Li Jin-Ling, Wang Li-Qiong, Zhang Na, Su Xin-Tong, Lin Ying, Yang Jing-Wen, Shi Guang-Xia, Liu Cun-Zhi
International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China.
Cardiovasc Diagn Ther. 2021 Oct;11(5):1067-1079. doi: 10.21037/cdt-21-201.
Current evidence suggests that acupuncture is an effective adjunctive therapy that can bring potential benefits to patients with cardiac arrhythmias. However, there are relevant gaps in the optimal therapeutic strategy, which may cause uncertainties on the best practice of acupuncture treatment for arrhythmia. We aim to develop consensus-based recommendations for clinical guidance on acupuncture treatment of cardiac arrhythmias.
A multidisciplinary panel of specialists was invited to participate in a two-round semi-open clinical issue investigation. Meanwhile, relevant literature reviews were searched in 3 databases to provide evidence. Subsequently, an initial consensus voting list on acupuncture as an adjunctive therapy for cardiac arrhythmias was derived from the clinical investigation and literature review. Finally, 30 authoritative experts reached a consensus on the key issues of the voting list by a three-round modified Delphi survey. Consensus was defined when >80% agreement was achieved.
Following the three-round Delphi survey, there were 32 items (91.43%) finally reaching consensus, including the following 5 domains: (I) the benefits of acupuncture for the appropriate population; (II) the general therapeutic principle; (III) the acupuncture strategy; (IV) the relevant adverse events; (V) others.
Consensus was achieved on some key elements. Given the lack of guidelines and the substantial heterogeneity of previous studies, these recommendations are of value in providing guidance for clinical practice of acupuncturists and in assisting patients with arrhythmia to obtain standardized acupuncture treatment. It also pointed out some problems that need to be carefully explored in future studies.
目前的证据表明，针灸是一种有效的辅助治疗方法，可为心律失常患者带来潜在益处。然而，在最佳治疗策略方面存在相关差距，这可能导致心律失常针灸治疗最佳实践的不确定性。我们旨在制定基于共识的建议，为心律失常的针灸治疗提供临床指导。
邀请多学科专家小组参与两轮半开放式临床问题调查。同时，在3个数据库中检索相关文献综述以提供证据。随后，根据临床调查和文献综述得出关于针灸作为心律失常辅助治疗的初步共识投票清单。最后，30位权威专家通过三轮改良德尔菲调查就投票清单的关键问题达成共识。当达成>80%的一致意见时定义为达成共识。
经过三轮德尔菲调查，最终有32项（91.43%）达成共识，包括以下5个领域：（I）针灸对合适人群的益处；（II）一般治疗原则；（III）针灸策略；（IV）相关不良事件；（V）其他。
在一些关键要素上达成了共识。鉴于缺乏指南以及以往研究存在大量异质性，这些建议对于为针灸师的临床实践提供指导以及帮助心律失常患者获得标准化针灸治疗具有价值。它还指出了一些在未来研究中需要仔细探索的问题。
