Efficacy of Acupuncture for Chronic Spontaneous Urticaria
Hui Zheng, et al.
Abrstrct
Background: The effectiveness of acupuncture for patients with chronic spontaneous urticaria (CSU), reported in a few small-scale studies, is
not convincing.
Objective: To investigate whether acupuncture leads to better effects on CSU than sham acupuncture or waitlist control.
Design: A multicenter, randomized, sham-controlled trial. (Chinese Clinical Trial Registry: ChiCTR1900022994).
Setting: Three teaching hospitals in China from 27 May 2019 to 30 July 2022.
Participants: 330 participants diagnosed with CSU.
Intervention: Participants were randomly assigned in a 1:1:1 ratio to receive acupuncture, sham acupuncture, or waitlist control over an
8-week study period (4 weeks for treatment and another 4 weeks for follow-up).
Measurements: The primary outcome was the mean change from baseline in the Weekly Urticaria Activity Score (UAS7) at week 4. Secondary outcomes
included itch severity scores, self-rated improvement, and Dermatology Life Quality Index scores.
Results: The mean change in UAS7 (range, 0 to 42) for acupuncture from baseline (mean score, 23.5 [95% CI, 21.8 to 25.2]) to week 4 (mean score,
15.3 [CI, 13.6 to 16.9]) was -8.2 (CI, -9.9 to -6.6). The mean changes in UAS7 for sham acupuncture and waitlist control from baseline (mean
scores, 21.9 [CI, 20.2 to 23.6] and 22.1 [CI, 20.4 to 23.8], respectively) to week 4 (mean scores, 17.8 [CI, 16.1 to 19.5] and 20.0
[CI, 18.3 to 21.6], respectively) were -4.1 (CI, -5.8 to -2.4) and -2.2 (CI, -3.8 to -0.5), respectively. The mean differences between
acupuncture and sham acupuncture and waitlist control were -4.1 (CI, -6.5 to -1.8) and -6.1 (CI, -8.4 to -3.7), respectively, which did not
meet the threshold for minimal clinically important difference. Fifteen participants (13.6%) in the acupuncture group and none in the other
groups reported adverse events. Adverse events were mild or transient.
Limitation: Lack of complete blinding, self-reported outcomes, limited generalizability because antihistamine use was disallowed, and short
follow-up period.
Conclusion: Compared with sham acupuncture and waitlist control, acupuncture produced a greater improvement in UAS7, although the difference
from control was not clinically significant. Increased adverse events were mild or transient.
Ann Intern Med.2023 Dec;176(12):1617-1624.
doi: 10.7326/M23-1043. Epub 2023 Nov 14.
Source: PubMed
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Acupuncture Techniques and Acupoints Used in Individuals under
Chemotherapy or Radiotherapy Treatment of Cancer
Tatiane Regina de Sousa, et al.
Abstract
Aims and objectives: To describe the main acupuncture techniques and parameters that have been used in the most varied symptoms of different
types of cancer.
Background: Clinical evidence about the potential effectiveness of acupuncture and related therapies to control signs and symptoms associated
with cancer or its treatment has been in several studies. Currently, there is already evidence of the use of acupuncture for the treatment of
nausea and vomiting, fatigue, dry mouth, anxiety, depression, insomnia and pain. However, many studies lack firm rights or reproducible
guidelines for treatment.
Design: This study performs a systematic review of clinical trials related to the topic, based on the PRISMA protocol. Thus, a search was
carried out in the Scopus, Pubmed and Web of Science databases, covering studies since January 2007.
Methods: Structured and organised according to PICO standards, using keywords ("cancer" OR "malignant tumour" OR "chemotherapy" OR
"radiotherapy") AND ("acupuncture" OR "electroacupuncture") AND ("pain" OR "nausea" OR "vomit" OR "fatigue" OR "xerostomia" OR "insomnia" OR
"depression" OR "neuropathy").
Results: After the selection and evaluation phase, 23 studies were included and analysed.
Conclusion: Based on this analysis, it is concluded that acupuncture is safe and there is evidence of the reduction of gastrointestinal
symptoms, chemotherapy-induced peripheral neuropathy, pain, dry mouth, fatigue, insomnia, and improvement of cognitive capacity.
Relevance to clinical practice: Acupuncture treatments could act by minimising the side effects of conventional treatments and reducing
symptoms induced by tumours.
J Clin Nurs.2023 Oct;32(19-20):6917-6933.doi: 10.1111/jocn.16812. Epub 2023 Jun 29.
Source: PubMed
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Topical Chinese Herbal Medicine in Treating Atopic Dermatitis (Eczema)
Meng-Chun Wang, et al.
Abstract
Ethnopharmacological relevance: Topical Chinese herbal medicine (CHM) is commonly used to relieve atopic dermatitis (AD); however, the
up-to-date evidence concerning the effectiveness of topical CHM on treating AD is lacking. Moreover, the CHM prescriptions are often too
complicated to realize the overall mechanisms of CHM, especially when compared to western medicines (WM).
Aim of the study: To evaluate the effectiveness of topical CHM for treating AD by conducting a meta-analysis on randomized clinical trials (RCTs).
Methods: Twenty RCTs comparing topical CHM to active control/placebo were included in the final analysis. The primary outcome was the symptom
scores changed from baseline and the effectiveness rate was the secondary outcome. Subgroup analysis on different initial symptom severity and
the different interventions in control groups was performed. System pharmacology analysis was performed to explore core CHM and possible
pharmacological mechanisms of CHM for AD.
Results: Compared with active/blank placebo, topical CHM seemed more effective (SMD: -0.35, 95 %CI: -0.59 to -0.10, p-value = 0.005, I2 = 60%).
The effectiveness rate was higher (RR: 1.29, 95 %CI 1.15-1.44, p-value <0.00001, I2 = 71%). In subgroup analysis, mild and moderate AD patients
with topical CHM were more effective than placebo (SMD: -0.28, 95 %CI -0.56 to -0.01, p-value = 0.04, I2 = 5%; -0.34, 95%CI -0.64 to -0.03,
p-value = 0.03, I2 = 0%, separately). Topical CHM has 1.25 times more effective than the topical glucocorticoid (95 %CI 1.09-1.43, p-value
= 0.001, I2 = 64%). Core CHMs, such as Phellodendron chinense C.K. Schneid., Sophora flavescens Ait., Cnidium monnieri (L.) Cusson, and
Dictamnus dasycarpus Turcz., had effects on the pathways on immune and metabolism systems different from WM.
Conclusion: Our results exploit the potential role of CHM on treating AD, especially for mild and moderate AD.
J Ethnopharmacol2023 Dec 5:317:116790.
doi: 10.1016/j.jep.2023.116790. Epub 2023 Jun 14.
Source: PubMed
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