[Systematic review and Meta-analysis of efficacy and safety of Bidouyan Oral Liquid in treatment of rhinosinusitis].

This study aimed to systematically review the efficacy and safety of Bidouyan Oral Liquid in the treatment of rhinosinu-sitis(RS). CNKI, Wanfang, SinoMed, VIP, Cochrane Library, PubMed, EMbase, Web of Science, and Ovid were searched for the randomized controlled trial(RCT) of Bidouyan Oral Liquid for the treatment of RS patients. Moreover, the reference lists and the grey literature were searched manually. Two researchers independently screened the literature and extracted data. The Cochrane collaboration's tool for assessing risk of bias(RoB 2.0) in randomized trial was used to assess the methodological quality of the included stu-dies. Meta-analysis was performed in RevMan 5.3 and Stata 12.0, and the grades of recommendation, assessment, development and evaluation(GRADE) was employed to evaluate the quality of evidence. A total of 54 RCTs(35 with drug combinations and 19 with single drugs) comprising 7 511 patients(3 973 in the observation group and 3 538 in the control group) were included. Meta-analysis showed that Bidouyan Oral Liquid + conventional treatment was superior to conventional treatment alone in increasing the total response rate(RR=1.19, 95%CI[1.15, 1.24], P<0.000 01) and decreasing the Lund-Kennedy scores(MD=-1.94, 95%CI[-2.61,-1.26], P<0.000 01), Lund-Mackay scores(MD=-2.14, 95%CI[-2.98,-1.31], P<0.000 01), and visual analogue scale(VAS) scores(MD_(total VAS scores)=-1.28, 95%CI[-1.56,-1.01], P<0.000 01; MD_(nasal congestion VAS scores)=-0.58, 95%CI[-0.89,-0.27], P=0.000 2; MD_(runny nose VAS scores)=-0.61, 95%CI[-0.93,-0.29], P=0.000 2; MD_(olfactory dysfunction VAS scores)=-0.43, 95%CI[-0.52,-0.34], P<0.000 01; MD_(head and facial pain VAS scores)=-0.41, 95%CI[-0.57,-0.26], P<0.000 01). Furthermore, the combined treatment outperformed conventional treatment alone in improving the mucociliary transport rate(MTR)(MD=1.64, 95%CI[1.08, 2.20], P<0.000 01) and lowering the levels of inflammatory cytokines{tumor necrosis factor-α(TNF-α)(SMD=-1.95, 95%CI[-2.57,-1.33], P<0.000 01), interleukin-6(IL-6)(SMD=-2.64, 95%CI[-4.08,-1.21], P=0.000 3)} in RS patients. In addition, the combined treatment did not increase the incidence of adverse reactions(RR=0.83, 95%CI[0.44, 1.57], P=0.57). Bidouyan Oral Liquid was superior to conventional treatment in increasing total response rate(RR=1.25, 95%CI[1.18, 1.32], P<0.000 01), decreasing the Lund-Kennedy(P<0.01) and Lund-Mackay scores(P<0.05), alleviating major symptoms(P_(total VAS scores)<0.01; P_(nasal congestion VAS scores)<0.01; P_(runny nose VAS scores)<0.01; P_(olfactory dysfunction VAS scores)<0.05; P_(head and facial pain VAS scores)<0.01), and decreasing adverse reactions(P=0.03). The results showed that either Bidouyan Oral Liquid or Bidouyan Oral Liquid + conventional treatment can increase the total response rate, decrease the Lund-Kennedy and Lund-Mackay scores, and mitigate major symptoms. In addition, Bidouyan Oral Liquid + conventional treatment improved MTR and reduced the expression of TNF-α and IL-6 without causing serious adverse events. However, due to the limited methodological quality of the included studies, large-sample and high-quality RCTs are needed to provide evidence support.

[Acupuncture combined with smokeless or smoky moxibustion for regulating immune function of experimental chronic rhinosinusitis mice].

