Analysis of traditional Chinese medicine syndrome elements and clinical symptoms in prediabetes: A systematic review.

BACKGROUND: Prediabetes mellitus (PDM) and impaired glucose regulation precedes diabetes and serve as early warning signals. A 2018 Chinese epidemiological survey reported prediabetes at 25.5% prevalence and type 2 diabetes at 10.8%, respectively. Untreated carries one-third of the risk of diabetes progression. This study aimed to understand traditional Chinese medicine syndromes in PDM to guide clinical practice and diabetes prevention. METHODS: We systematically searched the Chinese and English literature in PubMed, EMBASE, Sinomed, CNKI, VIP, Wanfang until March 31, 2023. We manually explored the Chinese prediabetes literature, trial registrations, and references, adhering to predefined criteria. The results were independently summarized by 2 researchers. Statistical analysis was performed using EXCEL, IBM SPSS 27.0, and IBM SPSS Modeler 18.0, with data mining techniques including association and cluster analysis. RESULTS: Analysis of 23 clinical trials (8943 patients) identified phlegm dampness syndrome as predominant, with qi deficiency, dampness, and phlegm as the principal pathogenic elements. Spleen syndrome elements dominated, with a priori correlation analysis favoring spleen dampness. The prevalent PDM clinical symptoms include amnesia, mental fatigue, limb fatigue, dizziness, and lumbar discomfort. CONCLUSION: Prediabetes is strongly associated with spleen dampness, highlighting its role. Common traditional Chinese medicine syndrome elements include qi deficiency, phlegm, and dampness. Clinical diagnosis and treatment should prioritize syndrome differentiation and emphasize spleen-focused approaches. Although limited research exists on prediabetes syndromes, further exploration of PDM and spleen dampness is crucial.

Chaihu Longgu Muli Decoction for post-stroke insomnia: A protocol for systematic review and meta-analysis.

BACKGROUND: Poststroke insomnia (PSI) is a frequent complication of stroke usually as a comorbidity of poststroke depression and mainly occurs within the first 6 months after stroke.[1] Addressing PSI to improve stroke prognosis is of great value. Herbal medicine like Chaihu Longgu Muli Decoction (CLMD), which is commonly considered to be a good treatment for depression and epilepsy, has the therapeutic potential on PSI; however, insufficient systematic reviews were conducted to testify its efficacy. Therefore, the objective of this paper is to provide reliable evidence of the efficacy and safety of CLMD on PSI and a foundation for further investigation. METHODS: The literature of clinical randomized controlled trials (RCTs) regarding CLMD for PSI published before June of 2021 will be retrieved in the databases, and 2 investigators will be asked to collect and crosscheck the data independently. For the including studies, the quality evaluation on methodology will be assessed in the light of the Cochrane Handbook for Systematic Review of Interventions V.5.1.0 as well as the quality of evidence will be evaluated by the Grading of Recommendations Assessment, Development, and Evaluation. Besides, the assessment of heterogeneity and reporting bias, the sensitivity analysis and the subgroup analysis will be conducted. Stata 15 will be applied to analyze the above data. RESULTS: The review will conduct a high-quality synthesis on present evidence of CLMD for PSI. CONCLUSION: The conclusion of the study will indicate whether CLMD is effective and safe for PSI.

Effect of different acupuncture and moxibustion methods on functional dyspepsia caused by sequelae of COVID-19: A protocol for systematic review and meta-analysis.

BACKGROUND: Functional dyspepsia (FD) is a group of diseases that cannot be explained after routine clinical examination, and is characterized by postprandial fullness, early satiety, and upper abdominal pain or burning. According to the statistics, FD continues to become one of the high-risk sequelae of coronavirus disease 2019 (COVID-19), affecting patients' quality of life, increasing psychological burden and increasing economic costs. However, its optimal treatment is still an urgent problem. A large number of studies have shown that acupuncture and moxibustion is effective and safe in the treatment of FD caused by sequelae of COVID-19, which is of research value. Therefore, based on the current literatures, the effectiveness and safety of different acupuncture and moxibustion methods were systematically evaluated to provide possible alternative therapy on FD. METHODS: Studies search for eligible randomized controlled trials that use different acupuncture and moxibustion methods as the sole treatment on FD and their data extraction will be done by 2 researchers. In case of disagreement, a third researcher will be introduced for arbitration. Mean difference or relative risk with fixed or random effect model in terms of 95% confidence interval will be adopted for the data synthesis. To evaluate the risk of bias, the Cochrane risk of bias assessment tool will be utilized. The sensitivity or subgroup analysis will also be conducted when meeting high heterogeneity (I2 > 50%). RESULTS: This meta-analysis will provide an authentic synthesis of different acupuncture and moxibustion methods on FD caused by sequelae of COVID-19. CONCLUSION: This meta-analysis will evaluate the effect of acupuncture and moxibustion on FD caused by sequelae of COVID-19, providing evidence as to the treatment in these patients.

