Huang Fan, Xie Yumin, Zhao Siyi, Feng Zitong, Chen Guizhen, Xu Yunxiang
Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, China.
The Bao'an District TCM Hospital, The Affiliated Hospital of Guangzhou University of Chinese Medicine, Shenzhen, 518133, Guangdong, China.
Evid Based Complement Alternat Med. 2019 Aug 14;2019:2673763. doi: 10.1155/2019/2673763. eCollection 2019.
To evaluate the effectiveness and safety of acupoint catgut embedding therapy (ACET) in postmenopausal osteoporosis (PMOP).
Review of some databases from their inception to June 2018 and randomized controlled trials (RCTs) in which ACET with PMOP were included. Two researchers extracted and evaluated the information independently. Cochrane Collaboration's tool and Jadad scale were used to evaluate the quality of the studies. RevMan V.5.3.3 software was used to carry out the meta-analysis while trial sequential analysis (TSA) performed with TSA 0.9 software.
12 RCTs with 876 participants were included in this review. Meta-analysis showed that ACET alone was not superior to medication in effectiveness rate (RR= 1.11; 95% CI (0.89, 1.40); =0.35) and E2 (SMD= 0.20; 95% CI (-0.17, 0.57); 0.28; =20%) while ACET combining medication was more effective on the effectiveness rate (RR= 1.32; 95% CI (1.20, 1.46); <0.000 01) and E2 (SMD= 1.24; 95% CI (0.63, 1.84); <0.0001). Additionally, ACET combining calcium could increase the bone mineral density (BMD) of the L2~4 vertebrae and femur-neck [WMD = 0.03; 95% CI (0.01, 0.05); =0.003; and WMD = 0.07; 95% CI (0.03, 0.10); = 0.0006], reduce TCM syndrome score [WMD = -1.85; 95% CI (-2.13, -1.57); <0.000 01], improve patient's quality of life [WMD = 6.90; 95% CI (3.90, 9.89); <0.000 01; and WMD = 12.34; 95% CI (5.09, 19.60); =0.0009], and relieve pain [WMD = -1.26; 95% CI (-1.66, -0.85); <0.000 01; and WMD = -2.59; 95% CI (-4.76, -0.43); = 0.02]. The TSA showed that the effectiveness of ACET for PMOP was demonstrated accurately.
ACET combining medication but not ACET alone is more effective than medication as comparison in the treatment of PMOP. As a novel treatment, ACET shows the potential of effectiveness and deserves further high quality of well-designed study.
评估穴位埋线疗法（ACET）治疗绝经后骨质疏松症（PMOP）的有效性和安全性。
检索自建库至2018年6月的一些数据库，并纳入采用ACET治疗PMOP的随机对照试验（RCT）。两名研究人员独立提取和评估信息。采用Cochrane协作网工具和Jadad量表评估研究质量。使用RevMan V.5.3.3软件进行荟萃分析，同时使用TSA 0.9软件进行试验序贯分析（TSA）。
本综述纳入了12项RCT，共876名参与者。荟萃分析表明，单独使用ACET在有效率（RR = 1.11；95%CI（0.89，1.40）；P = 0.35）和雌二醇（E2）水平（SMD = 0.20；95%CI（-0.17，0.57）；P = 0.28；I² = 20%）方面并不优于药物治疗，而ACET联合药物治疗在有效率（RR = 1.32；95%CI（1.20，1.46）；P < 0.00001）和E2水平（SMD = 1.24；95%CI（0.63，1.84）；P < 0.0001）方面更有效。此外，ACET联合钙剂可提高L2~4椎体和股骨颈的骨密度[WMD = 0.03；95%CI（0.01，0.05）；P = 0.003；以及WMD = 0.07；95%CI（0.03，0.10）；P = 0.0006]，降低中医证候评分[WMD = -1.85；95%CI（-2.13，-1.57）；P < 0.00001]，改善患者生活质量[WMD = 6.90；95%CI（3.90，9.89）；P < 0.00001；以及WMD = 12.34；95%CI（5.09，19.60）；P = 0.0009]，并缓解疼痛[WMD = -1.26；95%CI（-1.66，-0.85）；P < 0.00001；以及WMD = -2.59；95%CI（-4.76，-0.43）；P = 0.02]。TSA表明，ACET治疗PMOP的有效性得到了准确验证。
与药物治疗相比，ACET联合药物治疗而非单独使用ACET在治疗PMOP方面更有效。作为一种新型治疗方法，ACET显示出有效性潜力，值得进一步开展高质量的精心设计研究。
