Dataset Information

Traditional Chinese medicine for knee osteoarthritis: An overview of systematic review.

ABSTRACT: Traditional Chinese medicine (TCM) has been accepted as a complementary therapy for knee osteoarthritis. However, the efficacy and safety of the intervention were still conflicting and uncertain. Meanwhile, the quality of methodology and evidence in the field was unknown.To summarize the characteristics and critically evaluate the quality of methodology, as well as the evidence of systematic reviews (SRs) on TCM for knee osteoarthritis.Five electronic databases were searched from inception to April 2016. The methodological quality of the included studies was assessed by AMSTAR and ROBIS. The quality of the evidence was determined using the GRADE approach.Ten SRs were included. The conclusions suggest that TCM provides potential benefits for patients with knee osteoarthritis. These benefits include pain relief, functional improvement, and presence of few adverse events. Limitations of the methodological quality mainly included the lack of a-priori protocol or protocol registration and incomprehensive literature search. A list of excluded studies was also not provided. The overall quality of evidence in the SRs was poor, ranging from "very low" to "low," mainly because of the serious risk of bias of original trials, inconsistencies, and imprecision in the outcomes.TCM generally appears to be effective for knee osteoarthritis treatment. However, the evidence is not robust enough because of the methodological flaws in SRs. Hence, these conclusions on available SRs should be treated with caution for clinical practice.

SUBMITTER: Yang M

PROVIDER: S-EPMC5739454 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Traditional Chinese medicine for knee osteoarthritis: An overview of systematic review.

Yang Min M Jiang Li L Wang Qing Q Chen Hao H Xu Guihua G

PloS one 20171221 12

<h4>Background</h4>Traditional Chinese medicine (TCM) has been accepted as a complementary therapy for knee osteoarthritis. However, the efficacy and safety of the intervention were still conflicting and uncertain. Meanwhile, the quality of methodology and evidence in the field was unknown.<h4>Objective</h4>To summarize the characteristics and critically evaluate the quality of methodology, as well as the evidence of systematic reviews (SRs) on TCM for knee osteoarthritis.<h4>Methods</h4>Five el ...[more]

PMID: 29267324

Similar Datasets

Project description:BackgroundA large number of protocols for Systematic Reviews (SR) of Traditional Chinese Medicine (TCM) for coronavirus disease 2019 (COVID-19) have been registered in the International Prospective Register of Systematic Reviews (PROSPERO). This study aimed to analyze the innovativeness and rigorousness of the SR protocols and make recommendations for the design and implementation of future SRs on TCM for COVID-19. This effort is likely to enhance the value of the produced information and prevent the futility of the research.MethodsPROSPERO was searched comprehensively for identifying SRs of TCM for COVID-19 from the inception of the database to August 2020. Two researchers independently screened the literature, extracted the data, and cross-checked the retrieved information for consistency. The following details were recorded: database, registration time, organizations, types of research included, participants, interventions, and outcome measures. All extracted data were analyzed by an overview. The "P - participants, I - interventions, C - controls, and O - outcomes (PICO)" included in the protocols were compared for similarity. The outcomes of the included SR protocols were compared with the newly published Core Outcome Sets (COSs).ResultsA total of 80 protocols of SR related to TCM for COVID-19 were obtained after a primary search, and finally 71 protocols were included. The majority of the protocols were from China. Thirty-two organizations participated in the protocol registrations, including 11 hospitals and 21 universities/colleges. However, some protocols were not innovative or rigorous enough, as the PICO of some protocols were similar and non-specific, and the searched literature was incomprehensive. In addition, COS is not commonly adopted.ConclusionsRegistering a protocol of SR is an effective way to ensure the usefulness of the produced information, and to avoid the duplication of research and the wastage of resources. In future SR protocols, it is important to focus on and solve the methodological problems such as non-specific PICO, incomprehensive literature retrieval, and improper outcome measures.

Project description:Background and aimsTraditional Chinese exercise (TCE) includes a variety of exercise, which is being accepted by more and more people in the treatment of knee osteoarthritis (OA) from different countries. With the attendant, many clinical reports focus on it. Our meta-analysis aimed to systematically assess the effects of traditional Chinese exercise on pain, stiffness, physical function, quality of life, mental health and adverse events in people with knee osteoarthritis.MethodsPubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), the Web of Science, and Chinese Biomedical Literature Database (CBM) were searched from the time of their inception through April 2016 and risk of bias was independently assessed by two authors. Outcome measures included pain, physical functional, joint stiffness, quality of life, mental health and safety. For pooled outcomes, standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated.ResultsEight randomized controlled trials with a sample size of 375 cases met the criteria to be included in the study indicating that high quality literature is lacking in this field. Results of the meta-analysis showed that short-term TCE could relieve pain (SMD: -0.77;95% CI: -1.13 to -0.41; P<0.0001), improve physical function (SMD -0.75; 95% CI: -0.98 to -0.52; P<0.00001), and alleviate stiffness (SMD: -0.56; 95%: CI -0.96 to -0.16; P<0.006), but had no significant effect on quality of life (SMD: 0.57; 95% CI: 0.17 to 0.97; P = 0.005), and mental health (SMD 4.12; 95% CI: -0.50 to 8.73; P = 0.08). Moreover, TCE was not associated with serious adverse events.ConclusionsOur systematic review revealed that short-term TCE was potentially beneficial in terms of reducing pain, improving physical function and alleviating stiffness. These results may suggest that TCE could prove useful as an adjuvant treatment for patients with knee OA. Further studies are urgently needed to confirm these results.

