Placebo response in sham acupuncture therapy trials for simple obesity: A systematic review and meta-analysis.

IF 4.2 2区医学 Q1 INTEGRATIVE & COMPLEMENTARY MEDICINE

Journal of Integrative Medicine-Jim Pub Date : 2025-04-27 DOI:10.1016/j.joim.2025.04.007

Ke-Jia Liu, Rui-Min Jiao, Jing Ji, Wei-Wei Yao, Chao-Ru Han, Xin-Yu Zhao, Jing-Jie Zhao

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引用次数: 0

Abstract

Background: Acupuncture has shown potential therapeutic benefits for individuals with simple obesity. However, some researchers argue that some of the effectiveness of acupuncture may be due to the placebo response.

Objective: To understand the placebo response of acupuncture treatment in simple obesity, a systematic review and meta-analysis was designed based on the comparison between sham acupuncture before and after treatment.

Search strategy: Eight databases (PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure, Wanfang Database, China Biology Medicine Database, and Chinese Scientific Journals Database) were searched from inception to August 1, 2023. The MeSH search terms comprised obesity and acupuncture.

Inclusion criteria: Randomized controlled trials (RCTs) using sham or placebo acupuncture as a control in treating obesity were enrolled.

Data extraction and analysis: Two researchers independently extracted data, and the results were cross-checked after completion. Each RCT's detailed sham/placebo acupuncture treatment protocol was assessed according to the SHam Acupuncture REporting guidelines. The revised Cochrane risk-of-bias tool for randomized trials and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system were used to determine the risk of bias and quality of evidence, respectively. Body mass index (BMI) was defined as the primary outcome. Anthropometric parameters and laboratory test parameters related to obesity were defined as secondary outcomes. We used standardized mean difference (SMD) with 95% confidence interval (CI) to calculate treatment effects of outcomes.

Results: Fifteen RCTs with a total of 1250 patients were included. The BMI significantly decreased after treatment in the sham acupuncture group compared to baseline (SMD 0.37, 95% CI 0.09-0.66; I² = 81%, random model; P < 0.01). Treatment duration (P = 0.02) and other interventions significantly impacted the placebo response rate (P = 0.00).

Conclusion: The placebo response of sham acupuncture was strong in the RCTs for simple obesity, and the effect sizes differed between various outcomes. The treatment duration and other interventions emerged as potential influencing factors for the placebo response of sham acupuncture. Please cite this article as: Liu KJ, Jiao RM, Ji J, Yao WW, Han CR, Zhao XY, Zhao JJ. Placebo response in sham acupuncture therapy trials for simple obesity: a systematic review and meta-analysis. J Integr Med. 2025; Epub ahead of print.

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单纯性肥胖的假针灸治疗试验中的安慰剂反应：系统回顾和荟萃分析。

背景：针灸对单纯性肥胖患者有潜在的治疗效果。然而，一些研究人员认为，针灸的一些有效性可能是由于安慰剂反应。目的：为了解针灸治疗单纯性肥胖患者的安慰剂效应，对假针灸治疗前后进行系统评价和meta分析。检索策略：检索自成立至2023年8月1日的8个数据库（PubMed、Web of Science、Cochrane Library、Embase、中国国家知识基础设施、万方数据库、中国生物医学数据库、中国科学期刊库）。MeSH搜索词包括肥胖和针灸。纳入标准：随机对照试验（rct）采用假针灸或安慰剂针灸作为治疗肥胖的对照。数据提取与分析：两位研究者独立提取数据，完成后对结果进行交叉核对。每个RCT的详细假/安慰剂针灸治疗方案根据假针灸报告指南进行评估。修订后的Cochrane随机试验偏倚风险工具和分级推荐评估、发展和评价（GRADE）系统分别用于确定偏倚风险和证据质量。身体质量指数（BMI）被定义为主要终点。与肥胖相关的人体测量参数和实验室测试参数被定义为次要结局。我们使用95%可信区间（CI）的标准化平均差（SMD）来计算结果的治疗效果。结果：纳入15项随机对照试验，共1250例患者。与基线相比，假针组治疗后BMI显著降低(SMD 0.37, 95% CI 0.09-0.66；I2 = 81%，随机模型；结论：在单纯性肥胖的随机对照试验中，假针灸的安慰剂效应较强，且不同结局间的效应量存在差异。治疗时间和其他干预措施是影响假针灸安慰剂反应的潜在因素。本文署名：刘建军，焦荣，季军，姚文文，韩荣，赵学勇，赵建军。单纯性肥胖的假针灸治疗试验中的安慰剂反应：系统回顾和荟萃分析。集成医学[J]；打印前Epub。

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来源期刊

Journal of Integrative Medicine-Jim Medicine-Complementary and Alternative Medicine

CiteScore

9.20

自引率

4.20%

发文量

3319

期刊介绍： The predecessor of JIM is the Journal of Chinese Integrative Medicine (Zhong Xi Yi Jie He Xue Bao). With this new, English-language publication, we are committed to make JIM an international platform for publishing high-quality papers on complementary and alternative medicine (CAM) and an open forum in which the different professions and international scholarly communities can exchange views, share research and their clinical experience, discuss CAM education, and confer about issues and problems in our various disciplines and in CAM as a whole in order to promote integrative medicine. JIM is indexed/abstracted in: MEDLINE/PubMed, ScienceDirect, Emerging Sources Citation Index (ESCI), Scopus, Embase, Chemical Abstracts (CA), CAB Abstracts, EBSCO, WPRIM, JST China, Chinese Science Citation Database (CSCD), and China National Knowledge Infrastructure (CNKI). JIM Editorial Office uses ThomsonReuters ScholarOne Manuscripts as submitting and review system (submission link: http://mc03.manuscriptcentral.com/jcim-en). JIM is published bimonthly. Manuscripts submitted to JIM should be written in English. Article types include but are not limited to randomized controlled and pragmatic trials, translational and patient-centered effectiveness outcome studies, case series and reports, clinical trial protocols, preclinical and basic science studies, systematic reviews and meta-analyses, papers on methodology and CAM history or education, conference proceedings, editorials, commentaries, short communications, book reviews, and letters to the editor. Our purpose is to publish a prestigious international journal for studies in integrative medicine. To achieve this aim, we seek to publish high-quality papers on any aspects of integrative medicine, such as acupuncture and traditional Chinese medicine, Ayurveda medicine, herbal medicine, homeopathy, nutrition, chiropractic, mind-body medicine, taichi, qigong, meditation, and any other modalities of CAM; our commitment to international scope ensures that research and progress from all regions of the world are widely covered. These ensure that articles published in JIM have the maximum exposure to the international scholarly community. JIM can help its authors let their papers reach the widest possible range of readers, and let all those who share an interest in their research field be concerned with their study.