Application exploration of comparative effectiveness research in clinical efficacy optimization of abdominal acupuncture / 中国针灸

The concepts and characteristics of comparative effectiveness research (CER) are analyzed to explore its scientific research methodology in clinical efficacy optimization of abdominal acupuncture. The designs of CER focus on patients, which emphasize assessment of comprehensive efficacy in real medical environment instead of simple efficacy in randomized controlled trial (RCT). Its research strategy involves four categories and three subject, covering acquiring, saving and management, comparison and application of clinical evidence, which has practical application value in comprehensive comparison of advantages and efficacy rules of different acupuncture therapies and acupoint prescriptions. By establishing clinical registration system, oversized-sample data could be acquired from different centers to effectively overcome insufficient sample-induced sampling error. It has important value in system summary and optimization of clinical efficacy of abdominal acupuncture. The CER fully illustrates clinical reality of acupuncture-moxibustion and provides strong support of scientific data for optimization of curative effect. It embodies prescription standardization, manipulation normalization and methodization of syndrome differentiation in clinic of abdominal acupuncture, which is expected to achieve evidence-based optimization of treatment prescription and technique in abdominal acupuncture.

Chronic neck pain of cervical spondylosis treated with acupuncture and moxibustion in terms of the heart and kidney theory: a randomized controlled trial / 中国针灸

<p><b>OBJECTIVE</b>To evaluate the clinical efficacy of acupuncture and moxibustion on chronic neck pain of cervical spondylosis in terms of the heart and kidney theory.</p><p><b>METHODS</b>One hundred and eleven cases were randomized into a heart-kidney acupuncture group (55 cases) and a conventional acupuncture group (56 cases). In the heart-kidney acupuncture group, acupuncture was applied to Bailao (EX-HN 15), Shenmen (HT 7) and Wangu (SI 4). Afterwards, the direct moxibustion was applied to Dazhui (GV 14), Xinshu (BL 15) and Shenshu (BL 23). After moxibustion, the intradermal needling therapy was provided at Bailao (EX-HN 15), Xinshu (BL 15) and Shenshu (BL 23). In the conventional acupuncture group, acupuncture was applied to Bailao (EX-HN 15) and Zhongzhu (TE 3) at first. Afterwards, the direct moxibustion was done at Dazhui (GV 14), Bailao (EX-HN 15) and Jianzhongshu (SI 15). After moxibustion, the interdermal needling therapy was provided at Bailao (EX-HN 15) and Jianzhongshu (SI 15). The northwick park pain questionnaire (NPQ) was adopted as the main efficacy index for the evaluation.</p><p><b>RESULTS</b>After the intervention and during the follow-up visit period, NPQ scores were all reduced remarkably as compared with those before the intervention for the patients in two groups (all P < 0.001), but the differences were not statistically significant in groups (all P > 0.05). By the age stratification analysis for the patients in two groups, the program in terms of the heart and kidney theory achieved the superior efficacy for the patients over 45 years old as compared with those in the conventional acupuncture group (P < 0.05, P < 0.01). By the stratification analysis of the sick duration, the program in terms of the heart and kidney theory achieved the superior efficacy for the patients with over 7 years sick duration as compared with those in the conventional acupuncture group (P < 0.05, P < 0.01).</p><p><b>CONCLUSION</b>The acupuncture and moxibustion therapeutic program in terms of the heart and kidney theory achieves the superior efficacy on chronic pain of cervical spondylosis for the patients over 45 years old and with over 7 years sick duration. It is one of the optimized programs for the treatment of this disease.</p>

Principles of ethics review on traditional medicine and the practice of institute review board in China / 中国结合医学杂志

As one of the significant parts of medical science research in China, the research on Chinese medicine (CM) reflects the essence of healthcare tradition in the country both theoretically and clinically, and embodies the values of Chinese culture. Therefore, in the practice of ethics review on CM research protocols, besides abiding by the contemporary prevalent international principles and guidelines on bioethics, which emphasizes the scientific and bioethical value of the study, we should also stress the CM theoretical background and relevant clinical experience in the framework of Chinese culture and values. In this paper, we went over the traits of CM clinical research and the experience from the practice of ethics review by the institution review board for bioethics, and then attempted to summarize the key points for the bioethics review to CM researches in China, so as to serve as reference for the bioethics review to traditional and alternative medicine researches.