Project description:BackgroundOsteoarthritis (OA) is a common degenerative disease of bone and joint characterized by the damage of articular cartilage and hypertonia, which often occurs in the middle-aged and elderly. Traditional Chinese medicine (TCM) therapy, including acupuncture (ACU), oral administration, and external use of traditional Chinese medicines (TCMs), can significantly improve the therapeutic effect on OA and reduce the occurrence of side effects. We provide a latest meta-analysis on the treatment of OA with TCM.Materials and methodsIn the electronic database, appropriate articles without language restrictions on keywords were selected until August 1, 2019. All trajectories are screened according to certain criteria. The quality of qualified research was also assessed. We have made a detailed record of the results of the measurement. Meta-analysis was carried out with Revman 5.3 software.ResultsForty-four articles involving 4014 patients (2012 cases in the experimental group and 2002 cases in the control group) with OA were selected. This article focuses on the study of the treatment of OA by using the general mode of TCM. The quality evaluation included in the study was evaluated independently according to the Cochrane intervention system evaluation manual. In this meta-analysis, 68.18% of the literature correctly described the conditions for the generation of random assignment sequences, only 6.82% of the literature correctly mentioned the hidden details of allocation, and all studies mentioned randomly assigned participants. Compared with Western medicine, the total effective rate (TER) of OA treatment in TCM was significantly increased and the recurrence rate (RR) was significantly decreased (P < 0.00001). In addition, the experimental group was also superior to the control group in terms of the indicators of joint activity function, inflammatory factor content, and various indicators affecting bone metabolism. It can be showed by the network analysis diagram that Aconiti Radix, Achyranthis Bidentatae Radix, and other TCMs can inhibit inflammatory stimulation and relieve the pain symptoms of patients with OA. ACU at Yinlingquan, Xiyan, and other acupoints can effectively improve the clinical symptoms of patients with OA.ConclusionTCM therapy in treatment of patients with OA could effectively restore joint function, enhance the TER, and reduce RR. However, the results of this study should be handled with care due to the limitations existing. Some rigorous randomized controlled trials (RCTs) are needed to confirm these findings.

Project description:Background: Growing evidences have advocated the potential benefits of traditional Chinese exercise (TCE) on symptomatic improvement of knee osteoarthritis (KOA). However, most of them have been derived from cross-sectional studies or case reports; the effectiveness of TCE therapies has not been fully assessed with a randomized control trial (RCT). In order to evaluate the combined clinical effectiveness of TCE for KOA, we conducted a systematic review and meta-analysis on the existing RCTs on KOA. Methods: A systematic search was performed in four electronic databases: PubMed, Web of Science, Cochrane Library, and EMBASE from the time of their inception to February 2020. All eligible RCTs were included in which TCE was utilized for treating KOA as compared to a control group. Two reviewers independently extracted the data and evaluated the risk of bias following the Cochrane Risk of Bias Tool for RCT. The symptoms of KOA evaluated by the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) were regarded as the primary outcomes in this study. Each outcome measure was pooled by a standardized mean difference (SMD) with 95% confidence intervals (CI). A meta-analysis was applied with a random or fixed effect model for the collected data to calculate the summary SMD with 95% CI based on different statistical heterogeneity. In addition, subgroup analyses were used to investigate heterogeneity and sensitivity analysis was carried out for the results of the meta-analysis. Egger's test and the funnel plots were used to examine the potential bias in the RCTs. Results: A total of 14 RCTs involving 815 patients with KOA were included. Compared with a control group; the synthesized data of TCE showed a significant improvement in WOMAC/KOOS pain score (SMD = -0.61; 95% CI: -0.86 to -0.37; p < 0.001), stiffness score (SMD = -0.75; 95% CI: -1.09 to -0.41; p < 0.001), and physical function score (SMD = -0.67; 95% CI: -0.82 to -0.53; p < 0.001). Conclusions: Our meta-analysis suggested that TCE may be effective in alleviating pain; relieving stiffness and improving the physical function for patients with KOA. Yet; given the methodological limitations of included RCTs in this meta-analysis; more high-quality RCTs with large sample size and long-term intervention are required to further confirm the effectiveness and underlying mechanisms of TCE for treating KOA.

