With the wide application of acupuncture in the world, neuroscience research results on some of the acupuncture efficacy mechanism of scientific significance of the affirmation, gradually formed the concept of Western acupuncture. The following is the Chinese medicine acupuncture Thesis that I have organized for you for your reference.
Traditional Chinese Medicine Acupuncture Dissertation Essay Sample 1: Analysis of the pain-relieving effect of acupuncture treatment for HZ
Herpes Zoster (HZ) is a viral skin disease characterized by varicella zoster virus invasion of the ganglion and the skin, the distribution of herpes and neuralgia along the peripheral nerves in clusters, and is characterized by the invasion of unilateral one or more dermatomes. It is characterized by invasion of one or more dermatomes unilaterally, mostly presenting as ring or strip-shaped damage on the trunk. The authors used a centralized randomized controlled study to treat patients with herpes zoster in the acute phase using different acupuncture methods, observe the pain-relieving effect of different acupuncture methods, and analyze the relationship between patient satisfaction and pain-relieving effect, and the results are reported as follows.
1 Data and Methods
1.1 Subjects
The cases came from the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou Hospital of Traditional Chinese Medicine, and the Second Hospital of Traditional Chinese Medicine of Guangdong Province, and they were the inpatients or outpatients of the Department of Acupuncture, Department of Dermatology, in April 2007?October 2009, and they were the patients who had been hospitalized or outpatients of the Department of Acupuncture, Department of Dermatology. One hundred and one patients in the acute stage of herpes zoster were allocated to 30 cases in group A (electroacupuncture group), 23 cases in group B (cotton paving moxibustion group), 25 cases in group C (fire-acupuncture group), and 23 cases in group D (percussion and cupping group) by using the method of center randomization. Excluding 5 cases of misnomer and 2 cases of shedding, the results finally conformed to the program 27 cases in group A, 23 cases in group B, 24 cases in group C, 20 cases in group D, and ****94 cases. Among them, 54 cases of male (57.4%), 40 cases of female (42.6%); the age of the smallest 20 years old, the largest 70 years old, the average (43.61?1.59) years old. 4 groups of patients of gender, age, height, weight, vital signs, by statistical calculation, the difference is not statistically significant (P>0.05); and the two groups of patients discomfort to the initial diagnosis of the time, herpes situation, by statistical calculation , the difference was not statistically significant (P>0.05). The groups are comparable.
1.2 test criteria
(1) Diagnostic criteria: Chinese medicine diagnostic criteria: refer to the "Chinese medicine disease diagnosis and efficacy standards" [1] in the diagnostic criteria of snake sores. Western medicine diagnostic criteria: reference to "Cecil Textbook of Medicine" [2] in the diagnostic criteria of herpes zoster. (2) Inclusion criteria: ① Age 18-70 years old; ② Herpes appeared within 1-7 days, without antiviral and pain relief treatment; ③ Signed informed consent, agreed to accept the various treatment methods of the group, and obeyed the arrangements of the group. (3) Exclusion criteria ① belong to special types of herpes zoster, including eye, ear herpes zoster, visceral herpes zoster, meningeal herpes zoster, generalized herpes zoster, rashless herpes zoster; ② pregnant or breastfeeding women; ③ allergic and allergic to a variety of drugs; ④ scarred body; ⑤ combined with serious cardiovascular, cerebrovascular, hepatic, renal, hematopoietic system and other primary diseases or systemic failure, diabetes mellitus Patients with diabetes mellitus, malignant tumors, psychiatric disorders, connective tissue disease, hemophilia, and bleeding tendency; (6) those with critical conditions, making it difficult to make a definitive evaluation of the efficacy and safety of the treatment; and (7) those who have had corticosteroids or immunosuppressants applied within 1 month.
