Systematic review and Meta-analysis of acupuncture and acupoint catgut embedding for the treatment of abdominal obesity

doi:10.19852/j.cnki.jtcm.2022.06.002

Abstract

Abstract:

OBJECTIVE: To systematically review and analyze the effect of acupuncture and acupoint catgut embedding in treatment of abdominal obesity to provide a more reasonable clinical treatment regimen.

METHODS: Ten databases were searched as of August 2022: the English databases PubMed, Embase, Cochrane Library, Web of Science, Wiley, and Scopus and the Chinese databases China National Knowledge Infrastructure Database, China Science and Technology Journal Database, Wanfang, and SinoMed/Chinese Biomedical Literature Database. Randomized controlled trials (RCTs) of acupuncture and acupoint catgut embedding as the main interventions to treat abdominal obesity were extracted. The investigators imported the citations into EndNote version X9.1 for deduplication, screening, extraction, and integration. The risk of bias in the included RCTs was assessed according to the Cochrane Handbook. RevMan 5.4 software was used to conduct a Meta-analysis of RCTs that met the inclusion criteria.

RESULTS: Thirteen RCTs (1069 patients) were included in this study, and the data of eleven RCTs (966 patients) were include in the Meta-analysis. The results showed that acupoint catgut embedding can significantly change the weight and waist circumference of patients with abdominal obesity when compared to sham acupuncture or no treatment [mean difference (MD) = 2.32, 95% confidence interval (CI) (1.88, 2.76), P < 0.000 01], [MD = 3.47, 95% CI (1.99, 4.94), P < 0.000 01]. The change in hip circumference after acupuncture was also significant [MD = 0.89, 95% CI (0.12, 1.66), P = 0.02].

CONCLUSION: This study found that acupuncture and acupoint catgut embedding can effectively treat abdominal obesity, therefore, these interventions can be used as clinical supplements and alternative therapies. The diagnostic criteria of the existing studies and the intervention measures of the control group are not unified. It will be necessary to improve the clinical study protocols and expand the sample size to further validate the reliability of the results obtained of this study.

Key words: obesity, abdominal, acupuncture, acupoint catgut embedding, Meta-analysis, systematic review

YE Wujie, XING Jingyu, YU Zekai, HU Xingang, ZHAO Yan. Systematic review and Meta-analysis of acupuncture and acupoint catgut embedding for the treatment of abdominal obesity[J]. Journal of Traditional Chinese Medicine, 2022, 42(6): 848-857.

Figures/Tables 6

References 67

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Study	Patients		Gender	Average age	Interventions	Treatment time	Outcomes	Adverse Events			Follow-up
Study	(T/C)	(male/female)		(years)	Treatment / Control	Treatment time	Outcomes	Adverse Events			Follow-up
Liang CM et al 2016³¹	50/23		21/52	T: 47.7±11.0 C: 49.4±11.4	Acupuncture, 3 times a week Health education	8 weeks	weight; BMI; WC; HC		None	None
Qin WL et al 2016³²	58/54		33/79	T: 42.14±11.83 C: 39.13±11.13	Catgut embedding, once a week Sham acupuncture	4 weeks	weight; BMI; WC		None	None
Xiong W 2019³³	31/32		12/51	T: 33.16±6.99 C: 33.00±6.75	Acupuncture, once a day, 2 d off after 5 d Oral orlistat, 1 tablet each time, t.i.d	28 days	weight; WHR		Mentioned	None
Wu KQ 2019³⁴	33/33		35/31	T: 35.61±8.24 C: 32.24±6.58	Acupuncture, twice a week Auricular point bean	4 weeks	weight; WC; HC; BMI; WHR; WHtR		None	Mentioned
Zhang XH 2020³⁵	25/25		20/30	T: 36.6±8.1 C: 36.4±7.9	Catgut embedding, once every 2 weeks Oral Chinese medicine, 1 dose per day	6 weeks	weight; WC; HC; BMI; WHR;		None	None
Song YX et al 2018³⁶	200/100		0/300	T: 33.2±2.6 C: 33.5±2.5	Catgut embedding, once every 2 weeks Tuina, once a day	8 weeks	weight; WC; WHR; BMI		Mentioned	None
Jin YH 2019³⁷	33/32		13/52	T: 34.58±9.95 C: 35.47±8.89	Catgut embedding, once every 2 weeks Sham acupuncture	8 weeks	weight; WC; HC		Mentioned	None
Meng JQ 2019³⁸	35/34		10/59	T: 36.51±10.13 C: 36.44±9.66	Catgut embedding, once every 2 weeks Sham acupuncture	8 weeks	weight; BMI; WC; HC		Mentioned	None
Pan XW 2017³⁹	26/24		16/34	T: 35.88±8.65 C: 37.62±8.84	acupuncture, 3 times a week Sham acupuncture	12 weeks	weight; WC; HC; BMI; WHR		Mentioned	Mentioned
Deng LJ, et al 2014⁴⁰	30/30		5/55	T: 33±8 C: 32±7	Catgut embedding, once a week no treatment	9 weeks	weight; WC		None	None
Chen LS et al 2019⁴¹	28/23		/	T: 34.43±7.63 C: 34.60±5.21	Catgut embedding, Once every 10 d no treatment	10 weeks	weight; BMI; WC; HC; WHR; WtHR		None	None
Chen IJ et al 2018⁴²	40/40		/	T: 39.9±9.8 C: 43.7±9.3	Catgut embedding, once a week Sham acupuncture	6 weeks	weight; WC; HC; WHR		None	None
Lei H et al 2017⁴³	15/15		/	T: 31.6±8.2 C: 31.4±8.4	Acupuncture, 3 times a week no treatment	12 weeks	BMI; WC		None	None