Project description:BackgroundCurrently, many systematic reviews (SRs) of moxibustion as a treatment of KOA have been published. However, the evidence of different SRs of moxibustion to treat KOA has not been comprehensively evaluated.AimThis overview aimed to evaluate the existing results and provide scientific evidence of the effectiveness and safety of moxibustion in the treatment of KOA.MethodsWe conducted a comprehensive search of Embase, PubMed, Web of Science, Cochrane Library, SinoMed, CNKI, Wanfang, VIP, and other databases until October 31, 2021. A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2) was used to assess the methodological quality of SRs. Preferred Reporting Item for Systematic Reviews and Meta-Analyses was used to evaluate the reporting quality, and the risk of bias in SRs was evaluated by ROBIS Tool. We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool to determine the strength of evidence and conducted a meta-analysis of the total effectiveness rate.ResultsFinally, 10 qualified SRs were included, including 57 randomized controlled trials and 5,149 participants. All SRs evaluated by AMASTAR-2 had more than one critical deficiency, so all SRs were rated as critically low. In the PRISMA checklist, the manuscript structures of the included SRs were relatively complete. Including four SRs with a low risk of bias and six with a high risk of bias using the ROBIS tool. In GRADE, two items (6.25%) were rated as high quality, three (9.37%) as medium quality, 17 (53.12%) as low quality and 10 (31.25%) as very low quality. A re-meta-analysis showed that moxibustion and moxibustion combined treatment improved the total effectiveness rate in knee osteoarthritis (risk ratio = 1.17, 95% confidence interval 1.13-1.21, P < 0.001 and risk ratio = 1.13, 95% CI: 1.04-1.23, P < 0.001), with low heterogeneity (I 2 = 36.3%, P = 0.020, and I 2 = 0.0%, P = 0.956). A total of eight SRs reported adverse events, and no serious adverse events occurred in the moxibustion group and control group.ConclusionMoxibustion seems to be effective in treating KOA. Four SRs reported 10 common discomfort symptoms caused by moxibustion, and these adverse events can spontaneously subside, even can be avoided, therefore, moxibustion for KOA appears to be safe. However, the reliability of the results is reduced by the high risk of bias of the original studies and the low methodological quality of SRs. Therefore, future studies should pay more attention to the quality of the original study and the evidence quality of the SRs to provide more powerful and scientific evidence of the effectiveness and safety of moxibustion treatment of KOA.

Project description:BackgroundIdiopathic membranous nephropathy (IMN) is a rare autoimmune disorder that causes nephrotic syndromes in adults. Conventional immunosuppressive therapies often exhibit limited efficacy in achieving remission and may result in notable adverse reactions, warranting the exploration of novel therapeutic approaches for IMN treatment. Traditional Chinese medicine (TCM), which is extensively used for kidney disease management, is a promising alternative.ObjectiveThis study aimed to examine the safety and efficacy of TCM alone or in combination with Western medicine for the management of patients diagnosed with IMN.MethodsThis study employed a systematic search of English and Chinese electronic databases to identify randomized controlled trials (RCTs) that examined the application of TCM in the treatment of IMN. RCTs that met the predetermined inclusion and exclusion criteria and assessed the safety and efficacy of TCM alone or in combination with Western medicine in patients with IMN were included in the analysis. The methodological quality of the included studies was evaluated by using a risk-of-bias tool. All statistical analyses were performed using the RevMan software (version 5.4.2). The evidence was evaluated on the https://www.gradepro.org/website.ResultsThis study included 29 randomized controlled trials (RCTs) involving 1982 patients with moderate methodological quality that met the inclusion criteria. The results showed that, compared to Western medicine alone therapy, the use of TCM alone or in combination with Western medicine significantly improved total remission (TR) rate (risk ratios [RR] 1.38, 95% confidence interval [CI] 1.29-1.46, I2 = 0%, P < 0.00001), complete remission (CR) rate (RR 1.78, 95% CI 1.48-2.15, I2 = 0, P < 0.00001), partial remission (PR) rate (RR 1.27, 95% CI 1.161.40, I2 = 0%, P < 0.00001), and serum albumin (ALB) levels (MD: 4.05, 95% CI: 3.02-5.09, I2 = 91%, P < 0.00001). TCM alone or in combination with Western medicine also reduced proteinuria levels (mean difference [MD]: 1.05, 95% CI: 1.30 to -0.79, I2 = 95%, P < 0.00001), serum creatinine (SCr) levels (MD: 7.47, 95% CI: 13.70 to -1.24, I2 = 97%, P = 0.02), and serum antibodies against M-type phospholipase A2 receptor levels (aPLA2Rab) (MD: 19.24, 95% CI: 33.56 to -4.93, I2 = 87%, P = 0.008). Moreover, the efficacy of combined TCM and Western medicine is superior to that of Western medicine alone in reducing the incidence of infection, hepatotoxicity, and thrombosis. Although the primary and secondary outcomes were consistent, the evidence was generally moderate.ConclusionThe results of this study suggest that TCM alone or in combination with Western medicine may be a feasible alternative therapeutic approach for the treatment of IMN. Nevertheless, additional, rigorously designed, high-quality, and extensive clinical trials are imperative to provide substantial evidence regarding the effectiveness of TCM in managing IMN.

Dataset Information

Traditional Chinese medicine for knee osteoarthritis: An overview of systematic review.

Publications

Traditional Chinese medicine for knee osteoarthritis: An overview of systematic review.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets