{"title":"针灸作为骨质疏松辅助治疗的疗效和安全性：随机对照试验的系统回顾和荟萃分析。","authors":"Zixin Teng, Jingwei Zhu, Kuiwu Li, Tingting Tong, Wei Li, Haoran Chu, Peiyang Sun","doi":"10.3389/fendo.2025.1561344","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To systematically evaluate the efficacy and safety of acupuncture as an adjuvant therapy for osteoporosis (OP) through a comprehensive synthesis of recent randomized controlled trial (RCT) evidence.</p><p><strong>Methods: </strong>A systematic literature search was conducted across PubMed, Web of Science, CNKI, and Wanfang databases (2014 - 2024) to identify RCTs investigating acupuncture combined with conventional therapy for OP. Study quality was appraised using the Cochrane Risk of Bias tool, and meta-analyses were performed using RevMan 5.4 and Stata 15.0, with subgroup analyses stratified by intervention type, population characteristics, and treatment duration.</p><p><strong>Results: </strong>28 RCTs (n=2,758) were included. Meta-analysis revealed acupuncture significantly enhanced bone mineral density (BMD) versus controls: total (SMD = 0.47, <i>p</i> = 0.03), femoral neck (MD = 0.05, <i>p</i> = 0.01), lumbar spine (SMD = 0.40, <i>p</i> < 0.001), Ward's triangle (MD = 0.07, <i>p</i> = 0.02), and hip (SMD = 0.55, <i>p</i> < 0.001), with particularly marked improvements in the postmenopausal osteoporosis subgroup. Acupuncture demonstrated significant improvements in treatment efficacy, biochemical markers, pain scores, and symptom assessments, while reducing adverse events. Warm needle moxibustion outperformed controls in femoral neck (MD = 0.07, <i>p</i> = 0.002) and hip BMD (SMD = 0.87, <i>p</i> < 0.001), while electroacupuncture significantly elevated serum calcium (MD = 0.18, <i>p</i> = 0.02). Short-term interventions (≤ 3 months) demonstrated optimal efficacy.</p><p><strong>Conclusion: </strong>Acupuncture demonstrates efficacy and safety as an OP adjuvant therapy. Current evidence is limited by regional bias and methodological heterogeneity. Multicenter, large-sample RCTs are needed to standardize protocols and validate long-term therapeutic efficacy.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024499354.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"16 ","pages":"1561344"},"PeriodicalIF":3.9000,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12098033/pdf/","citationCount":"0","resultStr":"{\"title\":\"Efficacy and safety of acupuncture as an adjuvant therapy for osteoporosis: a systematic review and meta-analysis of randomized controlled trials.\",\"authors\":\"Zixin Teng, Jingwei Zhu, Kuiwu Li, Tingting Tong, Wei Li, Haoran Chu, Peiyang Sun\",\"doi\":\"10.3389/fendo.2025.1561344\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To systematically evaluate the efficacy and safety of acupuncture as an adjuvant therapy for osteoporosis (OP) through a comprehensive synthesis of recent randomized controlled trial (RCT) evidence.</p><p><strong>Methods: </strong>A systematic literature search was conducted across PubMed, Web of Science, CNKI, and Wanfang databases (2014 - 2024) to identify RCTs investigating acupuncture combined with conventional therapy for OP. Study quality was appraised using the Cochrane Risk of Bias tool, and meta-analyses were performed using RevMan 5.4 and Stata 15.0, with subgroup analyses stratified by intervention type, population characteristics, and treatment duration.</p><p><strong>Results: </strong>28 RCTs (n=2,758) were included. Meta-analysis revealed acupuncture significantly enhanced bone mineral density (BMD) versus controls: total (SMD = 0.47, <i>p</i> = 0.03), femoral neck (MD = 0.05, <i>p</i> = 0.01), lumbar spine (SMD = 0.40, <i>p</i> < 0.001), Ward's triangle (MD = 0.07, <i>p</i> = 0.02), and hip (SMD = 0.55, <i>p</i> < 0.001), with particularly marked improvements in the postmenopausal osteoporosis subgroup. Acupuncture demonstrated significant improvements in treatment efficacy, biochemical markers, pain scores, and symptom assessments, while reducing adverse events. Warm needle moxibustion outperformed controls in femoral neck (MD = 0.07, <i>p</i> = 0.002) and hip BMD (SMD = 0.87, <i>p</i> < 0.001), while electroacupuncture significantly elevated serum calcium (MD = 0.18, <i>p</i> = 0.02). Short-term interventions (≤ 3 months) demonstrated optimal efficacy.</p><p><strong>Conclusion: </strong>Acupuncture demonstrates efficacy and safety as an OP adjuvant therapy. Current evidence is limited by regional bias and methodological heterogeneity. 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引用次数: 0