Study	Patients		Gender	Average age	Interventions	Treatment time	Outcomes	Adverse Events			Follow-up
Study	(T/C)	(male/female)		(years)	Treatment / Control	Treatment time	Outcomes	Adverse Events			Follow-up
Liang CM et al 2016³¹	50/23		21/52	T: 47.7±11.0 C: 49.4±11.4	Acupuncture, 3 times a week Health education	8 weeks	weight; BMI; WC; HC		None	None
Qin WL et al 2016³²	58/54		33/79	T: 42.14±11.83 C: 39.13±11.13	Catgut embedding, once a week Sham acupuncture	4 weeks	weight; BMI; WC		None	None
Xiong W 2019³³	31/32		12/51	T: 33.16±6.99 C: 33.00±6.75	Acupuncture, once a day, 2 d off after 5 d Oral orlistat, 1 tablet each time, t.i.d	28 days	weight; WHR		Mentioned	None
Wu KQ 2019³⁴	33/33		35/31	T: 35.61±8.24 C: 32.24±6.58	Acupuncture, twice a week Auricular point bean	4 weeks	weight; WC; HC; BMI; WHR; WHtR		None	Mentioned
Zhang XH 2020³⁵	25/25		20/30	T: 36.6±8.1 C: 36.4±7.9	Catgut embedding, once every 2 weeks Oral Chinese medicine, 1 dose per day	6 weeks	weight; WC; HC; BMI; WHR;		None	None
Song YX et al 2018³⁶	200/100		0/300	T: 33.2±2.6 C: 33.5±2.5	Catgut embedding, once every 2 weeks Tuina, once a day	8 weeks	weight; WC; WHR; BMI		Mentioned	None
Jin YH 2019³⁷	33/32		13/52	T: 34.58±9.95 C: 35.47±8.89	Catgut embedding, once every 2 weeks Sham acupuncture	8 weeks	weight; WC; HC		Mentioned	None
Meng JQ 2019³⁸	35/34		10/59	T: 36.51±10.13 C: 36.44±9.66	Catgut embedding, once every 2 weeks Sham acupuncture	8 weeks	weight; BMI; WC; HC		Mentioned	None
Pan XW 2017³⁹	26/24		16/34	T: 35.88±8.65 C: 37.62±8.84	acupuncture, 3 times a week Sham acupuncture	12 weeks	weight; WC; HC; BMI; WHR		Mentioned	Mentioned
Deng LJ, et al 2014⁴⁰	30/30		5/55	T: 33±8 C: 32±7	Catgut embedding, once a week no treatment	9 weeks	weight; WC		None	None
Chen LS et al 2019⁴¹	28/23		/	T: 34.43±7.63 C: 34.60±5.21	Catgut embedding, Once every 10 d no treatment	10 weeks	weight; BMI; WC; HC; WHR; WtHR		None	None
Chen IJ et al 2018⁴²	40/40		/	T: 39.9±9.8 C: 43.7±9.3	Catgut embedding, once a week Sham acupuncture	6 weeks	weight; WC; HC; WHR		None	None
Lei H et al 2017⁴³	15/15		/	T: 31.6±8.2 C: 31.4±8.4	Acupuncture, 3 times a week no treatment	12 weeks	BMI; WC		None	None