1.3 Treatment
The herpes localization of the four groups of patients were kept clean skin, pay attention to protect the skin lesions. The treatment was carried out in a lying position and the skin was routinely sterilized. (1)Group A (electroacupuncture group) Acupuncture points:Ah Yes point (lesion skin lesion), clip ridge point (affected side), Zhigou point, Houxi point. Methods of operation:All points were localized in accordance with the National Standard for Meridian Points [3]. A is the point with flat stabbing method of local circumferential needling, pinch the spine point to the direction of the spinal column oblique stabbing, Zhigou point, Houxi point straight stabbing, all into the needle about 0.8 ~ 1.0 inches, needle stabbing qi, connected to the Han's acupoint stimulation device, the use of sparse and dense wave, the frequency of 2/100Hz, 2 ~ 5mA, the strength of the patient's tolerance to the degree of the power for 30min after the needle out. Once a day, 10 times for 1 course of treatment, *** counted 1 course of treatment. (2) Group B (electroacupuncture + cotton moxibustion group) cotton moxibustion method of operation: defatted dry cotton torn into thin as a cicada, about 3cm?3cm size cotton, according to the area of the lesion to determine the number of pieces of cotton moxibustion. Spread on the Ah Yes point, use a match to burn up the cotton, and apply moxibustion 3 times each time. The rest of the treatment was the same as Group A. (3) Group C (electroacupuncture + fire needle group) fire needle operation method: the operator's left hand holding a lit alcohol lamp, the right hand holding a medium-coarse fire needle in the external flame to heat the needle body, until the tip of the needle burned to the reddish-white, quickly and accurately stabbed into the center of the herpes of about 0.2 ~ 0.3cm, according to the number of herpes, the first stabbing of the herpes of the early herpes, each time to select 3 ~ 5, each herpes needling twice, after the operation, squeezed out the herpes fluid, pressing about 30 seconds, and apply a layer of oil of flowers. After the procedure, squeeze out the blisters, press for about 30 seconds, and apply a layer of aventurine oil. The rest of the treatment and the course of treatment were the same as that of group A. (4) Group D (electroacupuncture + percussion cupping group) percussion cupping method: the operator with a disposable plum blossom needle percussion A is the point, in order to the degree of the local microbleed blood, and then select the appropriate size of the glass jar, quickly pull and press the percussion site and the ends of the lesions. Leave the jar for 5~10min, bleeding 3~5mL, disinfect the affected area with vital iodine after removing the jar, depending on the size of the herpes area, decide the type and number of fire canisters. The rest of the treatment and course of treatment was the same as group A.
1.4 Observation indexes
(1) Pain evaluation indexes ①Pain intensity (VAS assessment method, unit: mm): record the most painful point in the 24h before the observation point. Marked by 100mm, 0 means no pain, 100mm means the maximum pain intensity that the patient can imagine. ② Degree of pain relief (%):Record the relief of pain intensity in the 24h before the observation point compared with the baseline. The recording range was 0-100%, with 0 indicating no relief at all and 100% indicating complete relief. (iii) Time to onset of pain relief (d):The time required from the time the patient started to feel pain to the time when the degree of pain relief was constant at 30% or more. (iv) Duration of pain (d): The time from the beginning of pain to the complete disappearance of pain. Recorded before each treatment on the 1st to 10th day of observation and on the 11th day. If item (③④) could not be recorded during the course of treatment (pain was not relieved or disappeared), it was recorded on the 22nd, 30th, 60th, and 90th day of follow-up. (2) Patient satisfaction: Using the scale method, 0 to 100 represents the patient's tolerance of the treatment measures he/she has received, with 100 indicating very satisfied and 0 being very dissatisfied, the patient was asked to read the position that best represents his/her level of tolerance and record the reading (in points). Recorded on day 11.
1.5 Statistical methods
Values are expressed as (nowx?s) and all data were tested for K-S normal distribution before comparison. One-way analysis of variance (ANOVA) was used for normally distributed data, and non-parametric tests were used for non-normally distributed data. For non-normally distributed data, the Kruskal-Wallis test was used for comparisons between multiple groups, the Mann-WhitneyU test was used for comparisons between two groups, and Spearman's correlation coefficient was used for correlation analysis. Statistical analysis was performed with spss18.0.
