针灸治疗单纯性肥胖效果的Meta分析  

Meta Analysis on Efficacy of Acupuncture in the Treatment of Simple Obesity

作　　者：潘珺俊[1] 范肃[1] 张振宇[1] PAN Junjun;FAN Su;ZHANG Zhenyu(Wangjing Hospital, Chinese Academy of Chinese Medical Sciences, Beijing 100102, China)

机构地区：[1]中国中医科学院望京医院,北京100102

出　　处：《针灸临床杂志》2020年第8期54-61,共8页Journal of Clinical Acupuncture and Moxibustion

基　　金：中国中医科学院望京医院课题,编号:WJYY2018-18;北京市中医管理局“北京市第二批中医住院医师规范化培训三优教学团队”项目,编号:京中医科字2017-126号。

摘　　要：目的:对单纯性肥胖患者针灸减肥效果进行Meta分析。方法:系统性检索中文和英文文献数据库,获取以伪针灸为对照的针灸减肥效果随机对照试验。通过计算肥胖相关人体测量指标、激素指标以及生化指标的加权均数差(WMD)和95%CI评估干预效果差异。结果:纳入16项研究共计1109名单纯性肥胖患者。合并分析表明,针灸比伪针灸能更有效降低体质量(WMD=-1.44,95%CI=-2.26 to-0.63,P<0.001)、BMI(WMD=-0.61,95%CI=-2.26 to-0.63,P<0.001)和腰围(WMD=-2.03,95%CI=-3.26 to-0.79,P=0.001)。针灸还可显著降低瘦素水平(WMD=-2.78,95%CI=-5.13 to-0.43,P=0.021),但对其他肥胖相关激素无显著影响。针灸仅产生少量轻微不良反应,无严重不良反应。亚组分析表明,耳针、针刺和穴位埋线法均具有减肥效果。结论:本研究仅纳入以伪针灸为对照的临床随机对照试验,降低了安慰剂效应。与伪针灸相比针灸减肥效果更有效,但其长期治疗效果还需进一步研究。Objective:To investigate the effect of acupuncture in the treatment of simple obesity by meta-analysis.Methods:Chinese and English electronic databases were systematically searched to review RCTs,which investigated the effect of acupuncture on simple obesity and using sham acupuncture as control.The difference of treatment effect between acupuncture and sham acupuncture was assessed by calculating the weighted mean difference(WMD)and 95%CI of obesity-related anthropometric,hormone and biochemical indexes.Results:A total of 16 studies comprising 1,109 patients with simple obesity were included.Results of pooling analysis showed that acupuncture intervention could more effectively reduce body weight(WMD=-1.44,95%CI=-2.26 to-0.63,P<0.001),BMI(WMD=-0.61,95%CI=-2.26 to-0.63,P<0.001)and waist circumference(WMD=-2.03,95%CI=-3.26 to-0.79,P=0.001)compared to sham acupuncture.In addition,acupuncture could reduce leptin level(WMD=-2.78,95%CI=-5.13 to-0.43,P=0.021)but had no effect on the other obesity-related hormones.Only a small number of mild adverse events occurred and no serious adverse events happened.Subgroup analysis showed that auricular acupuncture,body acupuncture and acupoint catgut embedding were all effective in reducing weight.Conclusion:The present meta-analysis only included RCTs using sham acupuncture as controls,so as to reduce the placebo effects.The results demonstrated the effectiveness of acupuncture on reducing weight and the long-term effect needs further investigation.

关 键 词：针灸 伪针灸 单纯性肥胖 META分析 

分 类 号：R246.1[医药卫生—针灸推拿学]