Efficacy and Safety of Traditional Chinese Medicine Exercise Versus Oral Medication in the Treatment of Neck Pain: Study Protocol for a Systematic Review and Meta-Analysis

Intramuscular injections (depot preparations) offer an advantage over oral medication for treating schizophrenia by reducing poor compliance. The benefits gained by long-acting preparations, however, may be offset by a higher incidence of adverse effects. To assess the effects of fluphenazine decanoate and enanthate versus oral anti-psychotics and other depot neuroleptic preparations for individuals with schizophrenia in terms of clinical, social and economic outcomes. We searched the Cochrane Schizophrenia Group's Trials Register (February 2011 and October 16, 2013), which is based on regular searches of CINAHL, BIOSIS, AMED, EMBASE, PubMed, MEDLINE, PsycINFO, and registries of clinical trials. We considered all relevant randomised controlled trials (RCTs) focusing on people with schizophrenia comparing fluphenazine decanoate or enanthate with placebo or oral anti-psychotics or other depot preparations. We reliably selected, assessed the quality, and extracted data of the included studies. For dichotomous data, we estimated risk ratio (RR) with 95% confidence intervals (CI). Analysis was by intention-to-treat. We used the mean difference (MD) for normal continuous data. We excluded continuous data if loss to follow-up was greater than 50%. Tests of heterogeneity and for publication bias were undertaken. We used a fixed-effect model for all analyses unless there was high heterogeneity. For this update. we assessed risk of bias of included studies and used the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach to create a 'Summary of findings' table. This review now includes 73 randomised studies, with 4870 participants. Overall, the quality of the evidence is low to very low.Compared with placebo, use of fluphenazine decanoate does not result in any significant differences in death, nor does it reduce relapse over six months to one year, but one longer-term study found that relapse was significantly reduced in the fluphenazine arm (n = 54, 1 RCT, RR 0.35, CI 0.19 to 0.64, very low quality evidence). A very similar number of people left the medium-term studies (six months to one year) early in the fluphenazine decanoate (24%) and placebo (19%) groups, however, a two-year study significantly favoured fluphenazine decanoate (n = 54, 1 RCT, RR 0.47, CI 0.23 to 0.96, very low quality evidence). No significant differences were found in mental state measured on the Brief Psychiatric Rating Scale (BPRS) or in extrapyramidal adverse effects, although these outcomes were only reported in one small study each. No study comparing fluphenazine decanoate with placebo reported clinically significant changes in global state or hospital admissions.Fluphenazine decanoate does not reduce relapse more than oral neuroleptics in the medium term (n = 419, 6 RCTs, RR 1.46 CI 0.75 to 2.83, very low quality evidence). A small study found no difference in clinically significant changes in global state. No difference in the number of participants leaving the study early was found between fluphenazine decanoate (17%) and oral neuroleptics (18%), and no significant differences were found in mental state measured on the BPRS. Extrapyramidal adverse effects were significantly less for people receiving fluphenazine decanoate compared with oral neuroleptics (n = 259, 3 RCTs, RR 0.47 CI 0.24 to 0.91, very low quality evidence). No study comparing fluphenazine decanoate with oral neuroleptics reported death or hospital admissions.No significant difference in relapse rates in the medium term between fluphenazine decanoate and fluphenazine enanthate was found (n = 49, 1 RCT, RR 2.43, CI 0.71 to 8.32, very low quality evidence), immediate- and short-term studies were also equivocal. One small study reported the number of participants leaving the study early (29% versus 12%) and mental state measured on the BPRS and found no significant difference for either outcome. No significant difference was found in extrapyramidal adverse effects between fluphenazine decanoate and fluphenazine enanthate. No study comparing fluphenazine decanoate with fluphenazine enanthate reported death, clinically significant changes in global state or hospital admissions. There are more data for fluphenazine decanoate than for the enanthate ester. Both are effective antipsychotic preparations. Fluphenazine decanoate produced fewer movement disorder effects than other oral antipsychotics but data were of low quality, and overall, adverse effect data were equivocal. In the context of trials, there is little advantage of these depots over oral medications in terms of compliance but this is unlikely to be applicable to everyday clinical practice.

