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Wang X, Luo P, Zhang L, Sun J, Cao J, Lei Z, Yang H, Lv X, Liu J, Yao X, Li S, Fang J. Altered functional brain activity in first-episode major depressive disorder treated with electro-acupuncture: A resting-state functional magnetic resonance imaging study. Heliyon 2024; 10:e29613. [PMID: 38681626 PMCID: PMC11053281 DOI: 10.1016/j.heliyon.2024.e29613] [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: 12/19/2023] [Revised: 03/27/2024] [Accepted: 04/10/2024] [Indexed: 05/01/2024] Open
Abstract
Background Previous studies have found electroacupuncture could improve the clinical symptoms of first-episode major depressive disorder (MDD), but the exact neural mechanism of action needs to be further elucidated. Methods Twenty-eight first-episode MDD patients were randomly divided into 14 electro-acupuncture stimulation (EAS) groups and 14 sham-acupuncture stimulation (SAS) groups, and clinical symptoms were assessed and functional magnetic resonance imaging (fMRI) scans were done in both groups. Amplitude of low-frequency fluctuations (ALFF) was used to observe the changes between the pre-treatment and post-treatment in the two groups, and the altered brain areas were selected as region of interest (ROI) to observe the FC changes. Meanwhile, the correlation between the altered clinical symptoms and the altered ALFF and FC of brain regions in the two groups was analyzed. Results The EAS significantly decreased the HAMD-24 and HAMA-14 scores of MDD than SAS group. The imaging results revealed that both groups were able to increase the ALFF of the left middle temporal gyrus and the left cerebellar posterior lobe. When using the left middle temporal gyrus and the left posterior cerebellar lobe as ROIs, EAS group increased the FC between the left middle temporal gyrus with the left superior frontal gyrus, the left middle frontal gyrus, and the left hippocampus, and decreased the FC between the left posterior cerebellar lobe and the left calcarine gyrus, while SAS group only increased the FC between the left middle temporal gyrus with the left superior frontal gyrus. The alternations in clinical symptoms after EAS treatment were positively correlated with the altered ALFF values in the left middle temporal gyrus and the altered FC values in the left middle temporal gyrus and the left middle frontal gyrus. Conclusion EA demonstrates modulation of functional activity in the default mode network (DMN), sensorimotor network (SMN), cognitive control network (CCN), limbic system, and visual network (VN) for the treatment of the first-episode MDD. Our findings contribute to the neuroimaging evidence for the efficacy of EAS.
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Affiliation(s)
- XiaoLing Wang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ping Luo
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ling Zhang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - JiFei Sun
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - JiuDong Cao
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zhang Lei
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Hong Yang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - XueYu Lv
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jun Liu
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - XiaoYan Yao
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - ShanShan Li
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - JiLiang Fang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Tan Y, Duan R, Wen C. Efficacy of acupuncture for depression: a systematic review and meta-analysis. Front Neurosci 2024; 18:1347651. [PMID: 38745939 PMCID: PMC11091333 DOI: 10.3389/fnins.2024.1347651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 04/12/2024] [Indexed: 05/16/2024] Open
Abstract
Introduction Depression is a pervasive mental health challenge with substantial global ramifications. Contemporary therapeutic strategies predominantly consist of psychological interventions and pharmacological treatments. Acupuncture, deeply rooted in ancient traditions and bolstered by a plethora of clinical trials, demonstrates considerable efficacy in depression. This study aims to elucidate the efficacy and safety of acupuncture as a standalone therapy for depression patients by reviewing randomized controlled trials that compare acupuncture treatment with conventional drug therapy. Methods Comprehensive searches were conducted across six databases in both Chinese and English: CNKI, Wanfang, VIP, Embase, Medline, and CENTRAL. The literature search spanned from 1 July 2013, to 1 July 2023. Two researchers independently carried out literature screening and data extraction. Review Manager 5.4 was utilized for data analysis and bias risk assessment. A total of 20 randomized controlled trials were included in the qualitative synthesis, involving 1,376 participants and 43 relevant acupoints. Results The Meta-analysis results, based on the HAMD scale scores, revealed that acupuncture regimens (RR: -1.63; 95% CI: -2.49 to -0.76; P = 0.0002; I2 = 86%; n = 1,668) were significantly more effective compared to standalone medication. Moreover, efficacy metrics from the HAMD highlighted a substantial advantage of acupuncture (RR: 2.6; 95% CI: 1.6 to 4.23; P = 0.0001; I2 = 0; n = 614). Further assessments utilizing SERS and TESS demonstrated a lower incidence of side effects and adverse outcomes in the acupuncture group. Conclusions Acupuncture, when compared to conventional pharmacotherapy, exhibits significant efficacy as a standalone treatment after four weeks of intervention, with fewer side effects and adverse reactions. However, further investigation is needed to determine the most effective acupoints and appropriate types of acupuncture techniques for treating depression. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier CRD42023443711.
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Affiliation(s)
| | | | - Chuanbiao Wen
- School of Intelligent Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Ha J, Youn I, Han Y, Kim J, Kim S, Jin H, Kang JW, Leem J. Firefighters' medical use and Korean Medicine experience in Korea: A qualitative study protocol. PLoS One 2024; 19:e0300532. [PMID: 38527034 PMCID: PMC10962829 DOI: 10.1371/journal.pone.0300532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 02/22/2024] [Indexed: 03/27/2024] Open
Abstract
INTRODUCTION Firefighters, compared to other occupational groups, are exposed more frequently in their working environment not only to physical issues, such as musculoskeletal disease, respiratory disease, and burns but also to mental health issues, such as PTSD and depression. Specifically, Korean firefighters experience significantly higher rates of work-related injuries compared to those in other countries. Recent statistics from the Korea National Fire Agency indicate a steady increase in the number of firefighting work-related injuries. However, there is a shortage of measures in place to address these issues. This study aims to investigate the health needs, overall healthcare usage, and unmet needs of firefighters in Korea. We also aim to investigate, through in-depth interviews, perceptions and hindering factors for integrative medicine approaches to fulfilling unmet needs. METHOD This study was conducted in accordance with the consolidated criteria for reporting qualitative research. Convenience and snowball sampling methods will be used to recruit firefighters to participate in the study, and interviews will be conducted using a semi-structured interview guide. The data will be analyzed in four stages using the qualitative analysis method of Krippendorff. DISCUSSION In this study, we examine the state of health issues and healthcare usage among Korean firefighters and investigate their perceptions of and needs for integrative medicine. In this way, we aim to explore how integrative medicine and Korean medicine approaches could improve and assist healthcare services for firefighters. Furthermore, our findings will provide policymakers and healthcare providers with the necessary basic information to develop integrative medicine systems suited to firefighters.
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Affiliation(s)
- Jisu Ha
- Department of Acupuncture and Moxibustion, National Medical Center, Seoul, Republic of Korea
| | - Inae Youn
- Department of Acupuncture and Moxibustion, National Medical Center, Seoul, Republic of Korea
| | - Yuri Han
- College of AI convergence, Donggkuk University, Seoul, Republic of Korea
| | - Jinwon Kim
- Department of Internal Medicine of Korean Medicine, National Medical Center, Seoul, Republic of Korea
| | - Sunjoong Kim
- Department of Acupuncture and Moxibustion, National Medical Center, Seoul, Republic of Korea
| | - Hanbit Jin
- Department of Diagnostics, College of Korean Medicine, Wonkwang University, Iksan, Jeollabuk-do, Republic of Korea
| | - Jung Won Kang
- Department of Acupuncture and Moxibustion, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Jungtae Leem
- Department of Diagnostics, College of Korean Medicine, Wonkwang University, Iksan, Jeollabuk-do, Republic of Korea
- Research Center of Traditional Korean Medicine, Wonkwang University, Iksan, Jeollabuk-do, Republic of Korea
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Zhang J, Qin Z, So TH, Chang TY, Yang S, Chen H, Yeung WF, Chung KF, Chan PY, Huang Y, Xu S, Chiang CY, Lao L, Zhang ZJ. Acupuncture for chemotherapy-associated insomnia in breast cancer patients: an assessor-participant blinded, randomized, sham-controlled trial. Breast Cancer Res 2023; 25:49. [PMID: 37101228 PMCID: PMC10134666 DOI: 10.1186/s13058-023-01645-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 03/30/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND Insomnia is a highly prevalent symptom occurred during and post-chemotherapy. Acupuncture may have beneficial effects in the management of chemotherapy-associated insomnia. This study was conducted to determine the efficacy and safety of acupuncture in improving chemotherapy-associated insomnia in breast cancer patients. METHODS This assessor-participant blinded, randomized, sham-controlled trial was conducted from November 2019 to January 2022 (follow-up completed July 2022). Participants were referred by oncologists from two Hong Kong hospitals. Assessments and interventions were conducted at the outpatient clinic of School of Chinese Medicine, the University of Hong Kong. The 138 breast cancer patients with chemotherapy-associated insomnia were randomly assigned to receive either 15 sessions of active acupuncture regimen by combining needling into body acupoints and acupressure on auricular acupoints or sham acupuncture control (69 each) for 18 weeks, followed by 24 weeks of follow-up. The primary outcome was measured using Insomnia Severity Index (ISI). Secondary outcomes included the Pittsburgh Sleep Quality Index, Actiwatch and sleep diary for sleep parameters, depression and anxiety, fatigue and pain, and quality of life. RESULTS There were 87.7% (121/138) participants who completed the primary endpoint (week-6). The active acupuncture regimen was not superior to the sham control in reducing ISI score from baseline to 6 weeks (mean difference: - 0.4, 95% CI - 1.8-1.1; P = 0.609), but produced short-term treatment and long-term follow-up better outcomes in improving sleep onset latency, total sleep time, sleep efficiency, anxiety, depression, and quality of life. Participants of the active acupuncture group had a pronouncedly higher cessation rate of sleeping medications than the sham control (56.5% vs. 14.3%, P = 0.011). All treatment-related adverse events were mild. No participants discontinued treatments due to adverse events. CONCLUSION The active acupuncture regimen could be considered as an effective option for the management of chemotherapy-associated insomnia. It also could serve as a tapering approach to reduce and even replace the use of sleeping medications in breast cancer patients. Trial registration Clinicaltrials.gov : NCT04144309. Registered 30 October 2019.
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Affiliation(s)
- Jialing Zhang
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, 10 Sassoon Road, Pokfulam, Hong Kong, China
- School of Chinese Medicine, Hong Kong Baptist University, Kowloon Tong, Hong Kong, China
| | - Zongshi Qin
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, 10 Sassoon Road, Pokfulam, Hong Kong, China
| | - Tsz Him So
- Department of Clinical Oncology, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - Tien Yee Chang
- Comprehensive Oncology Centre, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong, China
| | - Sichang Yang
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, 10 Sassoon Road, Pokfulam, Hong Kong, China
| | - Haiyong Chen
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, 10 Sassoon Road, Pokfulam, Hong Kong, China
| | - Wing Fai Yeung
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
| | - Ka Fai Chung
- Department of Psychiatry, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - Pui Yan Chan
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, 10 Sassoon Road, Pokfulam, Hong Kong, China
| | - Yong Huang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Shifen Xu
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200071, China
| | - Chun Yuan Chiang
- Hong Kong Institute of Cell & Molecular Medicine and Digital Centre of State-Key-Laboratory on Quality Appraisal of TCM, Hong Kong, China
| | - Lixing Lao
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, 10 Sassoon Road, Pokfulam, Hong Kong, China.
- Virginia University of Integrative Medicine, Fairfax, VA, 22031, USA.
| | - Zhang-Jin Zhang
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, 10 Sassoon Road, Pokfulam, Hong Kong, China.
- Department of Chinese Medicine, The University of Hong Kong Shenzhen Hospital (HKU-SZH), Shenzhen, 518053, Guangdong, China.
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Liao HY, Kumaran Satyanarayanan S, Lin YW, Su KP. Clinical Efficacy and Immune Effects of Acupuncture in Patients with Comorbid Chronic Pain and Major Depression Disorder: A Double-Blinded, Randomized Controlled Crossover Study. Brain Behav Immun 2023; 110:339-347. [PMID: 36948325 DOI: 10.1016/j.bbi.2023.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 03/14/2023] [Accepted: 03/16/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND Depression and pain are highly comorbid and share biological mechanisms. Acupuncture is commonly used to manage both pain and depression, but the choice of acupoints for specific disorders differs. This study aimed to investigate whether specific acupuncture intervention on pain- and depression-acupoints would have specific efficacy and immune effects in patients with comorbid chronic pain and major depressive disorder (MDD). METHODS We performed a subject- and assessor-blinded, crossover, and randomized controlled clinical trial of depression- and pain-specific acupuncture intervention and measured clinical responses and proinflammatory cytokines in patients with comorbid chronic pain and MDD. Specific acupoints for pain and depression were used in random order with a washout interval. Forty-seven patients were enrolled and randomly assigned to two groups: (1) the depression-pain group (23 patients who were treated with depression-specific acupoints and then the pain-specific acupoints after the washout) and (2) pain-depression group (24 patients with the reverse order). RESULTS The pain-specific acupoints for pain did not reduce Brief Pain Inventory scores to a significantly greater degree (-0.97 ± 1.69) than the depression-specific acupoints (-0.28 ± 1.88); likewise, the depression-specific acupoints did not significantly ameliorate Hamilton Depression Rating Scale (-4.59 ± 6.02) than the pain-specific acupoints (-6.69 ± 6.61). The pain-specific acupoints improved Beck Depression Inventory-Second Edition (-6.74 ± 9.76) even better than the depression-specific acupoints (-1.92 ± 10.74). The depression-specific acupoints did not significantly decrease the depression-related interleukin (IL)-6 level (-1.24 ± 6.67) than the pain-specific acupoints (-0.60 ± 4.36). The changed levels of IL-1β, tumor necrosis factor (TNF)-α between the depression-specific acupoints (-37.41 ± 194.49; -12.53 ± 54.68) and the pain-specific acupoints (-15.46 ± 87.56; -7.28 ± 27.86) could not reach significantly different, too. CONCLUSION This study rejected our hypothesis that the pain-specific acupoints might produce superior analgesic effects than the depression-specific acupoints and vice versa. The cytokine results might imply that pain and depression share common biological mechanisms. (trial registration: https://www. CLINICALTRIALS gov: NCT03328819).
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Affiliation(s)
- Hsien-Yin Liao
- School of Post-Baccalaureate Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan; Department of Acupuncture, China Medical University Hospital, Taichung 40402, Taiwan
| | | | - Yi-Wen Lin
- Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan; Chinese Medicine Research Center, China Medical University, Taichung 40402, Taiwan.
| | - Kuan-Pin Su
- Mind-Body Interface Research Center (MBI-Lab), China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan; Depression Center, An-Nan Hospital, China Medical University, Tainan, Taiwan.
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Zhang ZJ, Zhang SY, Yang XJ, Qin ZS, Xu FQ, Jin GX, Hou XB, Liu Y, Cai JF, Xiao HB, Wong YK, Zheng Y, Shi L, Zhang JN, Zhao YY, Xiao X, Zhang LL, Jiao Y, Wang Y, He JK, Chen GB, Rong PJ. Transcutaneous electrical cranial-auricular acupoint stimulation versus escitalopram for mild-to-moderate depression: An assessor-blinded, randomized, non-inferiority trial. Psychiatry Clin Neurosci 2023; 77:168-177. [PMID: 36445151 DOI: 10.1111/pcn.13512] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 11/15/2022] [Accepted: 11/21/2022] [Indexed: 12/03/2022]
Abstract
AIM Transcutaneous electrical cranial-auricular acupoint stimulation (TECAS) is a novel non-invasive therapy that stimulates acupoints innervated by the trigeminal and auricular vagus nerves. An assessor-blinded, randomized, non-inferiority trial was designed to compare the efficacy of TECAS and escitalopram in mild-to-moderate major depressive disorder. METHODS 468 participants received two TECAS sessions per day at home (n = 233) or approximately 10-13 mg/day escitalopram (n = 235) for 8 weeks plus 4-week follow-up. The primary outcome was clinical response, defined as a baseline-to-endpoint ≥50% reduction in Montgomery-Åsberg Depression Rating Scale (MADRS) score. Secondary outcomes included remission rate, changes in the severity of depression, anxiety, sleep and life quality. RESULTS The response rate was 66.4% on TECAS and 63.2% on escitalopram with a 3.2% difference (95% confidence interval [CI], -5.9% to 12.9%) in intention-to-treat analysis, and 68.5% versus 66.2% with a 2.3% difference (95% CI, -6.9% to 11.4%) in per-protocol analysis. The lower limit of 95% CI of the differences fell within the prespecified non-inferiority margin of -10% (P ≤ 0.004 for non-inferiority). Most secondary outcomes did not differ between the two groups. TECAS-treated participants who experienced psychological trauma displayed a markedly greater response than those without traumatic experience (81.3% vs 62.1%, P = 0.013). TECAS caused much fewer adverse events than escitalopram. CONCLUSIONS TECAS was comparable to escitalopram in improving depression and related symptoms, with high acceptability, better safety profile, and particular efficacy in reducing trauma-associated depression. It could serve an effective portable therapy for mild-to-moderate depression.