2 Results
2.1 Relationship between patient satisfaction and VAS pain scores
See Table 1 and Fig. 1. VAS scores of herpes zoster patients in each group were significantly reduced after treatment, and there was a difference in VAS scores in each group after treatment (P<0.05), with VAS scores of (0.63?1.62) in Group A and (0.63?1.62) in Group B after treatment ( 8.04?10.95) points.Comparison of the difference between the 4 groups before and after treatment showed no significant difference (P>0.05), indicating that the overall pain-relieving effect of acupuncture was comparable in all groups after 1 course of acupuncture treatment. After treatment, the satisfaction of herpes zoster patients in each group was somewhat different (P<0.05), and the satisfaction of patients in group A (electroacupuncture group) and group C (electroacupuncture + fire acupuncture group) was higher than that of patients in group B (electroacupuncture + cotton paving moxibustion group) and group D (electroacupuncture + percussion cupping group) (P<0.05); the satisfaction of patients in the electroacupuncture group was comparable to that of patients in the electroacupuncture + fire acupuncture group (P>0.05); the satisfaction of patients in the electroacupuncture + cotton paving moxibustion group and electroacupuncture + percussion cupping group had comparable patient satisfaction (P>0.05). From the patient's point of view, patients agreed more with electroacupuncture treatment or electroacupuncture combined with fire-acupuncture treatment than electroacupuncture + cotton spreading moxibustion and electroacupuncture + percussion cupping. Patient satisfaction refers to the comprehensive evaluation of the medical services received by patients with their understanding of health, weighing their economic conditions, and combining their requirements for health care. [4] involves every aspect of the entire disease consultation process, and the correlation analysis between patient satisfaction and post-treatment VAS score, and the difference in VAS score before and after treatment, the results are shown in Fig. 1, and there is no significant correlation between patient satisfaction and post-treatment VAS score, and the difference in VAS score before and after treatment (all P>0.05).
2.2 Relationship between patient satisfaction and patients' pain relief, pain duration, and degree of pain relief
See Table 2 and Fig. 2. The differences in pain relief time and pain duration among the four groups of herpes zoster patients were not significant (P>0.05), but the differences in the degree of pain relief were significant (P<0.01), with group A ( Electroacupuncture group) than group B (Electroacupuncture + Cotton paving moxibustion group) the degree of pain relief was more obvious (P<0.01). There was no significant correlation between patient satisfaction and pain duration, pain relief time, and degree of pain relief in the four groups (P>05).
3 Discussion
Herpes zoster belongs to Chinese medicine? Herpes zoster belongs to Chinese medicine. Category, its occurrence is mostly due to the body of positive energy deficiency, dampness, heat and toxicity through the liver and gallbladder meridian fumigation skin; in the late stage of the lesion, the residual toxicity has not been cleared, blood stasis stagnation of the skin and the occurrence of neuralgia. Neuralgia is one of the characteristics of herpes zoster, which can appear before or along with the rash, and it is the main reason why herpes zoster bothers patients. Pain relief is a major function of acupuncture, which has the effect of reducing herpes zoster pain and shortening the duration of pain [5-6]. This program takes A-shi point, Jie-ji point, Zhi-gou point, Hou-xi point for treatment, this acupuncture point taking program has the function of clearing heat and detoxification, activating blood circulation and removing blood stasis, dispelling dampness and relieving pain from the disease mechanism of snake string sores. Electro-acupuncture, electro-acupuncture + cotton spreading moxibustion, electro-acupuncture + fire-acupuncture, electro-acupuncture + percussion and cupping were used to treat patients with herpes zoster, although the differences in VAS scores and the degree of pain relief of each group after treatment were statistically significant, the difference between the VAS scores before and after treatment, the difference in the duration of pain, the duration of pain relief was not statistically significant, and the patients' satisfaction was related to the intensity of the pain, the difference in the VAS scores before and after treatment, the pain duration, pain relief time, and pain relief were not significantly correlated. Different acupuncture methods for the treatment of acute phase herpes zoster each stop before the effect indicators, in addition to the degree of pain relief group A is better than group B, the rest of the VAS score before and after the treatment of the difference, pain duration, pain relief time, the degree of pain relief between the group difference is not significant, considerations related to the natural course of herpes zoster is generally 2-3 weeks [7], it is estimated that by the observation point of the post-treatment, the natural course of the majority of the patients has been regressed towards healing, and therefore the difference in pain relief effect of each treatment could not be reflected. The electroacupuncture method was the peri-acupuncture of Ah Yes point plus the electroacupuncture treatment of Jie Ji point, Zhi Gou point and Hou Xi point, and the remaining three therapies were the addition of cotton paving moxibustion, fire acupuncture and percussion and cupping on top of this, and the VAS scores of the post-treatment VAS scores of the group A (electroacupuncture group) were significantly lower than that of group B (electroacupuncture+cotton paving moxibustion group), whereas the degree of pain relief of the group A was better than that of the group B. The results showed that acupuncture itself also caused some pain to the patients, and that the combination of electroacupuncture and cotton paving moxibustion The results suggest that acupuncture itself also brings some pain to patients, and that overlapping electroacupuncture and cotton spreading moxibustion to treat acute-phase herpes zoster not only fails to alleviate patients' pain, but may also increase it.
