The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
Guangzhou University of Chinese Medicine, Guangzhou, China.
Medicine (Baltimore). 2021 Sep 24;100(38):e27050. doi: 10.1097/MD.0000000000027050.
The aim of this study was to determine the efficacy and safety of acupuncture treatment (AT) or acupuncture plus conventional medicine (CM) versus CM alone using a meta-analysis of all published randomized controlled trials (RCTs) for nonalcoholic fatty liver disease (NAFLD).
Eight databases were searched independently from inception to April 30, 2020. RCTs were included if they contained reports on the use acupuncture or the use of acupuncture combined with CM and compared with the use of CM. Summary odds ratio (OR) and 95% confidence intervals (CIs) were used to calculate the overall clinical efficacy. Secondary outcomes, namely aspartate aminotransferase, alanine aminotransferase, total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and body mass index, were calculated by mean difference with 95% CIs.
After the final screening, 8 RCTs with 939 patients were included. This meta-analysis showed that AT was superior to CM in improving overall clinical efficacy (OR = 3.19, 95% CI: 2.06-4.92, P < .00001). In addition, AT plus CM could significantly improve overall clinical efficacy compared to treatment with CM alone (OR = 5.11, 95% CI: 2.43-10.75, P < .0001). Moreover, the benefits were also demonstrated in other outcomes, including alanine aminotransferase, aspartate aminotransferase, total cholesterol, triglyceride, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol indexes. However, AT plus CM could not decrease body mass index levels in comparison with CM. The safety profile of Acupuncture therapy was satisfactory. Taichong, Zusanli, Fenglong, and Sanyinjiao were major acupoints on NAFLD treatment.
Acupuncture may be effective and safe for treatment of NAFLD. However, due to insufficient methodological quality and sample size, further high-quality studies are needed.
本研究旨在通过对所有已发表的非酒精性脂肪性肝病（NAFLD）随机对照试验（RCT）进行荟萃分析，确定针灸治疗（AT）或针灸加常规医学（CM）与单独 CM 相比的疗效和安全性。
从建库至 2020 年 4 月 30 日，独立检索 8 个数据库。纳入报告使用针灸或针灸联合 CM 与 CM 比较的 RCT。使用汇总优势比（OR）和 95%置信区间（CI）计算总体临床疗效。次要结局，即天冬氨酸转氨酶、丙氨酸转氨酶、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇和体重指数，通过均数差和 95%CI 计算。
最终筛选后，纳入 8 项 RCT，共 939 例患者。荟萃分析显示，AT 在改善总体临床疗效方面优于 CM（OR=3.19，95%CI：2.06-4.92，P<0.00001）。此外，AT 加 CM 与单独 CM 治疗相比，可显著改善总体临床疗效（OR=5.11，95%CI：2.43-10.75，P<0.0001）。此外，这些益处也在其他结局中得到体现，包括丙氨酸转氨酶、天冬氨酸转氨酶、总胆固醇、甘油三酯、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇指标。然而，与 CM 相比，AT 加 CM 并不能降低体重指数水平。针灸治疗的安全性良好。太冲、足三里、丰隆和三阴交是治疗 NAFLD 的主要穴位。
针灸可能对治疗 NAFLD 有效且安全。然而，由于方法学质量和样本量不足，需要进一步开展高质量的研究。