OBJECTIVE: To observe the therapeutic effect of moxa fume in the treatment of chronic rhinosinusitis（CRS） and the effect of acupuncture plus smokeless moxibustion or smoky moxibustion on the expression of thymic stromal lymphopoietin (TSLP) and pituitary adenylate cyclase activating polypeptide (PACAP) proteins in the sinus mucosal tissue in CRS mice. METHODS: Sixty male C57BL/6J mice were randomly divided into 6 groups, namely normal control, sham operation, CRS model, medication, acupuncture plus smokeless moxibustion (Acu+smokeless Moxi) and acupuncture plus smoky moxibustion (Acu+smoky Moxi) groups, with 20 mice in each group. The CRS model was established by inserting a piece of polyporous sponge filled with streptococcus pneumoniae into the maxillary sinus after operation. The mice in the sham operation group received skin incision after opening the maxillary sinus. Mice of the medication group received gavage of clarithromycin 0.103 g·kg-1·d-1 for 21 days. For mice of the Acu+smokeless Moxi and Acu +smoky Moxi groups, manual acupuncture stimulation was applied to bilateral "Zusanli" (ST36), "Shenshu" (BL23) and "Hegu" (LI4) with the needles retained for 30 min, once every other day, and on the following day, moxibustion was applied to "Guanyuan" (CV4) and "Shenque" (BL23) for 20 min, once every other day. The treatment was given for 21 days. Mice of the normal, sham operation and model groups received gavage of normal saline (200 µL/d) for 21 days. Histopathological changes of the nasal mucosa were observed after H.E. staining, the TSLP and PACAP contents and expression were determined by enzyme-linked immunosorbent assay (ELISA) and immunohistochemistry, separately. RESULTS: At the end of the treatment, mice of the model group still had symptoms of nasal obstruction and runny nose, but those of the 3 treatment groups were obviously relieved in the nasal symptoms. H.E. staining showed an obvious chronic inflammatory reaction in the sinus mucosa, uneven distribution of the mucosal epithelium and necrotic and exfoliated epithelial cells, hyperplasia of fibrous tissue in the submucosa, etc. in the model group, which were relatively milder in the medication, Acu+smokeless Moxi and Acu+smoky Moxi groups, while no obvious inflammation was found in the normal group and sham operation group. In comparison with the normal group, no significant changes were found in the expression levels of PACAP and TSLP in the sham operation group (P>0.05). The expression level of PACAP was significantly lower (P<0.05) and that of TSLP significantly higher in the model group than in the normal and sham operatin groups (P<0.05). Compared with the model group, no significant changes were found in the expression of PACAP in the medication, Acu+smokeless Moxi and Acu+smoky Moxi groups (P>0.05), and the expression of TSLP was further obviously increased in the Acu+smokeless Moxi group (P<0.01), but obviously decreased in the Acu+smoky Moxi group (P<0.01). CONCLUSION: Acupuncture combined with smoky moxibustion can down-regulate the expression of TSLP protein in the nasal sinus mucosa in CRS mice, which maybe contribute to its effect in reducing the inflammatory reaction and nasal symptoms.

Acupuncture for diabetic neurogenic bladder: A protocol for systematic review and meta-analysis.

BACKGROUND: Diabetic neurogenic bladder (DNB) is one of the common complications of diabetes mellitus, which has a high prevalence rate. Some research suggested that acupuncture can improve the clinical symptoms of diabetic neurogenic bladder patients, but there is no systematic review or meta-analysis to assess this therapy. Therefore, this study aims to explore the effectiveness and safety of acupuncture for patients with DNB. METHODS: In this study, we will search for electronic databases including the Cochrane Library, Web of Science, PubMed, MEDLINE, EMBASE,China National Knowledge Infrastructure (CNKI), Wan-Fang, and Baidu Scholar Database from inception to December 2020. We will select randomized controlled trials that have been published in English or Chinese related to acupuncture for DNB. Selection of study, extraction of data, and assessment of study quality will be performed independently by 2 researchers, and we will use Revman 5.3 software which is provided by Cochrane assistance network, to perform the data analysis. RESULTS: This study will provide evidence of the effectiveness and safety of acupuncture for DNB. CONCLUSION: This study will clarify whether acupuncture is an effective treatment for DNB, and will also provide a reference for clinical practice and guidelines development.

Electro-acupuncture treatment for internet addiction: Evidence of normalization of impulse control disorder in adolescents.