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Affiliation(s)
- Zhang-Jin Zhang
- Department of Chinese Medicine, the University of Hong Kong-Shenzhen Hospital (HKU-SZH), Shenzhen, China.,School of Chinese Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong, China
| | - Shui-Yan Zhang
- Department of Chinese Medicine, the University of Hong Kong-Shenzhen Hospital (HKU-SZH), Shenzhen, China
| | - Xin-Jing Yang
- Department of Chinese Medicine, the University of Hong Kong-Shenzhen Hospital (HKU-SZH), Shenzhen, China.,School of Chinese Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong, China
| | - Zong-Shi Qin
- Department of Chinese Medicine, the University of Hong Kong-Shenzhen Hospital (HKU-SZH), Shenzhen, China.,School of Chinese Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong, China
| | - Feng-Quan Xu
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences (CACMS), Beijing, China
| | - Gui-Xing Jin
- The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xiao-Bing Hou
- Beijing First Hospital of Integrated Chinese and Western Medicine, Beijing, China
| | - Yong Liu
- The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Ji-Fu Cai
- Department of Neurology, the University of Hong Kong-Shenzhen Hospital (HKU-SZH), Shenzhen, China
| | - Hai-Bing Xiao
- Department of Neurology, the University of Hong Kong-Shenzhen Hospital (HKU-SZH), Shenzhen, China
| | - Yat Kwan Wong
- Department of Chinese Medicine, the University of Hong Kong-Shenzhen Hospital (HKU-SZH), Shenzhen, China.,School of Chinese Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong, China
| | - Yu Zheng
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences (CACMS), Beijing, China
| | - Lei Shi
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences (CACMS), Beijing, China
| | - Jin-Niu Zhang
- The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yuan-Yuan Zhao
- The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xue Xiao
- Beijing First Hospital of Integrated Chinese and Western Medicine, Beijing, China
| | - Liu-Lu Zhang
- The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Yue Jiao
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences (CACMS), Beijing, China.,Department of TCM, Tsinghua University Hospital Beijing, Beijing, China
| | - Yu Wang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences (CACMS), Beijing, China
| | - Jia-Kai He
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences (CACMS), Beijing, China
| | - Guo-Bing Chen
- Department of Microbiology and Immunology, School of Medicine; Institute of Geriatric Immunology, School of Medicine, Jinan University, Guangzhou, China
| | - Pei-Jing Rong
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences (CACMS), Beijing, China
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Jiang H, Zhang Y, Zhang J, Li B, Zhu W, Liu C, Deng S, Du Y, Meng Z. Acupuncture for the treatment of thalamencephalic and mesencephalic injury secondary to electrical trauma: A case report. Front Neurosci 2023; 17:1139537. [PMID: 36950129 PMCID: PMC10025331 DOI: 10.3389/fnins.2023.1139537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 02/16/2023] [Indexed: 03/08/2023] Open
Abstract
In a case of thalamencephalic and mesencephalic injury secondary to electrical trauma, a 29-year-old patient has been receiving manual acupuncture for 17 months in National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion. As a result of treatment, the patient's self-care ability and quality of life have greatly improved. In order to fully understand how acupuncture can benefit neurological sequelae resulting from electrical trauma, further research is needed. Additionally, there should be consideration given to the promotion of acupuncture therapy in the neurological sequelae of electric shock.
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Affiliation(s)
- Hailun Jiang
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yi Zhang
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Jieying Zhang
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Boxuan Li
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Weiming Zhu
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Chaoda Liu
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Shizhe Deng
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yuzheng Du
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- *Correspondence: Yuzheng Du
| | - Zhihong Meng
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Zhihong Meng
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Wang X, Shi X, Lv J, Zhang J, Huo Y, Zuo G, Lu G, Liu C, She Y. Acupuncture and related therapies for the anxiety and depression in irritable bowel syndrome with diarrhea (IBS-D): A network meta-analysis of randomized controlled trials. Front Psychiatry 2022; 13:1067329. [PMID: 36620677 PMCID: PMC9816906 DOI: 10.3389/fpsyt.2022.1067329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 12/07/2022] [Indexed: 12/25/2022] Open
Abstract
Objective A growing number of clinical studies have suggested the value of acupuncture-related therapies for patients with irritable bowel syndrome with diarrhea (IBS-D), and the patient's mental state plays an important role, but there are many types of acupuncture-related therapies involved. This study aimed to evaluate the mental status, efficacy and safety of the different acupuncture-related therapies for IBS-D patients. Methods We searched seven databases to collect randomized controlled trials of acupuncture-related therapies for IBS-D. After independent literature screening and data extraction, the quality of the final included literature was evaluated. Hamilton anxiety rating scale (HAMA), hamilton depression rating scale (HAMD), self-rating anxiety scale (SAS), and self-rating depression scale (SDS) was used as the primary outcome indicator. And the network meta-analysis (NMA) was performed by using Revman 5.4, Stata 15.0 and WinBUGS 1.4.3 software, and the surface under the cumulative ranking curve was conducted to rank the included interventions. Results We analyzed 24 eligible studies with 1,885 patients, involving eight types of acupuncture and related therapies along with comprehensive therapies. The NMA result shows that: for SAS scores, combined therapies were more efficacious than anti-diarrheal or antispasmodic (western medicine, WM) (SMD: -8.92; 95% CI: -15.30, -2.47); for SDS scores, combined therapies were more efficacious than WM (SMD: -8.45; 95% CI: -15.50, -1.41). For HAMA scores, moxibustion (MOX) was more efficacious than placebo (SMD: -8.66; 95% CI: -16.64, -0.38). For HAMD scores, MOX was more efficacious than all other included interventions. For response rate, MOX was more efficacious than the following interventions: acupuncture (ACU) (SMD:0.29; 95% CI:0.08,0.93), Chinese herb medicine (CH) (SMD:0.09; 95% CI:0.02,0.36), combined therapies (SMD:0.23; 95% CI:0.06, 0.85), electroacupuncture (EA) (SMD:0.06; 95% CI:0.01,0.33), warm acupuncture (WA) (SMD:22.16; 95% CI:3.53,148.10), WM (SMD:15.59; 95% CI:4.68,61.21), and placebo (SMD:9.80; 95% CI:2.90,45.51). Combined therapies were more efficacious than the following interventions: CH (SMD:0.39; 95% CI:0.19,0.80), WA (SMD:4.96; 95% CI:1.30,21.62), and WM (SMD:3.62; 95% CI:2.35,5.66). The comprehensive ranking results show that MOX, ACU, combined therapies, and EA had high SUCRA rankings involving different outcome indicators. Conclusion MOX, ACU, combined therapies, and EA better alleviate anxiety and depression among IBS-D patients, and with a higher safety level, may be the optimal therapies. In addition, combining acupuncture-related treatments and other therapies also delivers a higher global benefit level. Systematic review registration [https://www.crd.york.ac.uk/], identifier [CRD42022364560].
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Affiliation(s)
- Xuesong Wang
- School of Acupuncture-Moxibustion and Tuina, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
| | - Xuliang Shi
- School of Acupuncture-Moxibustion and Tuina, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
- Hebei International Joint Research Center for Dominant Diseases in Chinese Medicine and Acupuncture, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
| | - Jing Lv
- School of Acupuncture-Moxibustion and Tuina, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
- Hebei International Joint Research Center for Dominant Diseases in Chinese Medicine and Acupuncture, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
| | - Juncha Zhang
- School of Acupuncture-Moxibustion and Tuina, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
- Hebei International Joint Research Center for Dominant Diseases in Chinese Medicine and Acupuncture, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
| | - Yongli Huo
- Department of Spleen and Stomach, Hebei Province Hospital of Chinese Medicine, Shijiazhuang, Hebei, China
| | - Guang Zuo
- School of Acupuncture-Moxibustion and Tuina, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
| | - Guangtong Lu
- School of Acupuncture-Moxibustion and Tuina, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
| | - Cunzhi Liu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Yanfen She
- School of Acupuncture-Moxibustion and Tuina, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
- Hebei International Joint Research Center for Dominant Diseases in Chinese Medicine and Acupuncture, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
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Zhang J, Song Z, Gui C, Jiang G, Cheng W, You W, Wang Z, Chen G. Treatments to post-stroke depression, which is more effective to HAMD improvement? A network meta-analysis. Front Pharmacol 2022; 13:1035895. [PMID: 36601053 PMCID: PMC9806231 DOI: 10.3389/fphar.2022.1035895] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 12/02/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction: Post-stroke depression (PSD) is a common mental health problem after cerebrovascular accidents. There are several treatments that have been shown to be effective in treating post-stroke depression. However, it is not clear which treatment is more effective. Methods: In this meta-analysis, an appropriate search strategy was used to search eligible randomized controlled trials (RCTs) on different treatments to treat patients with Post-stroke depression published up to December 2021 from the CNKI, PubMed, and Cochrane Library. We assessed the mean difference or odds ratio between each treatment and placebo and summarized them as the average and 95% confidence interval (CI) by conducting Bayesian network meta-analyses. Results: By constructing a Bayesian network meta-analysis, we found that acupuncture combined with fluoxetine (vs placebo MD, -8.9; 95% CI, [-15, -2.9]) or paroxetine (vs placebo MD,-8.5; 95% CI, [-15, -2.5]) was the most effective for change in Hamilton depression scale (HAMD) at the end of the 4th week. For change in Hamilton depression scale at the end of the 8th week, rTMS combined with paroxetine (vs placebo MD, -13; 95% CI, [-17, -7.9]) had the greatest amount of change. The efficacy of medication combined with adjuvant therapy was also superior for the percentage of patients with Hamilton depression scale change over 50%. Discussion: The combination of antidepressants with adjuvant therapy may enhance the efficacy of antidepressants and achieve better results than antidepressant monotherapy in both Hamilton depression scale changes at the end of week 4 or 8 and 50% Hamilton depression scale improvement rate. Acupuncture combined with fluoxetine treatment was more effective in the treatment of post-stroke depression at week 4, while rTMS combined with paroxetine was more effective at week 8. Further research is needed to determine whether acupuncture combined with fluoxetine is better than rTMS combined with paroxetine for post-stroke depression at week 8.
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Affiliation(s)
| | | | | | | | | | | | - Zhong Wang
- *Correspondence: Zhong Wang, ; Wanchun You,
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10
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Nowakowski-Sims E, Ferrante S. Perspectives of Integrative Body-Mind-Spirit Interventions Among Women with Substance Use Disorder: A Qualitative Study. ALCOHOLISM TREATMENT QUARTERLY 2022. [DOI: 10.1080/07347324.2022.2145924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
| | - Stephen Ferrante
- School of Social Work, Barry University, Miami Shores, Florida, USA
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11
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Birch S, Robinson N. Acupuncture as a post-stroke treatment option: A narrative review of clinical guideline recommendations. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2022; 104:154297. [PMID: 35816994 DOI: 10.1016/j.phymed.2022.154297] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 06/05/2022] [Accepted: 06/25/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Acupuncture may be useful to treat the various clusters of symptoms occurring after a stroke. The use of evidence to underpin clinical practice and treatment guidelines (CPGs and TGs respectively) varies from country to country and may affect what recommendations are made by guideline developers. PURPOSE To examine the extent to which international clinical and treatment guidelines on post-stroke treatment mention the role of acupuncture and to identify what symptoms they recommend for its use. METHOD Scoping of national and international websites of CPGs and TGs r on the after care and rehabilitation of stroke patients provided by professional and government organisations was conducted. The presence/absence of recommendations and the underpinning evidence was appraised for the use of acupuncture for symptoms following stroke. RESULTS Of 84 CPGs and TGs on post stroke after-care identified from 27 countries between 2001 and 2021, 49 made statements about acupuncture. Positive recommendations on the use of acupuncture were identified for 15 symptom areas from 11 countries for: stroke rehabilitation, dysphagia, shoulder pain, motor recovery, walking, balance, spasticity, upper limb extremity impairment, post-stroke pain, central post stroke pain, cognitive disorder, depression, and sleep problems. Thirty-five CPGs (2001-2018) from 18 countries published over the same period were identified that made no mention of acupuncture and therefore no recommendations were made on its use. CONCLUSIONS Currently, evidence used by international guideline developers varies and this influences whether a positive or negative recommendation is made. Recommendations to use acupuncture should be based on the best available evidence which has been quality appraised.
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Affiliation(s)
- Stephen Birch
- School of Health Sciences, Kristiania University College, Oslo, Norway
| | - Nicola Robinson
- Institute of Health and Social Care, London South Bank University, 103 Borough Road, London SE1 0AA, UK; Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China.
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12
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Ahn JH, Song MY, Park HJ. Discovering Influential Core-Keywords, Researcher Networks and Research Trends of Acupuncture on Depression Using Bibliometric Analysis. J Acupunct Meridian Stud 2022; 15:227-237. [PMID: 36521771 DOI: 10.51507/j.jams.2022.15.4.227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 11/29/2021] [Accepted: 03/23/2022] [Indexed: 01/26/2023] Open
Abstract
Depression is a common illness worldwide. Acupuncture is used as an alternative to non-pharmacological therapy. This study aimed to identify the development and global trends in the study of acupuncture therapy for depression over the past two decades using a bibliometric analysis. Articles published between 2001 and 2020 on acupuncture for depression were retrieved from the Web of Science database. Extracted information included authors, organizations, countries, keywords, and journals. The VOSviewer program was used to visualize the impacts and network hubs of the keywords, authors, and affiliations. Analyses of 871 original and review articles revealed that the number of publications has continually increased over the past 20 years. China has published the maximum number of articles, followed by the United States and South Korea. As for research areas, integrative complementary medicine was most well represented in terms of the number of articles. Co-occurrence analysis of keywords indicated that each five sub-group cluster (including "pain related to depressive symptoms," "CAM therapies of depression," "comorbid disease or symptoms of depression," "clinical trials of depression," and "mechanism of acupuncture on depression") has its own impact keyword. The most recent keywords were "protocol" and "systematic review," whereas early keywords were "acupuncture analgesia" and "St john's wort." Co-authorship analysis of authors and organizations revealed 4 influential authors and 2 organizations in the field of acupuncture for depression. The present study provided influential keywords that show comorbid symptoms, treatments, and mechanism. Additionally, it revealed the influential persons or groups related to acupuncture therapy for depression.
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Affiliation(s)
- Jae-Ha Ahn
- Department of Meridian Medical Science, School of Medicine, Kyung Hee University, Seoul, Korea.,Acupuncture and Meridian Science Research Center (AMSRC), College of Korean Medicine, Kyung Hee University, Seoul, Korea
| | - Mi-Yeon Song
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Korea
| | - Hi-Joon Park
- Department of Meridian Medical Science, School of Medicine, Kyung Hee University, Seoul, Korea.,Acupuncture and Meridian Science Research Center (AMSRC), College of Korean Medicine, Kyung Hee University, Seoul, Korea
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13
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Yang S, Qin Z, Yang X, Chan MY, Zhang S, Rong P, Hou X, Jin G, Xu F, Liu Y, Zhang ZJ. Transcutaneous Electrical Cranial-Auricular Acupoint Stimulation vs. Escitalopram for Patients With Mild-to-Moderate Depression (TECAS): Study Design for a Randomized Controlled, Non-inferiority Trial. Front Psychiatry 2022; 13:829932. [PMID: 35619617 PMCID: PMC9127209 DOI: 10.3389/fpsyt.2022.829932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 04/04/2022] [Indexed: 11/13/2022] Open
Abstract
Background Previous studies in animals and humans indicated that transcutaneous vagus nerve stimulation (tVNS) and transcutaneous electrical acupoint stimulation (TEAS) on trigeminal nerve-innervated forehead acupoints can relief the symptoms of depression. However, due to the limited investigations on these two interventions, more research are needed to confirm their efficacy in depression. To improve the efficacy of the single treatment, we combined two treatments and created a novel non-invasive stimulation, transcutaneous electrical cranial-auricular acupoint stimulation (TECAS). To assess the efficacy and safety of TECAS, we compare it with a selective serotonin reuptake inhibitor (SSRI), escitalopram, for the treatment of depression. Methods/Design This is a multi-center, non-inferiority, randomized controlled trial that will involve 470 patients with mild to moderate depression. Patients will be randomly assigned to either the TECAS group or the escitalopram group in a 1:1 ratio. The TEAS group will receive two sessions of treatments per day for 8 consecutive weeks, and the escitalopram group will receive 8 weeks of oral escitalopram tablets prescribed by clinical psychiatrists as appropriate for their condition. The primary outcome is the clinical response as determined by Montgomery-Åsberg Depression Rating Scale (MADRS) scores at week 8, with -10% as the non-inferior margin. The secondary outcomes include the response rate determined by 17-item Hamilton Depression Rating Scale (HAMD-17), remission rate, changes from baseline in the scores on the MADRS, the HAMD-17, the Hamilton Anxiety Rating Scale (HAMA), the Pittsburgh Sleep Quality Index (PSQI), and the Short Form 36 Health Survey (SF-36). Discussion This will be the first randomized controlled trial to compare the efficacy of TECAS with escitalopram for depression. If effective, this novel intervention could have significant clinical and research implications for patients with depression. Clinical Trial Registration [ClinicalTrials.gov], identifier [NCT03909217].
