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Hua K, Usichenko T, Cummings M, Bernatik M, Willich SN, Brinkhaus B, Dietzel J. Effects of auricular stimulation on weight- and obesity-related parameters: a systematic review and meta-analysis of randomized controlled clinical trials. Front Neurosci 2024; 18:1393826. [PMID: 39165337 PMCID: PMC11333859 DOI: 10.3389/fnins.2024.1393826] [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: 02/29/2024] [Accepted: 07/19/2024] [Indexed: 08/22/2024] Open
Abstract
Background Over the last three decades, the number of randomized controlled trials (RCTs) using stimulation of auricular vagal sensory nerves by means of electrical stimulation, auricular acupuncture, or acupressure to support weight loss has increased markedly. This systematic review focuses on the effects of auricular stimulation (AS) on anthropometric parameters and obesity-related blood chemistry. Methods and analysis The following databases were searched until November 2021: MEDLINE (PubMed), EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), ISI Web of Science, and Scopus Database. Data collection and analysis were conducted by two reviewers independently. Quality and risk assessment of included studies was performed using the risk of bias tool of the Cochrane Handbook, and the meta-analysis of the effect of the most frequently assessed biomarkers was conducted using the statistical software RevMan. Results The full texts of 1,274 studies were screened; 22 contained data on obesity-related outcomes, and 15 trials with 1,333 patients were included in the meta-analysis. The overall quality of the included trials was moderate. AS significantly reduced body mass index (BMI) (mean difference (MD) = -0.38 BMI points, 95% CI (-0.55 to -0.22), p < 0.0001), weight (MD = -0.66 kg, 95% CI (-1.12 to -0.20), p = 0.005), waist circumference (MD = -1.44 cm, 95% CI (-2.69 to -0.20), p = 0.02), leptin, insulin, and HOMA insulin resistance compared to controls. No significant reduction was found in body fat, hip circumference, ratio of waist/hip circumference, cholesterol, LDL, triglycerides, adiponectin, ghrelin, and glucose levels. The AS was safe throughout the trials, with only minor adverse reactions. Conclusion The study results suggest that a reduction of weight and BMI can be achieved by AS in obese patients; however, the size of the effect does not appear to be of clinical relevance. The effects might be underestimated due to active sham trials. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021231885.
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Affiliation(s)
- Kevin Hua
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - University Medicine, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Taras Usichenko
- Department for Anaesthesiology, University Hospital Greifswald, Greifswald, Germany
- Department of Anesthesia, McMaster University, Hamilton, ON, Canada
| | - Mike Cummings
- British Medical Acupuncture Society, London, United Kingdom
| | | | - Stefan N. Willich
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - University Medicine, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Benno Brinkhaus
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - University Medicine, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Joanna Dietzel
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - University Medicine, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Effect of Foot Reflexology on Sexual Function of Patients under Hemodialysis: A Randomized Parallel Controlled Clinical Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:8553549. [PMID: 34721645 PMCID: PMC8553438 DOI: 10.1155/2021/8553549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 10/09/2021] [Accepted: 10/11/2021] [Indexed: 11/24/2022]
Abstract
Introduction Hemodialysis patients experience sexual dysfunction due to the nature of their disease and its complications. Dialysis patients have reported sexual dysfunction as one of the most important stressors, which leads to many psychological and physiological problems. Sexual function in hemodialysis patients has been improved with pharmaceutical and nonpharmacological therapies. Foot reflexology is a complementary and alternative treatment that can be used in conjunction with contemporary care. By activating the chemical nerve system, reflexology may balance enzymes and regulate endocrine function. Objectives To determine the effect of foot reflexology on the sexual function of hemodialysis patients. Methods This randomized controlled trial was conducted on 47 patients on chronic hemodialysis referred to Imam Reza Hospital in Sirjan, Iran, who were divided into two groups of reflexology (n = 24; male = 19 and female = 5) and sham (n = 23; male = 18, and female = 5). The intervention group received foot reflexology during dialysis for four weeks, three times a week, 30 minutes each time (15 minutes per foot). The sham group received nonspecific foot massage without applying pressure on standard reflex points with the same condition and duration as the intervention group. The international index of erectile function and female sexual function index was assessed before, immediately, and one month after the intervention. Results The results showed that immediately after the intervention, male orgasm function, sexual desire, and intercourse satisfaction in the reflexology group was significantly higher than those of the sham group. There was no significant difference between the two groups regarding erectile function and overall satisfaction. Furthermore, there was no significant difference between the two groups in terms of different aspects of female sexual function. Conclusions Foot reflexology, as an effective intervention treatment, can reduce some aspects of sexual dysfunction of male patients under hemodialysis.
