Wu Cui, Li Yuandong, Piao Chunli, Wu Jiuru
College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China.
Department of Endocrinology, Shenzhen Hospital (Fu Tian) of Guangzhou University of Chinese Medicine, Shenzhen, China.
Iran J Public Health. 2024 Nov;53(11):2404-2418. doi: 10.18502/ijph.v53i11.16942.
This systematic review and meta-analysis aimed to explore the effectiveness of acupuncture for patients with diabetic nephropathy (DN).
Nine online databases were searched: China National Knowledge Infrastructure, China Science and Technology Journal Database, Wanfang Data Knowledge Service Platform, Chinese BioMedical Literature Database, China Clinical Trial Centre, Embase, PubMed, the Cochrane Library, and Web of Science. The search period was from the establishment of the database to 1 September 2023. The quality of the literature was evaluated using the Cochrane Risk of Bias Assessment Tool, and the data were analyzed using STATA/MP17 and Review Manager 5.3 software.
A total of 221 articles were identified, and 13 studies were included. The total sample size was 899, including 452 and 447 cases in the experimental and control groups, respectively. The meta-analysis showed that acupuncture combined with modern medical treatment was effective in improving urinary albumin excretion rate, 24 h urinary microalbumin, serum creatinine, blood urea nitrogen, fasting plasma glucose, 2 h post-prandial plasma glucose, total cholesterol, high-density lipoprotein cholesterol, hypersensitive C-reactive protein, and interleukin-6 in patients with DN. Adverse events were reported in only one trial; therefore, this review cannot yet conclude on the safety of acupuncture intervention in DN.
The clinical efficacy of acupuncture combined with modern medicine in DN is superior to that of modern medicine alone. To better evaluate the efficacy and safety of acupuncture intervention for DN, more rigorously designed large-sample, multicentre, randomized controlled trials are needed to provide evidence support in the future.
本系统评价和荟萃分析旨在探讨针刺对糖尿病肾病（DN）患者的疗效。
检索了9个在线数据库：中国知网、维普中文科技期刊数据库、万方数据知识服务平台、中国生物医学文献数据库、中国临床试验注册中心、Embase、PubMed、考克兰图书馆和Web of Science。检索时间为各数据库建库至2023年9月1日。采用Cochrane偏倚风险评估工具对文献质量进行评价，并使用STATA/MP17和Review Manager 5.3软件进行数据分析。
共检索到221篇文章，纳入13项研究。总样本量为899例，试验组和对照组分别为452例和447例。荟萃分析表明，针刺联合现代医学治疗能有效改善DN患者的尿白蛋白排泄率、24小时尿微量白蛋白、血清肌酐、血尿素氮、空腹血糖、餐后2小时血糖、总胆固醇、高密度脂蛋白胆固醇、超敏C反应蛋白和白细胞介素-6。仅1项试验报告了不良事件；因此，本评价尚不能得出针刺干预DN安全性的结论。
针刺联合现代医学治疗DN的临床疗效优于单纯现代医学治疗。为更好地评价针刺干预DN的疗效和安全性,未来需要更严格设计的大样本、多中心随机对照试验提供证据支持。
