温针灸与其他针灸方法治疗原发性肥胖症疗效比较的Meta分析

Efficacy difference between warming acupuncture and other acupuncture methods for primary obesity:a Meta-analysis

目的:系统评价温针灸与其他针灸方法治疗原发性肥胖症的疗效差异。方法:计算机检索Pub Med、荷兰医学文献数据库(EMBASE)、Cochrane图书馆(CENTRAL)、护理学数据库(CINAHL)、替代医学全文数据库(Alt Health Watch)、中国期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、万方数据库、维普期刊数据库(VIP),时限为从建库至2017年10月4日。纳入比较温针灸与其他针灸方法治疗原发性肥胖症的随机对照试验(RCT)。分类和连续型变量分别用相对危险度(RR)和加权均数差(WMD)为合并效应量。结果:纳入13篇文献,共878例患者。Meta分析结果显示:与其他针灸相比,温针灸可降低更多体重(WMD=-1.49 kg,95%CI-2.53^-0.45,P=0.005)、提高治疗总有效率(RR=1.16,95%CI 1.09~1.24,P<0.000 01)、减小BMI(WMD=-1.24 kg/m^2,95%CI-2.34^-0.14,P=0.03)、腰围(WMD=-1.65 cm,95%CI-2.53^-0.76,P=0.02)和臀围(WMD=-2.86 cm,95%CI-4.37^-1.35,P=0.000 2);但对总胆固醇无显著影响(WMD=-0.05 mmol/L,95%CI-0.98~0.88,P=0.91)。结论:温针灸治疗原发性肥胖疗效优于其他针灸,但对血脂指标影响较小。

Objective To systematically evaluate the efficacy difference between warming acupuncture and other acupuncture methods in the treatment of primary obesity. Methods A computer-based retrieval was conducted at Pub Med, EMBASE, CENTRAL, CINAHL, Alt Health Watch, CNKI, CBM, WANFANG database and VIP database. Retrieval time was from the establishment date of database to October 4, 2017. Randomized controlled trial（RCT） of warming acupuncture comparing with other acupuncture methods for the treatment of primary obesity were included. The relative risk（RR） and weighted mean difference（WMD） were used as combined effects for categorical variables and continuous variables, respectively. Results Totally 13 RCTs were included involving 878 patients. The Meta-analysis indicated compared with other acupuncture methods, warming acupuncture could more reduce weight（WMD ：-1.49 kg, 95% CI：-2.53 to-0.45, P=0.005）, improve the total effective rate（RR=1.16, 95% CI： 1.09 to 1.24, P〈0.000 01）, reduce BMI（WMD ：-1.24 kg/m, 95% CI：-2.34 to-0.14, P=0.03）, reduce waist circumference（WMD ：-1.65 cm, 95% CI：-2.53 to-0.76, P=0.02） and reduce hip circumference（WMD ：-2.86 cm, 95% CI：-4.37 to-1.35, P=0.000 2）, but had no significant influence on total cholesterol（WMD ：-0.05 mmol/L, 95% CI：-0.98 to 0.88, P=0.91）. Conclusion The warming acupuncture has better efficacy on primary obesity than other acupuncture methods, but less effects on lipid indicators.