Recent Approaches and Development of Acupuncture on Chronic Daily Headache

The acupuncture-related therapy for stable chronic obstructive pulmonary disease: A protocol for systematic review and network meta-analysis

BACKGROUND

Chronic obstructive pulmonary disease (COPD) has become a huge economic burden. Increasing randomized clinical trials have favored the efficacy of a specified kind of acupuncture-related therapies (ATs) for treating stable COPD. Nonetheless, comparative efficacy of different ATs for stable COPD remains unknown. Thus, the purpose of this network meta-analysis protocol aims to determine the optimal modality of ATs for treating stable COPD.

METHODS

Six Chinese and English mainstream databases, including PubMed, Cochrane Library, Embase, China Biomedical Literature Database, Chinese National Knowledge Infrastructure, and Wanfang Database, will be systematically retrieved. The time range of the literature search is from the establishment date of each database to July, 2021. The primary outcome measures will be pulmonary function and incidence of acute exacerbations. The secondary outcome measures will consist of 6-minute walking distance, St George's Respiratory Questionnaire, and COPD assessment test. The methodological quality of included studies will be evaluated by Cochrane risk-of-bias tool and the quality of evidence will evaluated through Grading of Recommendations Assessment, Development, and Evaluation instrument. Network meta-analysis will be completed using STATA software.

RESULTS

A synthesis of current evidence of ATs for stable COPD will be provided in this study.

CONCLUSION

This study will contribute to synthesizing the evidence regarding the comparative efficacy of different modalities of ATs for stable COPD. Therefore, it will yield decision-making reference to further assist clinicians in determining the optimal modality of ATs in the treatment of stable COPD.

STUDY REGISTRATION

This protocol was registered in the international prospective register of systematic reviews (PROSPERO) with the registration number CRD42020166649.

Acupuncture methods for acute migraine attack: a Bayesian network meta-analysis protocol

INTRODUCTION

Migraine is a primary cause of disability worldwide, particularly affecting young adults and middle-aged women. Although multiple clinical trials and systematic reviews have suggested that acupuncture could be effective in treating acute migraine attacks, the methodologies in academic studies and commonly applied practices vary greatly. This study protocol outlines a plan to assess and rank the effectiveness of the different acupuncture methods in order to develop a prioritised acupuncture-based treatment regimen for acute migraine attacks.

OBJECTIVE

To compare the efficacy of different acupuncture methods and conventional medicinal methods in the treatment of acute migraine attacks.

METHODS AND ANALYSIS

Six databases will be searched, including MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Chinese Science and Technology Periodical Database and Wanfang Database from inception to 31 August 2019. The primary outcomes will be assessed using metrics for intensity and duration (in hours) of pain post-treatment. Bayesian network meta-analysis will be conducted using WinBUGS V.1.4.3. Finally, we will use the Grading of Recommendations Assessment, Development and Evaluation System to assess the quality of evidence.

ETHICS AND DISSEMINATION

The results will be disseminated through peer-reviewed publication. Since no private and confidential patient data will be contained in the reporting, there are no ethical considerations associated with this protocol.

PROSPERO REGISTRATION NUMBER

CRD42019126472.

Acupuncture for chronic pain: an update and critical overview

PURPOSE OF REVIEW

Acupuncture is now recommended for several chronic pain conditions. Despite supportive evidence of its effectiveness, this ancient approach is often misunderstood, and may still be underused in mainstream practice. A critical review on its effectiveness and practice integration, and mechanisms of action is essential to the medical community that is continuing to seek nonopioid therapies for chronic pain.

RECENT FINDINGS

Mounting evidence supports the effectiveness of acupuncture to treat chronic low back, neck, shoulder, and knee pain, as well as headaches. Additional data are emerging that support the use of acupuncture as an adjunct or alternative to opioids, and in perioperative settings. Findings related to its mechanisms of action include transient receptor potential cation channel vanilloid 1 activation in the periphery, microglial suppression in the cerebral cortex and spinal cord, and regulation of cytokines and other key inflammatory factors in the spinal cord. Incremental integration of acupuncture into pain medicine practices and training programmes continues to grow.

SUMMARY

Acupuncture is effective, safe, and cost-effective for treating several chronic pain conditions when performed by well-trained healthcare professionals. Further studies on its use as an adjunct or alternative to opioids, and in perioperative settings are needed.