Patient satisfaction in this study is a patient-reported clinical outcome in which the patient's tolerance of the therapeutic measures he or she receives is expressed on a scale of 0 to 100, with the higher the score, the higher the satisfaction, which is a patient-reported clinical outcome. Patient-reported clinical information has become the focus of attention in clinical efficacy evaluation and can be used in the evaluation and selection of optimal treatment regimens. [8] The results of this study found that patients agreed more with electroacupuncture treatment or electroacupuncture combined with fire-acupuncture treatment for acute-phase herpes zoster by different acupuncture methods, but there was no significant correlation between patient satisfaction and post-treatment VAS scores, the difference between pre- and post-treatment VAS scores, the duration of pain, the duration of pain relief, and the degree of pain relief.
Acupuncture in Chinese medicine graduation thesis sample 2: Evidence-based medicine acupuncture evidence review
1 Acupuncture research evidence sources and the establishment of the scope of evidence
Based on the evidence evaluation system of evidence-based medicine on acupuncture medicine, according to the development of the current situation and characteristics of the discipline of acupuncture, as well as the range of sources of evidence, the acupuncture research identified in this study. Based on the current development and characteristics of the acupuncture discipline and the range of evidence sources, the scope of acupuncture research evidence identified in this study includes modern research evidence, ancient recorded evidence, and expert empirical evidence, of which modern research evidence includes randomized controlled trial studies, non-randomized controlled trial studies, case series studies, and case reports. The following is a brief description of the characteristics of each type of research evidence and the rationale for its inclusion.
1.1 Ancient medical records evidence of acupuncture handed down to the present day is the accumulation of acupuncture clinical experience over the generations, not only covers the success of acupuncture safety and effectiveness, acupuncture indications, contraindications and precautions and other valuable information, and after thousands of years of clinical practice repeatedly confirmed its authenticity, reliability and applicability. Therefore, the relevant evidence of acupuncture and disease prevention contained in ancient medical books is one of the best evidence that cannot be ignored for clinical decision-making in acupuncture. The evidence contained in the ancient medical books included in this study covers all the acupuncture therapeutic literature prior to the Qing Dynasty, and in terms of content form, it mainly includes the disease-oriented acupuncture prescription literature and acupuncture medical cases.
1.2 Evidence of experts' experience: Experiential literature is often the most direct record of experience in clinical medicine, and it is the result of the combination of clinical practice and medical theory, breakthroughs and innovations, with high theoretical generalization and practical guidance significance. Therefore, the summary of acupuncture experts' experiences is one of the best evidence for clinical decision-making in acupuncture, which should not be ignored. The expert experience summaries included in this study were mainly the clinical experience of domestic acupuncture experts after 1919, which were categorized into the experience of acupuncture experts and general acupuncture experts according to the qualifications of the experts.
1.3 Modern Clinical Research Evidence Recent modern clinical research literature is the main source of acupuncture clinical research evidence. One of the characteristics of acupuncture and moxibustion is evidence-based treatment, emphasis on individualized treatment, and abundance of therapies; therefore, a randomized controlled trial of acupuncture and moxibustion clinics using uniform and standardized treatment protocols is not sufficient to represent the full spectrum of acupuncture and moxibustion clinical research. Therefore, in addition to randomized controlled trial studies, this study also included non-randomized controlled trial studies, case series studies, and case reports, and did not include systematic evaluations or Meta-analyses.
(1) Randomized controlled trial:Randomized controlledtrial (RCT) is considered the best research design for evaluating the efficacy and safety of medical interventions, with the best strength of argument and scientific validity of evidence [4]. In this study, RCTs were used as one of the acupuncture research evidence, but the evaluation of acupuncture RCTs needs to consider both the quality of trial design completion and the clinical reality of acupuncture.
(2) Non-randomized controlled studies:At present, non-randomized clinical controltrial (CCT), still occupies the majority position in the field of traditional Chinese medicine and acupuncture [5]. Although these studies do not use randomized methods, they use control groups for comparison, so non-randomized clinical control studies can still provide valuable information or clues for clinical decision-making in acupuncture. Therefore, non-randomized clinical controlled studies are one of the sources of evidence inclusion for acupuncture research in this study.
