Pilot edition of international acupuncture guidelines for non-specific low back pain
KeAi Communications Co., Ltd.
Non-specific low back pain is a significant global health problem, with 90~95% of patients suffering from non-specific low back pain (NSLBP). Clinical practice has shown that acupuncture and moxibustion therapy have positive efficacy with fewer side effects, making it a more efficient treatment option.
To boost efforts in the field, a team of researchers in China established a set of guidelines to provide more comprehensive scientific, patient-centered clinical practice recommendations.
"Referencing the WHO guideline development process, clinical questions were initially investigated and collected from the perspectives of guideline users in different identities and regions,” shares leader of the guideline working group, Tao Yang, a professor of acupuncture at the China Academy of Chinese Medical Sciences. “Combined with multidisciplinary expert interviews and the use of a modified Delphi method, we formed a structured clinical question that reached expert consensus.”
Subsequently, evidence was gathered to construct the set of guidelines. Participants in the survey for the clinical questions and members of the guidelines development expert panel come from different countries and regions, making this set of guidelines more internationally representative and its clinical applicability more extensive.
The set of guidelines, published in the World Journal of Acupuncture – Moxibustion, provides seven recommendations for 10 clinical questions. The main recommendations are:
- For patients with acute/subacute NSLBP, compared with oral administration of Western medicine (non-steroidal anti-inflammatory drugs, muscle relaxants) or other non-pharmacological treatments (physical therapy, bed rest, tuina), filiform needle therapy (acupuncture or electroacupuncture) or comprehensive therapy of acupuncture therapy (acupuncture plus moxibustion, acupuncture plus cupping, acupuncture plus moxibustion and cupping) is prioritized.
- For patients with chronic non-specific low back pain, the degree of recommendations for therapy ranges from high to low : the comprehensive therapy of acupuncture therapy > filiform needle therapy > other non-pharmacological treatments (tuina, physical therapy plus exercise, and core stability training).
- For pregnant women with NSLBP, acupuncture should be delivered with caution, and the risk of safety may be induced if the acupoints are not appropriately selected or manipulated.
The clinical questions in the set of guidelines were formulated in the form of questionnaires, and the quality of the evidence from the included studies was found to be low.
“Notably, there was a lack of high-quality literature references. Therefore, higher quality clinical studies should be conducted on these clinical questions to provide more evidence-based references for subsequent clinical work,” adds Yang.
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Contact author: Tao YANG, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing100053, China ,bjytyangtao@163.com
Non-specific low back pain is a significant global health problem, with 90~95% of patients suffering from non-specific low back pain (NSLBP). Clinical practice has shown that acupuncture and moxibustion therapy have positive efficacy with fewer side effects, making it a more efficient treatment option.
To boost efforts in the field, a team of researchers in China established a set of guidelines to provide more comprehensive scientific, patient-centered clinical practice recommendations.
"Referencing the WHO guideline development process, clinical questions were initially investigated and collected from the perspectives of guideline users in different identities and regions,” shares leader of the guideline working group, Tao Yang, a professor of acupuncture at the China Academy of Chinese Medical Sciences. “Combined with multidisciplinary expert interviews and the use of a modified Delphi method, we formed a structured clinical question that reached expert consensus.”
Subsequently, evidence was gathered to construct the set of guidelines. Participants in the survey for the clinical questions and members of the guidelines development expert panel come from different countries and regions, making this set of guidelines more internationally representative and its clinical applicability more extensive.
The set of guidelines, published in the World Journal of Acupuncture – Moxibustion, provides seven recommendations for 10 clinical questions. The main recommendations are:
- For patients with acute/subacute NSLBP, compared with oral administration of Western medicine (non-steroidal anti-inflammatory drugs, muscle relaxants) or other non-pharmacological treatments (physical therapy, bed rest, tuina), filiform needle therapy (acupuncture or electroacupuncture) or comprehensive therapy of acupuncture therapy (acupuncture plus moxibustion, acupuncture plus cupping, acupuncture plus moxibustion and cupping) is prioritized.