摘要
目的：通过对近期随机对照试验（RCT）证据的综合分析，系统评价针刺辅助治疗骨质疏松症（OP）的疗效和安全性。方法：系统检索PubMed、Web of Science、中国知网（CNKI）和万方数据库（2014 - 2024）的文献，确定针刺联合常规治疗op的随机对照试验。使用Cochrane风险偏倚工具评价研究质量，使用RevMan 5.4和Stata 15.0进行meta分析，并按干预类型、人群特征和治疗时间进行亚组分析。结果：共纳入28项rct （n= 2758）。荟萃分析显示，与对照组相比，针灸可显著提高骨密度（BMD）：总骨密度（SMD = 0.47, p = 0.03）、股骨颈骨密度（MD = 0.05, p = 0.01）、腰椎骨密度（SMD = 0.40, p < 0.001）、沃德三角骨密度（MD = 0.07, p = 0.02）和髋部骨密度（SMD = 0.55, p < 0.001），其中绝经后骨质疏松亚组改善尤为显著。针灸在治疗效果、生化指标、疼痛评分和症状评估方面有显著改善，同时减少了不良事件。温针在股骨颈（MD = 0.07, p = 0.002）和髋部骨密度（SMD = 0.87, p < 0.001）方面优于对照组，电针可显著提高血清钙（MD = 0.18, p = 0.02）。短期干预（≤3个月）效果最佳。结论：针刺作为OP辅助治疗具有良好的疗效和安全性。目前的证据受到区域偏倚和方法异质性的限制。需要多中心、大样本随机对照试验来规范方案并验证长期治疗效果。系统评价注册：https://www.crd.york.ac.uk/PROSPERO/，标识符CRD42024499354。
Efficacy and safety of acupuncture as an adjuvant therapy for osteoporosis: a systematic review and meta-analysis of randomized controlled trials.
Objective: To systematically evaluate the efficacy and safety of acupuncture as an adjuvant therapy for osteoporosis (OP) through a comprehensive synthesis of recent randomized controlled trial (RCT) evidence.
Methods: A systematic literature search was conducted across PubMed, Web of Science, CNKI, and Wanfang databases (2014 - 2024) to identify RCTs investigating acupuncture combined with conventional therapy for OP. Study quality was appraised using the Cochrane Risk of Bias tool, and meta-analyses were performed using RevMan 5.4 and Stata 15.0, with subgroup analyses stratified by intervention type, population characteristics, and treatment duration.
Results: 28 RCTs (n=2,758) were included. Meta-analysis revealed acupuncture significantly enhanced bone mineral density (BMD) versus controls: total (SMD = 0.47, p = 0.03), femoral neck (MD = 0.05, p = 0.01), lumbar spine (SMD = 0.40, p < 0.001), Ward's triangle (MD = 0.07, p = 0.02), and hip (SMD = 0.55, p < 0.001), with particularly marked improvements in the postmenopausal osteoporosis subgroup. Acupuncture demonstrated significant improvements in treatment efficacy, biochemical markers, pain scores, and symptom assessments, while reducing adverse events. Warm needle moxibustion outperformed controls in femoral neck (MD = 0.07, p = 0.002) and hip BMD (SMD = 0.87, p < 0.001), while electroacupuncture significantly elevated serum calcium (MD = 0.18, p = 0.02). Short-term interventions (≤ 3 months) demonstrated optimal efficacy.
Conclusion: Acupuncture demonstrates efficacy and safety as an OP adjuvant therapy. Current evidence is limited by regional bias and methodological heterogeneity. Multicenter, large-sample RCTs are needed to standardize protocols and validate long-term therapeutic efficacy.
期刊介绍：
Frontiers in Endocrinology is a field journal of the "Frontiers in" journal series.
In today’s world, endocrinology is becoming increasingly important as it underlies many of the challenges societies face - from obesity and diabetes to reproduction, population control and aging. Endocrinology covers a broad field from basic molecular and cellular communication through to clinical care and some of the most crucial public health issues. The journal, thus, welcomes outstanding contributions in any domain of endocrinology.
Frontiers in Endocrinology publishes articles on the most outstanding discoveries across a wide research spectrum of Endocrinology. The mission of Frontiers in Endocrinology is to bring all relevant Endocrinology areas together on a single platform.
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