- Email: [email protected]
Systematic reviews: Their role in determining the evidence for acupuncture
Abstracts / European Journal of Integrative Medicine 7 (2015) 432–438
androgen receptor protein expression and circulating luteinizing hormone. These results may help explain the beneficial neuroendocrine effects of low-frequency EA in women with PCOS. The effect and mechanism of acupuncture on reproductive function will be discussed during the Panel Session 1. http://dx.doi.org/10.1016/j.eujim.2015.07.031
nerve. Homotopic-acupoints apply to the pathologic condition of vagal hyperfunction of their counterpart organs, while heterotopic-acupoints apply to the condition of their sympathetic hyperfunction ones. In a word, acupoint, exhibiting both ‘personality’ and/or a ‘common effect’, is in the soma-area where the cross-talk take place with their counterpart organ in pathological conditions.
The innovative idea of the neuromechanism of acupuncture bi-regulating gastrointestinal function: The hypothesis of homotopic/heterotopic-acupoints-organ
http://dx.doi.org/10.1016/j.eujim.2015.07.032
Bin Xu
Systematic reviews: Their role in determining the evidence for acupuncture
Vice Director of Key Laboratory of Acupuncture and Medicine Research of Ministry of Education and Leader of 2nd Clinical Acupuncture College of Nanjing University of Chinese Medicine, Nanjing, PR China E-mail address: [email protected]. The effect of acupuncture on regulating visceral organ function has been supported by evidence from clinic and basic research, but there is not yet a clear conclusion on whether acupoints have a consistent effect on viscera. In traditional theory of Chinese acupuncture, both “He Acupoint”, that is ST37 (Shangjuxu), and “Mu Acupoint”, that is ST25 (Tianshu), of the large intestine can regulate the function of gastrointestinal tract, and their combination is very common in clinical practice, but there has been no clear basis for the reason why combine and what the effect is after combination. With the financial support of National Key Basic Research Program (973 Program), a series of research projects have been carried out since 2011. The results suggested that ST25 and ST37 showed an opposite effect on gastric and intestinal motility, that is, ST25 inhibits and ST37 promotes, while an identical promoting effect on colonic movement. When ST37 and ST25 were stimulated together, it showed an inhibitory effect, which was lower than the effect of ST25. Furthermore, when sympathetic nerve function was inhibited (during adrenoceptor antagonist administration or in 12 knockout mice), the effect of ST25 on gastric and intestinal motility was diminished, and ST37 unaffected; when parasympathetic nerve function was inhibited (in the condition of muscarinic receptor antagonist administration or inM2M3 knockout mice), the effect of ST37 on gastric and intestinal motility was diminished, and ST25 unaffected. Based on the results above, our team suggested a homotopic/heterotopic-acupoints-organ hypothesis in acupuncture regulating gastrointestinal motility: Acupuncture exhibits a characteristic homeostasis system, which consists of homotopicacupoints-organ unit and heterotopic-acupoints-organ unit, in bi-regulating organic function. Homotopic-acupoints-organ unit, where afferent innervation is in the same segment from which the efferents innervate visceral organs, were innervated by sympathetic nerve, while heterotopic-acupointsorgan unit, involving different segmental innervation of the spinal cord to visceral organs, were innervated by vague
433
Panel Session 2 – Methodology of Research and EBM in Acupuncture
Myeong Soo Lee Korea Institute of Oriental Medicine (KIOM), Daejeon, South Korea E-mail address: [email protected]. ‘Systematic review aimed to identify, evaluate and summarize the findings of all relevant individual studies, thereby making the available evidence more accessible to decisionmakers.’ When appropriate, combining the results of several studies gives a more reliable and precise estimate of an intervention’s effectiveness than one study alone. Systematic review adheres to a strict scientific design based on explicit, prespecified and reproducible methods. Many clinical trials testing its clinical effectiveness for complementary medicine are available. However, the results of trials are far from uniform. This presentation is aimed at summarize the role of systematic review in determining the evidence in acupuncture. This study will discuss the general procedure in clinical practice, and the meaning of effects. It also looks into the formation of evidence from research, applying to clinical practice and the meaning of effects in evidence-based medicine. It will be compared the evidence from real world and trials. The reason why the differences occur will be discussed. Finally, we can discuss what is next for systematic reviews in building the evidence for acupuncture. This can be used to guide future research. http://dx.doi.org/10.1016/j.eujim.2015.07.033 Methodology of research and EBM in acupuncture Jian-Ping Liu Director of Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China E-mail address: [email protected]. One of the challenges in research methodology in metaanalysis is the appropriateness to pool all data to get an overall effect from heterogeneous studies in terms of participants, acupuncture treatment, the control interventions, and outcome measures. Meta-analysis could be misleading if it was used
androgen receptor protein expression and circulating luteinizing hormone. These results may help explain the beneficial neuroendocrine effects of low-frequency EA in women with PCOS. The effect and mechanism of acupuncture on reproductive function will be discussed during the Panel Session 1. http://dx.doi.org/10.1016/j.eujim.2015.07.031
nerve. Homotopic-acupoints apply to the pathologic condition of vagal hyperfunction of their counterpart organs, while heterotopic-acupoints apply to the condition of their sympathetic hyperfunction ones. In a word, acupoint, exhibiting both ‘personality’ and/or a ‘common effect’, is in the soma-area where the cross-talk take place with their counterpart organ in pathological conditions.
