Mingxiao Yang1,2, Mingsheng Sun3, Ting Du4, Hulin Long5, Ji Chen3, Fanrong Liang3, Lixing Lao1,2. 1. School of Chinese Medicine, University of Hong Kong, China. 2. Department of Chinese Medicine, University of Hong Kong-Shenzhen Hospital, China. 3. School of Acupuncture, Chengdu University of TCM, China. 4. Department of Rehabilitation, Xishan People's Hospital, China. 5. Department of Acupuncture, Teaching Hospital of Chengdu University of TCM, China.
Abstract
OBJECTIVE: The aim of this study was to assess the efficacy and safety of acupuncture in the treatment of patients with stable angina pectoris. METHODS: A literature search was performed in nine databases, including PubMed and the Cochrane Library, from their inception to 30 August 2018. Randomized controlled trials that compared acupuncture therapy with sham acupuncture or no treatment were included. Two reviewers under the guidance of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines assessed the eligibility of each record and extracted essential information independently. The data were merged using a fixed-effect model. RESULTS: Pooled analysis of 17 eligible trials with 1516 participants showed that acupuncture was associated with reduced angina attack frequency (-4.91; 95% confidence interval, -6.01- -3.82; p < 0.00001) and improved depression (-1.23; 95% confidence interval, -1.47- -1.00; p < 0.00001) and anxiety level (-0.96; 95% confidence interval, -1.16- -0.75; p < 0.00001) relative to sham treatment or standard care alone. No increased risk of adverse events was observed during treatment (relative risk, 0.70; 95% confidence interval, 0.33-1.48; p = 0.35). No significant improvement was shown in nitroglycerin use or angina intensity. The included studies were associated with unclear to high risk of selection or performance bias, and the quality of evidence was low to moderate. CONCLUSIONS: Acupuncture may safely and effectively improve physical restrictions, emotional distress, and attack frequency in patients with stable angina pectoris. However, angina intensity and medication use were not reduced. Studies with adequate blinding and a valid sham control group are still warranted due to the current low quality of evidence.
OBJECTIVE: The aim of this study was to assess the efficacy and safety of acupuncture in the treatment of patients with stable angina pectoris. METHODS: A literature search was performed in nine databases, including PubMed and the Cochrane Library, from their inception to 30 August 2018. Randomized controlled trials that compared acupuncture therapy with sham acupuncture or no treatment were included. Two reviewers under the guidance of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines assessed the eligibility of each record and extracted essential information independently. The data were merged using a fixed-effect model. RESULTS: Pooled analysis of 17 eligible trials with 1516 participants showed that acupuncture was associated with reduced angina attack frequency (-4.91; 95% confidence interval, -6.01- -3.82; p < 0.00001) and improved depression (-1.23; 95% confidence interval, -1.47- -1.00; p < 0.00001) and anxiety level (-0.96; 95% confidence interval, -1.16- -0.75; p < 0.00001) relative to sham treatment or standard care alone. No increased risk of adverse events was observed during treatment (relative risk, 0.70; 95% confidence interval, 0.33-1.48; p = 0.35). No significant improvement was shown in nitroglycerin use or angina intensity. The included studies were associated with unclear to high risk of selection or performance bias, and the quality of evidence was low to moderate. CONCLUSIONS: Acupuncture may safely and effectively improve physical restrictions, emotional distress, and attack frequency in patients with stable angina pectoris. However, angina intensity and medication use were not reduced. Studies with adequate blinding and a valid sham control group are still warranted due to the current low quality of evidence.
Entities:
Keywords:
Stable angina pectoris; acupuncture; complementary and alternative medicine; patient-centered outcomes; symptom management
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