Points - Recent Research
Traditional Chinese Medicine Enhances Myocardial Metabolism During Heart Failure
Revealing the Neuroimaging Mechanism of Acupuncture for Poststroke Aphasia
Effectiveness and Safety of Acupuncture for Treating Functional Constipation

Effectiveness and Safety of Acupuncture for Treating Functional Constipation

Jun-Peng Yao, et al.

Background: Functional constipation (FC) is one of the most prevalent functional gastrointestinal disorders. Dissatisfaction with medications prescribed to treat FC may lead patients to seek alternative treatments. Numerous systematic reviews (SRs) examining the use of acupuncture to treat FC have reported inconsistent results, and the quality of these studies has not been fully evaluated.
Objective: In this overview, we evaluated and summarized clinical evidence on the effectiveness and safety of acupuncture for treating FC and evaluated the quality and bias of the SRs we reviewed.
Search strategy: The search strategy was structured by medical subject headings and search terms such as "acupuncture therapy" and "functional constipation." Electronic searches were conducted in eight databases from their inception to September 2020.
Inclusion criteria: SRs that investigated the effectiveness and safety of acupuncture for managing FC were included.
Data extraction and analysis: Two authors independently extracted information and appraised the methodology, reporting accuracy, quality of evidence, and risk of bias using the following critical appraisal tools: (1) A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2); (2) Risk of Bias in Systematic Reviews (ROBIS); (3) Preferred Reporting Items for Systematic Reviews and Meta-analyses for Acupuncture (PRISMA-A); and (4) the Grading of Recommendations, Assessment, Development and Evaluations (GRADE). A ? index was used to score the level of agreement between the 2 reviewers.
Results: Thirteen SRs that examined the clinical utility of acupuncture for treating FC were identified. Using the AMSTAR 2 tool, we rated 92.3% (12/13) of the SRs as "critically low" confidence and one study as "low" confidence. Using the ROBIS criteria, 38.5% (5/13) of the SRs were considered to have "low risk" of bias. Based on PRISMA-A, 76.9% (10/13) of the SRs had over 70% compliance with reporting standards. The inter-rater agreement was good for AMSTAR 2, ROBIS, and PRISMA-A. Using the GRADE tool, we classified 22.5% (9/40) of the measured outcomes as "moderate" quality, 57.5% (23/40) as "low" quality, and 20.0% (8/40) as "very low" quality. The inter-rater agreement was moderate when using GRADE. Descriptive analyses indicated that acupuncture was more efficacious than sham acupuncture for improving weekly complete spontaneous bowel movements (CSBMs) and for raising the Bristol Stool Form Scale (BSFS) score. Acupuncture appeared to be superior to anti-constipation drugs for improving weekly spontaneous bowel movements, the total effective rate, and the Patient Assessment of Constipation Quality of Life score. Although ten SRs mentioned the occurrence of adverse events, serious adverse events were not associated with acupuncture treatment.
Conclusion: Acupuncture may be more efficacious than sham acupuncture for improving CSBMs and BSFS scores and may be superior to anti-constipation drugs for improving bowel movement frequency, as well as quality of life. Limitations to current studies and inconsistent evidence suggest a need for more rigorous and methodologically sound SRs to draw definitive conclusions.

J Integr Med2022 Jan;20(1):13-25.doi: 10.1016/j.joim.2021.11.001. Epub 2021 Nov 7.

Source: PubMed


Revealing the Neuroimaging Mechanism of Acupuncture for Poststroke Aphasia

Boxuan Li, et al.

