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Ci-dessous, les différences entre deux révisions de la page.

--- acupuncture:evaluation:orl:02. acouphenes [11 Dec 2020 07:36]
Nguyen Johan Replacement automatique de '⊕ positive recommendation' par '⊕ positive recommendation '
+++ acupuncture:evaluation:orl:02. acouphenes [23 Jun 2025 07:14] (Version actuelle)
Nguyen Johan [1.2.3.1. Ji 2023]
@@ Ligne 1: / Ligne 1: @@
-====== Acouphènes : évaluation de l'acupuncture ======
+/*English:Tinnitus*/
+====== Tinnitus ======
+====== Acouphènes ======
 | //Articles connexes//: - [[acupuncture:conduites therapeutiques:orl:02. acouphenes|conduites thérapeutiques]] - pathologie - acupuncture expérimentale - qigong - |
 ===== Systematic Reviews and Meta-Analysis=====
-| ☆☆☆ | Evidence for effectiveness and a specific effect of acupuncture |
-| ☆☆ | Evidence for effectiveness of acupuncture |
-| ☆ |Limited evidence for effectiveness of acupuncture |
-| Ø |No evidence or insufficient evidence |
-==== Acupuncture générique ====
-=== Song 2018 ===
+==== Generic Acupuncture ====
+=== Bousema 2023 ===
+Bousema EJ, Koops EA, van Dijk P, Dijkstra PU. Effects of Physical Interventions on Subjective Tinnitus, a Systematic Review and Meta-Analysis. Brain Sci. 2023 Jan 29;13(2):226.  https://doi.org/10.3390/brainsci13020226
+^Background|Increasingly, patients suffering from subjective tinnitus seek help from physical therapists. Numerous randomised controlled trials (RCTs) have investigated the effect of physical interventions commonly used in physical therapy practice on subjective tinnitus. This systematic review and meta-analysis aimed to analyse the effects of physical interventions on tinnitus loudness, tinnitus annoyance, and scores on the Tinnitus Handicap Index (THI).|
+^Methods| Four databases were searched from inception up to March 2022. A total of 39 RCTs were included in the systematic review, and 23 studies were appropriate for meta-analyses. Risk of bias assessments were also performed. Interventions analysed in at least five studies were summarised, including transcutaneous electrical nerve stimulation (TENS), laser therapy, and acupuncture. Random-effects meta-analysis models were used, and effect sizes were expressed as Hedge's standardised mean differences (SMD) with 95%CI's. |
+^Results|The quality of three-quarters of the studies was limited due to insufficient allocation concealment, lack of adequate blinding, and small sample sizes. Large, pooled effects sizes were found for acupuncture (SMD: 1.34; 95%CI: 0.79, 1.88) and TENS (SMD: 1.17; 95%CI: 0.48, 1.87) on THI as well as for acupuncture on tinnitus loudness (VAS Loudness (SMD: 0.84; 95%CI: 0.33, 1.36) and tinnitus annoyance (SMD: 1.18; 95%CI: 0.00, 2.35).|
+^Conclusions| There is some evidence that physical interventions (TENS and acupuncture, but not laser therapy) may be effective for tinnitus. However, the lack of high-quality studies and the risk of bias in many studies prohibits stronger conclusions.|
+=== Wu 2023 ===
+Wu Q, Wang J, Han D, Hu H, Gao H. Efficacy and safety of acupuncture and moxibustion for primary tinnitus: A systematic review and meta-analysis. Am J Otolaryngol. 2023 May-Jun;44(3):103821.  https://doi.org/10.1016/j.amjoto.2023.103821
+^Background| Tinnitus is a common otological symptom that can seriously affect a patient's quality of life, and effective therapies are still lacking. A large number of studies have found that compared with traditional therapy, acupuncture and moxibustion treatment are beneficial for the treatment of primary tinnitus, although current evidence remains inconclusive. This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to evaluate the efficacy and safety of acupuncture and moxibustion for primary tinnitus. |