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Affiliation(s)
- Sichang Yang
- Department of Chinese Medicine, The University of Hong Kong Shenzhen Hospital (HKU-SZH), Shenzhen, China
- LKS Faculty of Medicine, School of Chinese Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Zongshi Qin
- Department of Chinese Medicine, The University of Hong Kong Shenzhen Hospital (HKU-SZH), Shenzhen, China
- LKS Faculty of Medicine, School of Chinese Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Xinjing Yang
- Department of Chinese Medicine, The University of Hong Kong Shenzhen Hospital (HKU-SZH), Shenzhen, China
- LKS Faculty of Medicine, School of Chinese Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Mei Yan Chan
- Department of Chinese Medicine, The University of Hong Kong Shenzhen Hospital (HKU-SZH), Shenzhen, China
- LKS Faculty of Medicine, School of Chinese Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Shuiyan Zhang
- Department of Chinese Medicine, The University of Hong Kong Shenzhen Hospital (HKU-SZH), Shenzhen, China
| | - Peijing Rong
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences (CACMS), Beijing, China
| | - Xiaobing Hou
- Beijing First Hospital of Integrated Chinese and Western Medicine, Beijing, China
| | - Guixing Jin
- Department of Mood Disorders, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Fengquan Xu
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yong Liu
- Department of Radiology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
| | - Zhang-Jin Zhang
- Department of Chinese Medicine, The University of Hong Kong Shenzhen Hospital (HKU-SZH), Shenzhen, China
- LKS Faculty of Medicine, School of Chinese Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
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14
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Lu R, Shi R, Zhang M, Shao X, Xue W, Guo Q, Wang C, Deng Y. Safety and efficacy of auricular acupuncture in patients with depression after percutaneous coronary intervention: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e29173. [PMID: 35475802 PMCID: PMC9276093 DOI: 10.1097/md.0000000000029173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND With the advantages of miniature damage and optimal effectiveness, percutaneous coronary intervention (PCI) has been performed in a large number of coronary artery disease patients. However, recent studies have indicated a higher incidence of depression on post-PCI patients. Acupuncture therapy is effective for depression. As a form of acupuncture, the auricular acupuncture has been used to relieve symptoms in patients with post-PCI depression, but its effectiveness and safety have not yet reached a definitive conclusion. Therefore, this systematic review and meta-analysis protocol is planned to evaluate the efficacy and safety of auricular acupuncture for depression in post-PCI patients. METHODS Six English databases (PubMed, Web of Science, MEDLINE, EMBASE, Springer Cochrane Library, and WHO International Clinical Trials Registry Platform) and 4 Chinese databases (Wan Fang Database, Chinese Scientific Journal Database, China National Knowledge Infrastructure Database, and Chinese Biomedical Literature Database) will be searched normatively according to the rule of each database from the inception to February 1, 2022. Two reviewers will independently conduct article selection, data collection, and risk of bias evaluation. Any disagreement will be resolved by discussion with the third reviewer. Either the fixed-effects or random-effects model will be used for data synthesis based on the heterogeneity test. The change in the scores on the Hamilton Depression Scale and the Self-rating Depression Scale will be used as the main outcome measure. All-cause mortality, cardiac mortality, major adverse cardiovascular events, rehospitalisation rate, and Quality of Life Scale as the secondary outcome. Treatment Emergent Symptom Scale, general physical examination (temperature, pulse, respiration, blood pressure), routine examination of blood, urine and stool, electrocardiogram, liver and kidney function examination as the security indexes. RevMan 5.3.5 will be used for meta-analysis. RESULTS This study will provide high-quality evidence to assess the efficacy and safety of auricular acupuncture for depression in post-PCI patients. CONCLUSION This systematic review will explore whether auricular acupuncture is an effective and safe intervention for depression in post-PCI patients. INPLASY REGISTRATION NUMBER INPLASY202230003.
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Affiliation(s)
- Ruozhu Lu
- School of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Rui Shi
- Branch of National Clinical Research Center for Chinese Medicine Cardiology, Hospital of Affiliated Changchun University of Chinese Medicine, Changchun, China
| | - Miao Zhang
- School of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Xiao Shao
- School of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Wen Xue
- School of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Qian Guo
- School of Basic Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Cheng Wang
- School of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Yue Deng
- Branch of National Clinical Research Center for Chinese Medicine Cardiology, Hospital of Affiliated Changchun University of Chinese Medicine, Changchun, China
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15
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An observational study of acupuncture and complementary treatments for major depression: Case series from a preliminary study of proposed collaborative care model. J Tradit Complement Med 2022; 12:499-504. [PMID: 36081817 PMCID: PMC9446101 DOI: 10.1016/j.jtcme.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 02/02/2022] [Accepted: 03/06/2022] [Indexed: 11/29/2022] Open
Abstract
Background Major depressive disorder is identified as a mood disorder characterized by episodically recurring and potentially life-threatening negative symptoms. It is currently important for study, as it involves high morbidity, mortality and prevalence, as well as unsatisfactory treatment results. Aim Establish an outpatient model from an integrative approach promoting the diversified development of traditional Chinese and Western medicine cooperation, leading to a holistic intervention for patients with depression. Experimental procedure Fifteen participants with moderate to severe depression were followed up for eight weeks in the Acupuncture Department of the China Medical University Hospital in Taichung, Taiwan, under a collaborative outpatient model that combined Western psychiatry and traditional Chinese medicine (TCM). Interdisciplinary Intervention included manual acupuncture twice a week (16 sessions), tai chi, yoga meditation, and nutritional assessment. Symptomatology was measured with primary outcomes (self-reporting via questionnaires) and secondary outcomes (heart rate variability [HRV] and blood samples to measure inflammation via high-sensitivity C-reactive protein [hs-CRP]). Results The response rate was 80% (12/15 participants), with a statistically and clinically significant decrease in depression severity according to the 21-question Hamilton depression rating scale (HDRS21) (p < 0.001), the Beck Depression Inventory (BDI) (p < 0.003), and quality of life (QoL) questionnaires (p < 0.002). We found body constitution heterogeneity in the participants with major depressive disorder (MDD), predominantly blood stagnation and Qi stagnation (in 70% of participants). Conclusion An interdisciplinary outpatient treatment method of complementary therapies can be applied successfully with pharmacological treatment in clinical practice to reduce depression symptomatology. Section Physical/Mental practices. Taxonomy Major Depressive Disorder, Collaborative healthcare Treatment, Observational study. The cooperation of different medical sciences successfully translated into clinical practice. A significant improvement of depressed symptomatology and quality of life with a multicomponent target. A collaborative health care methodology and schedule for the treatment of depression patients from a multisystem understanding of Human physiology. Evaluation of the Body constitution's modification using CCMQ (constitution Chinese medicine Questionnaire) as a tool for personalized treatment in the mental illness field.
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16
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Luo N, Wang Y, Xia Y, Tu M, Wu X, Shao X, Fang J. The effect of acupuncture on condition being studied emotional disorders in patients with postpartum: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e28669. [PMID: 35089211 PMCID: PMC8797587 DOI: 10.1097/md.0000000000028669] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 01/06/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND As one of the common postpartum diseases, postpartum emotional disorders (PEDs) mainly include postpartum depression, postpartum anxiety, posttraumatic stress disorder, and obsessive-compulsive disorder, which significantly affect the patient's quality of life. Acupuncture has been widely used as a popular alternative complementary therapy for the treatment of PEDs. Nevertheless, its effectiveness and safety remain uncertain. Hence, the first systematic review and meta-analysis will be urgently executed to explore the effectiveness and safety of acupuncture in the treatment of PEDs. METHODS Eight databases will be searched, including the PubMed, Web of Science, EMBASE, the Cochrane Central Register of Controlled Trials, Chinese National Knowledge Infrastructure, Chinese Biomedical Literature Database, Wanfang Database, and Technology Periodical Database. Only randomized controlled trials of acupuncture for PEDs will be considered. The languages are limited to English and Chinese. All publications were retrieved by 2 researchers independently. Assessment of the Edinburgh Postpartum Depression Scale will be dedicated as a primary outcome, and secondary outcomes include the Hamilton Anxiety Inventory, the Hamilton Depression Inventory, the Orientation to Life Questionnaire (sense of coherence 29-item scale), and adverse effects of acupuncture. The Cochrane Risk of Bias tool will be used to assess the quality of the eligible publications. Additionally, the level of evidence for results will be evaluated by using the Grades of Recommendation, Assessment, Development, and Evaluation method. All data will be analyzed statistically by using RevMan V.5.3 software. RESULTS This study will provide a high level of the evidence-based basis for the effectiveness and safety of acupuncture in the treatment of PEDs. CONCLUSION The findings of this study will assess the safety, efficacy, and adverse effects of acupuncture in the treatment of PEDs. ETHICS AND DISSEMINATION No ethical approval is required as patient data will not be collected. In addition, the results of this meta-analysis will be disseminated through publication in peer-reviewed scholarly journals or relevant academic conferences. REGISTRATION NUMBER INPLASY 2021120091.
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Li S, Zhang Z, Jiao Y, Jin G, Wu Y, Xu F, Zhao Y, Jia H, Qin Z, Zhang Z, Rong P. An assessor-blinded, randomized comparative trial of transcutaneous auricular vagus nerve stimulation (taVNS) combined with cranial electroacupuncture vs. citalopram for depression with chronic pain. Front Psychiatry 2022; 13:902450. [PMID: 35990057 PMCID: PMC9386062 DOI: 10.3389/fpsyt.2022.902450] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 07/14/2022] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Depression accompanying chronic pain (CP) is one of the most common comorbid psychiatric disorders. This study aimed to investigate the effectiveness of transcutaneous auricular vagus nerve stimulation (taVNS) combined with electroacupuncture at Baihui (GV20) and Yintang (GV29) acupoints compared with citalopram. METHODS Sixty patients with depression and pain comorbidity were enrolled in a prospective 8-week, single-blind, randomized controlled trial. Participants were randomly assigned to receive either taVNS combined with electroacupuncture treatment (taVNS: 8 weeks, 3 sessions per week; electroacupuncture: 8 weeks, twice per day, no drugs) or citalopram treatment (8 weeks, 40 mg/day). The primary outcome was Montgomery-Åsberg Depression Rating Scale (MADRS). The secondary endpoints were evaluated using the McGill Pain Questionnaire (SF-MPQ), self-reported 36-Item Short Form Survey (SF-36), Pittsburgh Sleep Quality Index (PSQI), Hamilton Depression Rating Scale (HAMD) and Hamilton Anxiety Scale (HAMA). RESULTS Both the taVNS combined with electroacupuncture and citalopram groups had significant reductions in depressive and pain symptoms, as indicated by the decrease in MARDS and SF-MPQ scores. Regarding the analgesic effect, the pain intensity score of the SF-MPQ showed a larger reduction with citalopram than with taVNS combined with electroacupuncture at 6 weeks (P = 0.036). The reduction in the BP score of the SF-36 was higher at week 4 (P = 0.000), with no significant difference observed at week 8 (P = 0.1110). This result indicated that the pain intensity can be improved rapidly with citalopram compared with taVNS combined with electroacupuncture. Similarly, the comparison of PSQI scores at 4, 6, and 8 weeks indicates that there was no significant difference between groups, except in the use of sleeping medications. At week 6, higher medication use was found in the citalopram group than in the taVNS combined with electroacupuncture group (P = 0.049). CONCLUSION In summary, compared with citalopram, taVNS combined with electroacupuncture produces similar positive effects on depressive and pain symptoms in patients with depression and chronic pain, which last for at least 8 weeks.
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Affiliation(s)
- Shaoyuan Li
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zixuan Zhang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yue Jiao
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Guixing Jin
- Psychiatry Department, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yue Wu
- Psychiatry Department, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Fengquan Xu
- Psychological Department, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yufeng Zhao
- Data Centre of Traditional Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Hongxiao Jia
- Psychiatry Department, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Zongshi Qin
- The School of Chinese Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Zhangjin Zhang
- The School of Chinese Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Peijing Rong
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
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18
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Xiang H, Li J, Li B, Tan Q, Cai G. Trends of Acupuncture Therapy on Depression From 2011 to 2020: A Bibliometric Analysis. Front Psychol 2021; 12:721872. [PMID: 34721179 PMCID: PMC8549834 DOI: 10.3389/fpsyg.2021.721872] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 09/06/2021] [Indexed: 11/22/2022] Open
Abstract
Objectives: The purpose of this study was to explore the current status and trends of acupuncture for depression in the last decade and provide new insights for researchers in future studies. Methods: The articles regarding acupuncture treatment for depression published between 2011 and 2020 were extracted from the Web of Science Core Collection. We used CiteSpace to analyze data on publications, countries, institutions, cited journals, cited authors, cited references, keywords, and citation bursts about acupuncture and depression. Results: A total of 1,032 publications were obtained from 2011 to 2020. We identified the most prolific journals, countries, institutions, and authors in the field of acupuncture for depression in the last decade. The most prolific country and institutions were the People's Republic of China and KyungHee University, respectively. Evidence-based Complementary and Alternative Medicine was the most prolific and cited journal. The author with the highest centrality was Zhangjin Zhang, and the author with the most publications was Park Hi-Joon. The keyword “cognitive behavioral therapy” was first for research developments with the highest citation burst. The five hot topics in acupuncture on depression were “acupuncture,” “depression,” “electro-acupuncture,” “quality of life,” and “anxiety.” Conclusions: The results from this bibliometric study provide insight into the research trends in acupuncture therapy for depression, and the current status and trends of the past decade, which may help researchers determine the current status, hotspots, and frontier trends in this field.
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Affiliation(s)
- Hongchun Xiang
- Department of Acupuncture and Moxibustion, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Li
- Department of Acupuncture and Moxibustion, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bocun Li
- Department of Acupuncture and Moxibustion, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qian Tan
- Department of Acupuncture and Moxibustion, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Guowei Cai
- Department of Acupuncture and Moxibustion, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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19
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Da XL, Yue LF, Li XJ, Chen JB, Yuan NJ, Chen JX. Potential therapeutic effect and methods of traditional Chinese medicine on COVID-19-induced depression: A review. Anat Rec (Hoboken) 2021; 304:2566-2578. [PMID: 34636498 PMCID: PMC8652675 DOI: 10.1002/ar.24758] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 07/01/2021] [Accepted: 07/06/2021] [Indexed: 11/08/2022]
Abstract
COVID‐19 (coronavirus) has spread all over the world with a high infection rate. Currently, there are no targeted therapeutic drugs for COVID‐19 as well as for stress induced by COVID‐19. The unpredictable events of COVID‐19 can trigger feelings of fear, worry, or unease in people, leading to stress‐related disorders such as depression and anxiety. It has been reported that individuals, including COVID‐19 patients, medical staff, and ordinary people, are under both physical and psychological pressure, and many of them have developed depression or anxiety during this pandemic. Traditional Chinese medicine (TCM) has been widely used in treating depression with relatively better safety and efficacy and may have an important role in treating stress‐related disorders induced by COVID‐19. In this review, we collected the common TCM treatment methods including Qigong, Acupuncture, Five Elements Musical Therapy, Five Elements Emotional Therapy, and Chinese herbal medicine from the databases of PubMed and the China National Knowledge Internet to illustrate the effect of TCM on depression. The better knowledge of TCM and implementation of TCM in COVID‐19 clinics may help to effectively improve depression induced by COVID‐19, may assist people to maintain a healthy physical and mental quality, and may alleviate the current shortage of medical resources.
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Affiliation(s)
- Xiao-Li Da
- Formula-Pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Li-Feng Yue
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Xiao-Juan Li
- Formula-Pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Jian-Bei Chen
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Nai-Jun Yuan
- Formula-Pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Jia-Xu Chen
- Formula-Pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
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20
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Wong YK, Wu JM, Zhou G, Zhu F, Zhang Q, Yang XJ, Qin Z, Zhao N, Chen H, Zhang ZJ. Antidepressant Monotherapy and Combination Therapy with Acupuncture in Depressed Patients: A Resting-State Functional Near-Infrared Spectroscopy (fNIRS) Study. Neurotherapeutics 2021; 18:2651-2663. [PMID: 34431029 PMCID: PMC8804104 DOI: 10.1007/s13311-021-01098-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2021] [Indexed: 11/28/2022] Open
Abstract
Depression is a common psychiatric illness affecting over 300 million people globally. Acupuncture has been reported to be a safe complementary treatment for depression. This study is aimed to investigate the efficacy and mechanism of combining acupuncture with antidepressants in treating depression compared to the sole use of antidepressants. Seventy depression patients were randomly assigned to the treatment group (n = 50) and control group (n = 20). The treatment group received acupuncture combined antidepressants treatment for 3 weeks, while the control group took antidepressants monotherapy for 3 weeks. Among the 70 patients, 40 participants (20 control; 20 treatment) were randomized for studying functional connectivity (FC) of the dorsolateral prefrontal cortex (DLPFC) measured by the functional near-infrared spectroscopy. The primary outcome was HAMD-17 and secondary outcomes were PHQ-9, and the relationships of resting-state FC (rsFC) with the depression severity. PHQ-9 and HAMD-17 scores in the treatment group were significantly lower than those in the control group at Week 3 (p = 0.01) with effect sizes of -0.4 and -0.61 respectively. The rsFC in F1, F3, AF3, AF7, FC3, FC5 (left DLPFC, 10-20 system), AF8, and F6 (right DLPFC) in the treatment group had significant temporal correlation (p < 0.05, FDR corrected) in DLPFC compared to the channels in the control group. No significant correlation was found between the changes of rsFC and depression severity. In conclusion, depressed patients receiving acupuncture combined with antidepressants have improvement of depressive symptoms and the stronger rsFC in the DLPFC compared to those using antidepressants alone.
