Mingzhu Xu

Background: Effective options for managing chemotherapy-induced peripheral neuropathy (CIPN) remain limited. Evidence supporting acupuncture for CIPN continues to accumulate, warranting a comprehensive synthesis to clarify its effects. Methods: We searched eight databases and extracted study characteristics from the included studies. We assessed risk of bias using the Cochrane RoB 2 tool and graded the certainty of evidence using the GRADE framework. Meta-analyses evaluated CIPN symptoms, clinical effectiveness rate (ER), nerve conduction study (NCS) parameters, and quantitative sensory testing (QST) outcomes. Prespecified subgroup, sensitivity, publication-bias, and trial sequential analyses (TSA) were conducted. Results: The review included 40 RCTs involving 2496 participants. Compared with controls, acupuncture interventions, used alone or with cointerventions, improved several CIPN symptom outcomes, including FACT-Ntx scores (MD = − 1.43, 95% CI [− 1.91, − 0.95]) and increased the ER (RR = 1.74, 95% CI [1.57, 1.93]). Acupuncture also improved nerve conduction velocity and amplitude; however, no significant effects were found for worst pain scores, onset latency, or QST outcomes. GRADE rated the certainty of evidence for FACT-Ntx, EORTC QLQ-CIPN20, and ER as very low. TSA crossed the monitoring boundaries for FACT-Ntx, EORTC QLQ-CIPN20, and ER. Subgroup findings varied by acupuncture type, intervention purpose, and chemotherapy regimen. Conclusion: Both manual acupuncture and electroacupuncture were associated with higher ERs, whereas their effects on specific outcomes varied by intervention type, including whether acupuncture was combined with other treatments. LI4 and ST36 were the most frequently used acupoints, and distal hand and foot acupoints were also commonly selected. Future studies should assess how acupuncture modality, intervention purpose, and chemotherapy regimen influence outcomes. Because the certainty of evidence was very low, these findings should be interpreted cautiously.

Background: Neuropathic pain (NP) is expected to increase due to the high risk of global population aging. Acupuncture has a definite clinical effect on NP. Therefore, a systematic review and meta-analysis were conducted to evaluate the effect on pain intensity and safety of acupuncture in patients with NP.Methods: An encompassing search of specific authoritative databases in English, from their inception to 2022, was performed. The databases were as follows: Scopus, Ovid EMBASE, Ovid Cochrane Database of Systematic Reviews, Ovid Cochrane Central Register of Controlled Trials, Ovid MEDLINE(R) and Epub Ahead of Print, In-Process and Other Non-Indexed Citations, and Daily. All the randomized controlled trials regarding the acupuncture treatment of NP will be included. Methodological quality assessment of the included trials was assessed based on the risk of bias from the Cochrane handbook. A meta-analysis was performed for the main outcomes. In addition, sensitivity analysis, subgroup analysis, and funnel plot were also carried out.Results: A total of 16 studies with 1,021 patients with NP were evaluated in a systematic review. According to the results of the overall meta-analysis in eight RCTs with 338 participants, the acupuncture group was better than the control group in improving changes in pain intensity (SMD −0.59, 95% CI: −0.95 to −0.23, P = 0.001). In subgroup analysis, five trials indicated that acupuncture was more effective in improving changes in pain intensity than sham acupuncture (SMD −0.54, 95% CI: −0.95 to −0.13, P = 0.01), two trials evaluated the effect on changes in pain intensity in the comparison of acupuncture and conventional treatments, no significant difference existed (SMD −0.61, 95% CI: −1.83 to 0.61, P = 0.33), and one trial compared acupuncture with blank control evaluating the effect of changes in pain intensity with a significant difference. Eleven studies mentioned the safety conditions and acupuncture-induced AEs were mild and reversible. Both the sensitivity analysis and funnel plot analysis showed that the meta-analysis was stable and irreversible without publication bias. The GRADE was rated as “very low.”Conclusion: The acupuncture group had higher effectiveness than sham intervention or blank control for changes in pain intensity, but there is no significant difference between acupuncture and conventional treatments in treating NP. The acupuncture-induced adverse events were mild and reversible. However, the interpretation of our results should be performed cautiously due to the low methodological quality of selected publications.Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022306461.

Background and Purpose. Mild cognitive impairment (MCI) is a common condition, which threatens the quality of life of older adults. Tai Chi (TC) is growing in popularity among patients with MCI. This study is aimed at evaluating the effectiveness and safety of TC in older adults with MCI. Design. Randomized controlled trials (RCTs) from multiple databases from inception to December 2020 published in English were searched. Two researchers independently performed eligible study screening and data extraction. The methodological quality was assessed with the Jadad score. Meta‐analysis of RCTs on TC in the treatment of MCI was performed with RevMan Version 5.4.1. Results. Seven RCTs with 1265 participants were included. For most RCTs, the overall reporting of methodological quality was high. Results of the meta‐analysis indicate that TC improved MCI patients’ cognitive function significantly, including overall cognitive function (MD = −2.24, 95% CI ‐3.51 to ‐0.97, P = 0.0005), memory and learning (SMD = 0.83, 95% CI 0.22 to 1.45, P = 0.008), visuospatial ability (MD = 3.15, 95% CI 0.74 to 5.56, P = 0.01), executive functions (MD = 0.32, 95% CI 0.03 to 0.61, P = 0.03), and physical activity (MD = 18.78, 95% CI 10.80 to 26.76, P < 0.00001). However, no significant benefit was found for TC on psychological activity (MD = 0.17, 95% CI ‐0.62 to 0.96, P = 0.36) and biomarker improvement. Conclusion. The meta‐analysis confirmed the clinical therapeutic effect of TC for MCI. More rigorous and long‐term follow‐up RCTs should be conducted in the future.