+^Methods| We conducted a comprehensive literature review in multiple databases from inception through December 2021, including PubMed, Medline, Ovid, Embase, Science Direct, Chinese National Knowledge Infrastructure (CNKI), Wanfang Data, Chinese Biomedical Literature (CBM) and VIP Database. The database search was supplemented by subsequent periodic scrutiny of unpublished and ongoing RCTs from the Cochrane Central Register of Controlled Trials (CENTRAL) and the WHO International Clinical Trials Registry (ICTRP). We included RCTs that compared acupuncture and moxibustion with pharmacological therapies, oxygen or physical therapies, or no treatment, for treating primary tinnitus. The main outcome measures were Tinnitus Handicap Inventory (THI) and efficacy rate; the secondary outcome measures were Tinnitus Evaluation Questionnaire (TEQ), Pure Tone Average (PTA), Visual Analogue Scale (VAS), Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD) and adverse events. Data accumulation and synthesis included meta-analysis, subgroup analysis, publication bias, risk-of-bias assessment, sensitivity analysis, and adverse events. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system was used to grade the evidence quality. |
+^Results| We included **34 RCTs involving 3086 patients**. Results indicated that compared with the controls, acupuncture and moxibustion resulted in significantly lower scores on the THI, achieved a significantly higher efficacy rate, reduced scores on TEQ, PTA, VAS, HAMA and HAMD. The meta-analysis revealed that acupuncture and moxibustion have a good safety profile in the treatment of primary tinnitus. |
+^Conclusion|The results showed that acupuncture and moxibustion for primary tinnitus yielded the greatest decrease in tinnitus severity and improvement in quality of life. Due to the low quality of GRADE evidence grade, the considerable heterogeneity among trials for several data syntheses, more high-quality studies with large sample sizes and longer follow-up periods are urgently needed. |
+=== Li 2022 ☆===
+<color #ed1c24>**RETRACTED.**</color> Li Y, Sang D, Wu Z, Cao X. Systematic Evaluation of the Efficacy of Acupuncture Associated with Physical and Mental Intervention when Treating Idiopathic Tinnitus and the Improvement of Tinnitus Symptoms. Comput Math Methods Med. 2022 Aug 30;2022:6764909.  https://doi.org/10.1155/2022/6764909.
+^Objective|To systematically evaluate the efficacy of acupuncture associated with physical and mental intervention when treating idiopathic tinnitus and the improvement of tinnitus symptoms, so as to supply evidence-based medicine for its popularization and adoption.|
+^Methods| PubMed, EMBASE, ScienceDirect, Cochrane Library, China knowledge Network Database (CNKI), China VIP Database, Wanfang Database, and China Biomedical Literature Database (CBM) online database were searched for the controlled trial of acupuncture associated with physical and mental intervention when treating idiopathic tinnitus. The retrieval time limit is from January 2010 to March 2022. Separately, two researchers extracted the data, and according to the Cochrane Handbook 5.3, the bias risk of each piece of literature was assessed. The collected data were measured using RevMan5.3 statistical software.|
+^Results|Finally, 5 CT articles were included in this study, with a total sample size of 282. Meta-analysis showed that the effective rate of the study group was significantly higher than that of the control group (P < 0.05). The scores of tinnitus disorder scale (THI) after treatment were analyzed by Meta. The THI scores of the study group after treatment were significantly lower than those before treatment. Meta-analysis of the severity of tinnitus after treatment showed that the severity of tinnitus in the observation group after treatment was significantly lower than that before treatment. There is a certain publication deviation in the literature, which may be related to the heterogeneity of the research and the small number of literatures.|
