| ObjectiveThis study from the Bibliometrics study moxibustion independent intervention system disease spectrum, and select some representative high-frequency symptoms of herpes zoster, bedsore, abnormal fetal position, using the principle of evidence-based medicine and evidence-based evaluation method, for the treatment of literature and refined to guide clinical practice of evidence information, provide a model for future moxibustion study on evidence-based rating and clinical evidence.MethodsAccording to the research method of acupuncture and moxibustion disease spectrum and the literature metrology, comprehensive and systematic retrieval of large document databases at home and abroad, a retrieval strategy effective and reasonable. According to the international classification of diseases and the coding system (ICD-10), the clinical research literatures of qualified, disorders using frequency statistics into the document. Batch process with the document manager to achieve the literature retrieval, screening, classification, into the final, based on modern literature gradually build moxibustion independent intervention disease spectrum. Selecting3representative high frequency conditions of herpes zoster, bedsore, malposition, methods of evidence-based medicine, using "on the quality evaluation method of clinical guidelines recommend acupuncture", with6standards of the international CONSORT22standards and STRICTA, evaluate the quality of strict system. The inclusion of the moxibustion clinical research literature, in turn, type analysis of randomized clinical trials, observational case series and case study, as a system evaluation of\/Meta, randomized controlled trial of homogeneous Meta analysis, analysis software using RevMan5.0.20. Clinical evidence analysis according to the common problems of four types of Moxibustion in clinical, compared the effect of moxibustion and the blank group, placebo group; comparison of curative effect of the moxibustion and conventional therapy, a standard positive control; the comparison of curative effect between different acupuncture moxibustion; comprehensive use of the moxibustion and other measures. Thus, refines every disease moxibustion evidence-based therapy.Results1. the literature study included502qualified papers, obtained15kinds of disease system,100kinds of disease, including western medicine disease85, western medicine, Chinese medicine symptoms of5types and10kinds of diseases. The systemic diseases according to the frequency order as follows:infectious and parasitic diseases:a total of8diseases,62articles; respiratory disorder:a total of3diseases,26articles; disorder of the musculoskeletal system and connective tissue:a total of14diseases,57articles; the mental and behavioral disorders:a total of4kinds of disease,22articles; genitourinary system diseases:a total of11diseases,58articles; endocrine, nutritional and metabolic disorders:a total of1diseases,6articles; the skin and subcutaneous tissue disease:a total of4kinds of disease,16articles; pregnancy and puerperal disease:a total of4kinds of disease,24pieces of literature; nervous system disorders:a total of11diseases,38articles; some consequences of injury, poisoning and external causes:a total of4kinds of disease,30articles; digestive system diseases:a total of17diseases,86articles; disorder of blood and hematopoietic system:a total of5diseases,14articles; the circulatory system disease:a total of5diseases,20articles; ocular and adnexal diseases:a total of4diseases,8articles; tumor:a total of5diseases,36articles.2. Research on evidence-based medicine evaluation of2methods in the treatment of herpes zoster①Analysis of Meta of moxibustion and Western medicine in the treatment of herpes zosterThe15included qualified RCT study. A total of1167subjects. Comparison of moxibustion and Western medicine, Meta analysis showed that the total clinical efficiency of RR=1.31,95%CI (1.12,1.53), P<0.00001, the difference was statistically significant. The4study pain VAS score of MD=-1.63,95%CI (-2.60, -0.65), P=0.001, the difference was statistically significant. Moxibustion for treatment of herpes zoster is better than the conventional western medicine in the clinical symptoms, analgesic effect.