RÉSUMÉ
The application status of acupuncture and moxibustion therapy for assisted reproductive field in the United States was analyzed, and the existing problems and future development directions were discussed. According to the survey on the 456 websites of assisted reproductive clinic in the United States mentioned in the report of U.S. Centers for Disease Control and Prevention (CDC), 111 clinics among 456 assisted reproductive clinics recommend and used acupuncture and moxibustion therapy, accounting for 24.3%. Acupuncture and moxibustion therapy had obvious effect, good safety and low cost, and the assisted reproductive institutions in the United States had a high degree of application and recognition to acupuncture and moxibustion therapy. However, some problems, such as immature treatment scheme, unclear mechanism and imperfect insurance policies, still existed. In the future, the advantages of Chinese traditional acupuncture and moxibustion should combine with international modern assisted reproductive technology, and multi-center and large-sample clinical randomized controlled trials and basic experimental research on the mechanism of acupuncture and moxibustion for assisted reproduction should be carried out.
Sujet(s)
Acupuncture , Thérapie par acupuncture , Médecine traditionnelle chinoise , Moxibustion , Reproduction , États-UnisRÉSUMÉ
Objective: To analyze the effect of acupuncture versus hormone replacement therapy (HRT) for premature ovarian insufficiency (POI). Methods: China National Knowledge Infrastructure (CNKI), Wanfang Academic Journal Full-text Database (Wanfang), Chongqing VIP Database (CQVIP), China Biology Medicine Disc (CBM), Web of Science, Cochrane Library, PubMed, and Excerpta Medica Database (EMBASE) were searched up to January 31st, 2019 to identify randomized controlled trials (RCTs) evaluating the effect of acupuncture for POI. The primary outcome was the level of basal serum follicle- stimulating hormone (FSH). Secondary outcomes included serum levels of luteinizing hormone (LH), estradiol (E2) and anti-Müllerian hormone (AMH). Two authors extracted data independently and assessed the risk of bias and the methodological quality using the Cochrane's tool. Meta-analysis was conducted by RevMan version 5.3. Results: Eight eligible RCTs with a total of 496 POI patients were included in the meta-analysis. The pooled results showed that there was a significant reduction in the basal serum FSH level (MD=-5.82, 95%CI:-9.76 to -1.87, I2=82%, P=0.004) and a remarkable elevation in the basal E2 level (SMD=0.93, 95%CI: 0.34 to 1.52, I2=88%, P=0.002) in the acupuncture group when compared with the control. Subgroup analysis showed that compared with HRT, a significant decrease in the FSH level was observed in both acupuncture alone (MD=-4.53, 95%CI:-8.96 to -0.10, I2=73%, P=0.04) and acupuncture plus HRT (MD=-9.60, 95%CI:-17.60 to -1.61, I2=50%, P=0.02), while a remarkable elevation of E2 was only found in acupuncture plus HRT (SMD=1.43, 95%CI: 1.03 to 1.82, I2=0%, P<0.00001). There was no significant difference in the LH level between acupuncture and HRT (MD=-3.16, 95%CI:-9.41 to 3.10, I2=0%, P=0.32), only one trial reported AMH, and no significant difference was found between acupuncture and HRT. Conclusion: The present study indicated that acupuncture had an advantage over HRT in reducing serum FSH level and increasing serum E2 level in women with POI. However, evidence supporting the finding is limited due to the small sample size, potential methodological flaws and significant heterogeneity. Hence, this conclusion still needs to be verified by high-quality RCTs.
RÉSUMÉ
To explore the basic principles and methods of quality control of clinical registry research in the field of acupuncture. This study drawed on the data quality control methods of clinical trials in the United States and combined clinical practice experience, based on the "International Patient Registry Platform of Acupuncture and Moxibustion", and the registry study of acupuncture treatment for early-onset ovarian insufficiency as a model. The principles of accuracy, authenticity, consistency and completeness were followed. A remote and on-site quality control method with remote quality control as the main and on-site quality control as the supplement is formed, with a view to providing ideas and reference for the quality control of registry research.