Clinical efficacy of different shoulder joint drug injections for rotator cuff injuries: A network meta-analysis.

BACKGROUND: Rotator cuff injury is a common clinical disorder of the musculoskeletal system. It is one of the most common causes of shoulder pain and shoulder joint dysfunction. Intra-articular injection therapy is one of the common conservative treatments for rotator cuff injury in clinical practice, but scholars have been controversial about the different drugs used for injection therapy and their clinical effectiveness, and there is no complete agreement on the choice of different injectables, and the existing original studies are mostly direct comparisons in 1 arm, lacking indirect comparisons, making it difficult to have a clear and comprehensive understanding. OBJECTIVE: A network Meta-analysis was used to comprehensively compare the effectiveness of drug injection therapies for rotator cuff injuries. METHODS: The PubMed, The Cochrane Library, EMbase, Chinese national knowledge infrastructure, Chinese BioMedical Literature on disc, China Science and Technology Journal Database, and Wan-Fang databases were searched for randomized controlled trials on the effectiveness of steroid injections for the comparative treatment of rotator cuff injury for the period April 19, 2013 to April 19, 2022 (the last decade). Two investigators independently screened the literature, extracted data according to inclusion and exclusion criteria, and evaluated the quality of the literature in parallel. Statistical analysis was performed using Stata 16.0 software to compare the differences in efficacy of each treatment measure and rank the efficacy using the ratio and 95% confidence interval (CI) as the effect indicator. RESULTS: 10 RCTs with a total of 861 patients with rotator cuff injury were included, involving 4 therapeutic measures: corticosteroid injection therapy (COR), platelet-rich plasma injection therapy (PRP), Hyaluronic acid injection therapy (HA), and prolotherapy therapy (PRO).Meta-analysis results showed that the ranking results of the 4 therapeutic measures were: corticosteroid injection + hyaluronic acid injection > platelet-rich plasma injection + corticosteroid injection > corticosteroid injection > platelet-rich plasma injection > PRO > platelet-rich plasma injection + hyaluronic acid injection > hyaluronic acid injection. CONCLUSION: we recommend that corticosteroid injections combined with hyaluronic acid injections can be used for the non-surgical conservative clinical management of rotator cuff injuries.

Exploring the clinical efficacy of different nonsurgical rehabilitation interventions for humeral lateral epicondylitis: A protocol for network meta-analysis.