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Li SQ, Chen JR, Liu ML, Wang YP, Zhou X, Sun X. Effect and Safety of Acupuncture for Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis of 21 Randomised Controlled Trials. Chin J Integr Med 2021; 28:463-471. [PMID: 34432205 DOI: 10.1007/s11655-021-3450-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To evaluate the effects of acupuncture on hypoglycaemic outcomes in type 2 diabetes mellitus (T2DM). METHODS PubMed, Embase, Cochrane Library, and ClinicalTrials.gov were searched from inception up to July 2020, to identify randomised controlled trials (RCTs) that enrolled patients with T2DM and compared acupuncture combined with antidiabetic drugs to antidiabetic drugs alone. The primary outcomes were haemoglobin A1c (HbA1c) and fasting blood glucose (FBG). The secondary outcomes included 2-h blood glucose (2hBG), fasting insulin (FINS), homeostatic model assessment for insulin resistance (HOMA-IR), and acupuncture-related adverse events. Mean difference (MD) and 95% confidence interval (CI) were used as the effect measure in the meta-analysis. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation tool. RESULTS Twenty-one RCTs (n=1,188) were included. The meta-analytic results showed that the acupuncture group had greater reductions in FBG (MD -6.46 mg/dL, 95% CI -11.95 to -0.98; moderate-quality evidence) and HOMA-IR (MD -1.23, 95% CI -2.16 to -0.31; low-quality evidence), but comparable changes in HbA1c (MD -0.39%, 95% CI -0.84 to 1.61; very-low-quality evidence), 2hBG (MD -4.99 mg/dL, 95% CI -20.74 to 10.76; low-quality evidence), and FINS (MD -1.32 µIU/mL, 95% CI -3.76 to 1.12; low-quality evidence). No data on the incidence of diabetic complications were found. All acupuncture-related adverse events reported were mild. CONCLUSIONS The current evidence suggests that acupuncture, as a complementary therapy to antidiabetic drugs, has a small but statistically significant effect on decreasing FBG and improving insulin resistance. The effects of acupuncture on HbA1c, 2hBG, and FINS remain uncertain. Acupuncture is generally safe in patients with mild diabetes. More evidence for the long-term effects of acupuncture on T2DM is needed. (Trial registration No. CRD42018115639).
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Affiliation(s)
- Shu-Qing Li
- Evidence-Based Medicine Research Centre, Jiangxi University of Traditional Chinese Medicine, Nanchang, 330004, China
| | - Jian-Rong Chen
- Department of Endocrinology, the First Affiliated Hospital of Nanchang University, Nanchang, 330006, China
| | - Mei-Lu Liu
- Department of Integrated Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Yan-Ping Wang
- Evidence-Based Medicine Research Centre, Jiangxi University of Traditional Chinese Medicine, Nanchang, 330004, China
| | - Xu Zhou
- Evidence-Based Medicine Research Centre, Jiangxi University of Traditional Chinese Medicine, Nanchang, 330004, China.
| | - Xin Sun
- Evidence-Based Medicine Research Centre, Jiangxi University of Traditional Chinese Medicine, Nanchang, 330004, China.,Chinese Evidence-Based Medicine Centre, West China Hospital, Sichuan University, Chengdu, 610041, China
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Melo GAA, Aguiar LL, Silva RA, Pereira FGF, Silva FLBD, Caetano JÁ. Effects of acupuncture in patients with chronic kidney disease: a systematic review. Rev Bras Enferm 2020; 73:e20180784. [DOI: 10.1590/0034-7167-2018-0784] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 07/03/2019] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objectives: to analyze the effects of acupuncture techniques in patients with chronic kidney disease. Methods: a systematic review conducted in six databases, from September to December 2017, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses’ criteria. The following descriptors were used: Acupuncture AND Chronic Renal Insufficiency AND Clinical Trial. Results: nine studies were selected; the acupuncture techniques used were auriculotherapy, electroacupuncture and acupressure aimed at improving quality of life, fatigue, sleep and clinical variables of the disease. The studies that assessed quality of life, sleep and fatigue presented significant benefits. Studies that assessed quality of life, sleep and fatigue presented significant benefits. There was no statistical significance in the improvement of serum creatinine levels and glomerular filtration rate. Methodological and assessment tools’ divergence made impossible meta-analysis Conclusions: studies reinforce the positive effect of acupuncture in improving quality of life, fatigue and sleep in patients.