②Analysis of clinical evidence of Moxibustion in the treatment of herpes zosterAn evaluation system of\/Meta2on2007and2011published in treatment of herpes zoster, the results show the effectiveness of the limited evidence in support of herpes zoster treated by moxibustion, reflected in the improvement of clinical symptoms and cure rate, but because the literatures of low quality, need more high quality evidence from clinical trials to further verify. Effect of moxibustion and conventional western medicine comparison of3RCT comparative study of the efficacy between lamp moxibustion and A Silowe+tramadol+vitamin B1, western medicine including antiviral drugs, vitamins, immunomodulator, results display lamp moxibustion therapeutic advantage in pain, the clinical total effective rate and cure rate are very likely to.1RCT comparative study of the strong effect of medicated thread moxibustion and recombinant human interferon, vitamin and differences, results showed that the medicated thread moxibustion in the total clinical efficiency has advantage of curative effect and cure rate. In addition to the1RCT study were compared and pressing moxibustion moxibustion and aciclovir in aciclovir;+vitamin B1++methylcobalamin methylcobalamin; moxibustion and acyclovir; thermal moxibustion and indomethacin. The results show that the moxibustion and conventional western medicine, may have the advantage of curative effect in different degree.Comparison of5RCT are different types of needling and moxibustion method. The results showed that cotton moxibustion in the cure rate, analgesic effect, scabby time are better than those of blood-letting puncture and cupping; thermal moxibustion in ameliorating pain of the patients, improve the clinical cure rate, the total efficiency is better than acupuncture cupping, is better than Electroacupuncture; Zhuang medicine medicated thread moxibustion and acupuncture is no advantage of curative effect comparison.Research of moxibustion and other measures are35, and Western medicine are15, involving the comprehensive measures including cotton moxibustion+by acupuncture round, cotton Moxibustion plus plum-blossom needle, moxibustion, moxibustion medicine pen+EA+acupuncture, thermal moxibustion+acupoint injection; control of Western medicine including antiviral (o famciclovir), vitamins (vitamin B, vitamin B1, vitamin B12), interferon inducer (polyinosinic, with spectral antiviral and immunomodulatory function). The results showed that moxibustion combined with other acupuncture moxibustion for treatment of herpes zoster is superior to Western medicine.5RCT for moxibustion combined with western medicine treatment, results show that compared with simple western medicine, moxibustion combined with western medicine effect.3. Research on evidence-based medicine evaluation3moxibustion for treatment of bedsore.①Analysis of Meta of moxibustion and conventional western medicine treatment of bedsoreThe18included qualified RCT study. A total of928subjects. Meta analysis showed that the total clinical efficiency of RR=1.28,95%CI (1.15,1.42), P <0.00001, the difference was statistically significant. The average recovery time of MD=-7.036study,95%CI (-8.52,-5.54), P<0.00001. The difference was statistically significant. Moxibustion, moxibustion control infrared radiation control routine, moxibustion combined with medicine conventional therapy in the control improved bedsore total clinical efficiency has certain advantages and shorten the healing time of conventional treatment.②Analysis of clinical evidence of moxibustion for treatment of bedsore At present there is no domestic evaluation system\/Meta moxibustion treatment of bedsore analysis, no related multi-center clinical research literature reports, from the moxibustion and conventional treatment of moxibustion combined with other measures of comparative advantage, two curative effect research. The moxibustion and conventional therapy in treating bedsore of6references, are RCT, no high quality studies. The moxibustion moxibustion and includes thermal moxibustion; conventional treatment control include the use of antibiotics in local wound (Bactroban ointment, gentamicin), vitamins (vitamin C, vitamin B1) and654-2mixed liquid inunction and infrared radiation, these treatments or single or combined use of. The results are better than the conventional treatment of moxibustion treatment of decubitus ulcer.Moxibustion with other measures with the literature on treating bedsore of21articles, dressing change compared with the routine debridement and14 articles, involving the comprehensive measures including Moxibustion plus traditional Chinese medicine (born muscle scattered, Mepilex border, moist burn cream, ointment Jiuhua, Shengjiyuhong ointment, scald lotion, coptis root dressing, purple burn ointment), moxibustion plus Western Medicine (recombinant human epidermal growth factor, Comfeel ulcer strap, Hide Sa, rifampicin, erythromycin ointment, oxacillin sodium+Furacilin Solution and hypertonic saline+T D T irradiation), western medicine moxibustion+(MEBO plus oculentum aureomycin)(see attached1); control routine cleaning wound dressing including antibiotics (gentamicin, nitrofurazone, compound sulfamethoxazole), vitamins (vitamin B2). The results showed that moxibustion combined with other therapeutic measures for treating bedsore is better than that of routine debridement dressing.2RCT for