(3) Case series studies: The value of case series studies (Caseseriestri-al) is that they can be used to observe the population excluded from clinical trials, and they can fully utilize the characteristics of the diagnosis and treatment of acupuncture, and they are inexpensive, and they are the most frequently published in the literature of modern clinical research in China, so they are also included in the scope of evidence for the research of acupuncture.
This study also includes it in the category of acupuncture research evidence.
(4) Case: Case (Singlecasestudy), also known as a single case report. Acupuncture cases are often flexible and varied record of acupuncture efficacy of the treatment program or complete treatment changes, is the most representative of Chinese medicine, acupuncture therapy, complex intervention characteristics of the form of literature, for acupuncture clinical practice has a certain value. Therefore cases are also included in the inclusion of acupuncture research evidence. It should be added that systematic evaluation or Meta-analysis is one of the best evidences advocated by evidence-based medicine, but acupuncture treatment protocols are flexible and changeable with evidence-based treatment, emphasizing the clinical research? homogeneity? The systematic evaluation and Meta-analysis are not enough to compare and analyze one by one, and it is difficult to take into account the core characteristics of acupuncture's evidence-based treatment and complex interventions, so this study did not include them in the research evidence category of clinical decision analysis.
2 The establishment of acupuncture clinical research evidence quality evaluation method
In this study, on the basis of the acupuncture research evidence evaluation methods and standards formed during the development of the Evidence-Based Acupuncture Clinical Practice Guidelines - Facial Palsy, we drew on the existing evidence evaluation methods and standards in the field of traditional Chinese medicine [6-7] for supplementation and refinement to preliminarily establish various types of acupuncture research evidence quality scoring standards and grading standards.
2.1 Quality evaluation method of evidence contained in ancient books The evidence in ancient medical books is expository, which is a record of clinical experience or a description of a specific medical process, therefore, this study mainly considers the quality of medical books, the qualification of medical practitioners, the form of record (medical case, exposition), the strength of the evidence application, and the degree of completeness of the content and other factors, and initially establishes a quality evaluation table and grading standards of the evidence contained in ancient books. (1) Quality grading standards: high-quality literature: score? 5 points, and must meet the first three of more than one, which meets the second for the classic writings Essay documents, meet the third for the ancient evidence used throughout the ages. Medium-quality documents: those with a score of ?4, and must meet at least 2 of the first 4 (including 2). Low-quality literature:Those who score ﹤4. (2) Description of evaluation indexes:Precious books:This study refers to the 67 acupuncture and moxibustion medical books included in the large-scale series "Acupuncture and Moxibustion Classical Gathering of Precious Books" edited by Prof. Xue-Tai Wang. Ancient Classical Works of Acupuncture and Moxibustion: Using a combination of expert consultation and group discussion, the ancient classical works of acupuncture and moxibustion initially identified in this study refer to the Suwen, Lingshu, Nanshou, and A Yi Jing. Ancient Acupuncture and Moxibustion Famous Doctors:Based on the bibliography of traditional Chinese medicine, history of medicine, and history of acupuncture and moxibustion development [8-9], and using a combination of expert consultation method and group discussion, 33 ancient acupuncture and moxibustion famous doctors were initially identified, including: Huangdi, Bianqi, Hua Tuo, Fulong, Guo Yu, Cao Xie, Lv Guang, Huangfu Tranquillity, Wang Shuho, Xu Qiu Fu, Xu Wenbo, Ge Hong, Zhen Quan, Yang Shangshun, Sun Simiao, Wang Toi, Wang Weiyi, and Wang Zhiizhong, He Ruoyu, Yan Mingguang, Dou Hanqing, Wang Guorui, Slide Shou, Xu Feng, Ling Yun, Gao Wu, Wang Ji, Ma Maki, Yang Jizhou, Li Shizhen, Wu Kun, Zhang Jingyue, Li Xuechuan. Recorded as used throughout the ages: refers to the repeated application of this treatment program in monographs throughout the ages.
