目的:评价针刺治疗原发性抑郁症系统评价的方法学质量、报告质量以及结论的可靠程度.方法:计算机检索Web of science、Embase、PubMed、Cochrane library、中国知网、中国生物医学文献数据库、万方数据库、维普数据库获取公开发表的针刺治疗原发性抑郁症的系统评价/Meta分析,检索时间限制为建库至2018年12月5日.由两名研究者独立筛选文献并提取资料,运用AMSTAR工具评价纳入研究的方法学质量,PRISMA工具评价报告质量,GRADE系统对结局指标重新进行证据质量分级.结果:最终纳入18篇系统评价/Meta分析,均以针刺干预为主,包含2个主要结局指标.根据AMSTAR,有4个高质量研究,12个中等质量研究和2个低质量研究.根据PRISMA清单,所有报告主要的问题在于均没有研究方案的注册以及对所提取的数据条目、具体检索策略和是否有资助来源等描述不足.GRADE评级显示,2项结局指标为中级,6个为低级,其余均为极低质量.结论:针刺治疗原发性抑郁症的疗效是明确的,但尚不能评价不同针刺干预方法之间的优劣,期待更多的系统评价以更好地综合最新证据全面比较不同针刺方法的优劣.

目的 总结近5年来临床随机对照试验(RCTs)中敏化态与非敏化态关元穴的主治范围与规律.方法 应用计算机检索中国期刊全文数据库(CNKI)、维普数据库(VIP)、中国生物医学光盘数据库(CBM)、万方数据库(WanFang Data)以及PubMed数据库,筛选出符合纳入标准的文献,以文献计量学的方法对纳入文献进行统计,归纳和分析出两种状态关元穴的主治疾病和治疗相关情况.结果 非敏化态关元穴共纳入370篇文献,其文献发表数量呈现先增加再逐渐减少的趋势,治疗的疾病有121种,尿潴留和原发性痛经文献数量最多,其次为多囊卵巢综合征、失眠症等,共纳入15707例患者;作用于关元穴的治疗方式有20种,以单纯针刺和艾灸为主;针刺角度以直刺为主,深度多在1-1.5寸之间,平补平泻法和补法是其常用补泻方法;常见病治疗频次主要为1次/日,不同疾病的配穴和疗程各有不同.敏化态关元穴共纳入24篇文献,文献发表数量趋势无明显变化,主治疾病有16种,共纳入919例患者,治疗方式主要为热敏灸,以热敏化形式为主.结论 非敏化态关元穴的主治疾病范围较广,且治疗方式多样,具体治疗时间、配穴和疗程因疾病种类不同而有所区别;敏化态关元穴有较好的临床疗效,但研究较少,有待进一步探索.

疾病状态下,腧穴从沉寂到激活的转变称为腧穴敏化,即腧穴所携带的病理信息和外在表象等特征随着脏腑功能的变化会发生实时动态的改变,多数研究对腧穴敏化的判断仅凭主观感受,缺乏客观评价标准.近年来对腧穴敏化现象中的客观现象进行了诸多探索,取得了一系列成果.研究综述了穴位敏化的光成像、光声成像、声成像、纳米分子以及显微镜成像5个方面.随着各种成像技术相继应用于穴位敏化研究领域,其客观现象研究不再局限于生物物理现象,对敏化腧穴局部的细胞、分子水平等层面也能进行深入探索,进一步为穴位敏化的确切内涵提供了的科学依据.就目前的研究进展来看,仍存在诸多局限性,如忽略了敏化的最佳时间节点、多为静态成像、观测指标单一以及技术本身的局限等,所以相关研究还有待进一步探索验证.