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Affiliation(s)
- Yat Kwan Wong
- School of Chinese Medicine, The University of Hong Kong, 10 Sassoon Road, Pokfulam, Hong Kong, China
| | - Jun Mei Wu
- School of Chinese Medicine, The University of Hong Kong, 10 Sassoon Road, Pokfulam, Hong Kong, China
- Acupucture and Tuina college, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Guodong Zhou
- Department of Electronic Engineering, The Chinese University of Hong Kong, New Territories, Hong Kong, China
| | - Frank Zhu
- Unique Mind Centre, Central, Hong Kong, China
| | - Quan Zhang
- Neural Systems Group, Massachusetts General Hospital/Harvard Medical School, Charlestown, MA, USA
| | - Xin Jing Yang
- School of Chinese Medicine, The University of Hong Kong, 10 Sassoon Road, Pokfulam, Hong Kong, China
| | - Zongshi Qin
- School of Chinese Medicine, The University of Hong Kong, 10 Sassoon Road, Pokfulam, Hong Kong, China
| | - Ni Zhao
- Department of Electronic Engineering, The Chinese University of Hong Kong, New Territories, Hong Kong, China
| | - Haiyong Chen
- School of Chinese Medicine, The University of Hong Kong, 10 Sassoon Road, Pokfulam, Hong Kong, China.
| | - Zhang-Jin Zhang
- School of Chinese Medicine, The University of Hong Kong, 10 Sassoon Road, Pokfulam, Hong Kong, China.
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21
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Zhong LLD, Lam TF, Yang W, Zheng Y, Lyu Z, Bian Z. Electro-acupuncture for irritable bowel syndrome patients: study protocol for a single-blinded randomized sham-controlled clinical trial. Trials 2021; 22:619. [PMID: 34526079 PMCID: PMC8441043 DOI: 10.1186/s13063-021-05563-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 08/24/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders in clinical practice. IBS diagnosis is based on symptoms defined by abdominal pain or discomfort associated with defecation or changes in bowel habits. Gut-brain interaction caused by stress or depressive emotion is one of the essential pathologies. Acupuncture has been used for the treatment of internal medicine, including digestive disorders and depressive disorders in Chinese medicine. This study aims to determine whether electro-acupuncture could have significant benefits than sham acupuncture for IBS. METHODS/DESIGN This is a single-blinded randomized sham-controlled clinical trial with two arms. A total of 120 IBS patients will be recruited. After a 2-week run-in period, eligible subjects will be randomly assigned to one of two arms, acupuncture (AC) arm and sham acupuncture (SAC) arm. Each eligible subject will go through a 2-week run-in-period, 6-week treatment period, and 6-week follow-up period. Five visits in total were scheduled for each subject in week 0, week 2, week 5, week 8, and week 14. The outcomes would be measured with (1) IBS-SSS, (2) Hamilton Depression Rating Scale (HAMD-17), (3) Clinical Global Impression-Severity (CGI-S), (4) Self-Rating Depression Scale (SDS), and (5) IBS Quality of Life (IBS-QoL). DISCUSSION The study will compare electro-acupuncture with sham acupuncture to explore the feasibility of electro-acupuncture in improving IBS symptoms. TRIAL REGISTRATION ClinicalTrials.gov NCT04387383 . Registered on 13 May 2020.
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Affiliation(s)
- Linda L D Zhong
- Hong Kong Chinese Medicine Clinical Study Centre, Hong Kong Baptist University, 3F, Jockey Club Chinese Medicine Building, 7 Baptist University Road, Kowloon, Hong Kong, SAR, P. R. China.
- School of Chinese Medicine, Hong Kong Baptist University, Jockey Club Chinese Medicine Building, 7 Baptist University Road, Kowloon, Hong Kong, SAR, P. R. China.
| | - Tsz Fung Lam
- Hong Kong Chinese Medicine Clinical Study Centre, Hong Kong Baptist University, 3F, Jockey Club Chinese Medicine Building, 7 Baptist University Road, Kowloon, Hong Kong, SAR, P. R. China
- School of Chinese Medicine, Hong Kong Baptist University, Jockey Club Chinese Medicine Building, 7 Baptist University Road, Kowloon, Hong Kong, SAR, P. R. China
| | - Wei Yang
- Hong Kong Chinese Medicine Clinical Study Centre, Hong Kong Baptist University, 3F, Jockey Club Chinese Medicine Building, 7 Baptist University Road, Kowloon, Hong Kong, SAR, P. R. China
- School of Chinese Medicine, Hong Kong Baptist University, Jockey Club Chinese Medicine Building, 7 Baptist University Road, Kowloon, Hong Kong, SAR, P. R. China
| | - Ya Zheng
- Hong Kong Chinese Medicine Clinical Study Centre, Hong Kong Baptist University, 3F, Jockey Club Chinese Medicine Building, 7 Baptist University Road, Kowloon, Hong Kong, SAR, P. R. China
- School of Chinese Medicine, Hong Kong Baptist University, Jockey Club Chinese Medicine Building, 7 Baptist University Road, Kowloon, Hong Kong, SAR, P. R. China
| | - Zipan Lyu
- Hong Kong Chinese Medicine Clinical Study Centre, Hong Kong Baptist University, 3F, Jockey Club Chinese Medicine Building, 7 Baptist University Road, Kowloon, Hong Kong, SAR, P. R. China
- School of Chinese Medicine, Hong Kong Baptist University, Jockey Club Chinese Medicine Building, 7 Baptist University Road, Kowloon, Hong Kong, SAR, P. R. China
| | - Zhaoxiang Bian
- Hong Kong Chinese Medicine Clinical Study Centre, Hong Kong Baptist University, 3F, Jockey Club Chinese Medicine Building, 7 Baptist University Road, Kowloon, Hong Kong, SAR, P. R. China
- School of Chinese Medicine, Hong Kong Baptist University, Jockey Club Chinese Medicine Building, 7 Baptist University Road, Kowloon, Hong Kong, SAR, P. R. China
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22
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Hwang SI, Sung SH, Yoon YJ, Park JK. Acupuncture treatment for emotional problems in infertile women: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e26306. [PMID: 34115040 PMCID: PMC8202593 DOI: 10.1097/md.0000000000026306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 05/25/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Infertility causes emotional and psychological problems, including anxiety, depression, low self-efficacy, and chronic mental stress in women. These emotional problems can negatively affect fertility treatment. Numerous studies have reported the clinical therapeutic effects of acupuncture on emotional problems; however, the efficacy and safety of acupuncture treatment for emotional problems in infertile women remain unclear. This protocol aims to evaluate the efficacy and safety of acupuncture for treating emotional problems in infertile women. METHODS We will search the following databases from their inception to April 30, 2021: MEDLINE, EMBASE, Cochrane Library, Korean Medical Databases (KoreaMed, Korean studies Information Service System, Korean Traditional Knowledge Portal, Oriental Medicine Advanced Searching Integrated System, Research Information Sharing Service, and National Digital Science Library), and Chinese databases (CNKI and Wan Fang Database). We will include randomized controlled trials on acupuncture for emotional problems in infertile women. There will be no restrictions regarding language or publication date. The primary outcome will be assessed using an emotion-related assessment scale. The risk of bias of the included studies will be measured using the Cochrane risk of bias assessment tool. For meta-analysis, RevMan Version 5.4 software will be used to combine the relative risks for dichotomous outcomes, as well as the mean differences or standardized mean differences for continuous outcomes, with both having 95% confidence intervals. RESULTS Based on current evidence, this study will assess the effectiveness and safety of acupuncture for emotional problems in infertile women. CONCLUSION This study will provide evidence for evaluating the acupuncture efficacy for infertile women with emotional problems. REGISTRATION NUMBER INPLASY202150082.
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Affiliation(s)
- Su-In Hwang
- Department of Korean Medicine Obstetrics and Gynecology, Pusan National University Korean Medicine Hospital
| | - Soo-Hyun Sung
- Department of Policy Development, National Development Institute of Korean Medicine
| | - Young-Jin Yoon
- Department of Korean Medicine Obstetrics and Gynecology, Pusan National University Korean Medicine Hospital
- Division of Clinical Medicine, School of Korean Medicine, Pusan National University, Yangsan, South Korea
| | - Jang-Kyung Park
- Department of Korean Medicine Obstetrics and Gynecology, Pusan National University Korean Medicine Hospital
- Division of Clinical Medicine, School of Korean Medicine, Pusan National University, Yangsan, South Korea
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23
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Zhang L, Chen B, Yao Q, Chen W, Yang W, Yang W, He L, Zhang Y. Comparison between acupuncture and antidepressant therapy for the treatment of poststroke depression: Systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e25950. [PMID: 34087835 PMCID: PMC8183854 DOI: 10.1097/md.0000000000025950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 02/04/2021] [Accepted: 04/27/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND In this paper, a systematic review and meta-analysis of published randomized controlled trials (RCTs) was conducted to compare the efficacies of acupuncture and antidepressant therapy for the treatment of poststroke depression (PSD). METHODS The research team searched RCTs published on PubMed; Medline; Cochrane library; Chinese National Knowledge Infrastructure (CNKI); Wanfang; Embase; Scopus, and Sinomed from their respective establishments to January 2019. We evaluated the Hamilton Depression Rating Scale (HAMD) scores, Treatment Emergent Symptom Scale (TESS) scores, National Institute of Health Stroke Scale (NIHSS) scores, and total clinical efficacy using fixed effects models. RESULTS Fourteen RCTs, representing a total of 1124 patients, were studied. Results showed that acupuncture was more effective in improving HAMD scores at 3 weeks after administration (mean difference [MD] = -1.17, 95%CI = -2.18 to -0.16), at 4 weeks (MD = -4.44, 95% CI = -5.64 to -3.23), at 6 weeks (MD = -1.02, 95% CI = -1.68 to -0.36), and at 8 weeks (MD = -4.33, 95% CI = -4.96 to -3.70). Similarly, acupuncture more dramatically decreased NIHSS scores (MD = -2.31, 95% CI = -2.53 to -2.09), and TESS scores (MD = -4.70, 95% CI = -4.93 to -4.48) than conventional Western medicinal therapy. Further, the total clinical efficacy in the acupuncture group was significantly higher than in the antidepressants group (risk ratio [RR] = 1.15, 95% CI = 1.08-1.21). CONCLUSIONS The results of this study suggest that acupuncture not only can reduce the severity of PSD, but also has significant effects on decreasing the appearance of other adverse events.
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Affiliation(s)
| | - Bing Chen
- College of Life Sciences, Zhejiang Chinese Medical University, Zhejiang
| | - Qigu Yao
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University
| | - Weiyan Chen
- College of Basic medical, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | | | - Weiji Yang
- College of Life Sciences, Zhejiang Chinese Medical University, Zhejiang
| | - Lan He
- Second Clinical Medical College
| | - Yuyan Zhang
- College of Life Sciences, Zhejiang Chinese Medical University, Zhejiang
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24
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Duan G, He Q, Pang Y, Chen W, Liao H, Liu H, Tan L, Liu Y, Tao J, Zhang J, Wei X, Sun P, Liu P, Deng D. Altered amygdala resting-state functional connectivity following acupuncture stimulation at BaiHui (GV20) in first-episode drug-Naïve major depressive disorder. Brain Imaging Behav 2021; 14:2269-2280. [PMID: 31432318 DOI: 10.1007/s11682-019-00178-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Amygdala is an important locus of dysfunction implicated in major depressive disorder(MDD). Aberrant amygdala networks(AN) had been reported in resting-state functional magnetic resonance imaging (rs-fMRI) study. The safety and efficacy of acupuncture treatment for MDD have been verified in previous clinical studies. This study is aimed to investigate whether acupuncture at GV20 could modulate the abnormal AN of patients with the first-episode, drug-naïve MDD by using rs-fMRI combined with functional connectivity (FC) method. Thirty MDD patient underwent 6-min rs-fMRI scans respectively before and after 20-min electro-acupuncture stimulate(EAS) at GV20. Twenty-nine healthy subjects underwent only a 6-min rs-fMRI scan. Based on the amygdala as the seed region, FC method was adopted to examine abnormal AN in patients by comparing with healthy subjects and to evaluate the influence of EAS on intrinsic connectivity within the AN in patients with MDD. Compared to healthy subjects, MDD patients had aberrant intrinsic AN which mainly showed increased FC between amygdala and hippocampus, precuneus, precentral gyrus and angular gyrus, as well as decreased FC between amygdala and orbital frontal cortex(OFC). Moreover, our results indicated that EAS at GV20 induced increased/decreased FC between amygdala and certain regions in MDD patients. In addition, the intrinsic amygdala FC within other certain brain regions in MDD patients were regulated by EAS at GV20. The abnormal AN of MDD patients could be modulated by EAS at GV20. Our findings may further provide the potential imaging evidence to support the modulatory mechanisms of acupuncture on MDD.
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Affiliation(s)
- Gaoxiong Duan
- Department of Radiology, First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning, 530023, Guangxi, China
| | - Qianchao He
- Department of Neurology, First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning, 530023, Guangxi, China
| | - Yong Pang
- Department of Acupuncture, First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning, 530023, Guangxi, China
| | - Wenfu Chen
- Department of Radiology, First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning, 530023, Guangxi, China
| | - Hai Liao
- Department of Radiology, First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning, 530023, Guangxi, China
| | - Huimei Liu
- Department of Acupuncture, First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning, 530023, Guangxi, China
| | - Lulu Tan
- Department of Neurology, First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning, 530023, Guangxi, China
| | - Yanfei Liu
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an, 710071, Shaanxi, China
| | - Jien Tao
- Department of Acupuncture, First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning, 530023, Guangxi, China
| | - Jian Zhang
- Department of Radiology, First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning, 530023, Guangxi, China
| | - Xiaomei Wei
- Department of Radiology, First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning, 530023, Guangxi, China
| | - Peiyi Sun
- Department of Radiology, First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning, 530023, Guangxi, China
| | - Peng Liu
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an, 710071, Shaanxi, China
| | - Demao Deng
- Department of Radiology, First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning, 530023, Guangxi, China.
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25
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Liu R, Zhang K, Tong QY, Cui GW, Ma W, Shen WD. Acupuncture for post-stroke depression: a systematic review and meta-analysis. BMC Complement Med Ther 2021; 21:109. [PMID: 33794857 PMCID: PMC8017746 DOI: 10.1186/s12906-021-03277-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 03/17/2021] [Indexed: 12/04/2022] Open
Abstract
Background Acupuncture for post-stroke depression (PSD) has been evolving, but uncertainty remains. To assess the existing evidence from randomized clinical trials (RCTs) of acupuncture for PSD, we sought to draw conclusions by synthesizing RCTs. Methods An exhaustive literature search was conducted in seven electronic databases from their inception dates to April 19, 2020, to identify systematic reviews (SRs) and meta-analyses (MAs) on this topic. The primary RCTs included in the SRs/MAs were identified. We also conducted a supplementary search for RCTs published from January 1, 2015, to May 12, 2020. Two reviewers extracted data separately and pooled data using RevMan 5.3 software. The quality of evidence was critically appraised with the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) system. Results A total of 17 RCTs involving 1402 patients were included. Meta-analysis showed that participants who received a combination of acupuncture and conventional treatments exhibited significantly lower scores on the HAM-D17, HAM-D24 and HAM-D (MD, − 5.08 [95% CI, − 6.48 to − 3.67], I2 = 0%), (MD, − 9.72 [95% CI, − 14.54 to − 4.91], I2 = 65%) and (MD, − 2.72 [95% CI, − 3.61 to − 1.82], respectively) than those who received conventional treatment. However, there was no significant difference in acupuncture versus antidepressants in terms of the 17-item, 24-item and HAM-D scales (MD, − 0.43 [95% CI, − 1.61 to 0.75], I2 = 51%), (MD, − 3.09 [95% CI, − 10.81 to 4.63], I2 = 90%) and (MD, − 1.55 [95% CI, − 4.36 to 1.26], I2 = 95%, respectively). For adverse events, acupuncture was associated with fewer adverse events than antidepressants (RR, 0.16 [95% CI, 0.07 to 0.39], I2 = 35%), but there was no significant difference in the occurrence of adverse events between the combination of acupuncture and conventional treatments versus conventional treatments (RR, 0.63 [95% CI, 0.21 to 1.83], I2 = 38%). The quality of evidence was low to very low due to the substantial heterogeneity among the included studies. Conclusions The current review indicates that acupuncture has greater effect on PSD and better safety profile than antidepressants, but high-quality evidence evaluating acupuncture for PSD is still needed. Supplementary Information The online version contains supplementary material available at 10.1186/s12906-021-03277-3.
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Affiliation(s)
- Ran Liu
- Department of Acupuncture, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.,Institute of Acupuncture and Anesthesia, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Kun Zhang
- Department of Acupuncture, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.,Institute of Acupuncture and Anesthesia, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Qiu-Yu Tong
- Department of Acupuncture, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Guang-Wei Cui
- Department of Acupuncture, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.,Institute of Acupuncture and Anesthesia, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Wen Ma
- Department of Acupuncture, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.
| | - Wei-Dong Shen
- Department of Acupuncture, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China. .,Institute of Acupuncture and Anesthesia, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.
