Liu Chunhui, Ao Youguang, Liu Baixue, Huang Juan, Wang Qi, Ao Xiaojing, Wang Xiongyao, Ban Xiufeng
College of Traditional Chinese Medicine, Inner Mongolia Medical University, Chilechuan Dairy Development Zone, Hohhot, China.
Medicine (Baltimore). 2025 May 2;104(18):e42272. doi: 10.1097/MD.0000000000042272.
Nonalcoholic fatty liver disease (NAFLD), the most common chronic liver ailment globally, remains a significant concern. Acupuncture has been increasingly utilized for the treatment of NAFLD in recent years. However, current evidence is insufficient to support its efficacy and safety. The aim of this study was to perform a recent and thorough meta-analysis concerning the impacts of acupuncture on NAFLD.
Randomized controlled trials (RCTs) investigating acupuncture for NAFLD were retrieved from 6 databases. The search encompassed the period from the inception of each database until February 28, 2024. We conducted literature screening based on predefined inclusion and exclusion criteria, resulting in the selection of 30 articles. Analysis of the data was carried out utilizing Review Manager 5.4 and Stata 15.1.
The meta-analysis revealed a marked enhancement in the overall clinical effectiveness rate within the acupuncture group in comparison to the control group (OR = 3.36; 95% CI:2.62 to 4.31; P < .00001, I2 = 0%). Acupuncture exhibited positive impact on liver function recovery, blood lipid reduction, glucose regulation, improvement in insulin levels, antiliver fibrosis treatment, and imaging outcomes. Comprehensive analysis revealed that acupoint embedding (OR = 3.14; 95% CI: 2.113 to 4.62; P < .00001, I2 = 0%) demonstrated the most effective and stable therapeutic effect, followed by manual acupuncture (MA) (OR = 3.27; 95% CI: 2.19 to 4.90; P < .00001, I2 = 0%) and electroacupuncture (EA) (OR = 3.32; 95% CI: 1.69 to 6.52; P < .0005, I2 = 0%). In contrast, acupoint injection (AI) (OR = 5.74; 95% CI: 2.23 to 14.883; P < .0003, I2 = 0%) exhibited relatively modest effects, particularly in lipid reduction. No significant adverse reactions were observed with acupuncture treatments.
Acupuncture has demonstrated safety and efficacy in the treatment of NAFLD, significantly improving hepatic function, lowering glucose and lipid levels, and mitigating liver fibrosis. Nevertheless, these findings necessitate validation through large-scale, rigorously designed randomized controlled trials.
非酒精性脂肪性肝病（NAFLD）是全球最常见的慢性肝病，仍然是一个重大问题。近年来，针灸越来越多地用于治疗NAFLD。然而，目前的证据不足以支持其有效性和安全性。本研究的目的是对针灸对NAFLD的影响进行最新、全面的荟萃分析。
从6个数据库中检索关于针灸治疗NAFLD的随机对照试验（RCT）。检索范围涵盖每个数据库创建之日至2024年2月28日。我们根据预先定义的纳入和排除标准进行文献筛选，最终选择了30篇文章。使用Review Manager 5.4和Stata 15.1进行数据分析。
荟萃分析显示，与对照组相比，针灸组的总体临床有效率显著提高（OR = 3.36；95%CI：2.62至4.31；P <.00001，I2 = 0%）。针灸对肝功能恢复、血脂降低、血糖调节、胰岛素水平改善、抗肝纤维化治疗和影像学结果均有积极影响。综合分析显示，穴位埋线（OR = 3.14；95%CI：2.113至4.62；P <.00001，I2 = 0%）显示出最有效和稳定的治疗效果，其次是手动针刺（MA）（OR = 3.27；95%CI：2.19至4.90；P <.00001，I2 = 0%）和电针（EA）（OR = 3.32；95%CI：1.69至6.52；P <.0005，I2 = 0%）。相比之下，穴位注射（AI）（OR = 5.74；95%CI：2.23至14.883；P <.0003，I2 = 0%）的效果相对较小，尤其是在降脂方面。针灸治疗未观察到明显不良反应。
针灸在治疗NAFLD方面已显示出安全性和有效性，可显著改善肝功能，降低血糖和血脂水平，并减轻肝纤维化。然而，这些发现需要通过大规模、严格设计的随机对照试验进行验证。
