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Op basis van de resultaten uit een placebo gecontroleerde studie naar de effectiviteit van acupunctuur en sham acupunctuur bij opvliegers van vrouwen in de menopauze blijkt dat acupunctuur in placebo gecontroleerde studies mogelijk niet zo effectief is als acupunctuur in de praktijk. Dat blijkt uit een reviewstudie van 8 verschillende studies. Uit de netwerkmeta-analyse bleek dat echte acupunctuur in de placebo gecontroleerde studies effectiever was dan echte acupunctuur in de placebo gecontroleerde studies (SMD -7,27, 95% CI -9,11 tot -5,43). Er werd geen significante heterogeniteit of inconsistentie waargenomen tussen de opgenomen studies of de vergelijkingen. Uit deze voorlopige analyse bleek dat verschillende vormen van echte acupunctuur mogelijk verschillende effectiviteit hebben met betrekking tot de ernst van opvliegers tijdens de menopauze.
Samengevat blijkt acupunctuur in de praktijk effectiever dan in placebo gecontroleeerde studies.
Zie onderstaande grafiek hoe de studie is opgezet.
Het volledige studierapport is gratis in te zien. Klik daarvoor op de titel van het abstract:
Randomised controlled trials of acupuncture performed using sham interventions to control for the placebo effect have mostly used two types of sham techniques: techniques with minimal insertion of acupuncture needles with no additional stimulation (shallow needling control) and techniques with sham acupuncture devices that do not penetrate the skin (sham device control). To achieve successful blinding, sham device controlled acupuncture trials also use the acupuncture base unit in the verum acupuncture group, but in the shallow needling control trials this is not necessary for the verum acupuncture treatment.
Objective:
In this study, we analysed the estimated comparative effectiveness of these two verum acupuncture modalities in studies of acupuncture for menopausal hot flashes that used two types of sham control treatments.
Methods:
We conducted a network meta-analysis that included randomised controlled trials of acupuncture for hot flashes. Electronic databases, including Medline, Embase, Cochrane Library and AMED, were searched through March 2017. Data were extracted using a predefined data extraction tool by two independent reviewers. The risk of bias was assessed using the Cochrane risk of bias tool for randomised controlled trials. A five-node network meta-analysis was conducted based on the frequentist framework.
Results:
Eight studies were included in this review. From the network meta-analysis, we found that verum acupuncture in the shallow needling controlled trials was more effective than verum acupuncture in the sham device controlled trials (SMD −7.27, 95% CI−9.11 to −5.43). Significant heterogeneity and inconsistency were not observed among the included studies or the comparisons.
Conclusions:
From this preliminary analysis, we found that different types of verum acupuncture may have different effect sizes with respect to the severity of menopausal hot flashes.
Acknowledgments
We would like to express our sincere gratitude to Nancy E Avis who provided us with data for analysis.
Footnotes
Contributors: T-HK, MSL, TA and SB devised the study design and collected the data. T-HK and MSL conducted the systematic review and network meta-analysis. T-HK wrote the first draft of this manuscript and MSL, TA and SB revised the manuscript. All authors approved the final version of the manuscript accepted for publication.
Declaration of conflicting interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding: The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: MSL was supported by grants from Korea Institute of Oriental Medicine (K17292 and K18122). T-HK was supported by a grant from Kyung Hee University in 2015.
Patient consent: Not required.
Provenance and peer review: Not commissioned; externally peer reviewed.
Supplemental material: Supplemental material for this article is available online.
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