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Yin C, Zhang J, Er Z. Clinical application of auricular point sticking in perioperative hemostasis for elderly patients with intertrochanteric fractures of the femur. Medicine (Baltimore) 2019; 98:e16963. [PMID: 31464938 PMCID: PMC6736476 DOI: 10.1097/md.0000000000016963] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
We investigated the clinical application of auricular point sticking (APS) combined with tranexamic acid in perioperative hemostasis in elderly patients with intertrochanteric fractures of the femur.This is a prospective cohort study, and we analyzed 86 elderly patients with intertrochanteric fractures of the femur who underwent closed reduction and internal fixation with proximal femoral nail antirotation (PFNA) between January 2016 and December 2016. The patients were divided into auricular point combined with tranexamic acid group (APS group, n = 43) and tranexamic acid alone group (Control group, n = 43). APS was performed for patients using Vaccaria seeds 1 to 2 days before the operation. The 4 acupoints of hemostasis, including spleen, diaphragm, pituitary, and adrenal gland, as well as acupoint of hip joint, were selected. Routine treatment was performed using tranexamic acid alone in the control group. Blood transfusion, intraoperative, postoperative, and total blood loss were compared between the 2 groups.This study enrolled 36 males and 50 females aged 71 to 93 years (average age: 78.5 years). There were no significant differences in gender, age, height, weight, preoperative hematocrit level, fracture classification, operative time, and hospitalization stay (P > .05). Total blood loss was lower in the APS group than the control group (244.26, 197.87-258.50 ml vs 533.94, 424.00-598.09 ml, P < .01). The blood transfusion rate was 14.0% in the APS group and 34.9% in the control group (P = .02).APS can reduce perioperative bleeding and decrease the need for blood transfusion in elderly patients with intertrochanteric fractures of the femur. This noninvasive method can be applied clinically. Randomized trials may be needed to confirm the findings.
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Li Y, Hou L, Wang Y, Xie L, Zhang M, Pan Z, Li Y, Ding Y, Sun M, Qu Y, Liu S. Auricular points acupressure for insulin resistance in overweight/obese women with polycystic ovary syndrome: protocol for a randomised controlled pilot trial. BMJ Open 2019; 9:e027498. [PMID: 31142530 PMCID: PMC6549699 DOI: 10.1136/bmjopen-2018-027498] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Approximately 5%-20% of reproductive women suffer from polycystic ovary syndrome (PCOS). Auricular points acupressure (AA) may serve as alternative management for PCOS for its benefits in both physical and psychological well-being. However, the effects of AA for insulin resistance (IR) in overweight/obese PCOS women have not been confirmed. METHODS AND ANALYSIS The present study is designed as a randomised, placebo-controlled pilot trial to evaluate the effectiveness and safety of AA in treating IR in women with PCOS. A total of 60 eligible PCOS subjects will be randomised into an intervention group (AA group) and a control group (sham AA group) in a ratio of 1:1. Magnetic beads will be taped to the auricular points by the same senior acupuncture specialist from the First Affiliated Hospital, Heilongjiang University of Chinese Medicine. The treatment will last for 12 weeks. Primary outcome measure will be changes in homeostasis model assessment of IR between baseline and after 3 months of AA/sham AA treatment. Secondary outcomes include hormonal profile, weight, waist/hip circumference, body mass index, blood pressure, Ferriman-Gallwey score, acne and the assessment of health-related quality of life. Outcome measures are collected at baseline and the end of treatment visit. ETHICS AND DISSEMINATION The protocol has been approved by the ethics committee of the First Affiliated Hospital of Heilongjiang University of Chinese Medicine (HZYLLKY201800301). Written informed consent will be obtained from all participants. The results will be disseminated through peer-reviewed journals for publications. TRIAL REGISTRATION NUMBER NCT03546595; Pre-results.
