Acupuncture & Moxibustion Formulas & Treatments (Great Masters Series)
However, this trial had a large, statistically significant effect size i. Insertion depth: 12 to 25 mm Was De Qi reportedly sought? The records were made before and after the 4 week treatment. The block sizes were 8, with four assigned to acupuncture and 4 assigned to drug treatment in each block. There were 63 total randomized, and 8 blocks of 8 were used with 1 assignment left over ] Allocation concealment: Not reported in the article. There were 63 total randomized, and 8 blocks of 8 were used with 1 assignment left over ] Allocation concealment selection bias High risk [We used envelope method.
The envelopes were sequentially numbered, opaque, unsealed]. We scored this trial as High Risk because the Cochrane Handbook requires that all 3 criteria i. Total length of treatment period weeks : 4 Number of sessions target mean : 28 Times per week: 7 Number of points used mean : 9 points Insertion depth: Not reported Was De Qi reportedly sought?
This categorization is a standard way of assessing treatment success in Chinese trials of IBS. Abdominal pain, diarrhea, abdominal distension, stool frequency and properties were assessed at baseline and the number of responders for each symptom were described after treatment Other bias High risk Intention-to-treat analysis was not reported There was a good balancing of the three groups at baseline for the age and duration of IBS, but there was no information about other baseline variables related to symptom severity.
Yes, the number of inpatients was not reported Were people with a history of acupuncture treatment excluded? During the trial, 3 withdrew in acupuncture group, 5 withdrew in sulfasalazine group.
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Participants were administrated totally 2 to 4 courses. Not reported Outcomes Symptom severity: Overall IBS symptom 3-point scoring system at end of treatment: 1 cured 2 improved 3 no effect. The evaluators who asked the patients the symptom score questions were blind to the participant assignment Adverse effects: Not reported. Notes [The number of participants assigned to either group was originally , which was different from that documented in the article i.
During the trial, 3 withdrew in acupuncture group, 5 withdrew in sulfasalazine group, leaving in the acupuncture group and in the sulfasalazine group. To reach an equal sample size in both groups, 2 participants who were assigned to the acupuncture group were not included in the analysis. So finally, there were participants analyzed in the acupuncture group and participants analyzed in the sulfasalazine group] Funding sources: Natural science foundation of Gansu Province, China Grant No.
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To reach an equal sample size in both groups, 2 participants who should be assigned to acupuncture group were finally not been recruited. The two groups were comparable at baseline. The moxa was made into a hemisphere with diameter of 4 cm and height of 2. The duration of moxibustion on each acupoint was 30 min The duration of moxibustion was not reported in the article.
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Overall abdominal symptom scale. Symptom improvement 3-point scoring system at end of treatment: 1 markedly effective 2 effective 3 no effect. The evaluation of symptom improvement was based on an intestinal symptoms scale. The two treatment groups were also comparable at baseline in terms of demographic characteristics and duration of IBS.
Characteristics of ongoing studies [ordered by study ID]. Cost-effectiveness study: European quality of life questionnaire EQ-5D at 12 months 3. Medication use at baseline, 3 months, 6 months, 9 months and 12 months 4. Health services used at baseline, 3 months, 6 months, 9 months and 12 months 5. Results of the search Figure 1 shows details of the search and selection process. Figure 1. Risk of bias in included studies All sham-controlled trials reported adequate methods for sequence generation and allocation concealment, and all trials except the Lowe trial adequately described and addressed losses to follow- up.
Figure 2. Effects of interventions See: Summary of findings for the main comparison Acupuncture versus sham acupuncture for irritable bowel syndrome; Summary of findings 2 Acupuncture versus pharmaceutical medications for irritable bowel syndrome The GRADE analyses for the main comparisons are presented in Summary of findings for the main comparison and Summary of findings 2. Scale from: 0 to Follow-up: 3—13 weeks 2 The mean symptom severity continuous outcome in the control groups was points 3 The mean symptom severity continuous outcome in the intervention groups was 9.
Follow-up: 3—5 weeks 2 The mean quality of life continuous outcome in the control groups was Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate.
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Better values are indicated by lower scores. Outcomes were measured at the end of the treatment period in all studies, and because in all studies the end of treatment time point coincided with the time point closest to 8 weeks and less than or equal to 3 months, our short term outcome time points were the end of treatment for all trials. Better values are indicated by higher scores. When investigators selected a cutpoint on a continuous scale to dichotomize between improvement and no improvement, we used the same cutpoint to define the dichotomous outcome. There were a total of control group participants, and of these participants experienced improvement in symptom severity.