Those with serious/severe mental illness, especially schizophrenia and schizophrenic-like disorders, often have little to no insight regarding the presence of their illness. Psychoeducation may be defined as the education of a person with a psychiatric disorder regarding the symptoms, treatments, and prognosis of that illness. Brief psychoeducation is a short period of psychoeducation; although what constitutes 'brief psychoeducation' can vary. A previous systematic review has shown that the median length of psychoeducation is around 12 weeks. In this current systematic review, we defined 'brief psychoeducation' as programmes of 10 sessions or less. To assess the efficacy of brief psychoeducational interventions as a means of helping severely mentally ill people when added to 'standard' care, compared with the efficacy of standard care alone.The secondary objective is to investigate whether there is evidence that a particular kind (individual/ family/group) of brief psychoeducational intervention is superior to others. We searched the Cochrane Schizophrenia Group register September 2013 using the phrase:[*Psychoeducat* in interventions of STUDY]. Reference lists of included studies were also inspected for further relevant studies. We also contacted authors of included study for further information regarding further data or details of any unpublished trials. All relevant randomised controlled trials (RCTs) comparing brief psychoeducation with any other intervention for treatment of people with severe mental illness. If a trial was described as 'double blind' but implied randomisation, we entered such trials in a sensitivity analysis. At least two review authors extracted data independently from included papers. We contacted authors of trials for additional and missing data. We calculated risk ratios (RR) and 95% confidence intervals (CI) of homogeneous dichotomous data. For continuous data, we calculated the mean difference (MD), again with 95% CIs. We used a fixed-effect model for data synthesis, and also assessed data using a random-effects model in a sensitivity analysis. We assessed risk of bias for each included study and created 'Summary of findings' tables using GRADE (Grading of Recommendations Assessment, Development and Evaluation). We included twenty studies with a total number of 2337 participants in this review. Nineteen studies compared brief psychoeducation with routine care or conventional delivery of information. One study compared brief psychoeducation with cognitive behavior therapy.Participants receiving brief psychoeducation were less likely to be non-compliant with medication than those receiving routine care in the short term (n = 448, 3 RCTs, RR 0.63 CI 0.41 to 0.96, moderate quality evidence) and medium term (n = 118, 1 RCT, RR 0.17 CI 0.05 to 0.54, low quality evidence).Compliance with follow-up was similar between the two groups in the short term (n = 30, 1 RCT, RR 1.00, CI 0.24 to 4.18), medium term (n = 322, 4 RCTs, RR 0.74 CI 0.50 to 1.09) and long term (n = 386, 2 RCTs, RR 1.19, CI 0.83 to 1.72).Relapse rates were significantly lower amongst participants receiving brief psychoeducation than those receiving routine care in the medium term (n = 406, RR 0.70 CI 0.52 to 0.93, moderate quality evidence), but not in the long term.Data from a few individual studies supported that brief psychoeducation: i) can improve the long-term global state (n = 59, 1 RCT, MD -6.70 CI -13.38 to -0.02, very low quality evidence); ii) promote improved mental state in short term (n = 60, 1 RCT, MD -2.70 CI -4.84 to -0.56,low quality evidence) and medium term; iii) can lower the incidence and severity of anxiety and depression.Social function such as rehabilitation status (n = 118, 1 RCT, MD -13.68 CI -14.85 to -12.51, low quality evidence) and social disability (n = 118, 1 RCT, MD -1.96 CI -2.09 to -1.83, low quality evidence) were also improved in the brief psychoeducation group. There was no difference found in quality of life as measured by GQOLI-74 in the short term (n = 62, 1 RCT, MD 0.63 CI -0.79 to 2.05, low quality evidence), nor the death rate in either groups (n = 154, 2 RCTs, RR 0.99, CI 0.15 to 6.65, low quality evidence). Based on mainly low to very low quality evidence from a limited number of studies, brief psychoeducation of any form appears to reduce relapse in the medium term, and promote medication compliance in the short term. A brief psychoeducational approach could potentially be effective, but further large, high-quality studies are needed to either confirm or refute the use of this approach.

Very few trials have investigated TFPIs for individuals with SMI and PTSD. Results from trials of TF-CBT are limited and inconclusive regarding its effectiveness on PTSD, or on psychotic symptoms or other symptoms of psychological distress. Only one trial evaluated EMDR and provided limited preliminary evidence favouring EMDR compared to waiting list. Comparing TF-CBT head-to-head with EMDR and brief psychoeducation respectively, showed no clear effect for either therapy. Both TF-CBT and EMDR do not appear to cause more (or less) adverse effects, compared to waiting list or usual care; these findings however, are mostly based on low to very low-quality evidence. Further larger scale trials are now needed to provide high-quality evidence to confirm or refute these preliminary findings, and to establish which intervention modalities and techniques are associated with improved outcomes, especially in the long term.

