Effects of traditional Chinese exercises in fibromyalgia syndrome: A meta-analysis of randomized controlled trials.

OBJECTIVES: To explore the efficacy and safety of five traditional Chinese exercises (TCEs) in patients with fibromyalgia syndrome (FMS). METHODS: The PubMed, Embase, Scopus, ProQuest, Web of Science, Cochrane, CNKI, WanFang, and VIP databases were comprehensively searched for randomized controlled trials (RCTs) related to TCEs published from inception until February 2023. Standardized mean differences (SMD) and 95% confidence intervals (CI) were used to determine the combined effects of the intervention, and the Cochrane risk-of-bias assessment tool and Review 5.2 software were used to assess methodological quality. The data were extracted and analyzed by the Stata15.0 random effects model. RESULTS: Nineteen RCTs including 1315 participants were included in the analysis. The studies were found to be heterogeneous (I2 =86.2, P = 0.000), and thus a random effects model was used to combine the data. The results showed that traditional Chinese exercises had potentially beneficial effects on reducing pain (SMD =-0.66,95% CI [-1.08, -0.25], P = 0.002), improving sleep (SMD = -0.35,95% CI [-0.68,0. 01], P = 0.041) and relieving depression (SMD= -0.24,95% CI [-0.47, -0.02], P = 0.034) in FMS patients. However, no significant effects were found on improved quality of life (SMD =-0.20,95% CI [-0.48,0.09], P = 0.176). CONCLUSIONS: TCEs can improve pain, sleep quality and depression in patients with FMS and are safe. However, they do not improve the quality of life significantly. Further large-scale, high-quality, and multi-center RCTs are required to verify the efficacy of TCEs.

The impact of humor therapy on people suffering from depression or anxiety: An integrative literature review.

OBJECTIVES: To identify and synthesize existing research on the effectiveness and feasibility of multiform humor therapy on people suffering from depression or anxiety, with the hope of benefiting future research. METHODS: An integrative literature review of quantitative, qualitative, and mixed studies was performed. The PubMed, Cochrane Library, Web of Science, Embase, and CINAHL databases were searched up to March 2022. Two independent reviewers conducted each stage of the review process, by assessing eligibility using preferred reporting items for systematic review and meta-analyses (PRISMA) and quality appraisal using the Mixed Methods Appraisal Tool, and data extraction. RESULTS: In this integrative review, 29 papers were included, containing 2964 participants across a diverse range of studies, including quantitative, qualitative, and mixed methods. The articles were from the United States, Australia, Italy, Turkey, South Korea, Iran, Israel, China, and Germany. The findings indicated that most of the subjects thought humor therapy was effective in improving depression and anxiety while a few participants considered the effect insignificant. However, more high-quality studies will be needed to confirm these conclusions. DISCUSSION: This review collated and summarized findings from studies examining the impact of humor therapy (medical clowns, laughter therapy/yoga) on people with depression or anxiety, including children undergoing surgery or anesthesia, older people in nursing homes, patients with Parkinson's disease, cancer, mental illness, and undergoing dialysis, retired women, and college students. The results from this review may help inform future research, policy, and practice in humor therapy to improve people's symptoms of depression and anxiety. IMPACT: This systematic review objectively evaluated the effect of humor therapy on depression and anxiety. As a simple and feasible complementary alternative therapy, humor therapy may provide a favorable alternative for clinicians, nurses, and patients in the future.

Tuina combined with physical therapy for spasticity of poststroke: A protocol for systematic review and meta-analysis.

BACKGROUND: Limb spasms are a common complication of stroke. It not only affects the quality of life of stroke survivors, but also brings an economic burden. Tuina combined with physical therapy is widely used in the rehabilitation of poststroke spasticity. However, there is no supporting evidence for its efficacy and safety. This study aimed to evaluate the effectiveness and safety of Tuinas combined with physical therapy in the treatment of spasticity after stroke. METHODS: Literature will be collected from the following databases: China Biology Medicine (CBM), Wanfang Database, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), PubMed, Embase, Cochrane Library, and Web of Science; We will include randomized controlled trials of Tuina combined with physical therapy for poststroke spasticity range from the establishment to May 1, 2021. There were no limitations to the publication time, and the language was limited to Chinese and English. The primary outcome was evaluated using the Modified Ashworth scale, and the secondary outcomes were the simplified Fugl-Meyer Assessment scale, Modified Barthel Index, Functional Independence Measurement (FIM), and Visual Analog Scale. RevMan V.5.4.1 software was used for the meta-analysis. The Cochrane Intervention System Evaluation Manual analyzes the risk of bias, and the recommended grading assessment, development and evaluation are used to assess the quality of evidence. ETHICS AND DISSEMINATION: This study will be based on published systematic review studies, no ethical approval is required and the results of the study will be published in a peer-reviewed scientific journal. SYSTEMATIC REVIEW REGISTRATION: INPLASY2021110064.