Abstract Background: The invasive surgical intervention for neurogenic bladder dysfunction (NBD) following spinal cord injury (SCI) involves permanently altering one's body system and carries many surgical related risks and medication side effects are often seen in long term usage of pharmaceutical medications. Therefore, acupuncture and moxibustion therapies have been recommended due to their efficacy, simplicity of operation, cost effectiveness and safety. This protocol is designed for systematic review and network meta-analysis, which will perform comparisons or rankings of efficacy among the currently available acupuncture and moxibustion techniques and provide evidence to guide the best practice in acupuncture and moxibustion treatments of NBD due to SCI. Methods/Design: The Cochrane Library, EMBASE, PubMed, Web of Science, CENTRAL, CNKI, The VIP Database, The Wanfang database, CDFD, CMFD will be searched from inception to November 1, 2019. All randomized controlled trials containing eligible interventions(s) and outcome(s) will be included. The quality of included trials will be assessed using the “Risk of bias” tool from the Cochrane Handbook (V.5.1.0). Data analysis will be conducted by using STATA software (Version 13.0). Continuous outcome will be indicated as mean difference (MD) or standard mean difference (SMD), and enumeration data will be presented with odds risk (OR) or relative risk (RR). Results: This systematic review and network meta-analysis study aims to determine the most effective and safe approach in relieving urinary symptoms, and whether it produces better results in urodynamic examination. And a high-quality ranking of the therapeutic classes will be presented. The report will follow the PRISMA checklist for network meta-analysis. Results of the search strategy and the study selection will be presented in a PRISMA compliant flow chart. Conclusion: This study aims to propose a standard clinical decision-making guideline for acupuncture and moxibustion treatment of NBD after SCI.

表观遗传学主要研究环境因素所致基因序列不变而表达变化的一门遗传学分支学科,抑郁症被认为是基因和环境相互作用导致的精神障碍疾病,目前有研究表明该病与表观遗传学有关.针灸在抗抑郁方面有着明显的作用,但其内在机理却仍不清晰.对表观遗传在抑郁症发生、发展中的机制进行综述,并探讨分析了表观遗传学视角下针灸的抗抑郁机制,以期为针灸抗抑郁的机制研究以及针灸学科的表观遗传学研究提供了一个新的视角.

Objective: In the current systematic review on acupuncture and/or moxibustion for lumbar disc herniation (LDH), we evaluated the methodology and quality of evidence and reports to provide necessary information for accurate clinical decision-making regarding acupuncture and/or moxibustion for LDH. Methods: From databases such as CBM (Chinese biomedical literature database), VIP (China science and technology journal database), CNKI (China national knowledge infrastructure), WF (Wanfang database), Web of Science, Embase, Medline, and Cochrane Library, systematic reviews on acupuncture and/or moxibustion for LDH were retrieved, and the methodological quality of the literature was evaluated according to the assessment of multiple systematic reviews (AMSTAR) list. Furthermore, the grading of recommendations assessment, development and evaluation (GRADE) system was used to grade the quality of evidence and the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement to evaluate the quality of the report. Results: A total of 18 systematic reviews were included, and the conclusion is that acupuncture and/or moxibustion have some advantages in terms of efficacy and safety with regard to LDH treatment. According to the AMSTAR score, there were 4 high-quality studies, 13 moderate-quality studies, and 1 low-quality study. GRADE showed that quality of evidence such as total effective rate of LDH and VAS was low and that of other forms of evidence was lower. The PRISMA statement showed that 8 articles were in line with 20 or more of the 27 items, and 10 articles were in line with 10-19 of the 27 items. Conclusion: At present, acupuncture and/or moxibustion for LDH has a good curative effect. More importantly, its methodological quality was of moderate level and the report quality was generally good and relatively complete. However, the poor quality of the original research results was reflected in the quality of evidence. More studies are needed to make sure whether acupuncture is more effective than other treatment methods.

ObjectiveTo systematically evaluate the efficacy and safety of electroacupuncture at Jiaji points and single western medicine for herpes zoster,so as to provide accurate clinical decision-making for the treatment of herpes zoster.MethodsLiteratures on randomized controlled trials(RCTs)about the treatment of herpes zoster using electroacupuncture at Jiaji points were retrieved from the CNKI,Wanfang,VIP,CBM,Web of Science,EMbase,PubMed,Cochrane Library and related registration platforms.Meta-analysis was carried out by using Sofeware RevMan 5.3.And quality of evidence was graded,according to GRADE system.ResultTotally 23 RCTs were included in this study,involving 1 758 patients.Meta-analysis showed that there were statistical differences（P<0.001）on total efficacy[RR=1.22,95%CI(1.15,1.30)],Visual Analogue Scale(VAS)[MD=1.93,95%CI(1.64,2.23)],and clinical symptoms score[MD=1.21,95%CI(1.03,1.38)]between electroacupuncture at Jiaji points and western medicine.However,GRADE system showed that the quality of evidence was at a lower level.ConclusionExisting evidence shows that the efficacy of electroacupuncture at Jiaji points combined with other therapies could be more better than that of single western medicine for the treatment of herpes zoster.But the quality of evidence is still at a lower level.Therefore,RCTs with more rigorous design and more large scale shoule be conducted,in order to confirm the therapeutic effect of electroacupuncture at jiaji points on herpes zoster.