The use of clear aligners (CA) has exponentially increased in the last decades due to their superior esthetic, ease of use and cleaning, and comfort in comparison to conventional fixed appliance (FA). However, prolonged wearing of CA could also alter oral microbiome and adversely affect oral hygiene and periodontal health. To assess oral hygiene level and periodontal health status in patients treated with CA versus those treated with FA using a combination of risk of bias (RoB) and Grading of Recommendations Assessment, Development and Evaluation (GRADE) tools. A comprehensive electronic search was conducted in four databases, including Scopus, PubMed, Web of Science, and Google Scholar, to retrieve relevant randomized controlled trials (RCTs) in the last 10 years from 2015 to April 2025. The study aimed to include RCTs that focused on the impact of CA and FA orthodontic treatments on oral hygiene and periodontal health. Independent eligibility assessment, data extraction, and filtering process were performed. The RoB 2 tool was used to assess the quality of the included RCTs. Data relating to oral hygiene/periodontal health assessed by different clinical periodontal indices (primary outcome) and other findings (secondary outcomes) were extracted. Certainty of evidence was determined using GRADE system. Initial search process yielded 1098 records which were assessed for eligibility, screened according to titles, abstracts, and full-text reading. Six RCTs were found eligible for analysis and included for synthesis of evidence. Qualitative analyses of the included RCTs showed that periodontal parameters were significantly better in patients treated with CA than with FA. Five RCTs exhibited high RoB together with overall inconsistencies in the given oral hygiene instructions, age, follow-up, diagnosis, and measurements. Certainty of evidence ranged from very low for oral hygiene level and low for periodontal health. Dual quality assessment indicated that the advantages of CA over FA in terms of oral hygiene and periodontal health are highly compliance dependent. However, due to heterogeneities, high RoB, and low to very low certainty of evidence in current RCTs, outlining a firm conclusion was impeded. PROSPERO (CRD420251120933).

Background:Postpartum depression (PPD) is one of the most common mental disorders in women following childbirth with heightened prevalence across the globe. Both pharmacotherapy and non-pharmacological interventions are effective for PPD. However, due to the concerns about the side effect on the mother and child of pharmacological treatments, most of women with PPD choose non-pharmacological therapies as their first line option. Prescription of these non-drug approaches should be guided by high quality evidence. Therefore, this network meta-analysis aims to compare, rank and interpret existed non-pharmacological evidence for the effective treatment of women with PPD.Methods:Electronic bibliographic databases including EMBASE, PubMed, Scopus, The Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI),VIP Database, Wanfang Database and Chinese Biomedical Literature Database will be searched for relevant randomized controlled trials (RCTs) of non-pharmacological interventions for PPD. Heterogeneity and inconsistencies will be analyzed by I2 statistic and Z test, respectively. We will assess the quality of evidence by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) and evaluate the risk of bias according to Cochrane risk of bias tool. R software 3.6.1 (R Foundation for Statistical Computing, Vienna, Austria) will be used to conduct a network meta-analysis.Results:Formal ethical approval is not required, because the present study is a meta-analysis based on existed studies. The findings of this research will be reported in a recognized journal.Conclusion:The review results will ascertain the hierarchy of effectiveness of different non-pharmacological approaches for PPD, and systematically provide suggests for physicians and patients.Trial registration number:PROSPERO CRD42020166801

Objective: To systematically review the effects of Tai Chi exercise as a nonpharmacological therapeutic strategy on the physical and mental health in individuals with knee osteoarthritis. Data sources: A systematic literature retrieval has been conducted in PubMed, Web of Science, EMbase, CENTRAL, OVID, CINAHL, Physiotherapy Evidence Database, Chinese Biomedical Database and China National Knowledge Infrastructure up to June 2020 to identify the relevant randomised controlled trials (RCTs). Methods: Two authors assessed independently the risk of bias using the Cochrane Collaboration’s tool. Standardised mean difference (SMD) and 95% CI were calculated and data were combined using the fixed or random-effect model. The strength of evidence was rated with Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Results: A total of 16 RCTs involving 986 patients with knee osteoarthritis met the established inclusion criteria. The strength of evidence for the main outcomes was low or moderate. The systematic review illustrated the efficacy of Tai Chi exercise in treating and managing knee osteoarthritis. Patients’ outcomes practising Tai Chi exercise were improved significantly, including pain (SMD = ‒0.69, 95%CI: ‒0.95 to ‒0.44, P < 0.001), stiffness (SMD = ‒0.59, 95%CI: ‒0.91 to ‒0.27, P < 0.001), physical function (SMD = ‒0.92, 95%CI: –1.16 to ‒0.69, P < 0.001), dynamic balance (SMD = 0.69, 95%CI: 0.38 to 0.99, P < 0.001), physiological and psychological health (SF-36 PCS: SMD = 0.48, 95%CI: 0.28 to 0.68, P < 0.001; SF-36 MCS: SMD = 0.26, 95%CI: 0.06 to 0.45, P = 0.01). No adverse events associated with Tai Chi exercise were reported. Conclusion: Tai Chi exercise was beneficial for ameliorating physical and mental health of patients with knee osteoarthritis and should be available as an alternative non-pharmacological therapy in rehabilitation programmes.

IntroductionTotal glucosides of paeony (TGP) is a natural plant extract, which is widely used in China for treating rheumatoid arthritis (RA). Many relevant randomised controlled trials (RCTs) of TGP for...

Background:Research into acupuncture and moxibustion and their application for chronic fatigue syndrome (CFS) has been growing, but the findings have been inconsistent.Objective:To evaluate the existing randomized clinical trials (RCTs), compare the efficacy of acupuncture, moxibustion and other traditional Chinese medicine (TCM) treatments.Data sources:Three English-language databases (PubMed, Embase, Web of Science, and The Cochrane Library) and 4 Chinese-language biomedical databases (Chinese Biomedical Literature Database, VIP Database for Chinese Technical Periodicals, China National Knowledge Infrastructure, and Wanfang) were searched for RCTs published from database inception through August 2021.Study selection:RCTs include acupuncture, moxibustion, traditional Chinese herbal medicine, western medicine and no control.Data extraction and synthesis:Data were screened and extracted independently using predesigned forms. The quality of RCTs was appraised with the Cochrane Collaboration risk of bias tool. We conducted a random-effects network meta-analysis within a frequentist framework. We assessed the certainty of evidence contributing to network estimates of the main outcomes with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework.Main outcomes and measures:The primary outcomes were the overall response rate and FS-14 scale.Results:A total of 51 randomized controlled trials involving 3473 patients with CFS were included in this review. Forty one studies indicate low risk or unknown risk, and the GRADE scores of the combined results show low levels. Among the main indicators, traditional Chinese medicine therapies have excellent performance. However, the overall response rate is slightly different from the results obtained from the Fatigue Scale-14 total score. Moxibustion and traditional Chinese medicine (Odds ratios 48, 95% CrI 15–150) perform better in the total effective rate, while moxibustion plus acupuncture (MD 4.5, 95% CrI 3.0–5.9) is better in the FS-14 total score.Conclusions:The effect of acupuncture and moxibustion in the treatment of CFS was significantly higher than that of other treatments. Traditional Chinese medicine should be used more widely in the treatment of CFS.

Probiotics have garnered increasing attention for their potential role in managing insomnia. This meta-analysis evaluated the effects of probiotics on sleep quality and mood in patients with insomnia. Eight public databases were searched to identify relevant randomized controlled trials (RCTs) published before December 2024. Data from included studies were extracted, and their risk of bias was assessed. Meta-analysis, sensitivity analysis, and publication bias assessment were conducted using Review Manager 5.3 software. The certainty of evidence was evaluated using Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Six studies, encompassing 424 patients, were included. Compared to control groups, the probiotic interventions were associated with a significant reduction in Pittsburgh Sleep Quality Index (PSQI) (mean difference [MD] -2.10, 95% confidence interval [CI] -3.86 to -0.34, p = 0.02, GRADE: moderate) and Hamilton Depression Scale (HAMD) (MD -7.72, 95% CI -14.55 to -0.89, p = 0.03, GRADE: very low) scores. However, no significant effects were observed on total sleep time (MD 43.70, 95% CI -18.07 to 105.46, p = 0.17, GRADE: very low), sleep efficiency (MD 0.41, 95% CI -1.67 to 2.48, p = 0.70, GRADE: moderate), or sleep latency (MD -4.74, 95% CI -9.42 to -0.05, p = 0.05, GRADE: moderate). Additionally, no significant differences in total adverse events were noted between probiotic and control groups. Funnel plots indicated no publication bias for PSQI, sleep efficiency, or sleep latency, whereas potential publication bias was detected for HAMD, total sleep time, and total adverse events. Probiotic interventions improved sleep quality and reduced depressive symptoms in patients with insomnia without increasing the risk of adverse events. These findings highlight the potential of probiotics as complementary treatments for insomnia. However, due to the limited sample size, further high-quality clinical studies are warranted to confirm these findings. https://www.crd.york.ac.uk/PROSPERO/view/CRD420251077696, identifier CRD420251077696.

Evidence Evaluation Process and Management of Potential Conflicts of Interest: 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations.

BackgroundNeck pain with high incidence and recurrence rates significantly impairs patients’ quality of life and imposes a considerable economic burden. Traditional Chinese medicine therapies such as Yijinjing exercise and Tuina have shown promising efficacy in alleviating the local symptoms of neck pain. However, there is currently insufficient high-level evidence to robustly support these findings.ObjectiveThis study aims to evaluate the efficacy and safety of combining Yijinjing exercise with Tuina for the treatment of neck pain.MethodsPubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure, Chinese Biomedical Database, VIP Chinese Science and Technology Periodicals Full-Text database, and Wanfang database will be systematically searched for all relevant randomized controlled trials (RCTs) from their inception to September 2025, without language or publication status restrictions. The Cochrane Risk of Bias 2 assessment tool will be used to evaluate the risk of bias in the included studies, and the GRADE (Grades of Recommendation, Assessment, Development, and Evaluation) system will be employed to grade the quality of evidence. Heterogeneity will be evaluated through I2 statistics and Cochran’s Q test: a fixed-effect model will be used when I2<50% and P≥.01. If I2≥50% or P<.01, subgroup analysis will be conducted. When heterogeneity still exists, sensitivity analysis or exploratory subgroup analysis will be performed. If it cannot be explained ultimately, the random-effects model will be adopted and the GRADE evidence level will be reduced.ResultsAs of June 2025, we have completed the preliminary screening of titles and abstracts for 573 studies. The full-text screening is expected to be completed by September 2025, and data analysis is planned to be completed by December 2025. About two-thirds of the studies were published after 2015. Geographically, the samples in the studies were highly concentrated in Asia. The results were comprehensively developed around the core outcomes. The primary outcome was presented by changes in the visual analog scale. The secondary outcomes were evaluated by the neck disability index, self-rating anxiety scale score, mean vertebral artery blood flow velocity, and Cobb angle.ConclusionsIf the results of this study confirm the effectiveness of massage combined with Yijinjing, it can provide a direction for the nonpharmaceutical treatment of neck pain. However, some studies have risks of bias such as insufficient standardization of massage operations and difficulty in implementing blinding methods. The expected heterogeneity is significant due to differences in intervention plans and patients’ cultural backgrounds, and the original RCTs are few and regionally concentrated, with limited extrapolation of conclusions. In the future, it is necessary to optimize the plan and supplement data through high-quality multicenter research to enhance reliability.Trial RegistrationPROSPERO CRD420251026508; https://www.crd.york.ac.uk/PROSPERO/view/CRD420251026508International Registered Report Identifier (IRRID)DERR1-10.2196/77864