Efficacy and safety of tuina for senile insomnia: A protocol for systematic review and meta-analysis.

BACKGROUND: Insomnia is a common diseases of the elderly, tuina is a widely used treatment. At present, there is a lack of supportive evidence on efficacy and safety of tuina for senile insomnia. The purpose of this systematic review is to assess the effectiveness and safety of tuina therapy in the treatment of senile insomnia. METHODS: Literature on tuina for senile insomnia in the PubMed, EMBASE, Web of Science, Cochrane, China National Knowledge Infrastructure Database, Wanfang, Chinese Scientific and Journal Database, Japanese medical database, Korean Robotics Institute Summer Scholars, and Thai-Journal Citation Index Center will be conducted to search from the creation of these databases. We will search the databases from the beginning to January 2022. The primary outcome was the Pittsburgh Sleep Quality Index score, and the secondary outcomes included clinical efficacy and safety. RevMan 5.4.1 will be used for the meta-analysis. RESULTS: This study aimed to will prove the effectiveness and safety of tuina therapy for the treatment of insomnia in the elderly. CONCLUSION: This study provides up-to-date evidence of the effectiveness and safety of tuina for the treatment of senile insomnia. INPLASY REGISTRATION NUMBER: INPLASY2021110063. ETHICS AND COMMUNICATION: This systematic review will evaluate the effectiveness and safety of massage therapy for insomnia in the elderly population. As all the included data have been published, systematic reviews do not require ethical approval.

Tuina for perimenopausal insomnia: A protocol for systematic review and meta-analysis.

BACKGROUND: Insomnia in perimenopausal women has a negative impact on quality of life and increases health care costs. With the increasing incidence of the disease, Tuina has been accepted by perimenopausal women. The purpose of this study is to explore the effectiveness and safety of Tuina for perimenopausal insomnia. METHODS: We will search 9 electronic databases: Chinese Biomedical Literature Database, Cochrane Library, China National Knowledge Infrastructure, EMBASE, MEDLINE, Web of Science, PubMed, Wan fang, Chinese Scientific Journal Database, and 1 clinical trials register platform: WHO International Clinical Trials Registry Platform. All relevant randomized controlled trial using Tuina for perimenopausal insomnia will be included. Two reviewers will independently screen date, and meta-analysis will be performed with RevMan (V5.3.5) software. RESULTS: This study will provide an evidence of Tuina for perimenopausal insomnia. CONCLUSION: This study will provide a reliable evidence for the evaluation of the efficacy and side effects of Tuina in the treatment of perimenopausal insomnia. PROSPERO REGISTRATION NUMBER: CRD42021259017. ETHICS AND DISSEMINATION: This systematics review will evaluate the efficacy and safety of tuina in the treatment of perimenopausal insomnia. Since all the data included were published, the systematic review did not require ethical approval.

Therapeutic effect of acupuncture combined montelukast sodium on cough variant asthma in children: A protocol for systematic review and meta-analysis.

BACKGROUND: Cough variant asthma in children is a special type of asthma. Although there are many effective cases of combined acupuncture and western medicine in the clinical treatment of this kind of children, there is no standardized acupuncture combined with western medicine to evaluate the curative effect. Therefore, combined with existing reports, a systematic review and meta-analysis of acupuncture combined with montelukast sodium in the treatment of cough variant asthma in children were carried out to obtain conclusive results. METHODS: The following electronic databases will be searched: PubMed, the Cochrane Library, Embase, Web of Science, Medline, CNKI, Chinese Biomedical Literature Database, VIP, and Wan Fang databases. We will consider articles published between database initiation and October 2021. We will use Review Manager 5.4, provided by the Cochrane Collaborative Network for statistical analysis. Clinical randomized controlled trials related to acupuncture combined with montelukast sodium on cough variant asthma in children were included in this study. Language is limited to both Chinese and English. Research selection, data extraction, and research quality assessments were independently completed by two researchers. We then assessed the quality and risk of the included studies and observed the outcome measures. RESULTS: This study provides a high-quality synthesis to assess the effectiveness and safety of acupuncture combined with montelukast sodium on cough variant asthma in children. CONCLUSION: This systematic review will provide evidence to determine whether acupuncture combined with montelukast sodium is an effective and safe intervention for patients with cough variant asthma in children. INPLASY REGISTRATION NUMBER: INPLASY2021110006.

