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Ding L, Li C, Zhang P, Chen C, Zhan J, Zeng J, Lu L. Acupuncture-related therapies for protracted opioid abstinence syndrome:A systematic review and meta-analysis. Integr Med Res 2023; 12:100976. [PMID: 37637184 PMCID: PMC10448024 DOI: 10.1016/j.imr.2023.100976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 07/12/2023] [Accepted: 07/17/2023] [Indexed: 08/29/2023] Open
Abstract
Background An increasing amount of clinical evidence of acupuncture's effect on protracted opioid abstinence syndrome (POAS) has emerged in recent years. The aim of this study was to evaluating the evidence of efficacy of acupuncture for POAS. clinical and scientific research work. Methods Four English-language databases (PubMed, Medline, Embase, Cochrane Libraries) and three Chinese-language databases (CNKI, WanFang and VIP Libraries) were searched, with coverage from database inception to March 31, 2022. Randomized clinical trials (RCTs) evaluating the effects of acupuncture and acupuncture-related therapies for prophylaxis or treatment of POAS were included. Data were screened and extracted independently according to pre-set tabular formats. RCT quality was assessed using risk of bias tool in the Cochrane Collaboration. The primary outcome was opiate withdrawal scale. The secondary outcomes are depression, anxiety for assessing protracted symptoms. The scores on the above scales are proportional to the severity of the symptoms. Results Twenty-eight trials met the inclusion criteria and provided data for the meta-analysis. A total of only 3 studies (11%) were judged to be low-risk overall due to various biases in them. Acupuncture-related therapy showed statistical differences in improving protracted withdrawal symptom scores compared with sham acupuncture (5 studies, Standard mean difference (SMD), -1.85, 95% CI [-3.21, -0.50], P = 0.007), western medicine(7 studies, SMD, -0.72, 95% CI [-1.22, -0.21], P = 0.005)and no treatment(3 studies, SMD,-2.26, 95% CI [-3.82, -0.69], P = 0.005)with high heterogeneity. Conclusions Acupuncture maybe safe and effective in relieving POAS individuals' protracted withdrawal symptoms. However, the results of our review should be interpreted with caution because of the high risk of bias of the included trials. Study registration The protocol of this review has been registered at PROSPERO (CRD42022335505).
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Affiliation(s)
- Lu Ding
- Clinical Research and Big Data Laboratory, South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Cui Li
- Clinical Research and Big Data Laboratory, South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Peiming Zhang
- Department of Acupuncture and Moxibustion, Foshan Hospital of Traditional Chinese Medicine, Foshan, China
| | - Chen Chen
- Clinical Research and Big Data Laboratory, South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jie Zhan
- Postdoctoral Research Station, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Rehabilitation, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Jinchun Zeng
- Department of Rehabilitation, The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Liming Lu
- Clinical Research and Big Data Laboratory, South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
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Ren H, Zeng Y, Zhang M, Zhang S, Chen Z, Wu B, Liu J, Ren Y. Electro-acupuncture for protracted amphetamine abstinence syndrome: study protocol for a pragmatic randomized controlled trial. Trials 2022; 23:216. [PMID: 35292088 PMCID: PMC8922742 DOI: 10.1186/s13063-022-06154-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 03/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Protracted amphetamine abstinence syndrome is one of the primary causes of relapse for amphetamine-type drug abusers during withdrawal. However, the importance of the management of protracted amphetamine abstinence syndrome is underestimated. Electro-acupuncture may be a safe and effective alternative therapy for protracted amphetamine abstinence syndrome, but the evidence is limited. METHODS The study is a prospective, two-center, randomized, waitlist controlled, open-label pragmatic trial. A total of 300 patients with protracted amphetamine abstinence syndrome will be recruited. All participants will be randomly assigned to an electro-acupuncture group or a waitlist group in a 1:1 ratio. Participants in the electro-acupuncture group will receive the electrical-acupuncture treatment. Waitlist group participants will not receive electro-acupuncture treatment but will be assessed at each visit. Treatments will be administered twice a week for a total of 4 consecutive weeks. The primary outcome in this study is the change in the ACSA between baseline (week 0) and the completion of treatment (week 4), and the secondary outcomes are changes in the Hamilton Depression Scale (HAMD), the visual analog scale (VAS), the Hamilton Anxiety Scale (HAMA), the Pittsburgh Sleep Quality Index (PSQI), the Montreal Cognitive Assessment (MoCA), and the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36). DISCUSSION This study will assess the effectiveness of acupuncture in PAAS in real-world settings to provide support for clinical decisions and a basis for subsequent trials comparing acupuncture with other positive regimens. TRIAL REGISTRATION ClinicalTrials.gov ChiCTR2000040619 . Registered on 3 December 2020.