The innovative idea of the neuromechanism of acupuncture bi-regulating gastrointestinal function: The hypothesis of homotopic/heterotopic-acupoints-organ
http://dx.doi.org/10.1016/j.eujim.2015.07.032
Bin Xu
Systematic reviews: Their role in determining the evidence for acupuncture
Vice Director of Key Laboratory of Acupuncture and Medicine Research of Ministry of Education and Leader of 2nd Clinical Acupuncture College of Nanjing University of Chinese Medicine, Nanjing, PR China E-mail address: [email protected]. The effect of acupuncture on regulating visceral organ function has been supported by evidence from clinic and basic research, but there is not yet a clear conclusion on whether acupoints have a consistent effect on viscera. In traditional theory of Chinese acupuncture, both “He Acupoint”, that is ST37 (Shangjuxu), and “Mu Acupoint”, that is ST25 (Tianshu), of the large intestine can regulate the function of gastrointestinal tract, and their combination is very common in clinical practice, but there has been no clear basis for the reason why combine and what the effect is after combination. With the financial support of National Key Basic Research Program (973 Program), a series of research projects have been carried out since 2011. The results suggested that ST25 and ST37 showed an opposite effect on gastric and intestinal motility, that is, ST25 inhibits and ST37 promotes, while an identical promoting effect on colonic movement. When ST37 and ST25 were stimulated together, it showed an inhibitory effect, which was lower than the effect of ST25. Furthermore, when sympathetic nerve function was inhibited (during adrenoceptor antagonist administration or in 12 knockout mice), the effect of ST25 on gastric and intestinal motility was diminished, and ST37 unaffected; when parasympathetic nerve function was inhibited (in the condition of muscarinic receptor antagonist administration or inM2M3 knockout mice), the effect of ST37 on gastric and intestinal motility was diminished, and ST25 unaffected. Based on the results above, our team suggested a homotopic/heterotopic-acupoints-organ hypothesis in acupuncture regulating gastrointestinal motility: Acupuncture exhibits a characteristic homeostasis system, which consists of homotopicacupoints-organ unit and heterotopic-acupoints-organ unit, in bi-regulating organic function. Homotopic-acupoints-organ unit, where afferent innervation is in the same segment from which the efferents innervate visceral organs, were innervated by sympathetic nerve, while heterotopic-acupointsorgan unit, involving different segmental innervation of the spinal cord to visceral organs, were innervated by vague
433
Panel Session 2 – Methodology of Research and EBM in Acupuncture
Myeong Soo Lee Korea Institute of Oriental Medicine (KIOM), Daejeon, South Korea E-mail address: [email protected]. ‘Systematic review aimed to identify, evaluate and summarize the findings of all relevant individual studies, thereby making the available evidence more accessible to decisionmakers.’ When appropriate, combining the results of several studies gives a more reliable and precise estimate of an intervention’s effectiveness than one study alone. Systematic review adheres to a strict scientific design based on explicit, prespecified and reproducible methods. Many clinical trials testing its clinical effectiveness for complementary medicine are available. However, the results of trials are far from uniform. This presentation is aimed at summarize the role of systematic review in determining the evidence in acupuncture. This study will discuss the general procedure in clinical practice, and the meaning of effects. It also looks into the formation of evidence from research, applying to clinical practice and the meaning of effects in evidence-based medicine. It will be compared the evidence from real world and trials. The reason why the differences occur will be discussed. Finally, we can discuss what is next for systematic reviews in building the evidence for acupuncture. This can be used to guide future research. http://dx.doi.org/10.1016/j.eujim.2015.07.033 Methodology of research and EBM in acupuncture Jian-Ping Liu Director of Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China E-mail address: [email protected]. One of the challenges in research methodology in metaanalysis is the appropriateness to pool all data to get an overall effect from heterogeneous studies in terms of participants, acupuncture treatment, the control interventions, and outcome measures. Meta-analysis could be misleading if it was used