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26
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Matos LC, Machado JP, Monteiro FJ, Greten HJ. Understanding Traditional Chinese Medicine Therapeutics: An Overview of the Basics and Clinical Applications. Healthcare (Basel) 2021; 9:257. [PMID: 33804485 PMCID: PMC8000828 DOI: 10.3390/healthcare9030257] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 02/23/2021] [Accepted: 02/23/2021] [Indexed: 12/12/2022] Open
Abstract
Traditional Chinese medicine (TCM) is a systematic healthcare system developed from clinical experience based on a scientific model of regulation. TCM relies on unique theories and practices to treat diseases and enhance health. These practices include Chinese herbal medicine and dietetics, acupuncture and moxibustion, and other non-medication therapies such as Chinese bodywork or manual therapy, known as "Tuina", and traditional biofeedback exercises, known as "Qigong" and "Taijiquan". The integration of TCM in Western health systems and research requires a rational communicable theory, scientific proof of efficacy and safety, and quality control measures. Understanding the structural concepts of the TCM language makes possible the parallelism to Western physiology, and the inherent rational use of the reflex therapeutic systems, anti-inflammatory mechanisms and mental training involved, for example, in acupuncture and "Qigong". The results of TCM clinical trials and fundamental research on its nature and mechanisms have encouraged the development and application of well-designed research strategies such as double blinding in acupucture to overcome limitations and resistances in integrating these practices into the existing biomedical paradigms of the West. This review aims to overview some TCM theoretical concepts and the evidence-based clinical application of TCM's leading practices to create an easy-to-consult and condensed source of information, available for the healthcare community, facilitating the understanding and communication between conventional health professionals and TCM practitioners and acupuncturists.
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Affiliation(s)
- Luís Carlos Matos
- Faculdade de Engenharia da Universidade do Porto, 4200-465 Porto, Portugal;
- CBSIn—Centro de Biociências em Saúde Integrativa, Atlântico Business School, 4405-604 Vila Nova de Gaia, Portugal;
- CTEC—Centro Transdisciplinar de Estudos da Consciência, Universidade Fernando Pessoa, 4249-004 Porto, Portugal
| | - Jorge Pereira Machado
- CBSIn—Centro de Biociências em Saúde Integrativa, Atlântico Business School, 4405-604 Vila Nova de Gaia, Portugal;
- ICBAS—Institute of Biomedical Sciences Abel Salazar, University of Porto, 4050-313 Porto, Portugal;
| | - Fernando Jorge Monteiro
- Faculdade de Engenharia da Universidade do Porto, 4200-465 Porto, Portugal;
- INEB—Instituto de Engenharia Biomédica, Universidade do Porto, 4200-135 Porto, Portugal
| | - Henry Johannes Greten
- ICBAS—Institute of Biomedical Sciences Abel Salazar, University of Porto, 4050-313 Porto, Portugal;
- German Society of Traditional Chinese Medicine, 69126 Heidelberg, Germany
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Li H, Chen Y, Hu Z, Jiang J, Ye J, Zhou Y, Yu Z, Tang H. Effectiveness of acupuncture for anxiety and depression in irritable bowel syndrome: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e24958. [PMID: 33663136 PMCID: PMC7909111 DOI: 10.1097/md.0000000000024958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 02/09/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Irritable bowel syndrome (IBS) is the most commonly gastrointestinal diseases. The Rome Foundation's global study on 33 countries shows the total prevalence of IBS under the Rome IV Diagnostic Criteria was 3.8%. It is well established that people with IBS have higher levels of anxiety and depression. The impact of the acupuncture associated with anxiety and depression has been widely studied in Western countries. Acupuncture may be a promising choice for the treatment of anxiety and depression in IBS. METHODS RCTs of acupuncture for depression and anxiety in IBS will be searched in the relevant database, including PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Database, Chinese Biomedical Literature Database (CBM), and Chinese Scientific Journal Database (VIP database). The studies of electronic searches will be exported to EndNote V.9.1 software. We will run meta-analyses using the Review Manager (RevMan) V.5.3 software. Any disagreement will be solved in consultation with a third reviewer. RESULTS Our study aims to explore the efficacy of acupuncture for depression and anxiety in IBS and to provide up-to-date evidence for clinical of IBS. CONCLUSION This study will perform a comprehensive systematic review and meta-analysis on the efficacy of acupuncture for depression and anxiety in IBS, making up for the lack of relevant evidence of the clinical use of acupuncture. INPLASY REGISTRATION NUMBER INPLASY 202120014.
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Affiliation(s)
- Huaiyu Li
- Jiangxi University of Traditional Chinese Medicine, Nanchang
| | - Yun Chen
- First Affiliated Hospital of Gannan Medical University, Ganzhou
| | - Ziyi Hu
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, P.R. China
| | - Jiawang Jiang
- Jiangxi University of Traditional Chinese Medicine, Nanchang
| | - Jing Ye
- Jiangxi University of Traditional Chinese Medicine, Nanchang
| | - Yuliang Zhou
- Jiangxi University of Traditional Chinese Medicine, Nanchang
| | - Zhiying Yu
- Jiangxi University of Traditional Chinese Medicine, Nanchang
| | - Haiyi Tang
- Jiangxi University of Traditional Chinese Medicine, Nanchang
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Matos LC, Machado JP, Monteiro FJ, Greten HJ. Can Traditional Chinese Medicine Diagnosis Be Parameterized and Standardized? A Narrative Review. Healthcare (Basel) 2021; 9:177. [PMID: 33562368 PMCID: PMC7914658 DOI: 10.3390/healthcare9020177] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/25/2021] [Accepted: 02/03/2021] [Indexed: 12/14/2022] Open
Abstract
The integration of Traditional Chinese Medicine (TCM) in Western health systems and research requires a rational communicable theory, scientific proof of efficacy and safety, and quality control measures. The existence of clear definitions and the diagnosis standardization are critical factors to establish the patient's vegetative functional status accurately and, therefore, systematically apply TCM therapeutics such as the stimulation of reflex skin areas known as acupoints. This science-based conceptualization entails using validated methods, or even developing new systems able to parameterize the diagnosis and assess TCM related effects by objective measurements. Traditionally, tongue and pulse diagnosis and the functional evaluation of action points by pressure sensitivity and physical examination may be regarded as essential diagnostic tools. Parameterizing these techniques is a future key point in the objectification of TCM diagnosis, such as by electronic digital image analysis, mechanical pulse diagnostic systems, or the systematic evaluation of acupoints' electrophysiology. This review aims to demonstrate and critically analyze some achievements and limitations in the clinical application of device-assisted TCM diagnosis systems to evaluate functional physiological patterns. Despite some limitations, tongue, pulse, and electrophysiological diagnosis devices have been reported as a useful tool while establishing a person's functional status.
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Affiliation(s)
- Luís Carlos Matos
- Faculdade de Engenharia da Universidade do Porto, 4200-465 Porto, Portugal;
- CBSIn—Centro de Biociências em Saúde Integrativa, Atlântico Business School, 4405-604 Vila Nova de Gaia, Portugal;
- CTEC—Centro Transdisciplinar de Estudos da Consciência da Universidade Fernando Pessoa, 4249-004 Porto, Portugal
| | - Jorge Pereira Machado
- CBSIn—Centro de Biociências em Saúde Integrativa, Atlântico Business School, 4405-604 Vila Nova de Gaia, Portugal;
- ICBAS—Institute of Biomedical Sciences Abel Salazar, University of Porto, 4050-313 Porto, Portugal;
| | - Fernando Jorge Monteiro
- Faculdade de Engenharia da Universidade do Porto, 4200-465 Porto, Portugal;
- INEB—Instituto de Engenharia Biomédica, Universidade do Porto, 4200-135 Porto, Portugal
| | - Henry Johannes Greten
- ICBAS—Institute of Biomedical Sciences Abel Salazar, University of Porto, 4050-313 Porto, Portugal;
- German Society of Traditional Chinese Medicine, 69126 Heidelberg, Germany
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Zhang J, Wu X, Nie D, Zhuo Y, Li J, Hu Q, Xu J, Yu H. Magnetic Resonance Imaging Studies on Acupuncture Therapy in Depression: A Systematic Review. Front Psychiatry 2021; 12:670739. [PMID: 34489749 PMCID: PMC8417590 DOI: 10.3389/fpsyt.2021.670739] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 07/12/2021] [Indexed: 12/12/2022] Open
Abstract
Accumulating studies had been performed using magnetic resonance imaging (MRI) to understand the neural mechanism of acupuncture therapy for depression. However, inconsistencies remain due to differences in research designs and MRI analytical methods. Therefore, we aim to summarize the current MRI research and provide useful information for further research by identifying papers published in English and Chinese about MRI studies on acupuncture for depression up to November 2020. A total of 22 studies met the inclusion criteria, including 810 depression patients and 416 health controls (HCs). The applied designs of these studies are mainly random control trial and pre-post designs. The MRI analytical methods are mainly (fractional) amplitude of low-frequency fluctuation (fALFF/ALFF) and functional connectivity (FC), whereas a small subset of studies used voxel-based morphometry (VBM) and diffusion tensor imaging (DTI). The most consistent functional MRI (fMRI) results showed increased N-acetylaspartate/creatine (NAA/Cr) ratios, increased ALFF in the right precuneus, decreased ALFF in the inferior frontal gyrus (IFG), and increased FC of the anterior cingulate cortex (ACC). In contrast, no significant neurological changes were identified in any of the DTI or VBM studies. However, clear, reliable conclusions cannot be drawn due to the use of different designs, analytical methods, seed points selected, types of depression, acupuncture points, and so on. Improved report specifications, well-designed studies, consistent analytical methods, and larger sample sizes will enable the field to better elucidate the underlying mechanisms of acupuncture in depressed patients.
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Affiliation(s)
- Jinhuan Zhang
- The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China.,Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Xiaoxiong Wu
- The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Dehui Nie
- The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Yuanyuan Zhuo
- Acupuncture Department, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
| | - Jiaying Li
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Qingmao Hu
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China
| | - Jinping Xu
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Haibo Yu
- The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China.,Acupuncture Department, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
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30
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Chen KY, Huang MC, Lin CL, Lee YC, Wu MY, Yen HR. Acupuncture Treatment is Associated with a Decreased Risk of Dementia in Patients with Depression: A Propensity Score-Matched Cohort Study. Neuropsychiatr Dis Treat 2021; 17:3255-3266. [PMID: 34764650 PMCID: PMC8575370 DOI: 10.2147/ndt.s331026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 10/12/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Depression is one of the most disabling disorders, which causes long-term complications such as neurodegenerative disorder and cerebrovascular disease. Some patients with depression seek acupuncture treatment. We aimed to investigate the association between acupuncture treatment and the risk of dementia in patients with depression from the perspective of real-world evidence. METHODS Patients over 18 years old and newly diagnosed with depression between 1997 and 2010 were selected from the Taiwanese National Health Insurance Research Database and followed up until the end of 2013. Propensity score was used to match equal numbers of patients 1:1 (N = 16,609 per group) into acupuncture and non-acupuncture cohorts based on characteristics including sex, age, baseline comorbidity and drug use. The outcome measurement was the comparison of dementia incidence in the two cohorts. RESULTS Compared with the non-acupuncture cohort, patients who received acupuncture treatment had a decreased risk of dementia (adjusted hazard ratio (aHR) = 0.54; 95% confidence interval (CI) = 0.50-0.58, P < 0.001) after adjustment for age, sex, comorbidities and drug use. Compared with depression patients who did not receive acupuncture, the aHR of vascular dementia and Alzheimer's disease incidences for patients who had acupuncture therapy was 0.59 (95% CI 0.48-0.71) and 0.51 (95% CI 0.39-0.67), respectively. The cumulative incidence of dementia was significantly lower in the acupuncture cohort than in the non-acupuncture cohort (Log rank test, p < 0.001). CONCLUSION The present study from real-world data revealed that acupuncture reduced the risk of dementia in depression patients, which supports healthcare decisions in clinical practice.
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Affiliation(s)
- Kuan-Yu Chen
- Department of Chinese Medicine, Taipei City Hospital, Yangming Branch, Taipei, Taiwan
| | - Ming-Cheng Huang
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan.,Graduate Institute of Chinese Medicine, School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Yu-Chen Lee
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan.,Graduate Institute of Chinese Medicine, School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan.,Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Mei-Yao Wu
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan.,School of Post-Baccalaureate Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Hung-Rong Yen
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan.,Graduate Institute of Chinese Medicine, School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan.,Research Center for Traditional Chinese Medicine, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.,Chinese Medicine Research Center, China Medical University, Taichung, Taiwan.,Department of Medical Laboratory Science and Biotechnology, Asia University, Taichung, Taiwan
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31
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Huang CH, Lin MC, Hsieh CL. Acupuncture Treatment Reduces Incidence of Parkinson's Disease in Patients With Depression: A Population-Based Retrospective Cohort Study in Taiwan. Front Aging Neurosci 2020; 12:591640. [PMID: 33343332 PMCID: PMC7746549 DOI: 10.3389/fnagi.2020.591640] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 11/11/2020] [Indexed: 12/23/2022] Open
Abstract
Depression is a risk factor for subsequent Parkinson's disease (PD). Some patients with depression undergo acupuncture treatment because of other diseases in Taiwan. Therefore, the present study used data from Taiwan's National Health Insurance Research Database (NHIRD) to investigate the incidence of PD in patients having depression with and without acupuncture treatment. We conducted a retrospective study of a matched cohort of 48,981 patients with newly diagnosed depression between 2000 and 2012 who were selected from the NHIRD. The 1:1 propensity score method was utilized to match an equal number of patients (N = 9,189) in the acupuncture and non-acupuncture cohorts. We employed Cox proportional hazard models to evaluate the risk of PD. The cumulative incidence of PD in both cohorts was estimated using the Kaplan–Meier method, and the difference was examined through a log-rank test. Patients with depression who received acupuncture treatment demonstrated a lower risk of PD [adjusted hazard ratio (aHR) = 0.39, 95% confidence interval = 0.31–0.49] than those who did not undergo acupuncture treatment, after adjusting for age, sex, insurance amount, geographic region, urbanization levels, comorbidities, and drugs. The cumulative incidence of PD was significantly lower in the acupuncture cohort than in the non-acupuncture cohort (log-rank test, p < 0.001). The database did not indicate the severity of depression and acupoints. The results suggest that acupuncture treatment significantly reduced the development of PD in patients with depression; however, a future study should be conducted to provide more objective evidence.
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Affiliation(s)
- Cheng-Hao Huang
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan.,Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Mei-Chen Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Ching-Liang Hsieh
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan.,Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University, Taichung, Taiwan.,Chinese Medicine Research Center, China Medical University, Taichung, Taiwan
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32
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Zhang K, Cui G, Gao Y, Shen W. Does acupuncture combined with antidepressants have a better therapeutic effect on post-stroke depression? A systematic review and meta-analysis. Acupunct Med 2020; 39:432-440. [PMID: 33334118 DOI: 10.1177/0964528420967675] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of acupuncture combined with antidepressants in the treatment of post-stroke depression (PSD). METHODS The following electronic databases were systematically searched: PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, Wanfang Data, China National Knowledge Infrastructure and Chongqing VIP database. The primary outcome was the Hamilton depression scale (HAMD) score. Two independent investigators screened for eligible clinical trials. The Cochrane risk of bias tool was used to assess the methodological quality, and RevMan 5.3 was applied for meta-analysis. RESULTS Thirteen randomized controlled trials (RCTs) involving 904 participants were included in the study. The results of this meta-analysis showed that, compared with antidepressants alone, acupuncture combined with antidepressants led to a significant decrease in the HAMD score (mean difference (MD): -3.60, 95% confidence interval (CI): -4.25 to -2.95, P < 0.001), had a better effective rate (risk ratio (RR): 1.33, 95% CI 1.19 to 1.49, P < 0.001) and lower National Institutes of Health Stroke Scale (NIHSS) scores (MD: -2.39, 95% CI: -3.37 to -1.41, P < 0.001), and led to a significant increase in the Barthel index scores (MD: 8.10, 95% CI: 5.25 to 10.94; P < 0.001). CONCLUSIONS Acupuncture combined with antidepressants showed a more favourable effect on the treatment of PSD than antidepressants alone. However, given the limited methodological quality, more high-quality RCTs conducted based on the Consolidated Standards of Reporting Trials (CONSORT) and Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) guidelines are necessary.