+^Conclusion|On the basis of acupuncture treatment, associated with physical and mental intervention is helpful to the recovery of patients with idiopathic tinnitus, can effectively improve their clinical symptoms, and is suitable for clinical application. A popularization of this concept in clinical practice is worth considering, but further research and follow-up with a higher methodological quality and longer intervention time are needed to confirm its efficacy.|
+=== Huang 2021 ∅===
+Huang K, Liang S, Chen L, Grellet A. Acupuncture for tinnitus: a systematic review and meta-analysis of randomized controlled trials. Acupuncture in Medicine. 2021;39(4):264-271.   [221972]. https://doi.org/10.1177/0964528420938380
+^Objective| To evaluate the efficacy/effectiveness of acupuncture for the treatment of tinnitus. |
+^Methods| Four English and four Chinese databases were searched for randomized controlled trials (RCTs) of acupuncture for tinnitus published before 30 September 2018. RCTs applying acupuncture alone compared with conventional treatments, sham acupuncture, or no treatment, as well as acupuncture plus conventional treatments compared with conventional treatments alone, were included. The primary outcome was the visual analogue scale (VAS). Secondary outcomes included tinnitus handicap inventory (THI) and tinnitus severity index (TSI) scores. Meta-analysis was conducted using RevMan V5.3 software. The protocol was registered in the PROSPERO database (ref. CRD42018108692).|
+^ Results| **Eight studies involving 504 participants** were included. Meta-analysis showed no significant differences in the VAS score (mean difference (MD) = -1.81, 95% confidence interval (CI) = -3.69 to 0.07; p = 0.06) between the acupuncture and control groups. However, favorable effects of acupuncture on changes in THI score (MD = -10.11, 95% CI = -12.74 to -7.48; p < 0.001) and TSI score (MD = -8.36, 95% CI = -8.87 to -7.86; p < 0.001) were found. |
+^Conclusion| Acupuncture had no significant effect on the primary outcome of VAS score compared with control treatment; however, positive effects on secondary outcomes (THI and TSI score) were observed in acupuncture versus control groups. Due to the low quality and small sample size of the included trials, the level of evidence was insufficient to draw any definitive conclusions. Further rigorous and high-quality studies with larger sample sizes should be conducted to confirm the efficacy/effectiveness of acupuncture for tinnitus.|
+=== Song 2018 ★===
@@ Ligne 134: / Ligne 172: @@
 ^Conclusions|Nonspecific support and counseling are probably helpful, as are tricyclic antidepressants in severe cases. Benzodiazepines, newer antidepressants, and electrical stimulation deserve further study. Future tinnitus therapeutic research should emphasize adequate sample size, open trials before RCTs, careful choice of outcome measures, and long-term follow-up.|
-==== Techniques particulières ====
+==== Special Acupuncture Techniques ====
-=== He 2016 (electroacupuncture) Ø ===
+=== Electroacupuncture ===
+== He 2016  Ø ==
 He M, Li X, Liu Y, Zhong J, Jiang L, Liu Y et al. Electroacupuncture for Tinnitus: A Systematic Review. PLoS One 2016;11(3). {{:medias securises:acupuncture:evaluation:orl:he-176551.pdf|[176551].}}
@@ Ligne 146: / Ligne 188: @@
 ^ Conclusions  | Due to the poor methodological quality of the primary studies and the small sample sizes, no convincing evidence that electroacupuncture is beneficial for treating tinnitus could be found. There is an urgent need for more high-quality trials with large sample sizes for the investigation of electroacupuncture treatment for tinnitus. |
+=== Scalp Acupuncture ===
+== Chen 2025 ==
+Chen J, Jing R. The clinical efficacy of Scalp acupuncture for Tinnitus:A Systematic Review and Meta-Analysis. Complement Ther Med. 2025 Jan 17:103129.  https://doi.org/10.1016/j.ctim.2025.103129. Epub ahead of print. PMID: 39828220.