A preliminary study on the medical expenditure of Chinese medicine and integrative medicine treatment for influenza A (H1N1) in the fever clinics / 中国结合医学杂志

<p><b>OBJECTIVE</b>To analyze the effectiveness of Chinese medicine and integrated Chinese and Western medicine for influenza A (H1N1) in the fever clinics and its relevant expenditure.</p><p><b>METHODS</b>A prospective survey on the clinical epidemic observation and follow-up was conducted from July 2009 to October 2009 with a self-developed questionnaire whose contents including the clinical data of the confirmed 149 H1N1 cases and their relevant therapeutic expenditure. The patients were assigned to the Chinese medicine group (22 cases treated by Chinese medicine alone) and integrative medicine group (124 cases treated by both Chinese medicine and Western medicine). The data were processed with descriptive analysis, t test and χ (2), and sum-rank test.</p><p><b>RESULTS</b>The proportion of clinical recovery of Chinese medicine group (81.8%) was higher than that of integrative medicine group (54.8%) with statistical significance (P=0.02). The average fever durations in both groups were 3.5 to 4 days, showing no significant difference (P=0.86). In the comparisons of average cost of Chinese herbs, drugs, therapies, and total cost, those of the Chinese medicine group were lower than those in the integrative group (P=0.01, P=0.00, P=0.00, P=0.00).</p><p><b>CONCLUSIONS</b>The H1N1 patients in the fever clinic who received Chinese medicine treatment had a higher clinical recovery proportion than those who received integrated Chinese and Western medicine treatment with lower medical cost. However, due to small sample size of the Chinese medicine group in the study, the conclusion needs further confirmation by studies with large sample size.</p>

Logistic regression analysis on therapeutic effect of acupuncture on neck pain caused by cervical spondylosis and factors influencing therapeutic effect / 中国针灸

<p><b>OBJECTIVE</b>To explore the main factors influencing the therapeutic effect of acupuncture on neck pain caused by cervical spondylosis, so as to provide references for further increasing the therapeutic effect of acupuncture.</p><p><b>METHODS</b>One hundred and six cases were randomly divided into an observation group and a control group, 53 cases in each group. The observation group was treated with routine acupuncture at Dazhui (GV 14), Jingbailao (Ex-HN 15) and Jianzhongshu (SI 15); and the control group was treated with sham acupuncture at 1 cm lateral to Bailao (Ex-HN 15) and Jianzhongshu (SI 15). The needles were retained for 20 min in the two groups and infrared radiation was used for adjuvant treatment in this period. Northwick Park Neck Pain Questionnaire (NPQ) was used to assess the patients' quality of life before and after the treatment. The potential influential factors were analyzed by Logistic regression.</p><p><b>RESULTS</b>The effective rate was 75.5% in the observation group and 52.8% in the control group with a significant difference between the two groups (P<0.05). The Logistic regression analysis indicated that the therapeutic effect in the observation group was superior to the control group (OR = 2.670), and both the attack frequency and duration of the neck pain will influence the therapeutic effect (OR = 1.055 and OR = 2.446).</p><p><b>CONCLUSION</b>Acupuncture has a better therapeutic effect on neck pain caused by cervical spondylosis, and patient's clinical history about attack frequency and duration of neck pain are factors influencing clinical therapeutic effect.</p>

Analysis on the effect of acupuncture in treating cervical spondylosis with different syndrome types / 中国结合医学杂志

<p><b>OBJECTIVE</b>To observe the clinical effect of acupuncture in treating cervical spondylosis with different syndrome types.</p><p><b>METHODS</b>One hundred and seventeen patients were randomized into the treated group: (59 cases), treated with normal acupuncture, and the control group (58 cases), treated with sham acupuncture, operated once every other day, 9 times in total (in 18 days) as one therapeutic course, and a succeeding 3-month follow-up study was carried out after terminating the therapy. The efficacy of treatment was evaluated with the Northwick Park Neck Pain Questionnaire (NPQ) and Visual Analogue Scale (VAS), and the scores gained in patients with different syndrome types were analyzed with a general linear model.</p><p><b>RESULTS</b>The NPQ and VAS: scores showed a linear decreasing tendency in both groups at the time of ending treatment and the 1st month of follow-up, but showed a secondary curve increasing tendency in the 3rd month of follow-up. Multivariate analysis showed the difference was of statistical significance (P<0.05). However, the analysis through lead-in of syndrome type as an individual influencing factor showed that syndrome type exerts a significant influence on VAS score (P<0.05), but has insignificant influence on the NPQ score (P>0.05).</p><p><b>CONCLUSION</b>Acupuncture shows: good immediate effect in treating cervical spondylosis, but its long-term effect is not satisfactory. The difference in syndrome type may have some impact on the effects of acupuncture in alleviating pain, but exerts no evident influence on the comprehensive effect.</p>