目的 根据当今针灸治疗带状疱疹(HZ)及其后遗症的meta分析/系统评价(MA/SR),将其方法学及证据质量进行评价,以期为针灸治疗带状疱疹及其后遗症提供临床依据.方法 对中国知网(CNKI),万方(Wanfang)和维普(VIP)数据库,中国生物医学文献数据库(CBM),PubMed,Embase,Cochrane Library,Web of Science 8个数据库进行检索,收集有关针灸治疗带状疱疹及其后遗症的MAs/SRs,运用AMSTAR对MAs/SRs进行方法学质量评价,同时采用GRADE系统对证据质量进行评价分级.结果 本文共纳入20篇MAs/SRs,主要结论为针灸治疗HZ及其后遗症具有有效性和安全性.根据AMSTAR显示,20篇MAs/SRs中,有1个高质量研究,19个中等质量研究,无低等质量研究.GRADE评级显示,针灸对于带状疱疹及其后遗症的MAs/SRs具有较低的证据质量.所有结局指标中共有26个结局指标为极低质量,19个为低质量,11个为中等质量,无高质量的证据.结论 当前MAs/SRs显示,针灸对带状疱疹及其后遗症具有一定疗效和安全性,方法学质量属于中高级,但证据质量级别属于低级,其主要原因为原始研究质量不佳所致.

INTRODUCTION:Defecation dysfunction (DD) is one of the most common complications following sphincter-preserving surgery for rectal cancer. And there is no effective treatment of DD after sphincter-preserving surgery for rectal cancer. Although some studies suggested that acupuncture and moxibustion (AM) is effective and safe for DD after sphincter-preserving surgery for rectal cancer, lacking strong evidence, for instance, the relevant systematic review, meta-analysis and randomised controlled trial (RCT) of a large, multicentre sample, makes the effects and safety remain uncertain. The present protocol is described for a systematic review and meta-analysis to investigate the effectiveness and safety of AM for DD after sphincter-preserving surgery for rectal cancer.METHODS AND ANALYSIS:We will search nine online databases from inception to 1 October 2019; the language of included trials will not be restricted. This study will include RCTs that performed AM as the main method of the experimental group for patients with DD after sphincter-preserving surgery for rectal cancer. Two of the researchers will independently select the studies, conduct risk of bias assessment and extract the data. We will use the fixed-effects model or random-effects model of RevMan V.5.2 software to analyse data synthesis. The risk ratios with 95% CIs and weighted mean differences or standardised mean differences with 95% CIs will be used to present the data synthesis outcome of dichotomous data respectively and the continuous data. Evidence quality of outcome will be assessed by using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system.ETHICS AND DISSEMINATION:Ethical approval is not required in this secondary research evidence, and we will publish the results of this study in a journal or concerned conferences.TRIAL REGISTRATION NUMBER:CRD42019140097.

