School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China.
Shenzhen Bao'an Traditional Chinese Medicine Hospital, Guangzhou University of Chinese Medicine, Shenzhen, Guangdong Province, China.
Medicine (Baltimore). 2022 Aug 5;101(31):e29310. doi: 10.1097/MD.0000000000029310.
Research into acupuncture and moxibustion and their application for chronic fatigue syndrome (CFS) has been growing, but the findings have been inconsistent.
To evaluate the existing randomized clinical trials (RCTs), compare the efficacy of acupuncture, moxibustion and other traditional Chinese medicine (TCM) treatments.
Three English-language databases (PubMed, Embase, Web of Science, and The Cochrane Library) and 4 Chinese-language biomedical databases (Chinese Biomedical Literature Database, VIP Database for Chinese Technical Periodicals, China National Knowledge Infrastructure, and Wanfang) were searched for RCTs published from database inception through August 2021.
RCTs include acupuncture, moxibustion, traditional Chinese herbal medicine, western medicine and no control.
Data were screened and extracted independently using predesigned forms. The quality of RCTs was appraised with the Cochrane Collaboration risk of bias tool. We conducted a random-effects network meta-analysis within a frequentist framework. We assessed the certainty of evidence contributing to network estimates of the main outcomes with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework.
The primary outcomes were the overall response rate and FS-14 scale.
A total of 51 randomized controlled trials involving 3473 patients with CFS were included in this review. Forty one studies indicate low risk or unknown risk, and the GRADE scores of the combined results show low levels. Among the main indicators, traditional Chinese medicine therapies have excellent performance. However, the overall response rate is slightly different from the results obtained from the Fatigue Scale-14 total score. Moxibustion and traditional Chinese medicine (Odds ratios 48, 95% CrI 15-150) perform better in the total effective rate, while moxibustion plus acupuncture (MD 4.5, 95% CrI 3.0-5.9) is better in the FS-14 total score.
The effect of acupuncture and moxibustion in the treatment of CFS was significantly higher than that of other treatments. Traditional Chinese medicine should be used more widely in the treatment of CFS.
针灸及其在慢性疲劳综合征（CFS）中的应用的研究一直在增加，但研究结果并不一致。
评估现有的随机对照试验（RCT），比较针灸、艾灸和其他中医（TCM）治疗的疗效。
检索了 3 个英文数据库（PubMed、Embase、Web of Science 和 The Cochrane Library）和 4 个中文生物医学数据库（中国生物医学文献数据库、维普数据库、中国知网和万方），以获取从数据库成立到 2021 年 8 月发表的 RCTs。
RCT 包括针灸、艾灸、中药、西药和无对照。
使用预先设计的表格独立筛选和提取数据。使用 Cochrane 协作风险偏倚工具评估 RCT 的质量。我们在一个有频率主义框架的随机效应网络荟萃分析中进行了分析。我们使用推荐评估、制定和评估（GRADE）框架评估对主要结局网络估计有贡献的证据的确定性。
主要结局是总体反应率和 FS-14 量表。
共纳入 51 项 RCT，涉及 3473 例 CFS 患者。41 项研究表明风险较低或未知，综合结果的 GRADE 评分显示为低水平。在主要指标中，中医药疗法表现出色。然而，总体反应率与从疲劳量表-14 总分中得到的结果略有不同。艾灸和中医药（优势比 48，95%CrI 15-150）在总有效率方面表现更好，而艾灸加针灸（MD 4.5，95%CrI 3.0-5.9）在 FS-14 总分方面表现更好。
针灸治疗 CFS 的效果明显高于其他治疗方法。中医药在 CFS 的治疗中应得到更广泛的应用。