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Affiliation(s)
- Kun Zhang
- Department of Acupuncture, Shuguang hospital affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Guangwei Cui
- Department of Acupuncture, Shuguang hospital affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yuan Gao
- Department of Acupuncture, Shuguang hospital affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Weidong Shen
- Department of Acupuncture, Shuguang hospital affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
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33
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Chen SL, Liu YT, Hsueh KC, Tang PL. Body constitution of traditional Chinese medicine caused a significant effect on depression in adult women. Complement Ther Clin Pract 2020; 42:101288. [PMID: 33310625 DOI: 10.1016/j.ctcp.2020.101288] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 12/06/2020] [Accepted: 12/07/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND and purpose: Depression is a common mental disorder and reduces quality of life. As traditional Chinese medicine constitution (TCMC) has become an increasingly popular complementary and alternative approach for early detection and treatment of disease, this study investigated the relationship of female-related factors and constitution with depression. MATERIALS AND METHODS This cross-sectional study included 1423 women from the Taiwan Biobank. A questionnaire of 44 items was used covering a variety of factors and the Body Constitution Questionnaire. The constitution types were divided into Yang-deficiency, Yin-deficiency, and Phlegm stasis. RESULTS Yang (p = 0.022) or Yin (p = 0.017) deficiencies, being single (p = 0.027-0.033), previous use of women's health supplements (p = 0.005-0.008), and smoking (p = 0.033-0.036) were associated with a higher risk of depression. CONCLUSION Integration of TCMC with Western medicine may be an alternative option towards depression prevention and alleviation.
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Affiliation(s)
- Shih-Lin Chen
- Department of Ophthalmology, Kaohsiung Veterans General Hospital, 386, Dazhong 1st Rd., Kaohsiung City, 81362, Taiwan, ROC; College of Medicine, Kaohsiung Medical University, 100, Shih-Chuan 1st Road, Kaohsiung City, 80708, Taiwan, ROC.
| | - Yun-Ting Liu
- Department of Nursing, Kaohsiung Veterans General Hospital, Kaohsiung, 386, Dazhong 1st Rd., Kaohsiung City, 81362, Taiwan, ROC; College of Nursing, Meiho University, 23, Pingguang Rd., Neipu, Pingtung, 912009, Taiwan, ROC.
| | - Kuang-Chieh Hsueh
- Department of Family Medicine, Kaohsiung Veterans General Hospital, 386, Dazhong 1st Rd., Kaohsiung City, 81362, Taiwan, ROC; Department of Nursing, Shu-Zen Junior College of Medicine and Management, 452, Huanqiu Rd., Luzhu Dist., Kaohsiung City, 821, Taiwan, ROC.
| | - Pei-Ling Tang
- Research Center of Medical Informatics, Kaohsiung Veterans General Hospital, 386, Dazhong 1st Rd., Kaohsiung City, 81362, Taiwan, ROC; Department of Health-Business Administration, Fooyin University, 151, Jinxue Rd., Kaohsiung City, 83102, Taiwan, ROC; College of Nursing, Kaohsiung Medical University, 100, Shih-Chuan 1st Road, Kaohsiung City, 80708, Taiwan, ROC.
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The Effectiveness and Safety of Manual Acupuncture Therapy in Patients with Poststroke Cognitive Impairment: A Meta-analysis. Neural Plast 2020. [DOI: 10.1155/2020/8890521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background. Poststroke cognitive impairment (PSCI) is a common cause of disability among patients with stroke. Meanwhile, acupuncture has increasingly been used to improve motor and cognitive function for stroke patients. The aim of the present study was to summarize and evaluate the evidence on the effectiveness of acupuncture in treating PSCI. Methods. Eight databases (PubMed, The Cochrane Library, CNKI, WanFang Data, VIP, CBM, Medline, Embase databases) were searched from January 2010 to January 2020. Meta-analyses were conducted for the eligible randomized controlled trials (RCTs). Assessments were performed using Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Barthel Index (BI), or modified Barthel Index (MBI). Results. A total of 657 relevant RCTs were identified, and 22 RCTs with 1856 patients were eventually included. Meta-analysis showed that acupuncture appeared to be effective for improving cognitive function as assessed by MMSE (
, 95% confidence interval (CI) (1.39, 2.06),
) and MoCA (
, 95% CI (1.92, 2.73),
). Furthermore, it also suggested that acupuncture could improve the activities of daily life (ADL) for PSCI patients as assessed by BI or MBI (
, 95% CI (0.57, 1.38),
). Conclusions. Compared with nonacupuncture group, acupuncture group showed better effects in improving the scores of MMSE, MoCA, BI, and MBI. This meta-analysis provided positive evidence that acupuncture may be effective in improving cognitive function and activities of daily life for PSCI patients. Meanwhile, long retention time of acupuncture may improve cognitive function and activities of daily life, and twist technique may be an important factor that could influence cognitive function. However, further studies using large samples and a rigorous study design are needed to confirm the role of acupuncture in the treatment of PSCI.
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Taylor G, Addie YO, Burchett J, Durkin C, Crawford P, Ledford CJW. "Miracle" or "Medicine": A Turning-Point Analysis of Patients' and Physicians' Shifting Views on Acupuncture. Med Acupunct 2020; 32:263-271. [PMID: 33101570 DOI: 10.1089/acu.2020.1428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective: Acupuncture is one of the most widely used treatments of complementary and alternative medicine (CAM) within the military's health system. The success of CAM integration is partially dependent on both providers' and patients' perceptions that acupuncture is health-promoting. The aim of this research was to identify turning points, or changes, across treatments that enhanced or inhibited physicians' and patients' perception of acupuncture as health-promoting. Materials and Methods: Using a retrospective-interview approach, interviews were conducted with 15 family medicine physicians practicing medical acupuncture in a family medicine setting and with 17 patients (N = 32). Turning points were separated into 2 groups (health-promoting or health-inhibiting). Similarities and differences between perspectives were noted. Results: Patients and physicians identified two changes that enhanced their perspective of acupuncture as health-promoting: (1) observed health changes and (2) pain-medicine/narcotic reduction/elimination. Patients identified their ability to fulfill personal or professional roles, whereas physicians identified (1) training experiences and (2) enhanced relationships with patients. Health-inhibiting changes in perspective were identified as logistical constraints/barriers by both parties, although their perspectives differed to some degree. Turning points that were viewed as health-inhibiting treatment were identified as clinical challenges by physicians and as a lack of consistency in care by patients. Conclusions: The insight from these findings can help identify areas where medical acupuncture can be improved to promote successful integration in conventional medicine settings, as well as how providers can tailor communication with patients about acupuncture.
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Affiliation(s)
- Greenberry Taylor
- Department of Journalism, University of Florida, Gainesville, FL, USA
| | - Yewande O Addie
- Department of Journalism, University of Florida, Gainesville, FL, USA
| | - Jason Burchett
- Nellis Family Medicine Residency Program, Mike O'Callaghan Military Medical Center, Nellis Air Force Base, NV, USA
| | - Christopher Durkin
- Nellis Family Medicine Residency Program, Mike O'Callaghan Military Medical Center, Nellis Air Force Base, NV, USA
| | - Paul Crawford
- Nellis Family Medicine Residency Program, Mike O'Callaghan Military Medical Center, Nellis Air Force Base, NV, USA.,Department of Family Medicine, F. Edward Hebert School of Medicine, Military Primary Care Research Network, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Christy J W Ledford
- Department of Family Medicine, F. Edward Hebert School of Medicine, Military Primary Care Research Network, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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Cheung DST, Yeung WF, Chau PH, Lam TC, Yang M, Lai K, Ip CY, Lao L, Lin CC. Patient-centred, self-administered acupressure for Chinese advanced cancer patients experiencing fatigue and co-occurring symptoms: A pilot randomised controlled trial. Eur J Cancer Care (Engl) 2020; 31:e13314. [PMID: 32896014 DOI: 10.1111/ecc.13314] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 06/18/2020] [Accepted: 08/07/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To evaluate the feasibility and potential effects of patient-centred self-administered acupressure for alleviating fatigue and co-occurring symptoms among Chinese advanced cancer patients receiving treatment. METHODS Thirty advanced cancer patients who screened positive for moderate/severe fatigue with symptoms of insomnia and/or pain were recruited from a hospital in Hong Kong. They were randomly assigned (1:1) to receive a 4-week patient-centred self-administered acupressure intervention or health education. Fatigue (primary outcome) and secondary outcomes (sleep quality, pain, fatigue-sleep disturbance-pain symptom cluster severity, anxiety, depression and quality of life) were measured by questionnaires and actigraphy. RESULTS Twenty-four participants (80%) completed the study. Adherence to self-administered acupressure practice was satisfactory, with all retained participants attending all sessions and 90.9% practising acupressure daily. All completers rated the class as very enjoyable or quite enjoyable. Fatigue, pain, symptom cluster severity, anxiety, depression and quality of life appeared to improve from baseline to post-intervention in the intervention group. Among these outcomes, only the between-group difference in anxiety post-intervention was significant. The group × time interaction effect was nonsignificant for all outcomes. CONCLUSIONS Patient-centred self-administered acupressure appears to be feasible and acceptable among advanced cancer patients. A fully powered trial is warranted to confirm the intervention effect.
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Affiliation(s)
- Denise Shuk Ting Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Wing Fai Yeung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Pui Hing Chau
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Tai Chung Lam
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Mingxiao Yang
- School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Kithelia Lai
- Department of Clinical Oncology, Queen Mary Hospital, Hong Kong, China
| | - Chun Yat Ip
- Department of Clinical Oncology, Queen Mary Hospital, Hong Kong, China
| | - Lixing Lao
- School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.,Virginia University of Integrative Medicine, Virginia, United States
| | - Chia-Chin Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.,Alice Ho Miu Ling Nethersole Charity Foundation Professor in Nursing, Hong Kong, China.,School of Nursing, College of Nursing, Taipei Medical University, Taiwan
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37
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Zhang ZJ, Man SC, Yam LL, Yiu CY, Leung RCY, Qin ZS, Chan KWS, Lee VHF, Kwong A, Yeung WF, So WKW, Ho LM, Dong YY. Electroacupuncture trigeminal nerve stimulation plus body acupuncture for chemotherapy-induced cognitive impairment in breast cancer patients: An assessor-participant blinded, randomized controlled trial. Brain Behav Immun 2020; 88:88-96. [PMID: 32305573 DOI: 10.1016/j.bbi.2020.04.035] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 04/08/2020] [Accepted: 04/13/2020] [Indexed: 02/07/2023] Open
Abstract
Chemotherapy causes various side effects, including cognitive impairment, known as 'chemobrain'. In this study, we determined whether a novel acupuncture mode called electroacupuncture trigeminal nerve stimulation plus body acupuncture (EA/TNS + BA) could produce better outcomes than minimum acupuncture stimulation (MAS) as controls in treating chemobrain and other symptoms in breast cancer patients. In this assessor- and participant-blinded, randomized controlled trial, 93 breast cancer patients under or post chemotherapy were randomly assigned to EA/TNS + BA (n = 46) and MAS (n = 47) for 2 sessions per week over 8 weeks. The Montreal Cognitive Assessment (MoCA) served as the primary outcome. Digit span test was the secondary outcomes for attentional function and working memory. The quality of life and multiple functional assessments were also evaluated. EA/TNS + BA treated group had much better performance than MAS-treated group on reverse digit span test at Week 2 and Week 8, with medium effect sizes of 0.53 and 0.48, respectively, although no significant differences were observed in MoCA score and prevalence of chemobrain between the two groups. EA/TNS + BA also markedly reduced incidences of diarrhoea, poor appetite, headache, anxiety, and irritation, and improved social/family and emotional wellbeing compared to MAS. These results suggest that EA/TNS + BA may have particular benefits in reducing chemotherapy-induced working memory impairment and the incidence of certain digestive, neurological, and distress-related symptoms. It could serve as an effective intervention for breast cancer patients under and post chemotherapy (trial registration: https://www.clinicaltrials.gov: NCT02457039).
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Affiliation(s)
- Zhang-Jin Zhang
- Department of Chinese Medicine, The University of Hong Kong Shenzhen Hospital (HKU-SZH), Shenzhen, Guangdong 518053, China; School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
| | - Sui-Cheung Man
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Lo-Lo Yam
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Chui Ying Yiu
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Roland Ching-Yu Leung
- Department of Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Zong-Shi Qin
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Kit-Wa Sherry Chan
- Department of Psychiatry, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Victor Ho Fun Lee
- Department of Clinical Oncology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Ava Kwong
- Department of Surgery, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Wing-Fai Yeung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Winnie K W So
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, New Territory, Hong Kong
| | - Lai Ming Ho
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Ying-Ying Dong
- Department of Psychosomatic Disorders, The Seventh People Hospital of Shaoxing, Shaoxing, Zhejiang 312000, China.
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Hou Y, Zhang N, Hao J, Wang X, Wen Z, Luo D, Ning B, Fu W, Liu Y. Acupuncture plus rehabilitation for post-stroke depression: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e21078. [PMID: 32664126 PMCID: PMC7360238 DOI: 10.1097/md.0000000000021078] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 06/03/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Post-stroke depression (PSD) is a common stroke complication that is characterized by hopelessness, anxiety, disordered sleep, and lowered responsiveness. Rehabilitation and acupuncture treatments are often combined to treat PSD; however, there has been no meta-analysis on their synergistic effect. Therefore, we aim to perform a systematic review and meta-analysis to estimate the effectiveness of acupuncture and rehabilitation in PSD treatment. METHODS We will search the following electronic databases: PubMed, the Cochrane Library, EMBASE, the China National Knowledge Infrastructure, the Chinese Biomedical Literature Database, China Science and Technology Journal Database, and Wan Fang databases. We will include studies published between the database initiation and May 2020. Two reviewers will separately conduct study selection, data extraction, and risk of bias assessment. Disputes will be settled by consulting a third reviewer. Review Manager Software 5.3 will be employed for this meta-analysis. RESULTS This systematic review will assess whether acupuncture combined with rehabilitation treatment is more effective than rehabilitation alone in the management of PSD. CONCLUSION This systematic review will provide evidence regarding the synergistic effect of acupuncture and rehabilitation treatment for PSD.
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Affiliation(s)
- Yonghui Hou
- The First Hospital of Shijiazhuang City, Shijiazhuang, Hebei
| | - Ning Zhang
- The First Hospital of Shijiazhuang City, Shijiazhuang, Hebei
| | - Jieming Hao
- Shijiazhuang Community Health Service Management Center, Shijiazhuang, Hebei
| | - Xiangzhi Wang
- The First Hospital of Shijiazhuang City, Shijiazhuang, Hebei
| | - Zehuai Wen
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong
- National Center for Design Measurement and Evaluation in Clinical Research, Guangzhou University of Chinese Medicine
| | - Ding Luo
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong
- Situ Ling Studio of Lingnan Acupuncture School
- Famous Doctor's Studio of Academician Shi Xuemin, Guangzhou
- Shenzhen Bao’an Research Center for Acupuncture and Moxibustion, Shenzhen, Guangdong, China
| | - Baile Ning
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong
- Situ Ling Studio of Lingnan Acupuncture School
- Famous Doctor's Studio of Academician Shi Xuemin, Guangzhou
- Shenzhen Bao’an Research Center for Acupuncture and Moxibustion, Shenzhen, Guangdong, China
| | - Wenbin Fu
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong
- Situ Ling Studio of Lingnan Acupuncture School
- Famous Doctor's Studio of Academician Shi Xuemin, Guangzhou
- Shenzhen Bao’an Research Center for Acupuncture and Moxibustion, Shenzhen, Guangdong, China
| | - Ying Liu
- The First Hospital of Shijiazhuang City, Shijiazhuang, Hebei
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Zhang B, Liu J, Bao T, Wilson G, Park J, Zhao B, Kong J. Locations for noninvasive brain stimulation in treating depressive disorders: A combination of meta-analysis and resting-state functional connectivity analysis. Aust N Z J Psychiatry 2020; 54:582-590. [PMID: 32419470 DOI: 10.1177/0004867420920372] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Many noninvasive brain stimulation techniques have been applied to treat depressive disorders. However, the target brain region in most noninvasive brain stimulation studies is the dorsolateral prefrontal cortex. Exploring new stimulation locations may improve the efficacy of noninvasive brain stimulation for depressive disorders. We aimed to explore potential noninvasive brain stimulation locations for depressive disorders through a meta-analysis and a functional connectivity approach. METHODS We conducted a meta-analysis of 395 functional magnetic resonance imaging studies to identify depressive disorder-associated brain regions as regions of interest. Then, we ran resting-state functional connectivity analysis with three different pipelines in 40 depression patients to find brain surface regions correlated with these regions of interest. The 10-20 system coordinates corresponding to these brain surface regions were considered as potential locations for noninvasive brain stimulation. RESULTS The 10-20 system coordinates corresponding to the bilateral dorsolateral prefrontal cortex, bilateral inferior frontal gyrus, medial prefrontal cortex, supplementary motor area, bilateral supramarginal gyrus, bilateral primary motor cortex, bilateral operculum, left angular gyrus and right middle temporal gyrus were identified as potential locations for noninvasive brain stimulation in depressive disorders. The coordinates were: posterior to F3, posterior to F4, superior to F3, posterior to F7, anterior to C4, P3, midpoint of F7-T3, posterior to F8, anterior to C3, midpoint of Fz-Cz, midpoint of Fz-Fp1, anterior to T4, midpoint of C3-P3, and anterior to C4. CONCLUSION Our study identified several potential noninvasive brain stimulation locations for depressive disorders, which may serve as a basis for future clinical investigations.