The present study aimed to comprehensively assess the efficacy and safety of Chinese herbal compounds in the management of acute gouty arthritis (AGA). A systematic search was performed across multiple databases, including PubMed, The Cochrane Library, Embase, Web of Science, CBM, CNKI, VIP, and Wanfang, from their inception until December 1, 2024, to identify relevant randomized controlled trials (RCTs) involving Chinese herbal compounds for AGA. Two independent researchers were responsible for the retrieved literature screening, data extraction, and quality evaluation. A meta-analysis of RCTs that fulfill the inclusion criteria will be executed utilizing Stata 14.0 software. The quality of the outcomes will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). A total of 28 studies, encompassing 2100 participants, were included in the analysis. The meta-analysis showed that compared with conventional Western medicine, Chinese herbal compounds significantly enhance the overall efficacy of AGA treatment (RR=1.11, 95%CI (1.05, 1.16), P<0.00001; Level of evidence: very low). It also demonstrated improvements in the Visual Analogue Scale (VAS) (SMD=-1.46, 95%CI(-2.17, -0.75), P<0.00001; Level of evidence: very low), serum uric acid levels (SMD=-0.67, 95%CI (-1.00, -0.33), P<0.00001; Level of evidence: very low), blood sedimentation levels (SMD=-0.71, 95%CI (-1.08, -0.33), P<0.00001; Level of evidence: very low), C-reactive protein (CRP) levels (SMD=0.89, 95%CI(-1.33, -0.45), P<0.00001; Level of evidence: very low), and the traditional Chinese medicine syndrome score(SMD=-0.93, 95%CI (-1.37, -0.49), P<0.00001; Level of evidence: very low). Additionally, a reduced incidence of adverse effects was noted (RR=0.26, 95%CI (0.18, 0.39), P<0.00001; Level of evidence: moderate). Subgroup analysis revealed that regardless of whether the treatment duration was less than or more than 1week, Chinese herbal compounds were effective in improving the total effective rate of AGA treatment, VAS scores, serum uric acid levels, blood sedimentation levels, CRP levels, and Traditional Chinese medicine symptom scores, while simultaneously decreasing the occurrence of adverse reactions. Chinese herbal compounds demonstrated superior efficacy and safety compared to conventional Western medicine in treating AGA. However, further validation through multicenter, high-quality RCTs is warranted to strengthen this conclusion.

BackgroundThis meta-analysis was conducted to evaluate the clinical effectiveness and safety of Salvianolic acids for injection (SAFI) plus conventional treatment (CT) for patients with acute cerebral infarction (ACI) and to assess the evidence to guide clinical practice.Material/MethodsPubMed, EMBASE, Cochrane Library, Web of Science, and 4 Chinese electronic databases were searched to identify relevant randomized controlled trials (RCTs). The methodological quality of eligible studies was evaluated using the Cochrane risk of bias tool. The reporting quality of eligible studies was evaluated by Consolidated Standards of Reporting Trials (CONSORT) for traditional Chinese medicine. Meta-analysis and evidence quality were performed using RevMan 5.3 and Grading of Recommendations Assessment, Development, and Evaluation (GRADE).ResultsA total of 14 RCTs involving 1309 patients were included. Meta-analysis showed that SAFI plus CT was better than CT alone in improving the total effective rate (RR=1.35, 95% CI 1.25 to 1.44, P<0.00001), reducing the National Institutes of Health Stroke Scale (NIHSS) score (130 mg: WMD=−3.31, 95% CI −3.80 to −2.47, P<0.00001; 100 mg: WMD=−1.91, 95% CI −2.28 to −1.54, P<0.00001), improving the activity of daily living and cognitive function of ACI, and improving the hemorheology (HBV: high shear rate blood viscosity, LBV: low shear rate blood viscosity, PV: plasma viscosity) and C-reactive protein (CRP).ConclusionsSAFI plus CT in the treatment of ACI can improve the total effective rate, neurological deficit, and ability to perform activities of daily living, and there is no serious adverse reaction. Based on the GRADE system, the evidence quality is low. More large-scale, well-designed, and high-quality RCTs are required to confirm the positive results.

Comparative efficacy and safety of traditional Chinese medicine for IgA nephropathy: A systematic review and meta-analysis

Background:Electroacupuncture is increasingly used in rehabilitation for postoperative cognitive dysfunction (POCD), but relevant evidence remains unclear for patients receiving total knee arthroplasty (TKA).Methods:The databases research of PubMed, EMBASE, CINAHL, and China National Knowledge Infrastructure (CNKI) will be conducted from inception to December 31, 2020. The relevant randomized controlled trials (RCTs) from data will be screened one by one. The remaining studies that meet the inclusion criteria will be extracted and analyzed using RevMan V.5.3 software. Paired 2 reviewers will assess quality of the included studies and publication bias by using the Cochrane Collaboration risk of bias tool, and Egger test and Begg test respectively. And grading of recommendations assessment, development and evaluation (GRADE) will be used to estimate the quality of evidence.Results:In this study, we will analyze the effect of electroacupuncture on Mini-Mental State Examination (MMSE), interleukin 1β (IL-1β), tumor necrosis factor-α (TNF-α), S100-β protein, and adverse events for patients with TKA.Conclusion:Our findings will provide evidence for the effectiveness of electroacupuncture on the treatment and prevention of POCD for TKA patients.Registration number:Available at: https://osf.io/azyt9 (DOI number: 10.17605/OSF.IO/AZYT9).