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针刺与假针刺治疗单纯性肥胖的疗效比较:系统评价和荟萃分析。

Acupuncture versus sham acupuncture for simple obesity: a systematic review and meta-analysis.

机构信息

Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China.

The Affiliated Hospital, School of Medicine, UESTC, Chengdu Women's and Children's Central Hospital, Chengdu, China.

出版信息

Postgrad Med J. 2020 Apr;96(1134):221-227. doi: 10.1136/postgradmedj-2019-137221. Epub 2020 Feb 3.

Abstract

Obesity is a growing chronic health problem worldwide. Studies about acupuncture for obesity treatment are many. But there are some doubts about the effectiveness of acupuncture versus sham acupuncture in treating obesity due to its lack of medical evidence. Therefore, the aim of this study is to assess the efficacy of acupuncture for obesity treatment and provide clinic evidence. Four English databases (PubMed, EMBASE, Web of Science and Cochrane Central Register of Controlled Trials) and four Chinese databases (China National Knowledge Infrastructure, Chinese BioMedical Database, Chinese Scientific Journal Database and Wan-Fang Data) were searched from their receptions to August 2019. Randomized controlled trials (RCTs) using the comparison between acupuncture and sham acupuncture to treat simple obesity were included. The primary outcome of body mass index (BMI) would be used to measure the effect of acupuncture on obesity. According to the trial data extraction form based on the Cochrane Handbook, two reviewers separately extracted the data. Risk of bias of the RCTs was assessed by the Cochrane Risk of Bias Tool. The study included 8 RCTs with 403 patients. When compared with sham acupuncture, acupuncture showed obviously effect in BMI reduction (MD=1.0kg/m2, 95% CI=0.6 to 1.4, P<0.001). There was also significant reduction in body weight (MD=1.85kg, 95%CI=0.82 to 2.88, p<0.001), WC (MD=0.97cm, 95%CI=0.24 to 1.71, p=0.01) and body fat mass percentage (MD=1.01, 95%CI=0.25 to 1.77, p<0.05). However, WHR (MD=0.01, 95%CI=0 to 0.03, p>0.05) was not statistically and significantly different between the acupuncture and control groups. Adverse effects were reported in 3 studies. The review suggests that acupuncture is an effective therapy for simple obesity rather than a placebo effect. This potential benefit needs to be further evaluated by longer-term and more rigorous RCTs.

摘要

肥胖是一个在全球范围内日益严重的慢性健康问题。关于针灸治疗肥胖的研究很多。但是,由于缺乏医学证据,对于针灸与假针灸治疗肥胖的疗效存在一些质疑。因此,本研究旨在评估针灸治疗肥胖的疗效,并提供临床证据。检索了 4 个英文数据库(PubMed、EMBASE、Web of Science 和 Cochrane 中央对照试验注册库)和 4 个中文数据库(中国知网、中国生物医学文献数据库、中国科学引文数据库和万方数据),检索时间均从建库至 2019 年 8 月。纳入比较针灸与假针灸治疗单纯性肥胖的随机对照试验(RCT)。采用体重指数(BMI)作为主要结局来衡量针灸对肥胖的治疗效果。根据 Cochrane 手册制定的试验数据提取表,由 2 名评价员分别提取数据。采用 Cochrane 偏倚风险工具评估 RCT 的偏倚风险。本研究纳入了 8 项 RCT,共 403 名患者。与假针灸相比,针灸在 BMI 降低方面具有明显效果(MD=1.0kg/m2,95%CI=0.6 至 1.4,P<0.001)。体重(MD=1.85kg,95%CI=0.82 至 2.88,p<0.001)、腰围(MD=0.97cm,95%CI=0.24 至 1.71,p=0.01)和体脂百分比(MD=1.01,95%CI=0.25 至 1.77,p<0.05)也有显著降低。然而,针灸组与对照组的腰臀比(MD=0.01,95%CI=0 至 0.03,p>0.05)无统计学差异。有 3 项研究报告了不良反应。本综述表明,针灸是治疗单纯性肥胖的有效疗法,而不是安慰剂效应。这种潜在的益处需要通过更长期和更严格的 RCT 来进一步评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/125b/7146934/746505852885/postgradmedj-2019-137221f01.jpg

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