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Affiliation(s)
- Binlong Zhang
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Jiao Liu
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Tuya Bao
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Georgia Wilson
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Joel Park
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Bingcong Zhao
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Jian Kong
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
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40
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Zhang ZJ, Zhao H, Jin GX, Man SC, Wang YS, Wang Y, Wang HR, Li MH, Yam LL, Qin ZS, Yu KKT, Wu J, Ng FLB, Ziea TCE, Rong PJ. Assessor- and participant-blinded, randomized controlled trial of dense cranial electroacupuncture stimulation plus body acupuncture for neuropsychiatric sequelae of stroke. Psychiatry Clin Neurosci 2020; 74:183-190. [PMID: 31747095 DOI: 10.1111/pcn.12959] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 10/19/2019] [Accepted: 11/13/2019] [Indexed: 11/30/2022]
Abstract
AIM Acupuncture has benefits in the rehabilitation of neuropsychiatric sequelae of stroke. This study was aimed to evaluate the effectiveness of dense cranial electroacupuncture stimulation plus body acupuncture (DCEAS+BA) in treating poststroke depression (PSD), functional disability, and cognitive deterioration. METHODS In this assessor- and participant-blinded, randomized controlled trial, 91 stroke patients who initially had PSD were randomly assigned to either DCEAS+BA (n = 45) or minimum acupuncture stimulation as controls (n = 46) for three sessions per week over 8 consecutive weeks. The primary outcome was baseline-to-end-point change in score of the 17-item Hamilton Depression Rating Scale. Secondary outcomes included the Montgomery-Åsberg Depression Rating Scale for depressive symptoms, the Barthel Index for functional disability, and the Montreal Cognitive Assessment for cognitive function. RESULTS DCEAS+BA-treated patients showed strikingly greater end-point reduction than MAS-treated patients in scores of the three symptom domains. The clinical response rate, defined as an at least 50% baseline-to-end-point reduction in 17-item Hamilton Depression Rating Scale score, was markedly higher in the DCEAS+BA-treated group than that of controls (40.0% vs 17.4%, P = 0.031). Incidence of adverse events was not different in the two groups. Subgroup analysis revealed that DCEAS+BA with electrical stimulation on forehead acupoints was more apparent in reducing Barthel-Index-measured disability than that without electrical stimulation. CONCLUSION DCEAS+BA, particularly with electrical stimulation on forehead acupoints, reduces PSD, functional disability, and cognitive deterioration of stroke patients. It can serve as an effective rehabilitation therapy for neuropsychiatric sequelae of stroke.
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Affiliation(s)
- Zhang-Jin Zhang
- School of Chinese Medicine, University of Hong Kong, Hong Kong, China
| | - Hong Zhao
- Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center of Traditional Chinese Medicine, Tianjin, China
| | - Gui-Xing Jin
- Department of Psychiatry, First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Sui-Cheung Man
- School of Chinese Medicine, University of Hong Kong, Hong Kong, China
| | - Yi-Si Wang
- Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center of Traditional Chinese Medicine, Tianjin, China
| | - Ying Wang
- Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center of Traditional Chinese Medicine, Tianjin, China
| | - Hai-Rong Wang
- Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center of Traditional Chinese Medicine, Tianjin, China
| | - Meng-Han Li
- Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center of Traditional Chinese Medicine, Tianjin, China
| | - Lo-Lo Yam
- School of Chinese Medicine, University of Hong Kong, Hong Kong, China
| | - Zong-Shi Qin
- School of Chinese Medicine, University of Hong Kong, Hong Kong, China
| | - Kim-Kam Teresa Yu
- Department of Rehabilitation, Kowloon Hospital, Kowloon, Hong Kong, China
| | - Jing Wu
- Hong Kong Buddhist Association, The University of Hong Kong Clinical Centre for Teaching and Research in Chinese Medicine, Kowloon, Hong Kong
| | | | | | - Pei-Jing Rong
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
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Cheung DST, Tiwari A, Yeung WF, Yu DSF, So MKP, Chau PH, Wang XM, Lum TYS, Yuk Fung HYK, Ng BYM, Zhang ZJ, Lao L. Self-Administered Acupressure for Caregivers of Older Family Members: A Randomized Controlled Trial. J Am Geriatr Soc 2020; 68:1193-1201. [PMID: 32096884 DOI: 10.1111/jgs.16357] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 01/07/2020] [Accepted: 01/12/2020] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To test whether self-administered acupressure reduces stress and stress-related symptoms in caregivers of older family members. DESIGN In this randomized, assessor-blind, controlled trial, 207 participants were randomized (1:1) to an acupressure intervention or a wait-list control group. SETTING Community centers in Hong Kong, China. PARTICIPANTS Primary caregivers of an older family member who screened positive for caregiver stress with symptoms of fatigue, insomnia, or depression. INTERVENTION The 8-week intervention comprised four training sessions on self-administered acupressure, two follow-up sessions for learning reinforcement, and daily self-practice of self-administered acupressure. MEASUREMENTS The primary outcome was caregiver stress (Caregiver Burden Inventory). Secondary outcomes included fatigue (Piper Fatigue Scale), insomnia (Pittsburgh Sleep Quality Index), depression (Patient Health Questionnaire), and health-related quality of life (QoL) (12-item Short-Form Health Survey version 2). An intention-to-treat analysis was adopted. RESULTS Of 207 participants, 201 completed the study. Caregiver stress in the intervention group was significantly lower than that in the control group after 8 weeks (difference = -8.12; 95% confidence interval [CI] = -13.20 to -3.04; P = .002) and at 12-week follow-up (difference = -8.52; 95% CI = -13.91 to -3.12; P = .002). The intervention group, relative to the control group, also had significantly improved secondary outcomes of fatigue (difference = -0.84; 95% CI = -1.59 to -0.08; P = .031), insomnia (difference = -1.34; 95% CI = -2.40 to -0.27; P = .014), depression (difference = -1.76; 95% CI = -3.30 to -0.23; P = .025), and physical health-related QoL (difference = 3.08; 95% CI = 0.28-5.88; P = .032) after 8 weeks. CONCLUSION Self-administered acupressure intervention significantly relieves self-reported caregiver stress and co-occurring symptoms in those caring for older family members. Further studies are needed to measure the symptoms objectively and to examine the clinical importance of the observed improvement in caregiver stress. J Am Geriatr Soc 68:1193-1201, 2020.
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Affiliation(s)
- Denise Shuk Ting Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Agnes Tiwari
- School of Nursing, Hong Kong Sanatorium and Hospital, Hong Kong, China
| | - Wing-Fai Yeung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Doris Sau Fung Yu
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Mike Ka Pui So
- Department of Information Systems, Business Statistics and Operations Management, Hong Kong University of Science and Technology, Hong Kong, China
| | - Pui Hing Chau
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Xiao-Min Wang
- Department of Anaesthesiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Terry Yat Sang Lum
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | | | | | - Zhang-Jin Zhang
- School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Lixing Lao
- School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.,Virginia University of Integrative Medicine, Fairfax, Virginia
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Luo S, Long Y, Xiao W, Wang X, Chen R, Guo Q, Liu J, Shao R, Du L, Chen M. Risk of bias assessments and reporting quality of systematic reviews and randomized controlled trials examining acupuncture for depression: An overview and meta-epidemiology study. J Evid Based Med 2020; 13:25-33. [PMID: 32112515 DOI: 10.1111/jebm.12372] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To assess the use of risk of bias (ROB) assessment tools and the reporting quality of ROB assessment results in systematic reviews (SRs) of acupuncture for depression, as well as to evaluate the ROB of depression-related randomized controlled trials (RCT). METHODS Embase, Medline, Chinese Journal Full-Text Database (CJFD), VIP Chinese Technology Periodical Database, and WanFang Data Resource System of Digital Periodicals were searched from their inception to 24 November 2017. SRs of RCTs concerning acupuncture on depression were included. General characteristics and the information related to risk of bias in SRs were extracted. A descriptive analysis was used. RESULTS Thirty-nine SRs were included. Of these, two (5%) did not perform a ROB assessment, 18.9% did not report the ROB assessment results, and 62.2% did not report the assessment results of each ROB item. Text descriptions and tables were commonly used in reporting forms. Only 32.4% of SRs reported support for judgment. The reporting rate of ROB assessment results was low in all items (13.5%-35.1%). Regarding RCTs, 59.7% used adequate randomization methods, 13.1% performed adequate allocation concealment, 12.5% performed adequate blinding of participants and personnel, 27.3% performed adequate blinding of the assessment outcomes, and 41.5% and 49.3% had a low ROB in terms of incomplete outcome data and selective outcome reporting, respectively. CONCLUSION For the SRs of acupuncture for depression, the selection of ROB assessment tools needs to be optimized. The reporting quality is poor, and the overall ROB of RCTs is high. Therefore, the results may not be reliable.
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Affiliation(s)
- Shanxia Luo
- Department of Mental Health Center, West China Hospital of Sichuan University, Chengdu, P.R. China
| | - Youlin Long
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Wenzhe Xiao
- West China School of Public Health, Sichuan University, Chengdu, P.R. China
| | - Xin Wang
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, P.R. China
| | - Rui Chen
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, P.R. China
| | - Qiong Guo
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Jia Liu
- West China School of Medicine, Sichuan University, Chengdu, P.R. China
| | - Ruochen Shao
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, P.R. China
| | - Liang Du
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Min Chen
- Department of Traditional Chinese Medicine, The Third People's Hospital of Chengdu, Chengdu, P.R. China
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Tarsha MS, Park S, Tortora S. Body-Centered Interventions for Psychopathological Conditions: A Review. Front Psychol 2020; 10:2907. [PMID: 32038351 PMCID: PMC6993757 DOI: 10.3389/fpsyg.2019.02907] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 12/09/2019] [Indexed: 01/20/2023] Open
Abstract
World-wide, billions of dollars are spent each year on body-centered interventions to alleviate both physical and psychological pathologies. Given the high demand and increasing popularity of body-centered interventions, there is need for a systematic organization of empirical evidence associated with body-centered therapies. This article reviews the psychological effects of body-centered interventions on emotional well-being, including both self and other-administered (receptive) therapies. Theory behind body-centered interventions rely upon the bidirectional communication pathway between the brain and body. We investigated the bidirectional communication pathway between the brain and body by evaluating evidence across multiple body-centered therapies. The research reviewed includes studies that investigate effects of massage therapy, reflexology, acupuncture, functional relaxation, emotional freedom technique, Rolfing, yoga, tai-chi, and dance/movement therapy on psychological conditions across the lifespan. Results demonstrated that overall, massage therapy, tai-chi, dance/movement therapy, functional relaxation, reflexology, acupuncture and emotional freedom technique seem to alleviate stress, depression, anxiety, bipolar disorder and facilitate pain reduction. Of these, the most robust evidence available was for massage therapy, indicating it is an effective intervention for numerous age groups and populations. Rolfing and reflexology had the least amount of support, with few studies available that had small sample sizes. Although these conclusions are limited by scarcity of high-quality empirical data and contradictory findings, available evidence indicates that body-centered interventions can be effective in reducing psychopathology and supports the proposed mechanism of the bidirectional pathway between the brain and body: the body holds the potential to influence the mind. Integrating body-centered therapies in both clinical settings and as self-care could lead to better outcomes. Lastly, we propose the first taxonomy of body-centered interventions and empirical evidence of their effectiveness for clinicians and researchers.
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Affiliation(s)
- Mary S. Tarsha
- Department of Psychology, Kroc Institute for International Peace Studies, University of Notre Dame, Notre Dame, IN, United States
| | - Sohee Park
- Department of Psychology, Vanderbilt University, Nashville, TN, United States
| | - Suzi Tortora
- Dancing Dialogue: Healing and Expressive Arts, New York, NY, United States
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Jia J, Shen J, Liu FH, Wong HK, Yang XJ, Wu QJ, Zhang H, Wang HN, Tan QR, Zhang ZJ. Effectiveness of Electroacupuncture and Electroconvulsive Therapy as Additional Treatment in Hospitalized Patients With Schizophrenia: A Retrospective Controlled Study. Front Psychol 2019; 10:2306. [PMID: 31681100 PMCID: PMC6804524 DOI: 10.3389/fpsyg.2019.02306] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 09/27/2019] [Indexed: 12/18/2022] Open
Abstract
Electroacupuncture (EA) and electroconvulsive therapy (ECT) are often used in the management of schizophrenia. This study sought to determine whether additional EA and ECT could augment antipsychotic response and reduce related side effects. In this retrospective controlled study, 287 hospitalized schizophrenic patients who received antipsychotics (controls, n = 50) alone or combined with EA (n = 101), ECT (n = 55) or both (EA + ECT, n = 81) were identified. EA and ECT were conducted for 5 and 3 sessions per week, respectively, with a maximum of 12 sessions for ECT during hospitalization. The Scale for the Assessment of Positive Symptoms (SAPS) and Scale for the Assessment of Negative Symptoms (SANS) were used to assess the severity of psychotic symptoms. Clinical response on SAPS and SANS, weight gain, and adverse events were compared. Survival analysis revealed that the ECT and EA + ECT groups had markedly greater clinical response rate than controls on SAPS [72.7 and 90.1% vs. 64.0%; relative risk (RR), 1.974 and 2.628, respectively, P ≤ 0.004] and on SANS (67.3 and 70.4% vs. 42.0%; RR, 1.951 and 2.009, respectively, P ≤ 0.015). A significantly greater response rate on SANS than controls was also observed in the EA group (64.4% vs. 42.0%; RR = 1.938, P = 0.008). EA-containing regimens remarkably reduced weight gain and incidences of headache, insomnia, dry mouth, and electrocardiographic abnormalities. These results suggest that EA and ECT can serve as additional treatment for enhancing antipsychotic response and reduce the side effects in hospitalized patients with schizophrenia. Clinical Trial Registration: http://www.chictr.org.cn/showprojen.aspx?proj=38901, identifier ChiCTR1900023563.
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Affiliation(s)
- Jie Jia
- Department of Psychiatry, Xi'an Mental Health Center, Xi'an, China
| | - Jun Shen
- Department of Psychiatry, Xi'an Mental Health Center, Xi'an, China
| | - Fei-Hu Liu
- Department of Psychiatry, Xi'an Mental Health Center, Xi'an, China
| | - Hei Kiu Wong
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Xin-Jing Yang
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Qiang-Ju Wu
- Department of Psychiatry, Xi'an Mental Health Center, Xi'an, China
| | - Hui Zhang
- Department of Psychiatry, Xi'an Mental Health Center, Xi'an, China
| | - Hua-Ning Wang
- Department of Psychiatry, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Qing-Rong Tan
- Department of Psychiatry, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Zhang-Jin Zhang
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
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45
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Li M, Niu J, Yan P, Yao L, He W, Wang M, Li H, Cao L, Li X, Shi X, Liu X, Yang K. The effectiveness and safety of acupuncture for depression: An overview of meta-analyses. Complement Ther Med 2019; 50:102202. [PMID: 32444032 DOI: 10.1016/j.ctim.2019.102202] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 09/19/2019] [Accepted: 09/28/2019] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To provide an overview of existing meta-analysis (MAs) on the efficacy and safety of acupuncture for depression, and assess the methodological quality and the strength of evidence of the included MAs. METHODS We searched MAs of randomized trials that have evaluated the effects of acupuncture on depression in three international and three Chinese databases from their inception until August 2019. The methodological quality of included MAs was evaluated with the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), and the strength of evidence with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE). We used the intra-class correlation coefficient (ICC) to assess reviewer agreement in the pre-experiment. RESULTS We included 31 MAs and 59 RCTs. The results of included MAs were conflicting, our meta-analyses found that acupuncture may confer small benefit in reducing the severity of depression by end of treatment than no treatment/wait list/treatment as usual(SMD -0.74, 95% CI -1.06 to -0.41, eight trials, 624 participants), control acupuncture (invasive, non-invasive sham controls) (SMD 0.27, 95% CI -0.51 to -0.04, 20 trials, 1055 participants), antidepressants(Selective serotonin reuptake inhibitors (SSRI)/ Tetracyclic antidepressants(TCAs)) (SMD -0.28, 95% CI -0.46 to -0.10, 30 trials, 3068 participants), acupuncture plus antidepressants versus antidepressants(SSRI/TCAs) (SMD -0.99, 95% CI -1.37 to -0.61, 17 trials, 1110 participants). Subgroup analyses showed that there was no difference between electro-acupuncture and invasive control (P = 0.37), electro-acupuncture and non-invasive control (P = 0.90), manual acupuncture and Tetracyclic antidepressants (P = 0.57), electro-acupuncture and Tetracyclic antidepressants (P = 0.07). Six MAs concluded that acupuncture reduced the incidence of adverse events compared with antidepressants. The evaluation with AMSTAR-2 showed that the quality of included MAs was low or critically low. The results of the GRADE evaluation showed that the strength of evidence was low to very low for most outcomes. CONCLUSIONS Although acupuncture appears to be more effective and safer than no treatment, control acupuncture and antidepressants, the quality of the available evidence was very low. Further methodologically rigorous and adequately powered primary studies are needed to confirm the effectiveness of acupuncture for depression.