Background: Aphasia is a common symptom in stroke patients, presenting with the impairment of spontaneous speech, repetition, naming, auditory comprehension, reading, and writing function. Multiple rehabilitation methods have been suggested for the recovery of poststroke aphasia, including medication treatment, behavioral therapy, and stimulation approach. Acupuncture has been proven to have a beneficial effect on improving speech functions in repetition, oral speech, reading, comprehension, and writing ability. Neuroimaging technology provides a visualized way to explore cerebral neural activity, which helps reveal the therapeutic effect of acupuncture therapy.
In this systematic review, we aim to reveal and summarize the neuroimaging mechanism of acupuncture therapy on poststroke aphasia to provide the foundation for further study.
Methods: Seven electronic databases were searched including PubMed, Web of Science, Embase, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, the Wanfang databases, and the Chinese Scientific Journal Database. After screening the studies according to the inclusion and exclusion criteria, we summarized the neuroimaging mechanism of acupuncture on poststroke aphasia, as well as the utilization of acupuncture therapy and the methodological characteristics.
Result: After searching, 885 articles were retrieved. After removing the literature studies, animal studies, and case reports, 16 studies were included in the final analysis. For the acupuncture type, 10 studies used manual acupuncture and 5 studies used electroacupuncture, while body acupuncture (10 studies), scalp acupuncture (7 studies), and tongue acupuncture (8 studies) were applied for poststroke aphasia patients. Based on blood oxygen level-dependent (BOLD) and diffusion tensor imaging (DTI) technologies, 4 neuroimaging analysis methods were used including amplitude of low-frequency fluctuation (ALFF), regional homogeneity (ReHo), seed-based analysis, and independent component analysis (ICA). Two studies reported the instant acupuncture effect, and 14 studies reported the constant acupuncture's effect on poststroke aphasia patients. 5 studies analyzed the correlation between the neuroimaging outcomes and the clinical language scales.
Conclusion: In this systematic review, we found that the mechanism of acupuncture's effect might be associated with the activation and functional connectivity of language-related brain areas, such as brain areas around Broca's area and Wernicke's area in the left inferior temporal gyrus, supramarginal gyrus, middle frontal gyrus, and inferior frontal gyrus. However, these studies were still in the preliminary stage. Multicenter randomized controlled trials (RCT) with large sample sizes were needed to verify current evidence, as well as to explore deeply the neuroimaging mechanisms of acupuncture's effects.

Neural Plast. 2022 Apr 21;2022:5635596. doi: 10.1155/2022/5635596. eCollection 2022.

Source: PubMed


Effectiveness and Safety of Acupuncture for Treating Functional Constipation

You Wu, et al.

Objective: In this Meta-analysis, we evaluated the hypoglycemic effect of 5 flavonoids found in traditional Chinese herbs (naringenin, kaempferol, puerarin, baicalein, and luteolin) on diabetic rats.
Methods: Four databases including PubMed, Web of Science, Embase, and Cochrane Library, were searched from inception to May 2020. Only studies using diabetes model rats were included in the analysis. Blood glucose data from the last measurement were collected and analyzed. Pair-wise Meta-analyses were conducted using STATA v14.0 software and a Meta-analysis was conducted using STATA v14.0, ADDIS v1.16.6, and R v3.6.1. The quality of included studies was assessed with the SYRCLE risk of bias tool for animal studies, and publication bias was evaluated with a comparisonadjusted funnel plot.
Results: A total of 33 studies were included in the analysis, in which all 5 flavonoids showed a beneficial effect on blood glucose level of diabetic rats were included in the final analysis. The standardized mean differences (95% confidence intervals) were -4.92 (-6.67, -3.17) fornaringenin, -12 (-18.74, -5.27) for kaempferol, -2.52 (-3.77, -1.26) for puerarin, -3.04 (-5.75, -0.34) for baicalein, and -1.94 (-2.95, -0.92) for luteolin. The network Meta-analysis showed no statistically significant differences between the effect sizes of the flavonoids.
Conclusion: The results of the Meta-analysis showed that naringenin, kaempferol, puerarin, baicalein, and luteolin all have clear hypoglycemic effects in rat diabetes models, highlighting their therapeutic potential for preventing and treating diabetes mellitus in clinical practice.

J Tradit Chin Med. 2022 Feb;42(1):1-8.doi: 10.19852/j.cnki.jtcm.20210425.001.

Source: PubMed


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