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

--- acupuncture:evaluation:orl:02. acouphenes [16 Sep 2023 15:23]
Nguyen Johan [3.4. German interdisciplinary S3 guidelines (Germany) 2015 Ø]
+++ acupuncture:evaluation:orl:02. acouphenes [23 Jun 2025 07:14] (Version actuelle)
Nguyen Johan [1.2.3.1. Ji 2023]
@@ Ligne 6: / Ligne 6: @@
 ===== 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 |
 ==== 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 ===
@@ Ligne 24: / Ligne 31: @@
-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.
+<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.|
@@ Ligne 168: / Ligne 175: @@
-=== 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 176: / Ligne 187: @@
 ^ Results     | Eighty-nine studies were retrieved. After discarding 84 articles, five studies with 322 participants were identified. Assessment of the methodological quality of the studies identified weaknesses in all five studies. All studies were judged as having a high risk of selection and performance bias. The attrition bias was high in four studies. Incompleteness bias was low in all studies. Reporting bias was unclear in all studies. Because of the limited number of trials included and the various types of interventions and outcomes, we were unable to conduct pooled analyses.  |
 ^ 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.|
+=== Comparison of Acupuncture techniques ===
+== Ji 2023 ==
+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 =====
@@ Ligne 198: / Ligne 239: @@
 | ⊕ 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 ====
@@ Ligne 204: / Ligne 253: @@
 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] .
+  * 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)|
@@ Ligne 240: / Ligne 298: @@
-=====  Overviews of Clinical Practice Guidelines =====
+===== Overviews of Clinical Practice Guidelines =====
 ==== Meijers 2023 ====

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