moxibustion combined with debridement and dressing treatment, results show that compared with the single debridement dressing, moxibustion combined with debridement and dressing effect.2. moxibustion for treatment of malposition of the evidence-based medicine evaluation studies①Analysis of moxibustion and conventional treatment comparison treatment of malposition of the MetaThe5included qualified RCT, a total of915subjects. Moxibustion control knee chest decubitus method the total clinical efficiency comparison, RR=1.38,95%CI (1.27,1.50), P<0.00001, the difference was statistically significant. Moxibustion Zhiyin control has certain advantages knee-chest position method to correct the fetal position is not increasing the total clinical efficiency.②moxibustion for treatment of malposition of the evidence analysis Moxibustion and conventional western medicine treatment of malposition of the literature of15references, both studies, high quality RCT less. The mild moxibustion, moxibustion including ginger herbs; control of conventional western medicine for the use of knee-chest position method. The results were treated by moxibustion malposition curative effect is better than that of routine western medicine.1system evaluation\/Meta analysis shows, limited effectiveness evidence in support of the moxibustion treatment of malposition of fetal head back, in the clinical success rate.1RCT comparison of different time of moxibustion with ginger to Yin correction of fetal breech presentation. The results showed21PM to twenty-one thirty separated ginger moxibustion Zhiyin correcting fetal breech presentation is better than daytime moxibustion, the results with statistical significance. Moxibustion Sanyinjiao and moxibustion to Yin in the treatment of malposition of comparison between the1RCT display, the total efficiency of two groups had no statistical difference.Research of moxibustion and other measures are11, and Western medicine are4, involving the comprehensive measures including Danggui Shaoyao Powder, moxibustion moxibustion++supine carry breech, moxibustion, moxibustion++lateral knee-chest position, moxibustion, moxibustion++positive fetal soup to fetal side, moxibustion plus He-Ne laser irradiation, electroacupuncture, moxibustion moxibustion++press the ear; the control group for the pure moxibustion Zhiyin, routine for the knee-chest position. The results showed that moxibustion combined with other acupuncture moxibustion treatment of malposition of curative effect is better than that of routine western medicine and simple moxibustion.4RCT for moxibustion combined with western medicine treatment, results show that compared with conventional western medicine, moxibustion combined with other measures.Conclusion1. independent intervention on disease spectrum is an important aspect of its own characteristics and advantages of moxibustion. The study found that moxibustion independent intervention, disease spectrum range is quite wide, about the whole acupuncture disease spectrum of1/4. In the forefront of the system disorder of musculoskeletal system and connective tissue diseases, disorder of digestive system, genitourinary system diseases, nervous system diseases. The high frequency system acupuncture disease spectrum range is consistent. Different is less symptoms of mental and behavioral disorders. Document frequency is more concentrated disorder dysmenorrhea, herpes zoster, malposition, asthma, bedsore, insomnia, diarrhea etc.. These symptoms may be moxibustion independent intervention advantage condition, it is worth further study.2. high frequency conditions that study medicine evaluation:1) moxibustion for treatment of herpes zoster is better than the conventional western medicine in the clinical symptoms, analgesic effect. Comparison of needling and moxibustion method of different types, cotton moxibustion in the cure rate, analgesic effect, scabby time are better than those of blood-letting puncture and cupping; thermal moxibustion in ameliorating pain of the patients, improve the clinical cure rate, the total efficiency is better than acupuncture cupping, is better than Electroacupuncture; Zhuang medicine medicated thread moxibustion and acupuncture is no advantage of curative effect. Compared with simple western medicine, moxibustion combined with western medicine effect.2) moxibustion combined with conventional therapy or drug in improving the bedsore clinical total effective rate has certain advantages and shorten the healing time. Moxibustion with other therapeutic measures for treating bedsore is better than that of routine debridement dressing.3) moxibustion Zhiyin control has certain advantages knee-chest position method to correct the fetal position is not increasing the total clinical efficiency. |
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