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Guangzhou University of Traditional Chinese Medicine tops BMJ: Acupuncture has significant effects in 8 diseases, but is absent in clinical practice and policy

 Last Update: 2022-04-23
 Source: Internet
 Author: User

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Before 2000, acupuncture originated in China
.

Today, many doctors and patients around the world use acupuncture

Before 2000, acupuncture originated in China

Traditional Chinese medicine theory believes that acupuncture is the stimulation of meridians on acupoints to regulate body physiology

With the increasing number of basic biological research and clinical application of acupuncture, the clinical research of acupuncture is also developing

On February 25, 2022, Xu Nenggui's team from the South China Acupuncture Research Center, Guangzhou University of Traditional Chinese Medicine, Acupuncture and Rehabilitation Clinical School of Medicine , published a paper in The BMJ .

Source : The BMJ

Source : The BMJ The BMJ

First, the researchers identified 2,471 systematic reviews of acupuncture and moxibustion in the Web of Science between 2000 and 2020
.

The number of systematic reviews found to be increasing every year; published systematic reviews of randomized trials (63.

First, the researchers identified 2,471 systematic reviews of acupuncture and moxibustion in the Web of Science between 2000 and 2020

Number of systematic reviews of acupuncture published between 2000 and 2020

A recent review of systematic reviews of acupuncture found that of the 77 diseases investigated, acupuncture demonstrated significant effects in eight diseases or conditions: improving functional communication in post-stroke aphasia patients; relieving neck and shoulder pain; Relief of myofascial pain; relief of pain associated with fibromyalgia; relief of nonspecific low back pain; improved success in lactation within 24 hours of delivery; reduced severity of vascular dementia symptoms; and improvement in nasal symptoms of allergic rhinitis
.

However, only a few healthcare systems incorporate acupuncture into clinical practice guidelines and national health insurance
.

It can be said that acupuncture has not been recognized by health policy, nor has it been widely used in clinical practice

However, only a few healthcare systems incorporate acupuncture into clinical practice guidelines and national health insurance guidelines

For example, acupuncture is underutilized in the treatment of post-stroke aphasia

A 2015 cumulative meta-analysis showed that acupuncture was shown to improve verbal communication in post-stroke aphasia patients

Cumulative meta-analysis of acupuncture and language rehabilitation in communication function in post-stroke aphasia patients

In terms of limitations, an overview of systematic reviews of acupuncture therapy compared acupuncture with no intervention, sham acupuncture (similar to a placebo-controlled drug intervention), and other conventional medical interventions (such as standard of care, psychotherapy, and rehabilitation) and found these systematic reviews Major limitations: lack of a list of excluded studies and no explanation for protocol modifications
.

It is worth pointing out that earlier studies used AMSTAR2 to assess the methodological rigor of systematic reviews of acupuncture and concluded that the quality was generally low
.
However, the researchers noted that the criteria they used did not reflect the most serious problems in systematic reviews
.
Comprehensive searches, assessment of risk of bias, independent and duplicate screening, data extraction, and assessment of certainty of evidence are the most important methodological considerations in systematic reviews
.
Thus, the limitations identified in the systematic review of acupuncture had little effect on overall quality
.
For example, systematic reviews do not provide a list of excluded studies, and although there are minor limitations, systematic reviews of acupuncture therapy are generally methodologically rigorous
.

With the widespread use of acupuncture in clinical practice and the rapidly growing interest in acupuncture research, it is critical to use the vast body of evidence available to inform clinical and policy development, and to build funding support and research agendas globally
.
To encourage the use of systematic reviews of acupuncture in research and healthcare decision-making, the investigators make the following recommendations:

1) Incorporate acupuncture evidence into health system decision-making

1) Integrating acupuncture evidence into health system decision-making 1) Integrating acupuncture evidence into health system decision-making

Given the large number of systematic reviews of acupuncture in The BMJ
Acupuncture Collection, international, regional, national organizations and health systems should initiate, support and develop more evidence-informed decision-making on acupuncture .

2) Establish a joint research agenda

2) Establish a joint research agenda 2) Establish a joint research agenda

Knowledge users, funding agencies, and researchers should develop a joint research agenda to accelerate the generation, updating, evaluation, and dissemination of evidence to provide a basis for the application of acupuncture
.

3) Digital dissemination of acupuncture evidence

3) Digital dissemination of acupuncture evidence 3) Digital dissemination of acupuncture evidence

A digital repository should be created containing evidence matrices that map systematic reviews of acupuncture and disseminate specific information from systematic reviews through social media, subscriptions, and email to assist patients, clinicians, and policy makers in accessing Acupuncture evidence
.

4) Use existing evidence in health system decision-making

4) Use existing evidence in health system decision-making 4) Use existing evidence in health system decision-making

Greater communication among researchers, clinicians, and policy makers should be encouraged to expand the use of existing acupuncture evidence, especially in areas where acupuncture therapy shows high certainty supporting evidence
.

5) Coordinate priority funding

5) Coordinate priority funding 5) Coordinate priority funding

Researchers and funding agencies should increase support in broad areas of acupuncture (high-potential areas) with low or very low-certainty supporting evidence , and avoid research and funding in areas where interventions have proven beneficial
.
References [1] Lu, Liming, Yuqing Zhang, Xiaorong Tang, Shuqi Ge, Hao Wen, Jingchun Zeng, Lai Wang et al.
"Evidence on acupuncture therapies is underused in clinical practice and health policy.
" bmj 376 (2022).

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