Efficacy and safety of acupuncture as a complementary therapy for sepsis: a systematic review and meta-analysis.

IF 2.4 3区 医学 Q2 INTEGRATIVE & COMPLEMENTARY MEDICINE
Jin Xian, Ling Wang, Changyun Zhang, Jian Wang, Yushuo Zhu, Huijuan Yu, Xin Zhang, Qiwen Tan
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引用次数: 2

Abstract

Background: Sepsis is a life-threatening organ dysfunction caused by dysregulation of the host response to infection. Acupuncture is used for treatment of inflammatory diseases; however, its effectiveness and safety as a complementary therapy for sepsis has not been fully explored.

Methods: Data were retrieved from eight databases. Randomized controlled trials (RCTs) that compared acupuncture plus conventional therapies versus conventional therapies alone were included. Pre-specified primary outcomes were mortality at 28 days and Acute Physiologic and Chronic Health Evaluation (APACHE) II scores.

Results: A total of 17 studies with 1099 participants were included in this study. In terms of the primary outcomes, acupuncture plus routine therapy reduced mortality at 28 days (risk ratio (RR)): 0.69, 95% confidence interval (CI): 0.52 to 0.91, p < 0.001) and APACHE II scores (mean difference (MD): -2.84, 95% CI: -4.09 to -1.58, p < 0.001) at day 7 after treatment compared with routine therapy alone. In terms of secondary outcomes, acupuncture plus routine therapy reduced white blood cell counts and levels of procalcitonin (PCT), tumor necrosis factor (TNF)-α, interleukin (IL)-6 and lactic acid and intra-abdominal pressure (IAP), and improved CD3+, CD4+ and monocytes of human leukocyte antigen (HLA)-DR at day 7 after treatment compared with routine therapy alone. However, acupuncture plus routine therapy had no significant effects on levels of IL-10, C-reactive protein (CRP), CD8+ and CD4+/CD8+ ratios compared with routine therapy alone. Quality of evidence was low to very low for all parameters (GRADE).

Conclusion: The available evidence showed that combination of acupuncture and routine therapy may have benefit for sepsis compared with use of routine therapy only. Due to the low degree of certainty regarding its effects, further research is required.

Trial registration number: ICRD42019141491 (PROSPERO).

针灸作为脓毒症补充治疗的疗效和安全性:一项系统综述和荟萃分析。
背景:败血症是由宿主对感染反应失调引起的危及生命的器官功能障碍。针灸用于治疗炎症性疾病;然而,其作为一种补充治疗败血症的有效性和安全性尚未得到充分的探讨。方法:从8个数据库中检索数据。随机对照试验(rct)比较了针灸加常规疗法与单独常规疗法。预先指定的主要结局是28天死亡率和急性生理和慢性健康评估(APACHE) II评分。结果:本研究共纳入17项研究,1099名受试者。在主要结局方面,与单独常规治疗相比,针灸加常规治疗降低了治疗后第7天的死亡率(风险比(RR): 0.69, 95%可信区间(CI): 0.52至0.91,p < 0.001)和APACHE II评分(平均差值(MD): -2.84, 95% CI: -4.09至-1.58,p < 0.001)。次要结局方面,与单纯常规治疗相比,针刺加常规治疗降低了治疗后第7天的白细胞计数、降钙素原(PCT)、肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6、乳酸水平和腹内压(IAP),改善了CD3+、CD4+和人白细胞抗原(HLA)-DR单核细胞。针刺加常规治疗与单纯常规治疗相比,对白细胞介素-10、c -反应蛋白(CRP)、CD8+水平及CD4+/CD8+比值均无显著影响。所有参数的证据质量均为低至极低(GRADE)。结论:现有证据表明,针刺与常规疗法相结合治疗败血症比单纯使用常规疗法更有效。由于其影响的确定性较低,需要进一步研究。试验注册号:ICRD42019141491 (PROSPERO)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Acupuncture in Medicine
Acupuncture in Medicine INTEGRATIVE & COMPLEMENTARY MEDICINE-
CiteScore
4.70
自引率
4.00%
发文量
59
审稿时长
6-12 weeks
期刊介绍: Acupuncture in Medicine aims to promote the scientific understanding of acupuncture and related treatments by publishing scientific investigations of their effectiveness and modes of action as well as articles on their use in health services and clinical practice. Acupuncture in Medicine uses the Western understanding of neurophysiology and anatomy to interpret the effects of acupuncture.
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