针刺治疗胰岛素抵抗的作用：系统评价和荟萃分析。
Role of acupuncture in the treatment of insulin resistance: A systematic review and meta-analysis.
机构信息
Clinical Research Center, South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510006, China.
Department of Integrated Traditional Chinese and Western Medicine, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, 510405, Guangzhou, Guangdong, China.
出版信息
Complement Ther Clin Pract. 2019 Nov;37:11-22. doi: 10.1016/j.ctcp.2019.08.002. Epub 2019 Aug 5.
BACKGROUND
and purpose Acupuncture has gained increasing attention in the treatment of insulin resistance (IR). This study systematically reviews the efficacy of acupuncture on clinical IR outcomes.
METHODS
Cochrane Central Register of Controlled Trials, Embase, Medline (via OVID), China National Knowledge Infrastructure (CNKI), Wan Fang and China Science and Technology Journal Database (VIP) were searched to collect randomized controlled trials (RCTs) of patients with IR treated by acupuncture. Meta-analysis was performed by RevMan 5.3.
RESULTS
With acupuncture, the homeostasis model assessment of insulin resistance (homa-IR) significantly decreased (mean difference (MD) = -1.04, 95% confidence interval (CI) -1.37 to -0.71; P < 0.00001), as did fasting blood glucose (FBG) (MD = -0.56, 95% CI -0.88 to -0.25; P = 0.0005), 2 h postprandial blood glucose (2hPG) (MD = -0.91, 95% CI -1.62 to -0.20; P = 0.01), and fasting insulin (FINS) (MD = -3.23, 95% CI -4.14 to -2; P < 0.00001). Meanwhile, the insulin sensitivity index (ISI) (MD = 0.36, 95% CI 0.18 to 0.53; P < 0.0001) increased, and fewer adverse events occurred.
CONCLUSION
Acupuncture may improve homa-IR, ISI, FBG, 2hPG and FINS with fewer adverse events than other treatments, making it a viable treatment for IR.
背景
目的 针灸在治疗胰岛素抵抗（IR）方面受到越来越多的关注。本研究系统评价了针灸治疗临床 IR 结局的疗效。
方法
检索 Cochrane 中央对照试验注册库、Embase、Medline（通过 OVID）、中国知网（CNKI）、万方和中国科技期刊数据库（VIP），收集针灸治疗 IR 患者的随机对照试验（RCT）。采用 RevMan 5.3 进行 Meta 分析。
结果
针灸可显著降低稳态模型评估的胰岛素抵抗（homa-IR）（均数差（MD）= -1.04，95%置信区间（CI）-1.37 至 -0.71；P < 0.00001），空腹血糖（FBG）（MD = -0.56，95% CI -0.88 至 -0.25；P = 0.0005），餐后 2 小时血糖（2hPG）（MD = -0.91，95% CI -1.62 至 -0.20；P = 0.01）和空腹胰岛素（FINS）（MD = -3.23，95% CI -4.14 至 -2；P < 0.00001）。同时，胰岛素敏感性指数（ISI）（MD = 0.36，95% CI 0.18 至 0.53；P < 0.0001）增加，不良反应发生较少。
结论
与其他治疗方法相比，针灸可能改善 homa-IR、ISI、FBG、2hPG 和 FINS，且不良反应较少，是治疗 IR 的一种可行方法。
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