+^Backgound| No single treatment is considered to be universally effective for tinnitus.Scalp acupuncture has been explored as a potential treatment.|
+^Objective| This systematic review and meta-analysis aim to evaluate the clinical efficacy of scalp acupuncture in treating tinnitus.|
+^Methods| A comprehensive search of relevant databases was conducted to identify randomized controlled trials comparing scalp acupuncture with a control treatment for tinnitus.The clinical efficacy rate and reduction in tinnitus severity were assessed using relative risk (RR) and standardized mean difference (SMD), respectively. Sensitivity analyses was performed to investigate sources of heterogeneity.|
+^Results| A total of **20 research studies,with 1430 participants**,were included.The systematic review and meta-analysis revealed that the scalp acupuncture groups had a significantly higher clinical effective rate compared to the control groups (RR=1.25, 95% CI 1.16 to 1.35, p<0.00001),with low heterogeneity(p=0.27,I2=20%).The scalp acupuncture groups and scalp acupuncture plus auxiliary acupoints groups had greater reduction in tinnitus severity compared to the control groups(SMD=-0.76,95%CI:-1.02,-0.51,p<0.00001;SMD:-0.93,95%CI:-1.52,-0.33,p=0.002, respectively),with a moderate heterogeneity(p=0.005,I2=62%) and a significant heterogeneity (p<0.00001,I2=86%) observed due to differences in study design, sample characteristics, and intervention protocols.Sensitivity analysis confirmed the stability of the results.The summary table generated through GRADEpro indicated that the certainty of evidence ranged from moderate to low.|
+^Conclusions| Scalp acupuncture has demonstrated promising efficacy in the treatment of tinnitus compared to traditional acupuncture or pharmacotherapy. However, the current evidence is limited due to potential biases and heterogeneity across studies.Future studies should standardize protocols, ensure higher methodological rigor, and explore long-term effects to validate the findings further.|
-===== Recommandation de bonne pratique =====
+=== Comparison of Acupuncture techniques ===
+== Ji 2023 ==
-| ⊕ positive recommendation (quelque soit le niveau de preuve annoncé) \\ Ø recommandation négative (ou absence de preuve) |
+Ji L, Zhang H, Wang L, Yin Z, Cen J, Guo Y. Network meta-analysis of acupuncture for tinnitus. Medicine (Baltimore). 2023 Sep 29;102(39):e35019.  https://doi.org/10.1097/MD.0000000000035019
+^Objective| To provide evidence for medical management of tinnitus based on an assessment of the evidence concerning the effectiveness of acupuncture as a treatment for tinnitus using network meta-analysis (NMA).|
+^Methods| We conducted a systematic literature review by searching 8 national and international databases (inception to February 2023) for randomized controlled trials (RCTs) for tinnitus. Only RCTs that recruited participants aged over 18 and diagnosed with tinnitus, and that evaluated acupuncture or acupuncture in combination with conventional western medical therapy were included. We used response rate and tinnitus handicap inventory (THI) to examine efficacy. We conducted NMA with random effects, and the rate ratio or mean difference with its 95% credible interval was calculated. In addition, we ranked all treatments via their SUCRA and assessed the quality of evidence according to the GRADE criteria.|
+^Results| A total of 2575 patients were included in the study. The main findings of the current NMA were that acupoint injection combined with warm acupuncture was the most effective for response rate, followed by warm acupuncture and acupoint injection combined with western medical treatment. Acupuncture combined with western medical treatment was the most effective for THI, followed by electroacupuncture combined with warm acupuncture and acupuncture combined with moxibustion.|
+^Conclusion| Acupuncture seems to be a better trend treatment for tinnitus. Further rigorous RCT studies that include direct comparisons for different acupuncture-related treatments are encouraged to provide the most promising evidence for patients with tinnitus.|
+== Pang 2019 ==
+Pang P, Shi Y, Xu H, Deng L, Wu S, Chen X. Acupuncture methods put to the test for a tinnitus study: A Bayesian analysis. Complement Ther Med. 2019 Feb;42:205-213.  https://doi.org/10.1016/j.ctim.2018.11.017
+^Backgound| This study evaluated the effectiveness of different methods of acupuncture in the treatment of tinnitus due to neurological causes. In total, eight treatment methods were selected for this study: traditional acupuncture, electroacupuncture, moxibustion acupuncture, medicine only without acupuncture, traditional acupuncture with supplementary medicine, electroacupuncture with supplementary medicine, moxibustion acupuncture with supplementary medicine, and an electroacupuncture and moxibustion acupuncture combination. All sample data come from the results of clinical treatment studies.|
+^Methods| Both Chinese- and English-language online databases were searched. The Chinese language databases included the Wanfang database, the China National Knowledge Infrastructure (CNKI) database, and the VIP Chinese Science and Technique Journals database. The English language databases included PubMed, Web of Science, Embase and Cochrane Library. After the previously mentioned eight interventions for the treatment of neurological tinnitus were tested in a randomized controlled trial (RCT), the data were extracted, and the effectiveness of each intervention was evaluated. A meta-analysis was performed using Stata14.0 and GeMTC 0.14.3 statistical software.|