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Affiliation(s)
- Yan Li
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Lihui Hou
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yingji Wang
- School of Pharmacy, Harbin Medical University, Harbin, China
| | - Liangzhen Xie
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Meiwei Zhang
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Zimeng Pan
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yangyang Li
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yicheng Ding
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Miao Sun
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yufang Qu
- Qiqihar Traditional Chinese Medicine Hospital, Qiqihar, China
| | - Songjiang Liu
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
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Liu M, Chen J, Ren Q, Zhu W, Yan D, Nie H, Chen X, Zhou X. Acupuncture and related techniques for type 2 diabetes mellitus: A systematic review protocol. Medicine (Baltimore) 2019; 98:e14059. [PMID: 30633207 PMCID: PMC6336543 DOI: 10.1097/md.0000000000014059] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Accepted: 12/18/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is a major global health problem. As a complementary treatment, acupuncture and related techniques are widely used to treat metabolic and endocrine diseases, but their efficacy and safety for T2DM are yet to be established. This systematic review will qualitatively and quantitatively summarize the current randomized controlled trial (RCT) evidence regarding the efficacy and safety of acupuncture and related techniques in patients with T2DM. METHODS Comprehensive literature searches will be performed on PubMed, Embase, Cochrane Central Register of Controlled Trials, and a trial registry "ClinicalTrials.gov" from inception to December 3, 2018. We will include RCTs for patients with T2DM that compared acupuncture with placebo, antidiabetic drugs, lifestyle interventions, or the combination. Primary outcomes are fasting blood glucose and hemoglobin A1c. Secondary outcomes include 2-hour blood glucose, fasting insulin, homeostatic model assessment for insulin resistance, incidence of diabetic complications, and acupuncture-related adverse events. The risk of bias of the RCTs included in the review will be examined using a revised Cochrane handbook tool. Heterogeneity will be detected using Cochran Q test and I statistics. With the use of random effects model, we will perform meta-analyses to pool results of RCTs. The effect measures will be weighted or standardized mean difference with 95% confidence intervals (CIs) for the continuous outcomes and risk ratio with 95% CIs for the dichotomous outcomes. Subgroup analyses and meta-regression with predefined effect modifiers will be performed to explore the sources of heterogeneity. Where appropriate, we will assess the possibility of reporting bias based on funnel plots and quantitative detection. We will appraise the quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation system for each outcome. RESULTS This study will provide accurate results and balanced inferences on the efficacy and safety of acupuncture and related techniques on T2DM. CONCLUSION This well-designed systematic review will establish high-quality evidence of the efficacy and safety of acupuncture and related techniques for T2DM to facilitate the clinical practice and guideline development. PROSPERO REGISTRATION NUMBER CRD42018115639.
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Affiliation(s)
- Meilu Liu
- Evidence-based Medicine Research Center, Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi
| | - Jianrong Chen
- Department of Endocrinology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing
| | - Qing Ren
- School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China
| | - Weifeng Zhu
- Evidence-based Medicine Research Center, Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi
| | - Dongmei Yan
- Evidence-based Medicine Research Center, Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi
| | - Heyun Nie
- Evidence-based Medicine Research Center, Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi
| | - Xiaofan Chen
- Evidence-based Medicine Research Center, Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi
| | - Xu Zhou
- Evidence-based Medicine Research Center, Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi
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Yang G, Lin S, Wu Y, Zhang S, Wu X, Liu X, Zou C, Lin Q. Auricular Acupressure Helps Alleviate Xerostomia in Maintenance Hemodialysis Patients: A Pilot Study. J Altern Complement Med 2017; 23:278-284. [PMID: 28191857 DOI: 10.1089/acm.2016.0283] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- Guowen Yang
- The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangzhou Hospital of Integrated Traditional and Western Medicine, Guangzhou, China
| | - Shaoqin Lin
- The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China
| | - Yuchi Wu