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Affiliation(s)
- Huan Ren
- School of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, China
| | - Yiwei Zeng
- School of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, China
| | - Min Zhang
- School of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, China
| | - Su Zhang
- School of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, China
| | - Zhihan Chen
- School of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, China
| | - Binbin Wu
- Coercive Rehabilitation Center for Addicts Affiliated to the Public Security Bureau of Deyang, Deyang, Sichuan, 618007, China
| | - Jun Liu
- Medical Rehabilitation Department, Drug Rehabilitation Administration of Sichuan Province, Chengdu, Sichuan, 610036, China
| | - Yulan Ren
- School of Chinese Classics, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, China.
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Chen Z, Wang R, Zhang M, Wang Y, Ren Y. Acupuncture combined with medication for opioid use disorder in adults: a protocol for systematic review and meta-analysis. BMJ Open 2020; 10:e034554. [PMID: 32565455 PMCID: PMC7310998 DOI: 10.1136/bmjopen-2019-034554] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Opioid use disorder (OUD) is a worldwide health problem. Clinical trials indicated that acupuncture combined with medication is effective in OUD, however, there are different conclusions presented by previous trials. This study is designed to evaluate the efficacy and safety of acupuncture combined with medication in OUD. METHODS AND ANALYSIS PubMed, CENTRAL, Embase, Web of Science, CINAHL, PsycINFO, ProQuest Dissertation and Theses, AMED, OpenGrey, Clinicaltrials.gov and who.int/trialsearch will be searched in September 2019 without a language restriction. Randomised controlled trials (RCTs) and quasi-RCTs which included participants with OUD receiving acupuncture therapy combined with medication versus control group will be included in this study. Two reviewers will independently screen studies, extract data, assess risk of bias by the Cochrane risk of bias assessment tool and assess quality of evidence by Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Any disagreements will be arbitrated by the third reviewer. Data synthesis and analysis will be conducted by using RevMan V.5.3. Subgroup analyses, sensitivity analysis, meta-regression and reporting bias assessment will be conducted if necessary and appropriate. ETHICS AND DISSEMINATION On account of the nature of this systematic review and meta-analysis, ethical approval is not required. The results will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42019123436.
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Affiliation(s)
- Zhihan Chen
- School of Acupuncture Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Rui Wang
- School of Acupuncture Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Min Zhang
- School of Acupuncture Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yitong Wang
- School of Chinese Classics, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yulan Ren
- School of Chinese Classics, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Chen Z, Wang Y, Wang R, Xie J, Ren Y. Efficacy of Acupuncture for Treating Opioid Use Disorder in Adults: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2018; 2018:3724708. [PMID: 30622598 PMCID: PMC6304557 DOI: 10.1155/2018/3724708] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 10/26/2018] [Accepted: 11/11/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To assess the efficacy of acupuncture in treating opioid use disorder (OUD). DESIGN Systematic review and meta-analysis. METHODS PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, ProQuest Dissertation and Theses, Allied and Complementary Medicine Database (AMED), Clinicaltrials.gov, and who.int/trialsearch were searched from inception to 23 December 2017. The methodological quality of selected studies and the quality of evidence for outcomes were assessed, respectively, by the Cochrane risk of bias assessment tool and the GRADE approach. Statistical analyses were conducted by RevMan 5.3. RESULTS A total of nine studies involving 1063 participants fulfilled the inclusion criteria. The results showed that acupuncture could be more beneficial than no treatment/sham acupuncture in terms of changes in craving for opioid (MD -2.18, 95% CI -3.10 to -1.26), insomnia (MD 2.31, 95% CI 1.97 to 2.65), and depression (SMD -1.50, 95% CI -1.85 to -1.15). In addition, these findings showed that, compared to sham electroacupuncture (EA), EA had differences in alleviating symptoms of craving (SMD -0.50, 95% CI -0.94 to -0.05) and depression (SMD -1.07, 95% CI -1.88 to -0.25) and compared to sham transcutaneous acupoint electrical stimulation (TEAS), TEAS had differences in alleviating symptoms of insomnia (MD 2.31, 95% CI 1.97 to 2.65) and anxiety (MD -1.26, 95% CI -1.60 to -0.92) compared to no treatment/sham TEAS. CONCLUSIONS Acupuncture could be effective in treating OUD. Moreover, EA could effectively alleviate symptoms of craving for opioid and depression, and TEAS could be beneficial in improving symptoms of insomnia and anxiety. Nevertheless, the conclusions were limited due to the low-quality and small number of included studies. PROSPERO registration number is CRD42018085063.
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Affiliation(s)
- Zhihan Chen
- School of Acupuncture Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yitong Wang
- School of Basic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Rui Wang
- School of Acupuncture Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Jin Xie
- School of Acupuncture Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yulan Ren
- School of Chinese Classics, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
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Electroacupuncture in treating depression: A randomized controlled study. JOURNAL OF ACUPUNCTURE AND TUINA SCIENCE 2013. [DOI: 10.1007/s11726-013-0653-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Song XG, Li XL, Wei KC, Xu DB, Li H, Shi FZ, Zhao Y, Teng YS. Influence of acupuncture on sleep disorders and anxiety in patients with heroin dependence. JOURNAL OF ACUPUNCTURE AND TUINA SCIENCE 2012. [DOI: 10.1007/s11726-012-0592-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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