UNASSIGNED: Clinical studies have shown that electroacupuncture (EA) has therapeutic and modulatory effects on managing heart failure (HF) risk factors.
UNASSIGNED: This study aimed to determine the impact of combination drugs and EA on chronic HF patients with reduced ejection fraction (HFrEF) to maintain a stable heart rate (HR) and mean arterial pressure (MAP).
UNASSIGNED: This single-blind clinical randomized controlled trial included 42 patients with chronic HFrEF. The patients were divided into 3 groups: patients taking drugs and EA, patients taking drugs and sham EA (sham acupuncture [SA]), and patients taking drugs without EA. All patients underwent 16 sessions of therapy for 8 weeks.
UNASSIGNED: There was a significant difference in the average MAP based on therapy duration in the drugs + EA group, whereas there was no significant difference between drugs + SA and drugs without EA groups. There was a substantial difference between the average MAP in the drugs + EA group at the beginning of therapy compared with that at midtherapy (P < 0.05) and at the beginning of treatment and at the end of therapy (P < 0.05). There was no significant difference in the mean HR between the groups. Clinically, after 16 treatment sessions, patients receiving combined drugs and EA treatment presented with stable MAP and HR.
UNASSIGNED: Drugs combined with EA maintained the stability of MAP and HR in patients with chronic HFrEF.

OBJECTIVE: Is acupuncture effective in treating knee osteoarthritis (KOA)?
BACKGROUND: Although increasingly used in the clinical setting, acupuncture is not mentioned or weakly recommended in guidelines for the treatment of KOA.
CONCLUSIONS: We suggest acupuncture rather than no treatment in adult KOA (weak recommendation, moderate certainty evidence), and acupuncture combined with nonsteroidal anti-inflammatory drugs (NSAIDs) rather than acupuncture alone when KOA symptoms are severe (weak recommendation, moderate certainty evidence), with duration of acupuncture for 4-8 weeks depending on KOA severity and treatment response (weak recommendation, moderate certainty evidence), and discussing with patients in shared decision-making.
UNASSIGNED: This rapid recommendation was developed following the Making GRADE the Irresistible Choice (MAGIC) methodological framework. First, the clinical specialist identified the topic of recommendation and demand for evidence. Then the independent evidence synthesis group performed a systematic review to summarize available evidence and evaluate the evidence using the GRADE approach. Finally, the clinical specialist group produced recommendations for practice through a consensus procedure.
UNASSIGNED: The linked systematic review and meta-analysis included 9422 KOA patients, 61.1% of whom were women. The median mean age was 61.8 years. Compared with no treatment, acupuncture had beneficial effect on KOA in improving the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total score (moderate certainty evidence), and WOMAC pain (very low certainty evidence), WOMAC stiffness (low certainty evidence), and WOMAC function (low certainty evidence) subscale scores. Compared with usual care, acupuncture improved WOMAC stiffness subscale score (moderate certainty evidence). Subgroup analyses showed different effects in the improvement of WOMAC total scores by different durations of acupuncture and whether acupuncture combined with NSAIDs, but no difference between manual acupuncture and electroacupuncture was found.
UNASSIGNED: Compared with no treatment, acupuncture is suggested to reduce pain, stiffness, and disfunction in KOA patients, ultimately improving the patient\'s health status. Acupuncture can be used as an alternative therapy when usual care is ineffective or there are adverse reactions so that patients can no longer continue the treatment. Manual acupuncture or electroacupuncture is suggested for 4-8 weeks to improve the health status of KOA. The patient\'s values and preferences should be considered when selecting acupuncture for KOA treatment.

OBJECTIVE: To investigate the recommendations of acupuncture therapy in foreign clinical practice guidelines (CPGs) so as to understand the situation of foreign acupuncture guidelines and provide the suggestions on the development of acupuncture CPGs.
METHODS: A total of 5 website authorities were retrieved with the key words as \"acupuncture\" \"moxibustion\" \"acupressure\" and \"electroacupuncture\".
RESULTS: A total of 93 papers on CPGs had been searched, of which, the most CPGs were collected in the National Guidelines Clearinghouse (NGC). 68 papers were screened according to the requirement of CPGs, with 26 diseases and symptoms included. Since 2012, CPGs on acupuncture therapies have increased remarkably. Regarding the recommendations on acupuncture, there were 35 papers recommending acupuncture, about accounting for 51.5%. Of them, 1 paper strongly recommended and 10 papers were against recommendation. There was no CPG for moxibustion recommendation.
CONCLUSIONS: ① The foreign recommendations are weak and brief on acupuncture. The qualities of CPGs are various among countries, which results in the limit guidance in clinical practice. The specific acupuncture CPG should be developed so as to guide the clinical strategy on acupuncture more effectively. ② There are apparent limitations on the involved diseases between those mentioned in foreign CPGs and those in the treatment in foreign countries. Being the origin of acupuncture, China should proactively develop the advantages on acupuncture treatment and participate in the development of international CPGs. ③ The recommendation on moxibustion therapy is lack. In future research, the evaluation on the safety and effectiveness should draw attention.

With the rapid development of assisted reproductive technology, various reproductive disorders have been effectively addressed. Acupuncture-like therapies, including electroacupuncture (EA) and transcutaneous electrical acupoint stimulation (TEAS), become more popular world-wide. Increasing evidence has demonstrated that EA and TEAS are effective in treating gynecological disorders, especially infertility. This present paper describes how to select acupoints for the treatment of infertility from the view of theories of traditional Chinese medicine and how to determine critical parameters of electric pulses of EA/TEAS based on results from animal and clinical studies. It summarizes the principles of clinical application of EA/TEAS in treating various kinds of reproductive disorders, such as polycystic ovary syndrome (PCOS), pain induced by oocyte retrieval, diminished ovarian reserve, embryo transfer, and oligospermia/ asthenospermia. The possible underlying mechanisms mediating the therapeutic effects of EA/TEAS in reproductive medicine are also examined.

The NICE Osteoarthritis Guideline Development Group (GDG) has been challenged for not using the available acupuncture evidence in the most appropriate manner in three crucial areas. This response explains the methods used by the GDG with particular reference to the economic analysis, and illustrates that the methods used were those most appropriate for developing a NICE clinical guideline. The cost-effectiveness conclusions made by the GDG are supported by the currently available evidence.

A new guideline on the care and management of osteoarthritis has recently been published by the National Institute for Health and Clinical Excellence, and makes wide-ranging and authoritative recommendations. The guideline states that there is insufficient evidence to recommend acupuncture. There appears to be three areas where the guidelines may have not used the available evidence in the most appropriate manner. First, data on the long-term effectiveness of acupuncture may have been misinterpreted. Second, the specific rejection of electroacupuncture indicates a restricted understanding of acupuncture as a treatment, and is based on a cost-effectiveness analysis which may not be ideal. Third, the cost-effectiveness calculations used comparisons with sham acupuncture (\"placebo\") when comparison with standard care would have been more appropriate. The guideline may therefore lead some patients with osteoarthritis to miss out on a treatment that may be effective for them.