- Nephrology Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Shangpeng Zhang
- The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiuqing Wu
- Nephrology Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Xusheng Liu
- Nephrology Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Chuan Zou
- Nephrology Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Qizhan Lin
- The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
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Noll E, Shodhan S, Madariaga MC, Page CR, Santangelo D, Guo X, Al Bizri E, Pryor AD, Romeiser J, Bennett-Guerrero E. Randomized trial of acupressure to improve patient satisfaction and quality of recovery in hospitalized patients: study protocol for a randomized controlled trial. Trials 2017; 18:110. [PMID: 28270180 PMCID: PMC5341349 DOI: 10.1186/s13063-017-1839-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 02/12/2017] [Indexed: 01/08/2023] Open
Abstract
Background Acupressure therapy may be potentially beneficial in improving postoperative symptoms like postoperative nausea and vomiting (PONV), pain and sleep disorder and improving postoperative quality of recovery. The primary aim of this study is to investigate the efficacy of acupressure therapy on postoperative patient satisfaction and quality of recovery in hospitalized patients after surgical treatment. Methods/design This three-group, parallel, superiority, blinded, randomized controlled trial will test the hypothesis that a combination of PC6, LI4 and HT7 acupressure is superior to sham or no intervention for improving postoperative quality of recovery in hospitalized patients. A minimum of 150 patients will be randomly allocated to one of the three experimental groups: control (no visit), light touch (sham acupressure) or active acupressure therapy in a 1:1:1 ratio. Interventions will be performed three times a day for 2 days. Patient satisfaction, quality of recovery, PONV and pain will be measured during the 3 days following randomization. The study protocol was approved by the Stony Brook University Institutional Review Board on 21 March 2016. Written informed consent will be recorded from every consented patient. Discussion This study has the potential to improve the recovery of hospitalized patients by adding knowledge on the efficacy of acupressure therapy in this setting. A multipoint acupressure protocol will be compared to both a no intervention group and a light touch group, providing insight into different aspects of the placebo effect. Trial registration ClinicalTrial.gov, NCT02762435. Registered on 14 April 2016. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-1839-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Eric Noll
- Department of Anesthesiology Stony Brook Medicine, Stony Brook, NY, USA. .,Institut de Chirurgie Guidee par l'Image, IHU Hopitaux Universitaire de Strasbourg, Strasbourg, France. .,Service d'Anesthesie Reanimation Hautepierre - CCOM - CMCO, Hopitaux Universitaires de Strasbourg, Strasbourg, France. .,C.C.O.M., 10 avenue Achille Baumann, 67400, Illkirch-Graffenstaden, France.
| | - Shivam Shodhan
- Department of Anesthesiology Stony Brook Medicine, Stony Brook, NY, USA
| | | | | | - Diane Santangelo
- Department of Anesthesiology Stony Brook Medicine, Stony Brook, NY, USA
| | - Xiaojun Guo
- Department of Anesthesiology Stony Brook Medicine, Stony Brook, NY, USA
| | - Ehab Al Bizri
- Department of Anesthesiology Stony Brook Medicine, Stony Brook, NY, USA
| | - Aurora D Pryor
- Department of Surgery Stony Brook Medicine, Stony Brook, NY, USA
| | - Jamie Romeiser
- Department of Anesthesiology Stony Brook Medicine, Stony Brook, NY, USA
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Kim KH, Lee MS, Kim T, Kang JW, Choi T, Lee JD. Acupuncture and related interventions for symptoms of chronic kidney disease. Cochrane Database Syst Rev 2016; 2016:CD009440. [PMID: 27349639 PMCID: PMC8406453 DOI: 10.1002/14651858.cd009440.pub2] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND People living with chronic kidney disease (CKD) experience a range of symptoms and often have complex comorbidities. Many pharmacological interventions for people with CKD have known risks of adverse events. Acupuncture is widely used for symptom management in patients with chronic diseases and in other palliative care settings. However, the safety and efficacy of acupuncture for people with CKD remains largely unknown. OBJECTIVES We aimed to evaluate the benefits and harms of acupuncture, electro-acupuncture, acupressure, moxibustion and other acupuncture-related interventions (alone or combined with other acupuncture-related interventions) for symptoms of CKD. In particular, we planned to compare acupuncture and related interventions with conventional medicine, active non-pharmacological interventions, and routine care for symptoms of CKD. SEARCH METHODS We searched the Cochrane Kidney and Transplant Specialised Register up to 28 January 2016 through contact with the Information Specialist using search terms