目的 评价针刺治疗原发性抑郁症系统评价的方法学质量和研究结果的适用性.方法 计算机检索Web of Science、EMbase、PubMed、The Cochrane Library、CNKI、CBM、WanFang Data和VIP数据库获取公开发表的针刺治疗原发性抑郁症的系统评价/Meta分析,检索时限均从建库至2018年12月5日.由2名研究者独立筛选文献并提取资料,运用AMSTAR 2工具和ROBIS工具评价纳入研究质量,同时采用CASP-S.R中涉及结果适用性条目评价系统评价的适用性.结果 最终纳入18篇系统评价/Meta分析,均以针刺干预为主,包含2个主要结局指标.根据AMSTAR 2评价结果,有4个高质量研究、12个中等质量研究和2个低质量研究.根据ROBIS工具,共有10个研究偏倚风险高,7个研究偏倚风险较低,1个研究偏倚风险不确定.根据CASP-S.R,仅有4篇研究设计结果可能适用于当地人群,没有研究设计获益与成本危害之间的关系.结论 针刺治疗原发性抑郁症的系统评价方法学质量属中等水平,部分研究存在一定的偏倚,大部分研究可能不能直接适用于当地人群,所有研究均没有获益与成本危害之间的关系.期望今后的系统评价严格按照系统评价制作方法进行,以提高研究质量、减少偏倚,同时应当考虑到系统评价对不同人群的适用性以及获益与成本危害之间的关系.另外,尚需在针刺治疗原发性抑郁症的原始研究上投入更多的考虑,以提供更高质量、科学、精确的临床证据.

Abstract Background: Postcholecystectomy syndrome (PCS) is a term used to describe the persistence of biliary colic or right upper quadrant abdominal pain with a variety of postoperative gastrointestinal symptoms. Acupuncture and related treatments have shown clinical effects for PCS in many studies. But the systematic reviews and meta-analyses for them are lacking. We aim to evaluate the efficacy and safety of acupuncture on the treatment of PCS. Methods: We will search 8 electronic databases, including the Web of Science, PubMed, Cochrane Library, Embase, and 4 Chinese databases (CBM, Wanfang, VIP, and CNKI databases), and additional sources (WHO ICTRP, ChiCTR, Clinical Trials, Grey Literature Database), for potentially eligible studies. Literature retrieval, screening, and data extraction will be conducted by 2 researchers independently. In case of disagreement, a 3rd party shall be consulted to assist judgment. We will use RevmanV.5.3 to perform a fixed effect meta-analysis on the data of clinical homogeneity studies, and evidence's level will be assessed through the method for GRADE. Results: This systematic review and meta-analysis will put a high-quality synthesis of the efficacy and safety of acupuncture treatment in PCS. Conclusion: The conclusion of this systematic review will provide evidence to assess acupuncture therapy is an efficacy and safe intervention to treat and control PCS. Ethics and dissemination: Since this article does not involve patients’ private data, no ethical approval is required. The agreement will be disseminated by peer-reviewed journals or conference reports. Trial registration number: PROSPERO CRD4201929287.

Background Postcholecystectomy syndrome (PCS) has become a common postoperative syndrome that requires systematic and comprehensive therapy to achieve adequate clinical control. Acupuncture and related therapies have shown clinical effects for PCS in many studies. However, systematic reviews/meta-analyses (SRs/MAs) for them are lacking. Objective To evaluate the efficacy and safety of acupuncture in the treatment of PCS using randomized controlled trials (RCTs). Methods Potentially eligible studies were searched in the following electronic databases up to 1 February 2020: PubMed, Embase, Cochrane Library, Web of Science (WoS), Chinese databases (Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), WanFang Database (WF), and China Science and Technology Journal Database (VIP)), and other sources (WHO ICTRP, ChiCTR, Clinical Trials, and Grey Literature Database). The RevMan 5.3 was employed for analyses. The Cochrane Collaboration' risk of bias tool was used to assess the risk of bias (ROB). The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess the quality of the evidence. Results A total of 14 RCTs with 1593 participants were included in this SR. MA showed that acupuncture in combination with conventional medicine (CM) did not show statistical differences in reduction in pain. However, acupuncture in combination with CM significantly reduced the incidence of postoperative nausea and vomiting (PONV) (RR, 0.71; 95% CI, 0.55–0.92) and improved gastrointestinal function recovery compared to the CM group. Acupuncture combined with traditional Chinese medicine and CM, and acupuncture as monotherapy may improve gastrointestinal function recovery with acceptable adverse events. Conclusion Acupuncture may be an effective and safe treatment for PCS. However, this study lacks conclusive evidence due to poor quality evidence, limited data, and clinical heterogeneity of acupuncture methods in the included studies.