Electrocupuncture combined rehabilitation therapy for upper limb spasticity after stroke: A protocol for systematic review and meta-analysis.

BACKGROUND: The purpose of this study was to evaluate the effectiveness and safety of electroacupuncture combined with rehabilitation in the treatment of spasticity after stroke. METHODS: To collect relevant literature, we will research following databases: Medicine, PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wan-Fang Database, Chongqing VIP Chinese Science and Technology Periodicals Database and China Biomedical Database; the time is from its creation to May 2021, and the language is limited to Chinese and English. In addition, we will retrieve other literature resources, including the Chinese Clinical Trial Register and conference papers. Two reviewers will independently complete the literature screen and data extraction, and quality assessment of the included studies will be independently completed by two other researchers. The primary outcomes included the Modified Ashworth scale (MAS) and the simplified Fugl-Meyer Assessment scale (SFMA). The Modified Barthel Index (MBI), the China Stroke Scale (CSS), and adverse reactions as secondary outcomes were assessed. RevMan V.5.4.1 software will be used for meta-analysis, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) will be used to assess the quality of evidence. RESULTS: This systematic review will provide a high-quality synthesis to evaluate the efficacy and safety of electroacupuncture combined with rehabilitation therapy in the treatment of upper limb spasticity after stroke, providing a reference for the safe and effective treatment of upper limb spasm after stroke. CONCLUSION: This study provides evidence that electroacupuncture combined with rehabilitation therapy is effective. ETHICS AND DISSEMINATION: The protocol of the systematic review does not require ethical approval because it does not involve humans. This article will be published in peer-reviewed journals and presented at relevant conferences. SYSTEMATIC REVIEW REGISTRATION: INPLASY202160005.

Study on the mechanism of regulating the hypothalamic cortical hormone releasing hormone/corticotropin releasing hormone type I receptor pathway by vibro-annular abdominal massage under the brain-intestine interaction in the treatment of insomnia.

BACKGROUND: Insomnia is a common disease associated with different nervous system stress response and endocrine disorders. It has been reported previously that abdominal vibration and ring massage therapy can significantly improve the symptoms of insomnia patients, enhance the activity of neurons. In addition, functional MRI (resting state brain functional magnetic resonance imaging [Rs_fMRI]) of the resting state brain test has proved that the functional connection between hypothalamus and parahippocampal gyrus could be significantly enhanced after abdominal massage treatment. It has been confirmed that there is possible involvement of brain-gut interaction effect in the treatment of insomnia, but there is a lack of research to elucidate the possible mechanisms of brain-gut interaction in the treatment of insomnia. The purpose of this study is to investigate the relationship between the hypothalamus and intestinal interaction in the treatment of insomnia by abdominal massage. METHODS AND DESIGN: A single blind randomized controlled trial will be conducted. Sixty chronic insomnia volunteers and 30 healthy volunteers will be recruited for this study. Sixty insomnia volunteers will be randomly divided into a drug group and a massage group, and 30 healthy volunteers will be assigned to the healthy group. The manipulation of the treatment group will be mainly carried out through abdominal rubbing and vibration massage, once a day, 30 min/time, 5 days for a course of treatment, and a total of 4 intervention courses will be carried out. Patients in the drug group will be given orally spleen-invigorating bolus, twice a day, 1 pill in the morning and 1 pill in the evening. The course of treatment will be carried for 5 days, and a total of 4 courses of treatment will be administered.The massage group will be compared with the healthy group and the drug group by Pittsburgh Sleep Index scale (PSQI), Hyperarousal scale (HAS), Hamilton Depression scale (HAMD), Fatigue scale-14 (FS-14), and Wechsler Adult Memory scale (WAIS) scales using to observe the sleep quality. Rs-fMRI will be used to observe various BOLD signals in the brain and compare the values of Reho, fALFF, and FC. MRS technology will be used to observe the contents of GABA and 5-HT in the hypothalamus. Additionally, the contents of cortical hormone releasing hormone (CRH), adrenocorticotropic hormone (ACTH), COR, GABA, NE, PGE2, and 5-HT in the serum will be also detected. The serum of each group will be taken for 1H nuclear magnetic resonance (1HNMR) metabolomics study to analyze the various common metabolites, differential metabolites, potential metabolic biomarkers, and metabolic pathways among the 3 groups. Finally, in combination with the brain functional imaging and brain spectrum, the potential mechanism of abdominal vibration and ring massage will be discussed. DISCUSSION: The results of this study will be used to possibly elaborate the various mechanisms of brain and intestine interaction in the treatment of insomnia by employing abdomen ring rubbing.