Additionally, one study author Xue Y explained that allocation to treatment was by means of a random number table and did not give further details. Acupuncture versus sham Five trials Lowe ; Forbes ; Schneider ; Anastasi ; Lembo compared the effects of acupuncture and sham acupuncture. Figure 3. Analysis 1. Figure 4. Acupuncture versus other active treatments, as an adjuvant to other active treatments, and versus no specific treatment All trials reported dichotomous outcome data for all non-sham comparisons, We pooled these trials as relative risks see Figure 5.
Figure 5. Analysis 2. Analysis 7. Acupuncture versus other active treatments The five trials Xue ; Shi ; Zeng ; Chen ; Sun that compared acupuncture to pharmacological therapies for IBS found that participants receiving acupuncture reported a significantly greater improvement in symptom severity than participants receiving pharmacological therapies. Analysis 3. Analysis 4. Acupuncture as an adjuvant to other active treatments Five trials Liu ; Xiong a ; Chen ; Li ; Liu compared the combination of adjuvant acupuncture plus another IBS treatment received by all trial participants to the other IBS treatment alone.
Analysis 5. Analysis 6. Acupuncture versus no specific treatment Two trials Lembo ; Reynolds compared the effects of acupuncture to no specific treatment. Sensitivity analyses For the sham-controlled trials, sensitivity analyses based on risk of bias or treatment adequacy-related variables would be uninformative because all sham-controlled trials had similar results and no combination of these trials resulted in a pooled statistically significant benefit, for either the symptom severity or quality of life outcome.
Safety of acupuncture Nine trials included descriptions of adverse events associated with acupuncture Forbes ; Reynolds ; Anastasi ; Lembo ; An ; Liu ; Shi ; Chen ; Sun Overall completeness and applicability of evidence How externally valid are the results of this review? Potential biases in the review process Potential biases in the review process were avoided by conducting comprehensive searches to identify all relevant studies, conducting dual and independent data extraction, and blinding the acupuncture treatment adequacy assessors to the results of the trials they assessed.
http://thelab.jo/scripts/case/1291-wheel-bonus-round.php Agreements and disagreements with other studies or reviews The conclusions of this review have changed from the conclusions of our Cochrane review Lim which is the only other systematic review focused on acupuncture for IBS. Implications for research Considering that our meta-analysis found no differences between acupuncture and sham, and also considering that there are limited resources available to conduct trials of acupuncture, a non-proprietary therapy, additional sham-controlled trials of acupuncture among IBS patients should not be a high priority in acupuncture research, at least until the large, ongoing sham-controlled trial, which is expected to complete data collection in March , is published Anastasi.
Supplementary Material 01 Click here to view. Search date: November 28, Results Strategy in Chinese phonetic alphabet i. Search date: November 24, Results: Strategy in Chinese phonetic alphabet i. Search date: November 25, Results: Strategy in Chinese phonetic alphabet i. Appendix 2 Characteristics of randomized controlled trials in acupuncture for irritable bowel syndrome IBS. For 8 of these trials Xiong a ; Chen ; An ; Liu ; Shi ; Zeng ; Chen ; Sun , a percentage improvement from baseline scores was then calculated i.
For the other 3 trials Liu ; Xue ; Liu , it was not clear how the symptom scale scores were converted into the categorical data. The first arm was a wait-list control. Participants in the remaining 4 arms were randomized to sham or true acupuncture, with or without an augmented practitioner-patient interaction. There was no main effect of practitioner-patient interaction; therefore we combined the two acupuncture groups augmented and limited encounter and the two sham acupuncture groups augmented and limited encounter in order to compare the effects of acupuncture and sham acupuncture.
Adequate Adequate Potential for weak physiological activity. From the description, it sounds like a needle insertion sham at non-acupoints, which might cause a physiological response, although weaker than that of insertion of needles at true acupoints One acupuncturist XS is unaware of this study or its results. Use of non-insertion Streitberger sham device in the relative vicinity of the genuine acupoints is an adequate control.
Cancer And Master Acupuncture
It seems an adequate control. However, treatment once per week does not seem frequent enough. It is a weakness of the study design.
The one serious adverse event observed in the acupuncture groups in Lembo was not interpreted as treatment-related. The one adverse event observed in the acupuncture group in Shi was syncope due to acupuncture. Evaluation of the therapeutic effect of acupuncture and moxibustion on irritable bowel syndrome. Shanghai Journal of Acupuncture and Moxibustion. Gastroenterology Nursing.
Chen Y. Clinical reseach on treating irritable bowel syndrome mainly by acupuncture with warmed needles at Tiansh ST25 and Dangchangshu BL Clinical observation on combined warming needle and patented Chinese medicine for irritable bowel syndrome. Journal of Acupuncture and Tuina Science. Chen Q. Clinical study on irritable bowel syndrome of diarrhea type with Chang-three-needle technique].