BACKGROUND: Lateral epicondylitis is a common musculoskeletal disorder characterized by the decreased grip and upper limb strength and pain in the lateral aspect of the elbow joint. At present, shock wave, corticosteroid injection, platelet-rich plasma injection, and Dextrose prolotherapy therapy nonsurgical rehabilitation treatment methods are commonly used in clinical. However, the conclusions of studies comparing treatment efficacy between them are controversial, with most studies focusing on limited comparisons and a lack of direct and indirect comparisons between them, making it difficult to have a clearer and more comprehensive understanding of the efficacy between them. PURPOSE: To comprehensively compare the effectiveness of shockwave, corticosteroid injection, platelet-rich plasma injection, and Dextrose prolotherapy therapy for the treatment of external humeral lateral epicondylitis using a reticulo-meta-analysis. METHODS: Randomized controlled trials on the effectiveness of shock wave, corticosteroid injection, platelet-rich plasma injection, and Dextrose prolotherapy therapy for the treatment of external humeral lateral epicondylitis were searched in PubMed, The Cochrane Library, CNKI, and Wan-Fang databases for the period January 1, 2016 to January 1, 2021 for each database. Two investigators independently screened the literature, extracted data according to inclusion and exclusion criteria, and evaluated the quality of the literature in parallel. Statistical analyses were performed using Stata 14.0 software to compare differences in efficacy between treatment measures using ratio and 95% confidence interval as effect indicators and to rank efficacy. RESULTS: Nine randomized controlled trials with a total of 289 patients with external humeral lateral epicondylitis were included, involving 4 nonsurgical rehabilitation measures and 6 intervention options. Quadrilateral ring to test the inconsistency of each closed-loop study finding, and the results show that the inconsistency factor was bounded at 1.65, with lower 95% confidence interval of 0.47 and 2.84 for both, which in summary indicates that the formation between the treatment measures in this study indicates that each closed-loop inconsistency was good. The SUCRA curve showed that platelet-rich plasma injection + shockwave was the first treatment with an area under the curve of 86.9%. Six treatment measures were ranked as follows: platelet-rich plasma injection + shockwave > platelet-rich plasma injection > shockwave > corticosteroid > corticosteroid + shockwave > prolotherapy. CONCLUSIONS: It is believed that in the course of clinical practice, platelet-rich plasma injection combined with shockwave therapy can be preferred for patients with humeral epicondylitis.

Comparing the efficacy of different intra-articular injections for knee osteoarthritis: A network analysis.

BACKGROUND: The findings on the effectiveness of platelet-rich plasma, ozone, and hyaluronic acid in the treatment of osteoarthritis of the knee are controversial, and the existing original studies and meta-analyses are mostly comparisons of a single joint cavity injection method, lacking direct and indirect comparisons of different drugs in the joint cavity. The lack of direct and indirect comparisons of different drugs in the joint cavity makes it difficult to have a clearer and more comprehensive understanding of joint cavity injection methods. In this study, the efficacy of platelet-rich, ozone, sodium hyaluronate, and combined knee cavity injections were compared directly or indirectly using a reticulated meta-analysis in this field, and the efficacy of treatment measures was ranked to provide more comprehensive and reliable evidence-based clinical evidence for the selection of knee cavity injections in osteoarthritis of the knee. OBJECTIVE: To compare the effects of platelet-rich plasma, ozone, and sodium glassate injection interventions on the efficacy of osteoarthritis of the knee through reticulated Meta-analysis, and to comprehensively compare the clinical effectiveness of platelet-rich plasma, ozone, and sodium glassate injection joint cavity injection for the treatment of osteoarthritis of the knee. METHODS: The PubMed, CBM, CNKI, VIP, and Wan-Fang databases were searched for information on the effectiveness of platelet-rich plasma, ozone, and sodium vitrate injection for the comparative treatment of osteoarthritis of the knee, with a search time frame of each database from the date of creation to July 20, 2021. Two investigators independently screened the literature, extracted data according to inclusion and exclusion criteria, and evaluated the quality of the literature in parallel. Statistical analysis was performed using Stata 16.0 software to compare the differences in the efficacy of each treatment measure using the ratio and 95% confidence interval as effect indicators and to rank the efficacy. RESULTS: Thirty-three RCTs with 7003 patients with osteoarthritis of the knee were included, involving 5 therapeutic measures. Meta-analysis showed that the efficacy of platelet-rich plasma injection was superior to both ozone and hyaluronic acid therapies. Hyaluronic acid+ozone and platelet-rich plasma+hyaluronic acid were both superior to ozone and hyaluronic acid monotherapy. The differences in efficacy between hyaluronic acid and ozone compared with platelet-rich plasma were statistically significant, and the differences in efficacy between the 2 combination therapies (platelet-rich plasma+hyaluronic acid, hyaluronic acid+ozone) and the 3 monotherapies (platelet-rich plasma, ozone, hyaluronic acid) were statistically significant. Platelet-rich plasma+hyaluronic acid, hyaluronic acid+ozone compared with 3 monotherapies (platelet-rich plasma, ozone, hyaluronic acid) were statistically significant, except for the difference in efficacy with platelet-rich plasma, which was not statistically significant, indicating that this platelet-rich plasma+hyaluronic acid and Hyaluronic acid+ozone combination therapy was superior to monotherapy. Also, the efficacy of platelet-rich plasma was better than hyaluronic acid and ozone and the difference was statistically significant, indicating that platelet-rich plasma was more effective than ozone and sodium glass in the treatment of osteoarthritis of the knee in monotherapy. CONCLUSION: It is believed that in the course of clinical practice, hyaluronic acid+ozone or platelet-rich plasma+hyaluronic acid combination therapy or platelet-rich plasma therapy can be preferred for patients with osteoarthritis of the knee.

