Study On The Treatment Of Central Obesity Prediabetes With Abdominal Acupuncture

Objectives:Prediabetes(IGR)is the stage of transition to type 2 diabetes,and active intervention at this stage has important preventive significance.At present,Western treatment includes lifestyle intervention and drug treatment mainly,but due to the limitations of drugs and individual factors,the treatment effect is inaccurate.In this study,the meta-analysis was used to evaluate the current status of acupuncture treatment on IGR,followed by exploratory clinical research.Abdominal acupuncture as a new acupuncture theraph,which has advantages of safety,painlessness,high efficiency,quickness,standardization of acupoint and diagnostic organization,especially the treatment in chronic diseases,incurable diseases and geriatric diseases.Abdominal acupuncture therapy is used for interventional treatment of central obesity prediabetes,which provides an effective method and research basis for the clinical research on acupuncture treatment of IGR.Methods:1.Chinese literature database(Chinese National Knowledge Infrastructure Database(CNKI),Wanfang Data,Chongqing VIP Chinese Science and Technology Periodical Database(VIP))and English literature database(PubMed,Cochrane Library)were searched for studies reporting randomized controlled trials(RCT)of acupuncture treatment for pre-diabetes from the period of the establishment of the databases to November 2019.The search terms were"prediabetes","acupuncture" and "randomized".Eligible studies were selected based on the inclusion and exclusion criteria,and the basic and methodological information were extracted and evaluated based on Cochrane Review Handbook quality evaluation standard.Review Manager 5.3 software developed by the Cochrane Collaboration Network was used for meta-analysis to evaluate the clinical efficacy and safety of acupuncture in the treatment of prediabetes.2.25 patients with central obesity prediabetes recruited from 2019.04.01-2019.12.01 were treated with abdominal acupuncture combined with lifestyle(diabetes health education,diet control,exercise training).Prescription:Yin Qi Gui Yuan(Zhong wan(CV12),Xia Wan(CV10),Qi Hai(CV6),Guan Yuan(CV4)),Fu Si Guan(bilateral Hua Rou Men(ST 24),bilateral Wai Ling(ST26)),Qi Xue(KI13),bilateral Tian Shu(ST25)and bilateral Da Heng(SP15).Acupunture for 30 minutes each time,3 times a week,once every other day,rest for two days,followby the next week treatment,continuous treatment for 8 weeks.The patients'height,weight,waist circumference(WC),hip circumference,systolic blood pressure(SBP),and diastolic blood(DBP),detected fasting blood glucose(FPG),2h postprandial blood glucose(2hPG),glycosylated hemoglobin(HbA1c)and TCM syndrome points,were recorded and body mass index(BMI)and waist-to-hip ratio(WHR)were calculated according to the formula.Assessment were made before treatment,after 4 weeks of treatment and after 8 weeks of treatment.Results:1.Meta-analysisMeta-analysis was performed on 8 studies,518 patients in total with prediabetes,with studies using "effective treatment rate" and 3 studies using "TCM syndrome scores" as outcome measurement to assess the effectiveness of the study.The remaining literature were analyzed qualitatively.(1)Quantitative analysis results:?Groups with acupuncture treatment has a significantly higher effective rate than the groups with lifestyle intervention;?Groups with acupuncture treatment has a significantly effect on improving TCM syndrome compared to the groups with lifestyle intervention.(2)Qualitative analysis:In most of the studies,there are no significant differences in the improvement of FPG,2hPG and HbA1c between groups with acupuncture treatment and groups with lifestyle intervention.(3)Sensitivity analysis:After excluding treatment different methods and intervention in the studies,the results of effectiveness evaluation of the acupuncture group remain the same,indicating that the study results are reliable.(4)Safety analysis:There were no adverse reactions of acupuncture reported in the included literatures,hence study of the adverse reactions of acupuncture treatment are still inconclusive.2.Clinical researchThe following conclusions were drawn after 8 weeks of treatment:(1)The total effective rate was 84.00%.(2)Comparing the indices before and after 4 weeks of treatment,there are significant differences between the weight,BMI,WC,WHR,2hPG,SBP and TCM syndrome scores(P<0.05).(3)Comparing the indices after 4 weeks and after 8 weeks of treatment,there are significant differences between the weight,BMI,WC,WHR,FPG,2hPG and TCM syndrome scores(P<0.05);(4)Comparing the indices before and after 8 weeks of treatment,there are significant differences between the weight,BMM,WC,WHR,FPG,2hPG,SBP and TCM syndrome scores(P<0.05).Conclusion:1.Meta-analysis results show that acupuncture has a clinical effect on prediabetes,and is better in improving TCM syndromes than lifestyle intervention group only.There were no significant differences in the FPG,2hPG,and HbAlc levels between the groups with acupuncture treatment and groups with lifestyle interventions.However,due to the limited quantities of papers included in this study,the quality of this is lowered,and the lack of standardization may affect the results of this meta-analysis.When referring to the results of this study,it should be with reference to the specific clinical conditions.2.Abdominal acupuncture is an effective method for the treatment of central obesity prediabetes.It aids in weight loss,reducing blood sugar level and blood pressure reduction,especially on weight,BMI,WC,WHR,FPG,2hPG,SBP and TCM syndrome scores.Abdominal acupuncture therapy has the advantages of painlessness and safety,and is worthy of clinical promotion.