+^Results| A total of **40 studies** were included, which contained a total of **3657 patients** and 8 intervention methods. There was a trend of greater effectiveness of moxibustion acupuncture, followed by moxibustion acupuncture combined with electroacupuncture, moxibustion acupuncture combined with supplementary medicine, acupuncture combined with drugs, electroacupuncture with supplementary medicine, electroacupuncture, traditional acupuncture, and medicine only without acupuncture. There was no significant difference between the results of indirect comparisons and direct comparisons.|
+^Conclusions| Eight interventions are all effective in the treatment of neurological tinnitus, but moxibustion acupuncture seems to be a better trend treatment for tinnitus.|
+===== Overview of systematic reviews =====
+==== Xu 2022 ====
+Xu X, Xie H, Liu Z, Guo T, Zhang Y. Effects of acupuncture on the outcome of tinnitus: An overview of systematic reviews. Front Neurol. 2022 Nov 18;13:1061431. https://doi.org/10.3389/fneur.2022.1061431
+^Background|eatment, we assessed the methodological quality, reporting quality, and evidence quality of systematic reviews/meta-analyses (SRs/MAs) of acupuncture in the treatment of tinnitus.|
+^Methods| From inception to March 2022, we conducted a detailed and comprehensive search of eight electronic databases in Chinese and English. The Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) were used to assess methodological quality, reporting quality and evidence quality for inclusion in SRs/MAs, respectively.|
+^Results| **Fourteen published SRs/Mas** met the inclusion criteria and were included in the study. Eleven studies reported that acupuncture was effective in treating tinnitus, and three studies reported that no firm conclusions could be drawn about the effectiveness of acupuncture in treating tinnitus. The results of the AMSTAR-2 assessment showed that the methodological quality of the included studies was relatively low in general, with one being moderate quality and the rest being very low quality. The PRISMA checklist evaluation results showed that no studies fully report checklists, with protocol registration and search strategies being the main reporting weaknesses. The GRADE assessment showed that no results were high-quality evidence, 17 results were moderate-quality evidence, 25 results were low-quality evidence, and 12 results were very low-quality evidence.|
+^Conclusion|Acupuncture seems to be a positive and effective treatment for tinnitus. However, the methodological quality and quality of evidence for SRs/MAs in the included studies were generally low, and this result must be viewed with caution. Therefore, more high-quality, large-scale, multi-center randomized controlled trials are needed in the future to verify the effectiveness of acupuncture in the treatment of tinnitus.|
+===== Clinical Practice Guidelines =====
+| ⊕ positive recommendation (regardless of the level of evidence reported) \\ Ø negative recommendation (or lack of evidence) |
+==== Department of Veterans Affairs and the Department of Defense (VA/DoD, USA) 2024 Ø ====
+VA/DoD Clinical Practice Guideline. Tinnitus. 2024. Washington, DC: U.S. Government Printing Office. https://www.healthquality.va.gov/guidelines/CD/tinnitus/VADoD-CPG-Tinnitus-Full-CPG-2024_Final_508.pdf
+| There is insufficient evidence to recommend for or against acupuncture for tinnitus management. Strength : Neither for nor against. Category :  Reviewed, New-added |
+==== German Society for Otorhinolaryngology, Head and Neck Surgery e. V. (DGHNO-KHC, Germany) 2022 Ø ====
+Mazurek B, Hesse G, Sattel H, Kratzsch V, Lahmann C, Dobel C. S3 Guideline: Chronic Tinnitus : German Society for Otorhinolaryngology, Head and Neck Surgery e. V. (DGHNO-KHC). HNO. 2022 Nov;70(11):795-827.  https://doi.org/10.1007/s00106-022-01207-4
+| 4.1.11 Acupuncture Evidence-based recommendation (Electro)acupuncture should not be practiced for chronic tinnitus. Strength of evidence: 1c(no proof of efficacy); level of recommendation: recommendation Classification of consensus strength: strong consensus (100%) Based on RCTs, there is no evidence that acupuncture or electroacupuncture have proven efficacy on tinnitus. There is moderate evidence that they can improve comorbidities such as tension or pain with a possible positive effect on tinnitus.|
+==== Multidisciplinary European Guideline for Tinnitus (Europe) 2019 Ø ====
+Cima RFF, Mazurek B, Haider H, Kikidis D, Lapira A, Noreña A, Hoare DJ. A multidisciplinary European guideline for tinnitus: diagnostics, assessment, and treatment. HNO. 2019 Mar;67(Suppl 1):10-42. https://doi.org/10.1007/s00106-019-0633-7
+|NO RECOMMENDATION. There is evidence for safety but little high-level evidence for the effectiveness of acupuncture. Recommendation is based on systematic review.|
+==== Japan Audiological Society (JAS, Japan) 2019  Ø ====
+  * Japan Audiological Society. [Clinical Practice Guidelines For the Diagnosis and Management of Tinnitus 2019] . Tokyo: Kanehara Co. Ltd.; 2019 [in Japanese] .
