Department of Acupuncture and Moxibustion, Hubei University of Chinese Medicine, Wuhan, 430061, China.
Department of Physical Medicine and Rehabilitation, Hubei Provincial Hospital of Integrated Chinese and Western Medicine, Wuhan, 430015, China.
Curr Med Sci. 2018 Dec;38(6):1109-1116. doi: 10.1007/s11596-018-1991-1. Epub 2018 Dec 7.
This study aimed to evaluate the clinical efficacy of acupuncture for intervening insulin resistance (IR) by meta-analysis of related randomized controlled trials (RCTs). Studies published prior to 31 January 2018 were searched on Pubmed, Medline, Cochrane Library, Embase databases and Chinese databases. Only RCTs, which examined acupuncture as the sole or adjunctive treatment for IR-related diseases, were included. The primary outcome was homeostasis model assessment for insulin resistance (HOMA-IR). The secondary outcomes consisted of fasting blood glucose (FBG), fasting insulin (FINS) and 2-h postprandial blood glucose (2h-PBG). The differences between groups were reported as mean differences (MD). All statistical analyses were performed using RevMan software 5.3. After carefully screening relevant studies, 9 RCTs involving 562 patients (279 in experimental group and 283 in control group) were enrolled in this study. The pooled results showed that acupuncture had significant effects on HOMA-IR (MD 0.70, 95% CI 0.04 to 1.35, P=0.04<0.05), FINS (MD 3.35 mU/L, 95% CI 1.99 to 4.7, P<0.001) and 2h-PBG (MD 1.03 mmol/L, 95% CI 0.25 to 1.82, P=0.01). However, the differences in FBG were not significant (MD 0.28 mmol/L, 95% CI-0.28 to 0.84, P=0.32>0.05). The present meta-analysis indicated that acupuncture can help to improve IR to a certain extent, which remains to be confirmed by further high-quality RCTs.
本研究旨在通过对相关随机对照试验（RCT）的荟萃分析评估针刺干预胰岛素抵抗（IR）的临床疗效。检索了 Pubmed、Medline、Cochrane Library、Embase 数据库和中文数据库中截至 2018 年 1 月 31 日之前发表的研究。仅纳入以针刺作为 IR 相关疾病的单一或辅助治疗的 RCT。主要结局为稳态模型评估的胰岛素抵抗（HOMA-IR）。次要结局包括空腹血糖（FBG）、空腹胰岛素（FINS）和餐后 2 小时血糖（2h-PBG）。组间差异以均数差（MD）表示。所有统计分析均使用 RevMan 软件 5.3 进行。仔细筛选相关研究后，共纳入 9 项 RCT，涉及 562 例患者（实验组 279 例，对照组 283 例）。汇总结果显示，针刺对 HOMA-IR（MD 0.70，95%CI 0.04 至 1.35，P=0.04<0.05）、FINS（MD 3.35 mU/L，95%CI 1.99 至 4.7，P<0.001）和 2h-PBG（MD 1.03 mmol/L，95%CI 0.25 至 1.82，P=0.01）均有显著影响。但 FBG 的差异无统计学意义（MD 0.28 mmol/L，95%CI-0.28 至 0.84，P=0.32>0.05）。本荟萃分析表明，针刺在一定程度上有助于改善 IR，但仍需进一步高质量 RCT 加以证实。
