[Study on the rule of acupoint selection in treatment of acute exacerbation of chronic obstructive pulmonary disease].

OBJECTIVE: To explore the characteristics and rule of clinical acupoint selection in treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). METHODS: The clinical articles of acupuncture in treatment of AECOPD were retrieved from the databases of PubMed, EMbase, Cochrane Library, Web of Science, CNKI, Wanfang, VIP and SinoMed, from the date of establishment to July 15, 2020. The articles were screened in accordance with the inclusion and exclusion criteria, the prescriptions of acupuncture and the relevant information of the acupoints and meridians were extracted to establish the database. The data mining methods i.e. Apriori association rule analysis and cluster analysis were used to analyse the using frequency, involving meridians, acupoint distributions, association rules and cluster of selected acupoints. RESULTS: A total of 54 articles were included, 67 acupuncture prescriptions were extracted, 69 acupoints were involved and the total using frequency was 475 times. The top 5 acupoints in frequency were Danzhong (CV 17), Feishu (BL 13), Zusanli (ST 36), Fenglong (ST 40) and Dingchuan (EX-B1). The main involved meridians were bladder meridian of foot-taiyang, conception vessel, stomach meridian of foot-yangming and lung meridian of hand-taiyin. The acupoints were mainly distributed in chest and abdomen, waist and dorsum. The mainly selected special points were five-shu points, front-mu points, convergent points and back-shu points. Twenty strong association rules were summarized by association rule analysis, including Fenglong (ST 40)Þ Zusanli (ST 36), Fengmen (BL 12)Þ Danzhong (CV 17), Tianshu (ST 25)Þ Zhongwan (CV 12), Dingchuan (EX-B1)+ Feishu (BL 13) Þ Danzhong (CV 17), Fenglong (ST 40)+ Feishu (BL 13) Þ Zusanli (ST 36), etc. Five cluster groups were summarized by cluster analysis, i.e. ①Feishu (BL 13), ② Dingchuan (EX-B1) and Danzhong (CV 17), ③ Chize (LU 5), Lieque (LU 7) and Fengmen (BL 12), ④Zusanli (ST 36) and Fenglong (ST 40), ⑤Tianshu (ST 25), Guanyuan (CV 4) and Zhongwan (CV 12). CONCLUSION: The local acupoints and acupoints along meridians are the main acupuncture prescriptions for AECOPD, and the special points are the predominated selection. The acupoint compatibility embodies the therapeutic principle of "strengthening vital qi to eliminate pathogenic factors and considering both the root cause and symptoms".

[Network Meta-analysis of efficacy and safety of Chinese patent medicines in treatment of insomnia].

To evaluate the efficacy and safety of Chinese patent medicines in the treatment of insomnia by frequency network Meta-analysis. Randomized controlled trials of Chinese patent medicines for insomnia were retrieved from CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase and Cochrane Library databases from the time of database establishment to October 2020. The quality of the included RCTs was evaluated according to the Cochrane bias risk standard, and the data was analyzed by RevMan 5.3 and Stata/MP 15.1. A total of 11 kinds of Chinese patent medicines in 27 RCTs were included. According to Meta-analysis, in term of the effective rate, Tianmeng Liquid, Zaoren Anshen Capsules, Shumian Capsules, Shensong Yangxin Capsules, Shenqi Wuweizi Tablets, Shugan Jieyu Capsules, Anshen Bunao Liquid and Qiye Anshen Tablets combined with nonbenzodiazepine drugs(NBZDs) were superior to NBZDs alone. In term of the improvement of Pittsburg sleeping quality index(PSQI) score, Tianmeng Liquid, Shumian Capsules, Shensong Yangxin Capsules, Bailemian Capsules, Shenqi Wuweizi Tablets, Shugan Jieyu Capsules, Yangxue Qingnao Granules and Yindan Xinnaotong Capsules combined with NBZDs were superior to NBZDs alone. In terms of the safety, Shumian Capsules, Shensong Yangxin Capsules, Shenqi Wuweizi Tablets and Qiye Anshen Tablets combined with NBZDs were superior to NBZDs alone. In terms of the avoidance of dizziness and headache, Qiye Anshen Tablets combined with NBZDs were superior to NBZDs alone. The results of Network Meta-analysis indicated that in term of the effective rate, top three optimal medication regimens were NBZDs combined with Shugan Jieyu Capsules, combined with Zaoren Anshen Capsules and combined with Shensong Yangxin Capsules in the order from high to low. With the respect of improvement of PSQI score, top three optimal medication regimens were NBZDs combined with Yangxue Qingnao Granules, combined with Tianmeng Liquid and combined with Yindan Xinnaotong Capsules in the order from high to low. In terms of the safety, top three optimal medication regimens were NBZDs combined with Qiye Anshen Tablets, combined with Shensong Yangxin Capsules and combined with Shenqi Wuweizi Tablets in the order from high to low. In terms of the avoidance of dizziness and headache, top three optimal medication regimens were NBZDs combined with Qiye Anshen Tablets, combined with Zaoren Anshen Capsules and combined with Shumian Capsules in the order from high to low. In terms of the avoidance of fatigue, top three optimal medication regimens were NBZDs combined with Shensong Yangxin Capsules, combined with Shumian Capsules and combined with Qiye Anshen Tablets in the order from high to low. In conclusion, Chinese patent medicines combined with NBZDs can effectively alleviate the symptoms of insomnia with a high safety. However, the conclusion of this study needs to be verified by more high-quality studies because of the low methodological quality of the included studies.

Acupuncture for idiopathic pulmonary fibrosis: Protocol for a systematic review.

BACKGROUND: Patients with idiopathic pulmonary fibrosis (IPF) often suffer from progressive worsening of dyspnea and lung function. Although 2 drugs are now available for IPF treatment, many gaps are still to be filled. Evidences suggest that there may be some beneficial effect of acupuncture on pulmonary diseases. This review aims to systematically determine the efficacy and safety of acupuncture for treating IPF. METHODS: The following 8 databases will be searched from their inception to March 20, 2017: PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Chongqing VIP, and Wanfang Data. Randomized controlled trials (RCTs) of acupuncture for IPF without restriction of publication status will be included. Two review authors will independently undertake study selection, extraction of data, and assessment of study quality. Meta-analysis will be conducted after screening of studies if possible. Dichotomous data will be analyzed using odds ratio (OR), and continuous data mean difference (MD). Statistical analysis will be conducted using Review Manager (RevMan) software. RESULTS: This systematic review will provide a detailed summary of the current evidences related to the efficacy and safety of acupuncture in improving breathlessness, exercise limitation, health status impairment of patients with IPF. CONCLUSION: This evidence may be useful to clinicians, patients, and health policy-makers with regard to the use of acupuncture in IPF treatment. ETHICS AND DISSEMINATION: This systematic review will provide up-to-date information on acupuncture for IPF. This review does not require ethical approval and will be disseminated electronically through a peer-reviewed publication or conference presentations. TRIAL REGISTRATION NUMBER: PROSPERO 2017:CRD42017059848.