Acupuncture For Diabetic Nephropathy:Systematic Review

Objective To systematically review the efficacy ancd safety of acupuncture in treatment of DN.Methods All randormized controlled trials(RCTs)of acupuncture for the treatment of DN were collected from the Cochrane Library,PubMed,EMBASE,CBM,CNKI,VIP and WanFang Data without language limitation.Two reviewers independently screened literature according to the inclusion and exclusion criteria,extracted data,and assessed methodological quality of included studies.Meta—analysis was then conducted using RevMarn 5.3 software,while STATA12.0 software for Meta-regression analysis.Results A total of 30 RCTs involving 2260 patients were included.The result of Meta-analysis:(1)24-hour urinary protein:Compared with the basic treat ment,acupuncture showed more effects(MD-7.2.84,95%CI-115.55?-30.13,P<0.0001,I2=82%).(2)According to the study of selecting acupoirnts in 7 literatur es,it was found that the first 2 acupoints were Zusanli and Shenshu,respectiv ely.We found that the most frequently used merddian was Zusanming stomach Meridian,and the acupoint injection was the most selective acupuncture metho d.(3)In terms of the efficiency in relieving the symptoms such as lumbago,edema,frequent urination and numbness of limbs,acupuncture did show advant age(P<0.05).In the selection of acupoints,the effects of the two meridians of spleen and stomach were more obvious.(4)Meta—nalysis showed that acu puncture can reduce the level of serum creatinine(Scr),glycosylated hemoglobin(GHb),total cholesterol(TC)and triglyceride(TG).(5)The results of meta regr ession analysis showed that there were no significant differences between the mean age,sex composition,course of treatment and duration of the study and the effect of the study(P>0.05).(6)Side effects:In our study,there is onl y one article mentioned the incidence of infection.Conclusions Acupuncture could relive the symptoms such as lumbago,edema,firequent urination and numbness of limbs of DN.To some extent,acupuncture could reduce the level of serum Scr,GHb,TC and TG.In terms of side effects,acupuncture was relatively safe.