OBJECTIVE: To observe the impacts of electro-acupuncture (EA) and psychological intervention (PI) on impulsive behavior among internet addiction (IA) adolescents. METHODS: Thirty-two IA adolescents were allocated to either EA (16 cases) or PI (16 cases) group by a randomized digital table. Subjects in the EA group received EA treatment and subjects in the PI group received cognition and behavior therapy. All adolescents underwent 45-d intervention. Sixteen healthy volunteers were recruited into a control group. Barratt Impulsiveness Scale (BIS-11) scores, Young's Internet Addiction Test (IAT) as well as the ratio of brain N-acetyl aspartate (NAA) to creatine (NAA/Cr) and choline (Cho) to creatine (Cho/Cr) were recorded by magnetic resonance spectroscopy before and after intervention respectively. RESULTS: The IAT scores and BIS-11 total scores in both EA and PI group were remarkably decreased after treatment (P<0.05), while EA group showed more significant decrease in certain BIS-11 sub-factors (P<0.05). Both NAA/Cr and Cho/Cr were significantly improved in EA group after treatment (P<0.05); however, there were no significant changes of NAA/Cr or Cho/Cr in PI group after treatment (P>0.05). CONCLUSIONS: Both EA and PI had significantly positive effect on IA adolescents, especially in the aspects of psychological experiences and behavioral expressions, EA might have an advantage over PI in terms of impulsivity control and brain neuron protection. The mechanism underlying this advantage might be related to the increased NAA and Cho levels in prefrontal and anterior cingulate cortices.

Effects of electroacupuncture combined psycho-intervention on cognitive function and event-related potentials P300 and mismatch negativity in patients with internet addiction.

OBJECTIVE: To observe the effects of comprehensive therapy (CT) with electroacupuncture (EA) in combination with psycho-intervention (PI) on the cognitive function and event-related potentials (ERP), P300 and mismatch negativity (MMN), in patients with internet addiction (IA) for a preliminary exploration of the possible mechanism of the therapy. METHODS: One hundred and twenty patients with IA were randomly divided into three groups, and a total of 112 subjects reached the final analysis of the trial, the EA group (39 patients), the PI group (36 patients) and the CT group (37 patients). EA was applied at acupoints Baihui (GV20), Sishencong (EX-HN1), Hegu (LI4), Neiguan (PC6), Taichong (LR3) and Sanyinjiao (SP6), once every other day; PI with the cognitionbehavior mode was implemented every 4 days; both EA and PI were used in the CT group. The treatment course for all patients was 40 days. Changes before and after treatment in terms of scoring by the IA self-rating scale, short-term memory capacity, short-term memory span, and the latency and amplitude of P300 and MMN in patients were observed. RESULTS: After treatment, in all groups, the IA score was lowered significantly (P <0.05) and scores of short-term memory capacity and short-term memory span increased significantly (P <0.05), while the decreased IA score in the CT group was more significant than that in the other two groups (P <0.05). ERP measurements showed that P300 latency was depressed and its amplitude raised in the EA group; MMN amplitude increased in the CT group (all P<0.05). CONCLUSION: The EA in combination with PI could improve the cognitive function of IA patients, and its mechanism might be related to the speedup of cerebral discrimination on external stimulus and the enhancement of effective resource mobilization during information processing of the brain.

[Intervention on network craving and encephalofluctuogram in patients with internet addiction disorder: a randomized controlled trial].

OBJECTIVE: To observe the effect of electroacupuncture (EA) combined with psychological interference on abstinence symptom such as network craving and anxiety in internet addiction disorder (IAD) and explore its mechanism. METHODS: One hundred and twenty cases of IAD were randomly divided into EA group, psychotherapy group and EA plus psychotherapy group (combined therapy group). In EA group, Baihui (GV 20), Sishencong (EX-HN 1), Hegu (LI 4), Neiguan (PC 6), Taichong (LR 3) and Sanyinjiao (SP 6) were selected in EA, once every 2 days, for 20 sessions totally. In psychotherapy group, the cognition and behavior therapy was applied, once every 4 days, for 10 sessions totally. In combined therapy group, EA combined with psychological interference was administered. The changes in IAD self-scale table, network craving scale, ZUNG self-rating anxiety scale (SAS) and S spectrum of encephalofluctuogram (ET) were observed before and after treatment. RESULTS: After treatment, the results of IAD self-scale table, network craving scale and ZUNG SAS in combined therapy group were reduced significantly as compared with those before treatment (all P < 0.01) and the score of IAD self-scale table was lower significantly as compared with EA group and psychotherapy group (P < 0.01, P < 0.05), and the score of network craving scale was lower than that in psychotherapy group (P < 0.01). S11 spectrum in combined therapy group decreased significantly as compared with that before treatment (P < 0.05) and was lower significantly as compared with psychotherapy group and EA group (both P < 0.05). CONCLUSION: Electroacupuncture combined with psychological interference can reduce network craving and anxiety of IAD patients and its mechanism is probably related with the decrease of dopamine content in central system.