Sujet(s)
Humains , Thérapie par acupuncture , Essais cliniques comme sujet , Normes de référence , Moxibustion , Contrôle de qualité , EnregistrementsRÉSUMÉ
OBJECTIVE@#To review systematically the safety and effectiveness of acupuncture-related therapies on ovulation rate and pregnancy rate in patients with polycystic ovary syndrome (PCOS).@*METHODS@#From PubMed, EMbase, the Cochrane Library, China Biology Medicine disc (CBM), China National Knowledge Infrastructure (CNKI), Wanfang database and VIP database, the randomized controlled trials (RCTs) on PCOS were retrieved in the period from the date of database establishment to January 8, 2018. Two researchers screened the articles, extracted the data and assessed the bias risk of the eligible trials independently. Using Stata 13.0 and WinBUGS 1.4.3 software, the data were analyzed.@*RESULTS@#A total of 39 RCTs were collected, including 4605 cases of PCOS and 14 kinds of acupuncture-related therapies and the comprehensive therapies. The short-term therapeutic effects were observed. The results of mesh meta-analysis showed: regarding the ovulation rate, the effects of the acupuncture-medication therapy were better than western medication. The top 6 therapeutic measures were the treatment with acupoint thread-embedding therapy and medication (93.3%), the treatment with moxibustion and Chinese herbal medicine (91.4%), moxibustion (74.5%), the treatment with acupuncture and medication (65.7%), the treatment with acupuncture-moxibustion and auricular point therapy (61.9%) and the treatment with acupuncture and auricular point therapy (49.6%). Regarding the pregnancy rate, the effects of the acupuncture-medication therapy were better than western medication. The top 6 therapeutic measures were the treatment with acupuncture and auricular point therapy (91.5%), the treatment with moxibustion and Chinese herbal medication (86.9%), the treatment with acupuncture-moxibustion and auricular point therapy (81.1%), the treatment with acupoint thread-embedding therapy and medication (69.4%), the treatment with acupuncture and medication (66.1%) and the treatment with placebo and western medication (58.7%).@*CONCLUSION@#Among acupuncture-related therapies, the combined treatment is more advantageous than single therapy and its safety is superior to western medication. The combined therapies are various in advantages. Because of the limitation of the present researches, it needs a large scale of RCTs with rational design, high quality and proper methods to verify this research conclusion.
Sujet(s)
Femelle , Humains , Grossesse , Thérapie par acupuncture , Chine , Méta-analyse en réseau , Ovulation , Syndrome des ovaires polykystiques , Thérapeutique , Taux de grossesse , Essais contrôlés randomisés comme sujetRÉSUMÉ
The present study was aimed to analyze the association rules of Fufang Kushen injection in combination with other modern medications in treating lung cancer based on the electrical medical records in real world clinical situations extracted from hospital information system in Institute of Basic Medical Sciences, China Academy of Chinese Medical Sciences, and provide reference for improving rationality of clinical drug use and exploring the prescription rules as well as subsequent in-depth analysis. The electrical medical records of the hospitalized patients using Fufang Kushen injection for lung cancer were extracted to analyze the frequency distribution characteristics in combined application with western medicine, and Apriori algorithm was used to analyze the specific association rules in combined drug use. A total of 49 597 patients were included in the study. The commonly combined modern medications included 5-HT receptor blockers, antibiotics, chemotherapy drugs, antitumor immune regulating drugs, glucocorticoid drugs and analgesics, which was usually applied in combination with traditional Chinese medications such as those for removing blood stasis, spleen and stomach nourishing drugs, Qi-regulating agent, heat-clearing and detoxifying prescriptions, laxative and Qi invigorating agent in clinical treatment. The results revealed that the distribution characteristics in combined application and association combinations of Fufang Kushen injection had specific rules, consistent with the clinical orientation of this drug in treatment of lung cancer. Such results may provide reference for reasonable application of Fufang Kushen injection in clinical treatment.