Comparative effectiveness and safety of acupuncture vs metformin in insulin-resistant polycystic ovary syndrome women: A network meta-analysis of RCTs

IF 2.8 4区医学 Q2 INTEGRATIVE & COMPLEMENTARY MEDICINE

Integrative Medicine Research Pub Date : 2025-04-23 DOI:10.1016/j.imr.2025.101148

Wen-Li Yan , Zun-Qi Kan , Li-Qiong Wang , Zhen-Ping Yu , Cun-Zhi Liu , Shi-Yan Yan , Na-Na Yang

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引用次数: 0

Abstract

Background

The purpose of this study was to conduct a network meta-analysis (NMA) comparing the effectiveness and safety of traditional acupuncture with metformin. This study aims to identify an effective and safe alternative treatment for women with polycystic ovary syndrome (PCOS) complicated by insulin resistance (IR).

Methods

We searched PubMed, EMBASE, Web of Science, Cochrane, ClinicalTrials.gov, and relevant citations for eligible randomized controlled trials (RCTs) published up to August 12, 2024. Data extraction and bias assessment were performed by two independent reviewers, and Bayesian NMA was performed using the GeMTC package, with a random effects model. The NMA compared the effectiveness and safety of acupuncture with metformin which were measured using the Homeostasis Model Assessment Insulin Resistance (HOMA-IR) index, fasting plasma glucose, fasting insulin, and the incidence of adverse events (AEs).

Results

We included 12 RCTs (n = 870). Four RCTs compared acupuncture with metformin, six compared metformin with control interventions (blank control or placebo), and two compared acupuncture with sham acupuncture. Acupuncture (Mean difference (MD): -0.76, 95 % credible interval (CrI): -1.42, -0.03) and metformin (MD: -0.74, 95 % CrI: -1.28, -0.17) significantly reduced the IR level (HOMA-IR). No statistical difference was observed between both treatment methods in improving glucose metabolism; however, acupuncture had fewer AEs (risk ratio: 0.13, 95 % CrI: 0.01, 0.68). Acupuncture all ranked high in terms of surface under the cumulative ranking curve across all outcomes, thus demonstrating better effectiveness and safety potential.

Conclusions

Acupuncture may be a potential alternative for PCOS women with IR, as it is equally effective, easier to perform, and relatively safer than metformin. Further trials are necessary to confirm these findings owing to the current lack of sufficient evidence.

Protocol registration: PROSPERO, CRD42024581934.

查看原文本刊更多论文

针灸与二甲双胍治疗胰岛素抵抗型多囊卵巢综合征的疗效和安全性比较：随机对照试验的网络荟萃分析

本研究的目的是通过网络荟萃分析（NMA）比较传统针灸与二甲双胍的有效性和安全性。本研究旨在为多囊卵巢综合征（PCOS）合并胰岛素抵抗（IR）的女性寻找一种有效且安全的替代治疗方法。方法检索PubMed、EMBASE、Web of Science、Cochrane、ClinicalTrials.gov以及截至2024年8月12日发表的符合条件的随机对照试验（RCTs）的相关引文。数据提取和偏倚评估由两名独立审稿人进行，贝叶斯NMA使用GeMTC软件包，采用随机效应模型。NMA通过稳态模型评估胰岛素抵抗（HOMA-IR）指数、空腹血糖、空腹胰岛素和不良事件（ae）发生率来比较针灸与二甲双胍的有效性和安全性。结果纳入12项rct （n = 870）。4项随机对照试验比较针灸与二甲双胍，6项比较二甲双胍与对照干预（空白对照或安慰剂），2项比较针灸与假针灸。针刺（平均差值（MD）： -0.76, 95%可信区间（CrI）： -1.42, -0.03）和二甲双胍(MD: -0.74, 95%可信区间（CrI: -1.28, -0.17）显著降低IR水平（HOMA-IR）。两种治疗方法在改善糖代谢方面无统计学差异；而针灸的不良事件发生率较低（危险比：0.13,95% CrI: 0.01, 0.68）。针刺在所有结局的累积排名曲线下均排名较高，显示出更好的疗效和安全潜力。结论针刺治疗与二甲双胍相比，具有同样的疗效、操作简单且相对安全的优点，可能是PCOS合并IR患者的潜在替代方法。由于目前缺乏足够的证据，需要进一步的试验来证实这些发现。协议注册：PROSPERO， CRD42024581934。

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

Integrative Medicine Research Medicine-Complementary and Alternative Medicine

CiteScore

6.50

自引率

2.90%

发文量

审稿时长

12 weeks

期刊介绍： Integrative Medicine Research (IMR) is a quarterly, peer-reviewed journal focused on scientific research for integrative medicine including traditional medicine (emphasis on acupuncture and herbal medicine), complementary and alternative medicine, and systems medicine. The journal includes papers on basic research, clinical research, methodology, theory, computational analysis and modelling, topical reviews, medical history, education and policy based on physiology, pathology, diagnosis and the systems approach in the field of integrative medicine.