - 0.34, 95% CI (- 0.76, 0.08), P = 0.12] or HbA1c [SMD = - 0.34, 95% CI (- 0.76, 0.08), P = 0.12] was found after a duration ≤3 months. CONCLUSIONS: Tai Chi seems to be effective in treating type 2 diabetes. Different training durations and styles result in variable effectiveness. The evidence was insufficient to support whether long-term Tai Chi training was more effective.