Acupuncturing of myofascial pain trigger points for the treatment of knee osteoarthritis: A systematic review and meta-analysis.

BACKGROUND: Osteoarthritis of the knee is one of the major disorders leading to social dysfunction, economic loss and social development. This study was conducted to systematically evaluate the efficacy and safety effectiveness of acupuncture inactivation of myofascial pain trigger points in the treatment of osteoarthritis of the knee. METHODS: Randomized Controlled Trials (RCTs) on the treatment of knee pain were searched by computer from PubMed, The Cochrane Library, China journal full-text database (CNKI), Chinese biomedical literature database (CBM), China academic journal database (Wanfang Data) databases from the date of creation to December 2021, and the data were analyzed by Reman 5.3 software for data analysis. RESULTS: A total of 724 patients from 9 RCTs were finally included, and the results of meta-analysis showed that the acupuncture myofascial pain trigger point group was better than the control group in terms of total effective rate, cure rate, VAS score, Lysholm score, and WOMAC score. CONCLUSION: The efficacy and safety of acupuncturing myofascial pain trigger points in the treatment of knee osteoarthritis is positive, but due to the limited number of literature included in this study and the low quality of the included literature, there is still a need for high-quality and large sample size RCTs for the analysis of this treatment option.

Clinical use of platelet-rich fibrin in the repair of non-healing incision wounds after fibular fracture surgery: A case report.

RATIONALE: This report describes rehabilitation for a 53-year-old female recovering from non-healing skin and soft tissue defect after distal tibial open fracture by using platelet-rich fibrin topical repair following an automobile accident. PATIENT CONCERNS: The patient was admitted to a rehabilitation specialty hospital approximately 1 year post a fracture of the distal left tibiofibula and separate surgical tibiofibular fracture incision and internal fixation + bone grafting. DIAGNOSES: Clinical presentation included the left ankle incision was interrupted for about 3 cm with poor healing, a small amount of muscle necrosis, fat liquefaction, a large amount of yellow purulent secretion overflow and necrotic material was seen in the local wound. INTERVENTIONS: Platelet rich fibrin (PRF) gel was injected into the wounds and submerged sites to make full contact with the wounds and close the wounds with the autologous platelet-rich fibrin prepared by mixing, and then covered with oil gauze to keep the wounds moist and promote granulation growth. The outermost layer was covered with cotton pads. OUTCOMES: After 30 days of 2 PRF treatments, the skin defect was healed and no significant abnormality was observed at 6 months follow-up. LESSONS: Treatment with topical autologous platelet-rich plasma gel Significantly accelerates the healing of wounds, shortens healing time, improves healing quality and reduces scar formation without significant adverse effects.

Auricular acupuncture for shoulder pain: A protocol for systematic review and meta-analysis.

BACKGROUND: Shoulder pain is a common problem in outpatient medical practice. Recent studies show that acupuncture has therapeutic effect on releasing symptoms of shoulder pain. The aim of this systematic review and meta-analysis is to access the efficacy and safety of auricular acupuncture for shoulder pain. METHODS: Eight databases will be searched for randomized controlled trials of auricular acupuncture in the treatment of shoulder pain with retrieval time up to September 2020, including PubMed, Embase, The Cochrane Library, Web of science, CNKI, VIP, CBM, and Wangfang Data databases. We will evaluate the methodological quality of the included studies by using Cochrane Risk of Bias tool and conduct data analysis with Review Manager Software. RESULTS: The results of this study will be disseminated through a peer-reviewed journal publication. CONCLUSION: The systematic review will provide up-to-date evidence for the efficacy and safety of auricular acupuncture in treating shoulder pain. PROSPERO REGISTRATION NUMBER: CRD 42021238797.