relevant to this review. We also searched Korean medical databases (including Korean Studies Information, DBPIA, Korea Institute of Science and Technology Information, Research Information Centre for Health Database, KoreaMed, the National Assembly Library) and Chinese databases (including the China Academic Journal). SELECTION CRITERIA We included randomised controlled trials (RCTs) and quasi-RCTs that investigated the effects of acupuncture and related point-stimulation interventions with or without needle penetration that involved six sessions or more in adults with CKD stage 3 to 5, regardless of the language and type of publication. We excluded studies that used herbal medicine or co-interventions administered unequally among the study groups. DATA COLLECTION AND ANALYSIS Two authors independently extracted data and assessed risk of bias. We calculated the mean difference (MD) or standardised mean difference (SMD) with 95% confidence intervals (CI) for continuous outcomes and risk ratio (RR) for dichotomous outcomes. Primary outcomes were changes in pain and depression, and occurrence of serious of adverse events. MAIN RESULTS We included 24 studies that involved a total of 1787 participants. Studies reported on various types of acupuncture and related interventions including manual acupuncture and acupressure, ear acupressure, transcutaneous electrical acupuncture point stimulation, far-infrared radiation on acupuncture points and indirect moxibustion. CKD stages included pre-dialysis stage 3 or 4 and end-stage kidney disease on either haemodialysis or peritoneal dialysis.None of the included studies assessed pain outcomes, nor formally addressed occurrence of serious adverse events, although three studies reported three participant deaths and three hospitalisations as reasons for attrition. Three studies reported minor acupuncture-related harms; the remainder did not report if those events occurred.All studies were assessed at high or unclear risk of bias in terms of allocation concealment. Seventeen studies reported outcomes measured for only two months.There was very low quality of evidence that compared with routine care, manual acupressure reduced scores of the Beck Depression Inventory score (scale from 0 to 63) (3 studies, 128 participants: MD -4.29, 95% CI -7.48 to -1.11, I(2) = 0%), the revised Piper Fatigue Scale (scale from 0 to 10) (3 studies, 128 participants: MD -1.19, 95% CI -1.77 to -0.60, I(2) = 0%), and the Pittsburgh Sleep Quality Index (scale from 0 to 21) (4 studies, 180 participants: MD -2.46, 95% CI -4.23 to -0.69, I(2) = 50%).We were unable to perform further meta-analyses because of the paucity of data and problems with clinical heterogeneity, such as different interventions, comparisons and timing of outcome measurements. AUTHORS' CONCLUSIONS There was very low quality of evidence of the short-term effects of manual acupressure as an adjuvant intervention for fatigue, depression, sleep disturbance and uraemic pruritus in patients undergoing regular haemodialysis. The paucity of evidence indicates that there is little evidence of the effects of other types of acupuncture for other outcomes, including pain, in patients with other stages of CKD. Overall high or unclear risk of bias distorts the validity of the reported benefit of acupuncture and makes the estimated effects uncertain. The incomplete reporting of acupuncture-related harm does not permit us to assess the safety of acupuncture and related interventions. Future studies should investigate the effects and safety of acupuncture for pain and other common symptoms in patients with CKD and those undergoing dialysis.
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Affiliation(s)
- Kun Hyung Kim
- School of Korean Medicine, Pusan National UniversityDepartment of Acupuncture & MoxibustionBeom‐eo riMul‐geum eupYangsanKorea, South626‐770
| | - Myeong Soo Lee
- Korea Institute of Oriental MedicineMedical Research Division461‐24 Jeonmin‐dong, Yuseong‐guDaejeonKorea, South305‐811
| | - Tae‐Hun Kim
- College of Korean Medicine, Kyung Hee UniversityKorean Medicine Clinical Trial Center#23 Kyungheedae‐roDongdaemun‐guSeoulKorea, South130‐872
| | - Jung Won Kang
- College of Korean Medicine, Kyung Hee UniversityDepartment of Acupuncture & Moxibustion1, Hoegi‐DongDongdaemun‐GuSeoulKorea, South130‐702
| | - Tae‐Young Choi
- Korea Institute of Oriental MedicineMedical Research Division461‐24 Jeonmin‐dong, Yuseong‐guDaejeonKorea, South305‐811
| | - Jae Dong Lee
- Kyung Hee UniversityDepartment of Acupuncture & Moxibustion, College of Korean MedicineSeoulKorea, South
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Sok SR. Effects of Meridian Acupressure in Joktaeyang Bangkwang Kyeong on the Physical Health State, Depression, and Life Satisfaction of Korean Older Adult Women Living Alone. J Gerontol Nurs 2016; 42:28-35; quiz 36-7. [DOI: 10.3928/00989134-20151218-01] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 10/28/2015] [Indexed: 11/20/2022]
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