+//Cited by// Okawa Y, Yamashita H, Masuyama S, Fukazawa Y, Wakayama I. Quality assessment of Japanese clinical practice guidelines including recommendations for acupuncture. Integr Med Res. 2022 Sep;11(3):100838.  https://doi.org/10.1016/j.imr.2022.100838
+  * Ogawa K, Sato H, Takahashi M, et al. Clinical practice guidelines for diagnosis and treatment of chronic tinnitus in Japan. Auris Nasus Larynx 2020;47:1–6. https://doi.org/10.1016/j.anl.2019.09.007
+| Tinnitus. Grade 2D: weak recommendation (NOT to use)|
 ==== National Institute for Health and Clinical Excellence (NICE, UK) 2017 Ø====
@@ Ligne 161: / Ligne 276: @@
+==== The Association of the scientific Medical Societies (AWMF, Germany) 2015 Ø ====
+Zenner HP, Delb W, Kröner-Herwig B, Jäger B, Peroz I, Hesse G, Mazurek B, Goebel G, Gerloff C, Trollmann R, Biesinger E, Seidler H, Langguth B. Zur interdisziplinären S3-Leitlinie für die Therapie des chronisch-idiopathischen Tinnitus [On the interdisciplinary S3 guidelines for the treatment of chronic idiopathic tinnitus]. HNO. 2015 Jun;63(6):419-27. German. https://doi.org/10.1007/s00106-015-0011-z
+The Association of the scientific Medical Societies (AWMF). German S3 Guideline: 017/064: Chronic tinnitus. 2015;(017/064 S3).
+| Acupuncture. There are no studies proving the effectiveness of acupuncture. |
 ==== American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF, USA) 2014 Ø ====
 Tunkel DE, Bauer CA, Sun GH, Rosenfeld RM, Chandrasekhar SS, Cunningham ER Jr, Archer SM, Blakley BW, Carter JM, Granieri EC, Henry JA, Hollingsworth D, Khan FA, Mitchell S, Monfared A, Newman CW, Omole FS, Phillips CD, Robinson SK, Taw MB, Tyler RS, Waguespack R, Whamond EJ. Clinical practice guideline: tinnitus. Otolaryngol Head Neck Surg. 2014 Oct;151(2 Suppl):S1-40.  {{:medias securises:acupuncture:evaluation:orl:tunkel-177432.pdf|[177432].}}
@@ Ligne 175: / Ligne 297: @@
 |Only single studies evaluated high-frequency electromagnetic energy, ACRN, and **acupuncture**. Based on single studies for each of these interventions, there is insufficient evidence to conclude whether these findings represent true effects.|
+===== Overviews of Clinical Practice Guidelines =====
+==== Meijers 2023 ====
+Meijers S, Stegeman I, van der Leun JA, Assegaf SA, Smit AL. Analysis and comparison of clinical practice guidelines regarding treatment recommendations for chronic tinnitus in adults: a systematic review. BMJ Open. 2023 Sep 15;13(9):e072754. https://doi.org/10.1136/bmjopen-2023-072754
+|**Acupuncture** (6 out of 10 guidelines), dietary supplements (4 out of 10 guidelines), drug therapy (7 out of 10 guidelines),acoustic CR neuromodulation (4 out of 10 guidelines), rTMS (7 out of 10 guidelines),TDCS (5 out of 10) and NVS (3 out of 10 guidelines) were consistently not recommended by any guideline, with minimal differences in level of recommendation.|

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