Non-pharmacological intervention for rehabilitation of post-stroke spasticity: A protocol for systematic review and network meta-analysis.

BACKGROUND: Post-stroke spasticity (PSS) is a major worldwide health problem, and timely and effective rehabilitation is associated with the risk of diabetes development; there are a variety of non-pharmacological interventions applied to the rehabilitation of PSS in these treatments; however, the relative efficacy and safety of different therapies remain uncertain, and we will conduct a systematic review and network meta-analysis to evaluate different non-pharmacological interventions. The relative efficacy and safety of intervention in PSS rehabilitation, thus providing evidence to support the optimization of the PSS rehabilitation program. METHODS: We searched the following databases electronically, including four English literature databases (i.e., PubMed, Medline, Embase, and Cochrane Library) and two Chinese literature databases (i.e., China National Knowledge Infrastructure and VIP). We will also search for randomized controlled trials on non-pharmacological interventions for post-stroke spasticity, and the search time limit is from its establishment to May 2020. Two reviewers working independently will screen the titles, abstracts, and full papers. Data extraction will be completed by two independent authors. The primary outcome was the motor function. The secondary outcome was the assessment of daily living ability. We will use RevMan V.5.3 software to compute the data synthesis carefully when a meta-analysis is allowed. We will conduct Bayesian network meta-analysis using the Markov Chain Monte Carlo random effects model in Aggregate Data Drug Information System version 1.16.8 (Drugis, Groningen, NL). RESULTS: This study provides a high-quality synthesis to assess the effectiveness and safety of non-pharmacological interventions for patients with PSS. CONCLUSION: The results of this study will provide evidence to judge whether non-pharmacological interventions are effective interventions for patients with post-stroke spasticity. ETHICS AND DISSEMINATION: The results of this meta-analysis and meta-regression will be disseminated through publication in a peer-reviewed journal and presented at a relevant conference. The data used in the network meta-analysis did not contain individual patient data. Therefore, ethical approval was not required. INPLASY REGISTRATION NUMBER: INPLASY202140059.

Electroacupuncture for patients with spasticity after stroke: A protocol for systematic review and meta-analysis.

BACKGROUND: The purpose of this paper is to evaluate the effectiveness and safety of electroacupuncture in the treatment of spasticity after stroke. METHODS: We will electronically search PubMed, Medline, Embase, Web of Science, the Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Chinese Scientific Journal Database, and Wan-Fang Database from the date of creation to November 2020. In addition, we will manually retrieve other resources including the reference lists of identified publications, conference articles, and gray literature. The clinical randomized controlled trials or quasi-randomized controlled trials related to electroacupuncture in the treatment of spasticity after stroke will be included in the study. The language is limited to Chinese and English. Research selection, data extraction, and research quality assessment will be independently completed by 2 researchers. Data were synthesized by using a fixed effect model or random effect model depend on the heterogeneity test. The modified Ashworth scale was the primary outcomes. Simplified Fugl-Meyer assessment scale (FMA), Stroke specific quality of life scale (SS-QOL) and adverse events will also be assessed as secondary outcomes. RevMan V.5.3 statistical software will be used for meta-analysis. If it is not appropriate for a meta- analysis, then a descriptive analysis will be conducted. Data synthesis will use the risk ratio and the standardized or weighted average difference of continuous data to represent the results. RESULTS: This study will provide a high-quality synthesis to assess the effectiveness and safety of electroacupuncture in the treatment of spasticity after stroke. CONCLUSION: This systematic review will provide evidence to judge whether electroacupuncture is an effective and safety intervention for patients with spasticity after stroke. ETHICS AND DISSEMINATION: The protocol of the systematic review does not require ethical approval because it does not involve humans. We will publish this article in peer-reviewed journals and presented at relevant conferences. SYSTEMATIC REVIEW REGISTRATION: CRD42021220300.

Effectiveness of Chinese herbal medicine for patients with primary insomnia: A PRISMA-compliant meta-analysis.