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Affiliation(s)
- Meixuan Li
- School of Public Health, Lanzhou University, Lanzhou, 730000, China; Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Evidence Based Social Science Research Center, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | - Junqiang Niu
- The First Hospital of Lanzhou University, Lanzhou, 730000, China
| | - Peijing Yan
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Institute of Clinical Research and Evidence Based Medicine, The Gansu Provincial Hospital, Lanzhou, 730000, China
| | - Liang Yao
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, L8S4L8, Canada
| | - Wenbo He
- School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Meng Wang
- School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Huijuan Li
- School of Public Health, Lanzhou University, Lanzhou, 730000, China; Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Evidence Based Social Science Research Center, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | - Liujiao Cao
- School of Public Health, Lanzhou University, Lanzhou, 730000, China; Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Evidence Based Social Science Research Center, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | - Xiuxia Li
- School of Public Health, Lanzhou University, Lanzhou, 730000, China; Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Evidence Based Social Science Research Center, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | - Xiue Shi
- Institute of Evidence Based Rehabilitation Medicine of Gansu Province, Lanzhou, 730000, China
| | - Xingrong Liu
- School of Public Health, Lanzhou University, Lanzhou, 730000, China; Evidence Based Social Science Research Center, Lanzhou University, Lanzhou, 730000, China.
| | - Kehu Yang
- School of Public Health, Lanzhou University, Lanzhou, 730000, China; Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Evidence Based Social Science Research Center, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China; Institute of Clinical Research and Evidence Based Medicine, The Gansu Provincial Hospital, Lanzhou, 730000, China.
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Yang X, Gong W, Ma X, Wang S, Wang X, Guo T, Guo Z, Sun Y, Li J, Zhao B, Tu Y. Factor analysis of electroacupuncture and selective serotonin reuptake inhibitors for major depressive disorder: an 8-week controlled clinical trial. Acupunct Med 2019; 38:45-52. [PMID: 31544488 DOI: 10.1136/acupmed-2017-011412] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND There is evidence supporting electroacupuncture (EA) for the treatment of major depressive disorder (MDD), but its characteristics have not been well investigated. OBJECTIVE To investigate the effectiveness and characteristics of EA in MDD. METHODS 60 subjects were enrolled-35 in the EA group and 25 in the selective serotonin reuptake inhibitor (SSRI) group based on their preferences-in an 8-week non-randomised controlled clinical trial. The 24-item Hamilton depression rating scale (HAMD-24) and clinical global impression (CGI) were adopted for clinical assessment. The Columbia suicide severity rating scale and adverse event form were used to measure safety and tolerability. The characteristics of EA and SSRIs were compared by analysing seven factors of the HAMD-24. RESULTS There was no significant difference between the two groups in terms of HAMD-24 response rate after intervention (P>0.05). Patients treated with EA demonstrated a significant reduction in CGI scores (P<0.05) with fewer adverse events compared with SSRIs (P<0.01). Although HAMD-24 factor analysis showed both EA and SSRIs could improve factor scores in cognitive impairment, diurnal variation, retardation, sleep disturbance, anxiety/somatisation and feelings of despair, EA showed greater improvement in anxiety/somatisation and feelings of despair than SSRIs (P<0.05). CONCLUSIONS There was no significant difference between EA and SSRIs in the treatment of MDD with respect to our primary outcome. However, as a potential therapy for MDD, EA appeared to result in greater symptom improvement than SSRI treatment with respect to anxiety/somatisation and feelings of despair. The results of this secondary analysis should be interpreted cautiously given the inherent issues of multiple testing.
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Affiliation(s)
- Xinjing Yang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China.,Chinese Medicine Rehabilitation Center, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Weijun Gong
- Chinese Medicine Rehabilitation Center, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Xuehong Ma
- Acupuncture-Moxibustion Department, Dongfang Hospital, Clinical Medical College of Beijing University of Chinese Medicine, Beijing, China
| | - Sihan Wang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Xueqin Wang
- Psychiatric Department, Peking University Sixth Hospital, Beijing, China
| | - Tianwei Guo
- DAOM Program, American Academy of Acupuncture and Oriental Medicine, Roseville, Minnesota, USA
| | - Zhuo Guo
- School of Chinese Integrative Medicine, Hebei Medical University, Hebei, China
| | - Yang Sun
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Jing Li
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Bingcong Zhao
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Ya Tu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
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47
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Abstract
OBJECTIVES As clinical practice guidelines vary widely in their search strategies and recommendations of complementary and alternative medicine (CAM) for depression, this overview aimed at systematically summarising the level 1 evidence on CAM for patients with a clinical diagnosis of depression. METHODS PubMed, PsycInfo and Central were searched for meta-analyses of randomised controlled clinical trials (RCTs) until 30 June 2018. Outcomes included depression severity, response, remission, relapse and adverse events. The quality of evidence was assessed according to Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) considering the methodological quality of the RCTs and meta-analyses, inconsistency, indirectness, imprecision of the evidence and the potential risk of publication bias. RESULTS The literature search revealed 26 meta-analyses conducted between 2002 and 2018 on 1-49 RCTs in major, minor and seasonal depression. In patients with mild to moderate major depression, moderate quality evidence suggested the efficacy of St. John's wort towards placebo and its comparative effectiveness towards standard antidepressants for the treatment for depression severity and response rates, while St. John's wort caused significant less adverse events. In patients with recurrent major depression, moderate quality evidence showed that mindfulness-based cognitive therapy was superior to standard antidepressant drug treatment for the prevention of depression relapse. Other CAM evidence was considered as having low or very low quality. CONCLUSIONS The effects of all but two CAM treatments found in studies on clinical depressed patients based on low to very low quality of evidence. The evidence has to be downgraded mostly due to avoidable methodological flaws of both the original RCTs and meta-analyses not following the Consolidated Standards of Reporting Trials and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Further research is needed.
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Affiliation(s)
- Heidemarie Haller
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, Universitat Duisburg-Essen, Essen, Germany
| | - Dennis Anheyer
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, Universitat Duisburg-Essen, Essen, Germany
| | - Holger Cramer
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, Universitat Duisburg-Essen, Essen, Germany
| | - Gustav Dobos
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, Universitat Duisburg-Essen, Essen, Germany
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48
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Lee MJ, Ryu JS, Won SK, Namgung U, Jung J, Lee SM, Park JY. Effects of Acupuncture on Chronic Stress-Induced Depression-Like Behavior and Its Central Neural Mechanism. Front Psychol 2019; 10:1353. [PMID: 31333523 PMCID: PMC6625224 DOI: 10.3389/fpsyg.2019.01353] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 05/24/2019] [Indexed: 12/17/2022] Open
Abstract
Depression is a serious psychiatric disorder with an enormous socioeconomic burden, and it is commonly comorbid with pain, chronic fatigue, or other inflammatory diseases. Recent studies have shown that acupuncture is an effective therapeutic method for reducing depressive symptoms; however, the underlying mechanism remains unknown. In this study, we investigated the effects of acupuncture on chronic stress-induced depression-like behavior and its central neural mechanisms in the brain. We induced chronic restraint stress (CRS) in male C57BL/6 mice for 14 or 28 consecutive days. Acupuncture treatment was performed at KI10·LR8·LU8·LR4 or control points for 7 or 14 days. Depression-like behavior was assessed with the open field test. Then, brain neural activity involving c-Fos and serotonin-related mechanisms via the 5-HT1A and 5-HT1B receptors were investigated. Acupuncture treatment at KI10·LR8·LU8·LR4 points rescued the depressive-like behavior, while control points (LU8·LR4·HT8·LR2) and non-acupoints on the hips did not. Brain neural activity was changed in the hippocampus, cingulate cortex, motor cortex, insular cortex, thalamus, and the hypothalamus after acupuncture treatment. Acupuncture treatment increased expression of 5-HT1A receptor in the cortex, hippocampus, thalamus, and the hypothalamus, and of 5-HT1B in the cortex and thalamus. In conclusion, acupuncture treatment at KI10·LR8·LU8·LR4 was effective in alleviating the depressive-like behavior in mice, and this therapeutic effect was produced through central brain neural activity and serotonin receptor modulation.
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Affiliation(s)
- Min-Ju Lee
- Department of Korean Medicine, College of Korean Medicine, Daejeon University, Daejeon, South Korea
| | - Jae-Sang Ryu
- Department of Korean Medicine, College of Korean Medicine, Daejeon University, Daejeon, South Korea
| | - Seul-Ki Won
- Department of Korean Medicine, College of Korean Medicine, Daejeon University, Daejeon, South Korea
| | - Uk Namgung
- Department of Korean Medicine, College of Korean Medicine, Daejeon University, Daejeon, South Korea
| | - Jeeyoun Jung
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - So-Min Lee
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Ji-Yeun Park
- Department of Korean Medicine, College of Korean Medicine, Daejeon University, Daejeon, South Korea
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49
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Zhao B, Li Z, Wang Y, Ma X, Wang X, Wang X, Liu J, Huang Y, Zhang J, Li L, Hu X, Jiang J, Qu S, Chai Q, Song M, Yang X, Bao T, Fei Y. Manual or electroacupuncture as an add-on therapy to SSRIs for depression: A randomized controlled trial. J Psychiatr Res 2019; 114:24-33. [PMID: 31015098 DOI: 10.1016/j.jpsychires.2019.04.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 04/01/2019] [Accepted: 04/05/2019] [Indexed: 01/23/2023]
Abstract
Selective serotonin reuptake inhibitors (SSRIs) are first-line antidepressants, however, only around 60% of patients could benefit from them. Acupuncture is supported by insufficient evidence to help with symptom relieving and SSRIs tolerance. This pragmatic randomized controlled trial compared SSRIs alone versus SSRIs together with manual acupuncture (MA) or electroacupuncture (EA) in moderate to severe depressed patients. Patients were randomly allocated to receive MA + SSRIs (161), EA + SSRIs (160), or SSRIs alone (156) for six weeks, and then followed up for another four weeks. The primary outcome was response rate of the 17-item Hamilton Depression Scale (HAMD-17) at 6th week. The secondary outcomes were HAMD-17 (remission rate, early onset rate, total score), Self-Rating Depression Scale (SDS: total score), Clinical Global Impression (CGI), Rating Scale for Side Effects (SERS: total and domain scores), number of patients with adjusted dosage of SSRIs and adverse events (AEs). Both MA + SSRIs and EA + SSRIs were significantly better than SSRIs at 6th week on HAMD-17 response rate (RR = 1.21, 95% CI 1.04, 1.42, P = 0.013; RR = 1.27, 95% CI 1.09, 1.48, P = 0.0014), HAMD-17 early onset rate (P < 0.0001), HAMD-17 and SDS total scores (P < 0.05), CGI (P < 0.01), SERS total score (P < 0.01), number of patients with increased dosage of SSRIs (P < 0.01). For HAMD-17 remission rate, EA + SSRIs was significantly higher than SSRIs (P = 0.0083), while MA + SSRIs showed no significant difference at 6th week (P = 0.092). No unintended acupuncture-related severe AE was observed. This study identified that both MA and EA showed beneficial effects in addition to SSRIs alone in patients with moderate to severe depression, and were well tolerated. Clinical trials registration: ChiCTR-TRC-08000297.
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Affiliation(s)
- Bingcong Zhao
- Beijing University of Chinese Medicine, School of Acupuncture-Moxibustion and Tuina, Beijing, 100029, China; Capital Medical University, Beijing Hospital of Traditional Chinese Medicine, Department of Acupuncture and Moxibustion, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, 100010, China
| | - Zhigang Li
- Beijing University of Chinese Medicine, School of Acupuncture-Moxibustion and Tuina, Beijing, 100029, China
| | - Yuanzheng Wang
- (c)Peking University First Hospital, Department of Integrative TCM and Western Medicine, Beijing, 100034, China
| | - Xuehong Ma
- (d)Dongfang Hospital, The Second Clinical Medical College of Beijing University of Chinese Medicine, Department of Acupuncture & Moxibustion, Beijing, 100078, China
| | - Xiangqun Wang
- (e)Peking University Sixth Hospital, Department of Psychiatry, Beijing, 100191, China
| | - Xueqin Wang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Jianping Liu
- Beijing University of Chinese Medicine, Centre for Evidence-Based Chinese Medicine, Beijing, 100029, China
| | - Yong Huang
- Southern Medical University, TCM School, Guangzhou, 510515, China
| | - Jianbin Zhang
- The Second Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Provincial Second Chinese Medicine Hospital, The Acuology Department, Nanjing, 210017, China
| | - Liqin Li
- Sixth Hospital of Baotou, Department of Psychiatry, Baotou, 014060, China
| | - Xiaoyang Hu
- University of Southampton, Aldermoor Health Centre, Primary Care and Population Sciences, Southampton, SO16 5ST, United Kingdom
| | - Jinfeng Jiang
- Nanjing University of Chinese Medicine, Key Laboratory of Acupuncture and Medicine Research of Minister of Education, Nanjing, 210023, China
| | - Shanshan Qu
- Southern Medical University, TCM School, Guangzhou, 510515, China
| | - Qianyun Chai
- Beijing University of Chinese Medicine, Centre for Evidence-Based Chinese Medicine, Beijing, 100029, China
| | - Meng Song
- Beijing University of Chinese Medicine, School of Acupuncture-Moxibustion and Tuina, Beijing, 100029, China
| | - Xinjing Yang
- Beijing University of Chinese Medicine, School of Acupuncture-Moxibustion and Tuina, Beijing, 100029, China
| | - Tuya Bao
- Beijing University of Chinese Medicine, School of Acupuncture-Moxibustion and Tuina, Beijing, 100029, China.
| | - Yutong Fei
- Beijing University of Chinese Medicine, Centre for Evidence-Based Chinese Medicine, Beijing, 100029, China.
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50
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Lanctôt KL, Lindsay MP, Smith EE, Sahlas DJ, Foley N, Gubitz G, Austin M, Ball K, Bhogal S, Blake T, Herrmann N, Hogan D, Khan A, Longman S, King A, Leonard C, Shoniker T, Taylor T, Teed M, de Jong A, Mountain A, Casaubon LK, Dowlatshahi D, Swartz RH. Canadian Stroke Best Practice Recommendations: Mood, Cognition and Fatigue following Stroke, 6th edition update 2019. Int J Stroke 2019; 15:668-688. [PMID: 31221036 DOI: 10.1177/1747493019847334] [Citation(s) in RCA: 105] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
The 2019 update of the Canadian Stroke Best Practice Recommendations (CSBPR) for Mood, Cognition and Fatigue following Stroke is a comprehensive set of evidence-based guidelines addressing three important issues that can negatively impact the lives of people who have had a stroke. These include post-stroke depression and anxiety, vascular cognitive impairment, and post-stroke fatigue. Following stroke, approximately 20% to 50% of all persons may be affected by at least one of these conditions. There may also be overlap between conditions, particularly fatigue and depression. If not recognized and treated in a timely matter, these conditions can lead to worse long-term outcomes. The theme of this edition of the CSBPR is Partnerships and Collaborations, which stresses the importance of integration and coordination across the healthcare system to ensure timely and seamless care to optimize recovery and outcomes. Accordingly, these recommendations place strong emphasis on the importance of timely screening and assessments, and timely and adequate initiation of treatment across care settings. Ideally, when screening is suggestive of a mood or cognition issue, patients and families should be referred for in-depth assessment by healthcare providers with expertise in these areas. As the complexity of patients treated for stroke increases, continuity of care and strong communication among healthcare professionals, and between members of the healthcare team and the patient and their family is an even bigger imperative, as stressed throughout the recommendations, as they are critical elements to ensure smooth transitions from acute care to active rehabilitation and reintegration into their community.
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Affiliation(s)
- Krista L Lanctôt
- Sunnybrook Research Institute, Toronto, Canada.,University of Toronto Faculty of Medicine, Toronto, Canada
| | | | - Eric E Smith
- Calgary Stroke Program, Calgary, Canada.,Hotchkiss Brain Institute, University of Calgary Cumming School of Medicine, Calgary, Alberta
| | - Demetrios J Sahlas
- Division of Neurology, Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | | | - Gord Gubitz
- Queen Elizabeth II Health Sciences Centre, Halifax, Canada.,Department of Medicine (Neurology), Dalhousie University, Halifax, Canada.,Canadian Stroke Consortium, Ontario, Canada
| | - Melissa Austin
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | | | | | - Treena Blake
- GF Strong Rehabilitation Centre, Vancouver, Canada
| | - Nathan Herrmann
- Sunnybrook Research Institute, Toronto, Canada.,University of Toronto Faculty of Medicine, Toronto, Canada
| | - David Hogan
- University of Calgary Cumming School of Medicine, Calgary, Canada
| | - Aisha Khan
- Montreal University Health Center, Montreal, Canada
| | - Stewart Longman
- Calgary Stroke Program, Alberta Health Services, Calgary, Canada
| | - Andrea King
- Nova Scotia Health Authority, Halifax, Canada
| | - Carol Leonard
- Audiology and Speech-Language Pathology Program, University of Ottawa, Ottawa, Canada
| | | | - Trudy Taylor
- Carewest Dr. Vernon Fanning Centre, Calgary, Canada
| | - Moira Teed
- Heart and Stroke Foundation of Canada, Toronto, Canada
| | | | - Anita Mountain
- Dalhousie University Division of Physical Medicine and Rehabilitation, Halifax, Canada.,Nova Scotia Rehabilitation Centre Site, Halifax, Canada
| | - Leanne K Casaubon
- University of Toronto Faculty of Medicine, Toronto, Canada.,Canadian Stroke Consortium, Ontario, Canada.,Toronto Western Hospital, University Health Network, Toronto, Canada
| | | | - Richard H Swartz
- Sunnybrook Research Institute, Toronto, Canada.,University of Toronto Faculty of Medicine, Toronto, Canada
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