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针刺治疗 2 型糖尿病:随机对照试验的系统评价和荟萃分析。

Acupuncture for type 2 diabetes mellitus: A systematic review and meta-analysis of randomized controlled trials.

机构信息

Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, China.

Institute of Basic Research for Clinical Medicine, China Academy of Chinese Medical Sciences, China.

出版信息

Complement Ther Clin Pract. 2019 Aug;36:100-112. doi: 10.1016/j.ctcp.2019.04.004. Epub 2019 Jul 2.

Abstract

BACKGROUND

Acupuncture has been used to treat type 2 diabetes (T2DM) for 2000 years and there are emerging clinical evidence and animal studies for its efficacy. However, we are unable to conclude the effectiveness and safety on this issue yet.

OBJECTIVES

To assess the effects and safety of acupuncture for T2DM.

METHODS

We systematically searched 5 databases and 2 clinical registry platforms from inception to 2018-6-4. RCTs for acupuncture or its variants compared with sham acupuncture or no acupuncture controls for T2DM were included. The primary outcomes were glycemic control and adverse events.

RESULTS

A total of 21 studies, which comprised a total of 1943 participants, were included in the final meta-analysis. Compared with sham acupuncture or no acupuncture plus baseline treatments, acupuncture plus baseline treatments yield reduction in FBG(MD 1.21 mmol/l, 95%CI 1.56 to 0.87), 2 h BG(MD 2.13 mmol/l, 95%CI 2.79 to 1.46), HA1c (MD 1.12%, 95%CI 1.62 to 0.62). Our results also show acupuncture can improve blood lipids and blood pressure control, and reduce weight.

CONCLUSIONS

As one type of multifactorial intervention, acupuncture could be recommended as a supplementary treatment in the management of T2DM, especially in those with obesity or metabolic disorders. However, due to the small sample size, poor methodological quality of trials reviewed, the amount of evidence is not fully convincing. There is a need for well-planned, long-term studies.

REGISTRATION

International Prospective Register of Systematic Reviews (Number CRD42018094573).

摘要

背景

针灸治疗 2 型糖尿病(T2DM)已有 2000 年的历史,其疗效有越来越多的临床证据和动物研究支持。然而,我们尚不能就此问题得出其有效性和安全性的结论。

目的

评估针灸治疗 T2DM 的效果和安全性。

方法

我们系统地检索了 5 个数据库和 2 个临床注册平台,检索时间从建库至 2018 年 6 月 4 日。纳入的研究为针灸或其变体与假针灸或无针灸对照治疗 T2DM 的 RCT。主要结局为血糖控制和不良事件。

结果

最终纳入 21 项研究,共 1943 名参与者,进行了荟萃分析。与假针灸或无针灸加基础治疗相比,针灸加基础治疗可降低空腹血糖(MD 1.21mmol/L,95%CI 1.56 至 0.87)、餐后 2 小时血糖(MD 2.13mmol/L,95%CI 2.79 至 1.46)、糖化血红蛋白(MD 1.12%,95%CI 1.62 至 0.62)。我们的研究结果还表明,针灸可以改善血脂和血压控制,减轻体重。

结论

作为一种多因素干预手段,针灸可作为 T2DM 治疗的辅助手段,特别是对于肥胖或代谢紊乱的患者。然而,由于样本量小,所评价试验的方法学质量较差,证据的数量还不完全有说服力。需要进行精心设计、长期的研究。

注册

国际前瞻性系统评价注册库(注册号 CRD42018094573)。

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