2.2 Quality evaluation method of expert experience evidence Expert experience summary is generally summarized by the experts themselves or others profile, the source range includes expert experience representative monographs and journal articles. In this study, on the one hand, the inclusion and exclusion criteria are formulated in accordance with the diagnostic and therapeutic characteristics of the disease, and on the other hand, based on the definition of the scope of the expert, the author, the form of the carrier, and the reliability of the summary of the experience and other factors, the quality of the evidence of the expert's experience is preliminarily formulated as a quality evaluation table and grading standards. (1) Quality grading criteria: High-quality literature: those with a score of ?5, and must meet more than one of the first three criteria. Medium-quality literature: those with a score of ?4, and must meet more than 2 of the first 4 (including 2). Low-quality literature:Those who score ﹤4. (2) Explanation of evaluation indexes:Definition of famous and old Chinese medicine experts in the field of acupuncture and moxibustion:Defined in the time scope as the famous and old Chinese medicine doctors of acupuncture and moxibustion in the modern times from the Republic of China to the present day; then based on the bibliography, the history of medicine, and the process of the acupuncture and moxibustion development [8-9], with reference to the list of the first, the second, the third, and the fourth batch of the National Academic Experience Integration of the old Chinese medicine experts' mentors published by the State Administration of Traditional Chinese Medicine, and after the consultation of the experts, Discussion and summarization, initially determine the scope of modern acupuncture famous old Chinese medicine practitioners, their representative writings and summaries of experience completed by others as the source of evidence.
2.3 Quality evaluation methods of modern acupuncture research evidence(1) Randomized controlled trials:This study is based on the CONSORT statement [10], Jadad rating scale [11], combined with the clinical practice of acupuncture and literature characteristics of the intervention quality control standards, efficacy indicators, literature carrier indicators, etc., to supplement, initially formulate a randomized controlled trial study of the quality of evaluation table and Grading criteria. Quality grading criteria: High-quality literature: those with a score of ?11, and the first three scores of ?3, and the fourth to eleventh scores meet five or more. Medium-quality literature: those with a score of ?10, and the first three scores of ?2, and the fourth to eleventh articles meet more than three; or those with a score of ?8, and the first three scores of ?2, and must meet the fourth to eleventh articles meet more than five. Low-quality literature:Score ﹤8 points and the first 3 scores ?1 point; or there is no clear diagnostic criterion for the observed subjects. (2) Non-randomized controlled trials:Based on the evaluation of RCTs, this study initially formulated the quality evaluation table and grading criteria for this type of evidence according to the characteristics of non-randomized clinical controlled trial studies. Quality grading standards:High-quality literature: score?8 points, and the first eight criteria must meet five (including five) or more. Medium-quality literature: score of ?8, but the first 8 evaluation criteria must meet 5 or less. Low-quality literature:There is no clear diagnostic criteria for the observed subjects; or the score is ﹤8 points. (3)Quality evaluation method of serial studies:Based on the evaluation of RCT, this study formulated the quality evaluation table and grading standard of this type of evidence according to the characteristics of case serial studies, see Table 5.Quality grading standard:High-quality literature:Score ?8, and the first 8 criteria must be met with 5 or more (including 5). Medium-quality literature: score of ?8, but the first 8 evaluation criteria must meet only 5 or less. Low-quality literature:No clear diagnostic criteria for the observed subjects; or score ﹤8 points. (4)Cases:The quality evaluation form and grading criteria for acupuncture cases were developed by considering the form of carrier, author's qualification, completeness of patient's diagnostic and treatment information, therapeutic measures, and efficacy of treatment, etc., and are shown in Table 6.Quality Grading Criteria:High-quality literature: those with a score of ?5, and must meet the 4th and 7th criteria. Low-quality literature: those with a score of ﹤5, or a score of ?5, and not meeting the criteria of Articles 4 and 7.
3 Formation of the strength of evidence and recommended grade standards for acupuncture clinical research
This study followed the principles and methods of evidence-based medicine, combined with the characteristics of the discipline of acupuncture and moxibustion, and preliminarily formulated the strength of evidence and recommended grade standards for research on evidence-based decision-making in acupuncture and moxibustion through discussion at the expert meeting and questionnaire consultation, etc. The quality of the evidence is one-to-one with the grade of the recommended grade of the strength of the evidence, i.e., the strength of the recommendation of high-quality evidence is also high.
4 Conclusion
Following the best research evidence is a key part of practicing evidence-based medicine, and evaluation of evidence is a prerequisite to ensure its utilization. Therefore, this study organically integrates the concepts and methods of evidence-based medicine with the principles of clinical practice of acupuncture and the characteristics of the existing literature, and initially establishes a system for evaluating the evidence of acupuncture clinical research that meets the characteristics of acupuncture itself, which has the following characteristics.