BACKGROUND: Traditional medicine is widely used for patients with primary insomnia, but the studies showed inconsistent results. We performed a meta-analysis of randomized controlled trials (RCTs) to evaluate the effectiveness of Chinese herbal medicine (CHM) versus placebo for primary insomnia patients. METHODS: The electronic databases including PubMed, EmBase, Cochrane library, and China National Knowledge Infrastructure were searched to identify the RCTs published from inception till July 2018. The summary weighted mean difference (WMD) with its 95% confidence interval (CI) for Pittsburgh sleep quality index (PSQI), sleep onset latency, total sleep duration, Athens insomnia scale (AIS), and sleep efficiency were calculated using random-effects model. RESULTS: Fifteen RCTs comprising 1500 patients were finally included in the meta-analysis. Overall, patients who received CHM had lower levels of PSQI (WMD: -2.36; 95% CI: -4.02 to -0.70; P = .005), sleep onset latency (WMD: -11.54; 95% CI: -20.55 to -2.54; P = .012), and AIS (WMD: -0.59; 95% CI: -0.97 to -0.22; P = .002) as compared with placebo. Moreover, the summary WMDs of CHM versus placebo were associated with higher total sleep duration (WMD: 0.79; 95% CI: 0.56-1.02; P < .001), and sleep efficiency (WMD: 9.72; 95% CI: 6.49-12.96; P < .001). The treatment effect on PSQI might be affected by publication year, sample size, mean age, percentage male, diagnostic tool, duration of insomnia, treatment duration, and study quality. CONCLUSION: The findings of this meta-analysis indicated that CHM could significantly improve the symptoms of insomnia than placebo for patients with primary insomnia.

Experimental study of the effect on bone metabolism and bone histomorphometry of osteoporosis rats with birdpecking and revolving moxibustion on twelve back-shu points.

The aim of the study was to explore the effect of birdpecking and revolving moxibustion on twelve back shenshu points on the bone metabolism and bone histomorphometry of osteoporosis rats. The 50 female rats of 8 months old that did not pregnant were collected and randomly divided into sham-operation group, model group, moxibustion group, moxibustion and estrogen group, and estrogen group. All the rats, except for the rats in the sham-operation group, received ovarian surgery to establish the models. After 10 days postoperatively (healing), the rats received moxibustion and estrogen therapy. According to the different groups, the rats received rat femur in vivo bone mineral density assessment at 90 days after surgery. After that, the rats were sacrificed, and then the left femoral bones were collected for bone histomorphometry test; blood was taken for bone alkaline phosphatase (BALP) testing, and urine was collected for hydroxyproline testing. The urine hydroxyproline was tested once at 24 h after ovarian surgery. At 24 h after ovarian surgery, the urine hydroxyproline in the ovariectomy group was significantly higher than that in the sham-operation group (P < 0.05), indicating that after ovarian surgery, the collagen broke down which accelerated the process of osteoporosis. After the intervention therapy with moxibustion and estrogen, the BALP, urinary hydroxyproline and femoral bone histomorphometry were comparatively analyzed, and the results showed that the intervention groups were higher than the model group (P < 0.05). But when compared with the sham-operation group, the indexes in the intervention groups were decreased, and the differences were significant (P < 0.05), indicating that intervention could only delay the incidence of osteoporosis. The Chinese traditional measure of "birdpecking and revolving moxibustion on twelve back-shu points" can effectively prevent the recession of bone metabolism of osteoporosis rats, and slow down the degeneration of bone morphology, which can be used to delay the incidence of osteoporosis.

[Application of combination of he-mu points and combination of shu-yuan in syndrome differentiation of zang- and fu-organs].

OBJECTIVE: To explore the relation of syndrome differentiation of zang-and fu-organs with combination of acupoints. METHODS: Relation of syndrome differentiation with combination of shu-yuan points, and combination of he-mu points are analyzed through understanding intension of combination of he-mu points, combination of shu-yuan points and syndrome differentiation, in combination with Prof. WANG fu-chun's clinical experience of m any years. RESULTS: Combination of he-mu points and combination of shu-yuan points have better therapeutic effect on diseases of zang- and fu-organs. CONCLUSION: Combination of he-mu points and combination of shu-yuan points are suitable to treatment of diseases an d syndromes of zang- and fu-organs, and have better therapeutic effects under guidance of syndrome differentiation of zang- and fu-organs, with characteristics of less points selected and easily acceptance for the patients.