Adverse effects associated with acupuncture therapies: An evidence mapping from 535 systematic reviews.
Adverse effects associated with acupuncture therapies: An evidence mapping from 535 systematic reviews.
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DOI：
10.1186/s13020-023-00743-7
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发表时间：
2023-04-10
期刊：
影响因子：
4.9
通讯作者：
Yang K
中科院分区：
文献类型：
--
作者：
Xu M;Yang C;Nian T;Tian C;Zhou L;Wu Y;Li Y;Deng X;Li X;Yang K
考虑到医生和患者广泛使用针灸，有必要探讨其在治疗过程中的不良反应。在此，根据已发表的研究生成了证据图，以识别针灸引起的不良反应并评估其严重程度，总体目标是为安全有效的实施提供参考。在四个公共数据库（PubMed、Embase、Web of science 和 Cochrane 图书馆）中进行了全面的文献检索，以确定截至 2022 年 6 月 15 日发表的相关研究。此外，还在 Epistemonikos 数据库中探索了相关研究，并检索了参考文献列表作为补充。应用评估系统评价的测量工具第 2 版 (AMSTAR-2) 质量评估工具来确定纳入的系统评价 (SR) 和/或荟萃分析 (MA) 的方法学质量，而 Microsoft Excel 2019 工具用于数据提取和编码。生成热图以显示疾病类型、第一作者的原籍国以及原始研究的样本量。此外，气泡图全面呈现了干预类别、不良反应类型和证据水平。共纳入 535 个 SR，涉及 33 种不良反应。其中，22项研究被评为高质量，28项为中等质量，106项为低质量，其余为极低质量。研究中描述了许多不良反应，包括晕厥（86 个 SR）、器官或组织损伤（233 个 SR）、全身反应（113 个 SR）、感染（19 个 SR）和其他不良事件（373 个 SR）。重要的是，这些不良反应主要与19种针灸技术有关，包括电针（n = 67）、手法针灸（n = 47）和穴位埋线（n = 41）。此外，535 个 SR 描述了 23 种疾病，其中症状、体征或临床表现（83 个 SR）、精神、行为或神经发育障碍（67 个 SR）以及神经系统疾病（66 个 SR）的发生率最高。该证据图探讨了针灸的不良反应，表明针灸的不良反应有多种类型，且症状较轻。方法学评估显示，大多数纳入的研究质量低或极低。因此，未来有必要开展随机对照试验和SR来全面分析针灸相关的不良事件，以提供可靠、可信的证据。在线版本包含可在 10.1186/s13020-023-00743-7 获取的补充材料。
Considering that physicians and patients widely use acupuncture, it is necessary to explore its adverse effects during treatment. Herein, an evidence map was generated based on published studies to identify acupuncture-induced adverse effects and assess their severity, with the overarching goal of providing references for safe and effective implementation. A comprehensive literature search was performed in four public databases (PubMed, Embase, Web of science, and the Cochrane Library) to identify relevant studies published up to 15th June 2022. In addition, relevant studies were explored in the Epistemonikos database and reference lists were retrieved as a supplement. A MeaSurement Tool to Assess systematic Reviews, Version 2 (AMSTAR-2) quality assessment tool was applied to determine the methodological quality of included systematic reviews (SRs) and/or meta-analysis (MAs), whereas Microsoft Excel 2019 tool was used for data extraction and coding. Heatmaps were generated to display disease type, countries of origin for the first authors, and the sample sizes of original studies. Moreover, bubble charts comprehensively presented intervention categories, adverse reaction types, and evidence levels. A total of 535 SRs involving 33 adverse reactions were included. Among them, 22 studies were rated as high quality, 28 as moderate, 106 as low, and the rest were of critically-low quality. Numerous adverse effects were described in the studies, including syncope (86 SRs), organ or tissue injury (233 SRs), systemic reactions (113 SRs), infection (19 SRs), and other adverse events (373 SRs). Importantly, these adverse reactions were mainly associated with 19 acupuncture techniques, including electroacupuncture (n = 67), manual acupuncture (n = 47) and acupoint catgut embedding (n = 41). Furthermore, the 535 SRs described 23 diseases, among which symptoms, signs or clinical findings (83 SRs), mental, behavioral or neurodevelopmental disorders (67 SRs), and diseases of the nervous system (66 SRs) had the highest incidence. This evidence mapping explores the adverse effects of acupuncture, showing that there are multiple types of adverse reactions to acupuncture, with milder symptoms. The methodological assessment revealed that most of the included studies were of low- or critically low-quality. Therefore, there is a need for future randomized controlled trials and SRs to comprehensively analyze acupuncture-related adverse events in order to provide reliable and credible evidence. The online version contains supplementary material available at 10.1186/s13020-023-00743-7.
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影响因子：
7.2
作者：
Whiting P;Savović J;Higgins JP;Caldwell DM;Reeves BC;Shea B;Davies P;Kleijnen J;Churchill R;ROBIS group
通讯作者：
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通讯作者：
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影响因子：
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作者：
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影响因子：
4.3
作者：
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通讯作者：
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