Quality assessment							No of patients		Effect
No of studies	Design	Risk of bias	Inconsistency	Indirectness	Imprecision	Other considerations	Summary	Control	Relative (95%CI)				Absolute	Quality	Importance
Weight (better indicated by lower values)
11	Randomized Trials	No serious risk of bias	Very serious^a	No serious indirectness	No serious imprecision	None	539	427	-		MD 1.45 higher (1.4 to 1.5 higher)			LOW	IMPORTANT
Waist circumference (better indicated by lower values)
10	Randomized Trials	no serious risk of bias	Very serious^a	No serious indirectness	No serious imprecision	None	508	395	-		MD 3.9 higher (2.43 to 5.36 higher)			LOW	IMPORTANT
Hip circumference (better indicated by lower values)
7	Randomized Trials	no serious risk of bias	Very serious^a	No serious indirectness	Serious^b	None	220	211	-		MD 0.54 higher (0.2 lower to 1.27 higher)			VERY LOW	IMPORTANT
BMI (better indicated by lower values)
7	Randomized Trials	no serious risk of bias	Very serious^a	No serious indirectness	No serious imprecision	None	405	293	-			MD 1.37 higher (0.2 to 2.54 higher)		LOW	IMPORTANT
WHR (better indicated by lower values)
7	Randomized Trials	no serious risk of bias	Very serious^a	No serious indirectness	Serious^b	None	383	277	-	MD 0.03 higher (0.03 to 0.04 higher)				VERY LOW	NOT IMPORTANT
WtHR (better indicated by lower values)
3	Randomized Trials	no serious risk of bias	Very serious^a	No serious indirectness	Very serious^b	None	119	110	-	MD 0.07 higher (0.04 lower to 0.19 higher)				VERY LOW	NOT IMPORTANT

Quality assessment							No of patients		Effect
No of studies	Design	Risk of bias	Inconsistency	Indirectness	Imprecision	Other considerations	Summary	Control	Relative (95%CI)				Absolute	Quality	Importance
Weight (better indicated by lower values)
11	Randomized Trials	No serious risk of bias	Very serious^a	No serious indirectness	No serious imprecision	None	539	427	-		MD 1.45 higher (1.4 to 1.5 higher)			LOW	IMPORTANT
Waist circumference (better indicated by lower values)
10	Randomized Trials	no serious risk of bias	Very serious^a	No serious indirectness	No serious imprecision	None	508	395	-		MD 3.9 higher (2.43 to 5.36 higher)			LOW	IMPORTANT
Hip circumference (better indicated by lower values)
7	Randomized Trials	no serious risk of bias	Very serious^a	No serious indirectness	Serious^b	None	220	211	-		MD 0.54 higher (0.2 lower to 1.27 higher)			VERY LOW	IMPORTANT
BMI (better indicated by lower values)
7	Randomized Trials	no serious risk of bias	Very serious^a	No serious indirectness	No serious imprecision	None	405	293	-			MD 1.37 higher (0.2 to 2.54 higher)		LOW	IMPORTANT
WHR (better indicated by lower values)
7	Randomized Trials	no serious risk of bias	Very serious^a	No serious indirectness	Serious^b	None	383	277	-	MD 0.03 higher (0.03 to 0.04 higher)				VERY LOW	NOT IMPORTANT
WtHR (better indicated by lower values)
3	Randomized Trials	no serious risk of bias	Very serious^a	No serious indirectness	Very serious^b	None	119	110	-	MD 0.07 higher (0.04 lower to 0.19 higher)				VERY LOW	NOT IMPORTANT

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