Yan Wen-Li, Kan Zun-Qi, Wang Li-Qiong, Yu Zhen-Ping, Liu Cun-Zhi, Yan Shi-Yan, Yang Na-Na
International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, PR China.
Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, PR China.
Integr Med Res. 2025 Jun;14(2):101148. doi: 10.1016/j.imr.2025.101148. Epub 2025 Apr 23.
The purpose of this study was to conduct a network meta-analysis (NMA) comparing the effectiveness and safety of traditional acupuncture with metformin. This study aims to identify an effective and safe alternative treatment for women with polycystic ovary syndrome (PCOS) complicated by insulin resistance (IR).
We searched PubMed, EMBASE, Web of Science, Cochrane, ClinicalTrials.gov, and relevant citations for eligible randomized controlled trials (RCTs) published up to August 12, 2024. Data extraction and bias assessment were performed by two independent reviewers, and Bayesian NMA was performed using the GeMTC package, with a random effects model. The NMA compared the effectiveness and safety of acupuncture with metformin which were measured using the Homeostasis Model Assessment Insulin Resistance (HOMA-IR) index, fasting plasma glucose, fasting insulin, and the incidence of adverse events (AEs).
We included 12 RCTs ( = 870). Four RCTs compared acupuncture with metformin, six compared metformin with control interventions (blank control or placebo), and two compared acupuncture with sham acupuncture. Acupuncture (Mean difference (MD): -0.76, 95 % credible interval (CrI): -1.42, -0.03) and metformin (MD: -0.74, 95 % CrI: -1.28, -0.17) significantly reduced the IR level (HOMA-IR). No statistical difference was observed between both treatment methods in improving glucose metabolism; however, acupuncture had fewer AEs (risk ratio: 0.13, 95 % CrI: 0.01, 0.68). Acupuncture all ranked high in terms of surface under the cumulative ranking curve across all outcomes, thus demonstrating better effectiveness and safety potential.
Acupuncture may be a potential alternative for PCOS women with IR, as it is equally effective, easier to perform, and relatively safer than metformin. Further trials are necessary to confirm these findings owing to the current lack of sufficient evidence.: PROSPERO, CRD42024581934.
本研究旨在进行一项网状Meta分析（NMA），比较传统针灸与二甲双胍的有效性和安全性。本研究旨在为患有多囊卵巢综合征（PCOS）并伴有胰岛素抵抗（IR）的女性确定一种有效且安全的替代治疗方法。
我们检索了PubMed、EMBASE、Web of Science、Cochrane、ClinicalTrials.gov以及相关参考文献，以获取截至2024年8月12日发表的符合条件的随机对照试验（RCT）。由两名独立的评审员进行数据提取和偏倚评估，并使用GeMTC软件包进行贝叶斯NMA，采用随机效应模型。NMA比较了针灸与二甲双胍的有效性和安全性，有效性和安全性通过稳态模型评估胰岛素抵抗（HOMA-IR）指数、空腹血糖、空腹胰岛素以及不良事件（AE）发生率来衡量。
我们纳入了12项RCT（n = 870）。四项RCT将针灸与二甲双胍进行了比较，六项将二甲双胍与对照干预措施（空白对照或安慰剂）进行了比较，两项将针灸与假针灸进行了比较。针灸（平均差（MD）：-0.76，95%可信区间（CrI）：-1.42，-0.03）和二甲双胍（MD：-0.74，95% CrI：-1.28，-0.17）均显著降低了IR水平（HOMA-IR）。在改善糖代谢方面，两种治疗方法之间未观察到统计学差异；然而，针灸的不良事件较少（风险比：0.13，95% CrI：0.01，0.68）。在所有结局的累积排序曲线下面积方面，针灸均排名靠前，因此显示出更好的有效性和安全性潜力。
针灸可能是患有IR的PCOS女性的一种潜在替代疗法，因为它与二甲双胍同样有效，操作更简便，且相对更安全。由于目前缺乏足够的证据，需要进一步试验来证实这些发现。：PROSPERO，CRD42024581934
