山东中医杂志2018，Vol.37Issue(4)：282-288,7.DOI:10.16295/j.cnki.0257-358x.2018.04.006
针灸干预糖尿病前期系统评价
Systematic Review of Interventional Effect of Acupuncture and Moxibustion on Impaired Glucose Regulation
摘要
Abstract
Objective:To systematically assess the efficacy and safety of acupuncture and moxibustion on im-paired glucose regulation. Methods:The databases of CNKI,VIP,WanFang,CBM,PubMed,EMbase,Clinical-trails.gov and the Cochrane Library were searched to identify all published randomized controlled trials (RCTs) on acupuncture and moxibustion for treatment of impaired glucose regulation(IGR)from the database inception date to November 8,2016. Eligible studies were included. The Cochrane Risk of Bias tool was used to evaluate the methodological quality of the eligible studies. The statistical analysis was performed by Review Manager 5.3. Results:Eleven RCTs with 970 participants were included. The methodological quality of the included studies was generally low. Six trials reported that its random sequence was generated by a random number table and one trial described the allocation concealment and blinding of outcome assessment. Publication bias was assessed by the funnel plot based on fasting plasma glucose(FPG) reported in the 11 trials. The funnel plot was asymmetrical,indicating that potential publication bias might influence the results of this review. Three trials reported the effect of acupuncture and moxibustion on improving glucose tolera-tion. Two of the three trials showed that acupuncture and moxibustion could promote the normalization of glucose toleration,but the remaining one reported that there was no statistically significant difference be-tween acupuncture plus lifestyle interventions and lifestyle interventions alone in improv ing glucose toleration(P<0.05). This review also showed that acupuncture and moxibustion were probably associ-ated with the improvement of FPG and 2 h post-prandial blood glucose(2 h PG). In view of the li-mited number of included studies and the signifi-cant heterogeneity among these trials,the review couldn't assess the effects of acupuncture and moxibustion on improving blood glucose,hemoglobin A1c(HbA1c),body mass index(BMI) and insulin resistance. Only one trial clearly reported that no adverse reactions occurred in the trial. Sensitivity analysis and Meta-analy-sis were not performed due to generally poor methodological quality ,potential publication bias and the variety of clinical interventions. Conclusions:Acupuncture and moxibustion appears to play a role in the treatment of impaired glucose regulation,however,a firm conclusion about the efficacy and safety can not be drawn from this review due to the generally low methodological quality and small sample size. More evidence from high quality trials is needed to support the clinical use of acupuncture and moxibustion.关键词
针灸/糖尿病前期/糖耐量/空腹血糖/系统评价Key words
acupuncture and moxibustion/impaired glucose regulation/glucose toleration/fasting plasma glucose/systematic review分类
医药卫生引用本文复制引用
史丽伟,倪青,李晓文,杜立娟..针灸干预糖尿病前期系统评价[J].山东中医杂志,2018,37(4):282-288,7.基金项目
首都卫生发展科研专项项目(编号:首发2016-1-4151) （编号:首发2016-1-4151）
北京市自然科学基金项目(编号:7182143) （编号:7182143）