- For patients with chronic non-specific low back pain, the degree of recommendations for therapy ranges from high to low : the comprehensive therapy of acupuncture therapy > filiform needle therapy > other non-pharmacological treatments (tuina, physical therapy plus exercise, and core stability training).
- For pregnant women with NSLBP, acupuncture should be delivered with caution, and the risk of safety may be induced if the acupoints are not appropriately selected or manipulated.
The clinical questions in the set of guidelines were formulated in the form of questionnaires, and the quality of the evidence from the included studies was found to be low.
“Notably, there was a lack of high-quality literature references. Therefore, higher quality clinical studies should be conducted on these clinical questions to provide more evidence-based references for subsequent clinical work,” adds Yang.
###
Contact author: Tao YANG, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing100053, China ,bjytyangtao@163.com
Journal
World Journal of Acupuncture - Moxibustion
World Journal of Acupuncture - Moxibustion
DOI
Method of Research
Literature review
Literature review
Subject of Research
Not applicable
Not applicable
Article Title
World Federation of Acupuncture-Moxibustion Societies Clinical Practice Guideline on Acupuncture-Moxibustion: Non-Specific Low Back Pain recommendation summaries
World Federation of Acupuncture-Moxibustion Societies Clinical Practice Guideline on Acupuncture-Moxibustion: Non-Specific Low Back Pain recommendation summaries
Global review of acupuncture and moxibustion in CINV/RINV guidelines' status and future focus
image:
Diagram of star rating and number of recommendations
view moreCredit: Tian-yu Ming
A large number of patients undergoing chemotherapy and radiotherapy worldwide are severely afflicted by nausea and vomiting annually. Conventional drug treatments often bring numerous side effects. Meanwhile, acupuncture and moxibustion as an adjunctive therapy has drawn increasing attention, yet guidelines' recommendations vary. This heterogeneity and the absence of detailed acupuncture and moxibustion regimens pose a challenge for clinical practice.
In a new study published in the World Journal of Acupuncture - Moxibustion, a team of researchers from the Institute of Acupuncture and Moxibustion (IAM), China Academy of Chinese Medical Sciences (CACMS), conducted a review of 56 guidelines and expert consensus documents. The scope included recommendations on acupuncture and moxibustion for CINV and RINV.
"Our findings stress the importance of developing acupuncture specific clinical practice guidelines that provide potential acupuncture and moxibustion regimens to improve patient care,” explains Dr Wei-juan Gang, Director of the Center for Evidence-based Acupuncture and Moxibustion at IAM, CACMS.”
The study's findings not only shed light on the existing gaps in CINV and RINV management, but also suggest that the current approach to integrating acupuncture and moxibustion into treatment plans lacks the rigor required for widespread clinical adoption.
“The review's assessment of guideline quality, employing the Scientific, Transparent, and Applicable Rankings (STAR) tool, found the majority to be of medium quality, with none rated as high quality,” adds Gang. “This indicates improvement in the development process of future guidelines is needed.”
One of the surprising findings was the inconsistency in the quality of evidence supporting the recommendations, with many guidelines failing to provide a robust evidence base for their suggestions.
“Our findings call for a renewed focus on the development of acupuncture specific guidelines, emphasizing the importance of personalized antiemetic programs and the integration of acupuncture and moxibusiton with Western practices,” says Gang. “They also underscore the necessity for more research to elucidate the mechanisms of action of acupuncture and moxibustion in managing CINV and RINV.”
The researchers hope that new guidelines are founded on solid evidence and transparent methods, ultimately leading to improved patient outcomes and a better understanding of the role of acupuncture and moxibustion in modern medicine.
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Contact author: Wei-juan GANG, Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China, gangweijuan@126.com
Journal
World Journal of Acupuncture - Moxibustion
Method of Research
Literature review
Subject of Research
Not applicable
Article Title
A global review of acupuncture and moxibustion recommendations in guidelines/expert consensus for chemotherapy- and/or radiotherapy-induced nausea and/or vomiting
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