4.1 Referring to the evidence evaluation method of evidence-based medicine combined with acupuncture's own characteristics
Evidence-based medicine uses objective and real evidence as a reliable source of clinical decision-making, and its concepts, ideas, and methods are worthy of in-depth study and reference in acupuncture medicine. There is also a large amount of literature in the acupuncture clinical literature that can be used for clinical decision-making in acupuncture. Therefore, this study aims to explore real and effective treatment plans from the literature, and establish an evidence evaluation system for clinical evidence-based decision-making in acupuncture by referring to evidence-based medicine and combining with the characteristics of the discipline of acupuncture itself. The system includes the evaluation methods of research evidence such as RCT, CCT, case series, etc., and at the same time, emphasizes the status and role of the empirical evidence of famous and old experts and the evidence contained in ancient books, and stresses the role of evidence reflecting the actual characteristics of acupuncture and moxibustion clinics such as the role of individual cases in the evaluation system, which can basically reflect the laws and characteristics of acupuncture and moxibustion clinical practice.
4.2 Maximizing the inclusion of research evidence for the purpose of clinical decision-making in acupuncture
The acupuncture clinical research evidence evaluation system is a methodological exploration of the application of modern evidence-based medicine concepts and methods to study the clinical decision-making of acupuncture, which spans across two different systems of medicine, but in the final analysis, it is still based on the theory of acupuncture and its practice as a fundamental, and therefore, it must take into account the characteristics of the clinical individualization of acupuncture, empirical, etc. The system should also take into consideration the importance of the clinical practice of acupuncture. and other characteristics. Randomized, controlled, and blinded methods are certainly the best methods for clinical reliability assessment, but the two completely different theoretical systems of Chinese and Western medicine have led to a lot of inapplicability in applying these methods to the clinical practice of acupuncture and moxibustion. The clinical literature of acupuncture and moxibustion consists of RCTs, CCTs, case series studies, experts' experiences, case reports, and evidence contained in ancient books, etc. There are differences between the various types of literature, such as the strength of methodological reliability, the applicability of acupuncture and moxibustion to clinical practice, and the quality of the work done, as well as the habits of thousands of years of acupuncture and moxibustion inheritance, etc. Therefore, the present hierarchy of evidence is based on the current state of acupuncture and moxibustion clinical evidence. Therefore, this evidence level system is based on the current clinical evidence level of acupuncture and moxibustion, and the influence of multiple factors on the evaluation of the evidence level is harmonized to maximize the inclusion of various types of valuable evidence.
4.3 Consideration of factors affecting the quality of evidence from multiple perspectives
Acupuncture clinical decision-making is a very complex multifactorial process, and the evaluation of various types of acupuncture clinical literature from the perspective of evidence is a new field that deserves to be explored in depth, and for the specificity of the theory and practice of acupuncture, the study adds the personal qualification, level, unit of the medical practitioner to the consideration of the current evaluation indexes of the evidence-based medical science, in addition to the evaluation indexes of the current evidence-based medical science, In addition to considering the current evidence-based medical evaluation index, this study adds the personal qualification, level, unit, carrier, academic point of view, specific acupuncture program, theoretical explanations and other factors to explore the evaluation index, and proposes a set of strict evaluation methods and quality grading standards for various types of research evidence, in order to exclude low-quality or unqualified evidence, and to screen out high-quality and credible evidence, so as to provide practicable and valuable evidence for clinical application.
In summary, this study used literature analysis methods, expert interview methods and *** literacy methods, combined with the characteristics of the discipline of acupuncture and literature, compared the evidence evaluation system of evidence-based medicine, explored the scope and characteristics of the acupuncture research evidence, and initially established the evaluation methods and standards of acupuncture research evidence, and initially established the acupuncture clinical research evidence system. However, in view of the specificity of the theory and clinical practice of acupuncture, the establishment of evidence grading suitable for acupuncture diagnostic and treatment characteristics and the form of literature, the evaluation system is still an exploratory study, so there are still research evidence of the evaluation of the determination of the indicators may not be perfect, part of the evaluation of the indicators of the lack of authoritative reference standards and other inadequacies, and urgently need to be continuously supplemented and improved in the future research and practice.
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