[Clinical effect of electroacupuncture combined with psychologic interference on patient with Internet addiction disorder].

OBJECTIVE: To observe, adopting randomized controlled method, the therapeutic effect of electroacupuncture (EA) combined with psychologic interference in patients with internet addiction disorder (IAD). METHODS: Forty-seven patients with IAD were assigned to two groups treated respectively with psychotherapy alone (A, 23 cases) and EA plus psychotherapy (B, 24 cases). The psychotherapy was conducted by cognition and behavior method, once every 4 days, for 10 times totally. EA was applied at acupoints Baihui, Sishencong, Hegu, Taichong, Neiguan, Sanyinjiao, etc. once every other day, for 20 times. Changes of scoring by IAD self-rating scale (ISS), anxiety self-rating scale (SAS), self-rating depressive scale (SDS), Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA) and self-rating sub-health scale (SRSHS) before and after treatment were observed. RESULTS: The total effective rate was 91.3% (21/23) in Group B, better than that (59.1%, 13/22) in Group A. By the end of this study, all scores in Group B, except HAMD, were significantly lower than those in Group A respectively, i.e., for IAD, 33.20 +/- 4.53 vs. 44.00 +/- 5.81; for SAS, 30.90 +/- 6.30 vs. 39.60 +/- 5.80; for SDS, 35.38 +/- 4.59 vs. 39.60 +/- 6.33; for HAMA, 7.50 +/- 2.54 vs. 12.70 +/- 3.68; for SRSHS, 39.60 +/- 5.66 vs. 48.40 +/- 6.91, showing statistical significances (P < 0.05). CONCLUSION: Using psychologic interference alone or combined with EA can significantly reduce the ISS score and significantly reduce anxiety and improve self-conscious health status in patients with IAD, but the effect obtained by the combined therapy is better.

[Effects of electroacupuncture combined with psychologic interference on anxiety state and serum NE content in the patient of internet addiction disorder].

OBJECTIVE: To observe therapeutic effect of electroacupuncture (EA) on internet addiction disorder (lAD) and to preliminarily probe the mechanism. METHODS: Forty-seven cases of TAD were randomly divided into a psychotherapy group and an EA plus psychotherapy group. The psychotherapy group were treated with cognition and behavior therapy, once every 4 days, 10 sessions constituting one course; the EA plus psychotherapy group were treated with EA at Baihui (GV 20), Sishencong (EX-HN 1), Hegu (LI 4), Taichong (LR 3), Neiguan (PC 6), Sanyinjiao (SP 6), etc. once every other day, for 20 sessions, in combination with the same psychotherapy as that in the psychotherapy group. Changes of score of lAD, score of anxiety self-rating scale (SAS), score of Hamilton anxiety scale (HAMA) and serum norepinephrine (NE) content before and after treatment were observed. RESULTS: The total effective rate was 91.3% in the EA plus psychotherapy group and 59.1% in the psychotherapy group, the former being better than the latter (P<0.05). The scores for IAD, SAS, HAMA, and the se-rum NE content after treatment were significantly decreased in the two groups (both P<0.01). Those in the EA plus psychotherapy group were significantly lower than those in the psychotherapy group (P<0.05). CONCLUSION: Electroacupuncture combined with psychologic interference can significantly improve anxiety state and the mechanism is possibly related with the decrease of NE in the body.

[Effect of TCM formula for promoting blood circulation to remove blood stasis on brainstem auditory evoked potential and Transcranial Doppler parameters in patients with sudden deafness].

OBJECTIVE: To observe the therapeutic effect of Xuefu Zhuyu Decoction (XZD) on patients with sudden deafness (SD). METHODS: Sixty patients with SD were treated with XZD, and the changes of brainstem auditory evoked potential (BAEP) and transcranial Doppler (TCD) parameters in them were detected before and after treatment and analyzed statistically. RESULTS: I, III and V waveform and peak latency (PL) of BAEP, velocity of vertebral basilar arterial blood flow and parameters of cerebral blood flow in SD patients were all improved to different levels after treatment with XZD. CONCLUSION: TCM formula for promoting blood circulation to remove blood stasis can improve BAEP and TCD parameters in SD patients; BAEP detection and TCD parameters can reflect nerve function and blood-supply state of internal ear and brain stem, and therefore are of great importance in guiding the clinical treatment and assessing the prognosis.