Rédacteurs : Johan Nguyen, Claude Pernice
chronic atrophic gastritis:
Gastrite : évaluation de l'acupuncture
| ☆☆☆ | Evidence for effectiveness and a specific effect of acupuncture |
| ☆☆ | Evidence for effectiveness of acupuncture |
| ☆ | Limited evidence for effectiveness of acupuncture |
| Ø | No evidence or insufficient evidence |
1.1. Xue 2020
Xue Rongdan. [Therapeutic Effect of Acupuncture and Moxibustion on Chronic Atrophic Gastritis: A Meta-analysis]. Medical Recapitulate. 2020. [212908].
| Objective | To evaluate the clinical effect of acupuncture and moxibustion on chronic atrophic gastritis ( CAG). |
| Methods | The Chinese and English databases including Pub Med, the Cochrane Library, Embase, Web of science, CNKI, Wanfang, VIP, CBMdisc were searched to find randomized controlled trials of acupuncture and moxibustion treatment of CAG, and the documents that met the criteria were included according to the exclusion and inclusion criteria, to extract the data, assess the quality and perform the statistical analysis. |
| Results | A total of 13 articles involving 1 009 patients were included. Meta-analysis showed that the total effective rate of acupuncture combined with medicine, acupoint catgut embedding and acupoint catgut embedding combined with medicine was higher than that of the control group ( RR = 5. 20, 95% CI 2. 89-9. 33, P < 0. 000 01; RR = 6. 00, 95% CI 1. 41-25. 43, P = 0. 02; RR = 4. 69, 95% CI 1. 76-12. 47, P = 0. 002); there was no significant difference in total effective rate between acupuncture and moxibustion alone and control group ( RR =2. 74, 95% CI 0. 75-10. 06, P = 0. 13; RR = 3. 60, 95% CI 0. 67-19. 43, P = 0. 14). The traditional Chinese medicine syndrome scores of simple acupuncture, moxibustion and acupoint catgut embedding combined with drugs in CAG group were lower than those of the control group ( MD =-2. 30, 95% CI-3. 72–0. 88, P = 0. 002; MD =-2. 08, 95% CI-2. 72–1. 44, P < 0. 000 01; MD =-2. 23, 95% CI–4. 37–0. 09, P = 0. 04). The pathological scores of CAG treated by acupuncture and acupoint catgut embedding were lower than those of the control group ( MD =-3. 20, 95% CI-5. 33–1. 07, P = 0. 003; MD =-3. 64, 95% CI-5. 81–1. 47, P = 0. 001). The score of acupoint catgut embedding in CAG gastroscopy was lower than that in the control group ( MD =-0. 44, 95% CI-0. 55–0. 32, P < 0. 000 01). There was no significant difference in the negative conversion rate of Helicobacter pylori ( Hp) between acupuncture combined with drug and warm acupuncture and moxibustion trial and the control group ( RR = 1. 46, 95% CI 0. 80-2. 67, P = 0. 22; RR = 1. 71, 95% CI1. 44-2. 63, P = 0. 05; RR = 1. 20, 95% CI 1. 00-1. 44, P = 0. 05). |
| Conclusion | Acupuncture and moxibustion treatment for CAG than the drug treatment in terms of clinical efficacy, traditional Chinese medicine syndromes, gastric mucosal integral, pathological histological integral and Hp conversion rate. However, due to the high risk of selectivity, implementation and measurement bias of the included literatures, the methodology quality evaluation of the included literatures is not high, the future clinical research still needs to carry out more rigorous and high-quality randomized double-blind controlled trials in order to provide more reliable evidence for the future acupuncture clinical practice. |
1.2. Jiang 2016 ☆
Jiang Wenjie, Cao Lianzuo, Li , Chen , Zhang Wei, Yu Liqing, Leng Fengqiang, Wu Qinghong, Jin Zuo, Yuan Yanjie. [Meta-analysis of the Therapeutic Effect of Acupuncture on Chronic Atrophic Gastritis]. Shanghai Journal of Acupuncture and Moxibustion. 2016;35(7):886-92. [191436].
| Objective | To evaluate the clinical efficacy of acupuncture in treating chronic atrophic gastritis. |
| Methods | Databases were searched to find clinical randomized controlled trials (RCT) and quasi-randomized controlled trials (qRCT) of acupuncture treatment for chronic atrophic gastritis. The included studies were qualitatively assessed. The data were collected and statistically analyzed. |
| Results | A total of 19 pieces of literature were included with a total of 1502 patients. A meta-analysis showed that the total efficacy rates of combined acupuncture and medicine, and acupuncture point injection for chronic atrophic gastritis were higher than that of routine medication [OR=5.80, 95%CI (2.33,14.40)] and [OR=2.70,95%CI (1.34,5.45)]; the gastroscopic efficacy rates of acupuncture point injection, warm needling moxibustion and combined acupuncture and medicine for chronic atrophic gastritis were statistically different from that of medication as a control [OR=2.71, 95%CI (1.59,4.63)], [OR=3.40, 95%CI (1.82,6.36)] and [OR=4.31, 95%CI (1.01,18.46)]; there was a statistically significant difference in the pathological efficacy rate between the warm needling moxibustion and the control groups [OR=1.94, 95%CI (1.13,3.33)]; there was no statistically significant difference in eliminating helicobacter pylori between acupuncture and medication. Warm needling moxibustion could also improve general health perceptions, the vitality of life, mental health and the quality of life in patients. |
| Conclusions | Acupuncture increases the overall, gastroscopic and pathological efficacy rates compared with medication. The results of this systematic review needs to be cautiously considered because the number of the studies included for this systematic review is limited, the included studies have a high risk of selection bias, performance bias and detection bias, and the quality of included studies is not high. |
1.3. Xiang 2016 ☆
Xiang Juan, Xue Zhi-Hui, Chen Guo, Peng Liang, Li Tie-Lang. [Meta-analysis on acupuncture in treatment of chronic atrophic gastritis]. Guiding Journal of Traditional Chinese Medicine and Pharmacy. 2016;15:75-78; 8. [186976].
| Objectives | To evaluate the effect of acupuncture treatment on chronic atrophic gastritis. |
| Methods | Through comprehensive search of VIP, Wangfang and CNKI Chinese database in recent 10 years, and Cochorane system evaluation method, the Rev Man5. 2 software was applied for quality evaluation and Meta-analysis. |
| Results | A total of 7 literatures, including 783 patients, were selected. Meta-analysis results showed that the comprehensive curative effect comparison with no heterogeneity (P =0. 34, I2=12%), and the fixed effect model was selected; RR combined inspection: Z=5. 96, P<0. 00001, suggesting that acupuncture treatment showed better curative effect, compared with other treatments. Symptom scores showed MD=2. 19, 95% CI (1. 22, 3. 16); the RR Z combined inspection: Z =4. 43, P <0. 00001, suggesting that acupuncture has statistical significance to improve the symptoms. |
| Conclusions | Acupuncture treatment showed good effect on chronic atrophic gastritis, with improvement of the symptoms. But there should be more rigorously designed, high quality, large-scale, multi center, standardized controlled trials in future clinical work, for further verification support, in order to provide reliable evidence for clinical. |
1.4. Liao 2014 ☆
Wei-Lin Liao;Guo-Zhong Chen;Hui Hu;Li-Ming Xia;Guangxi. [Acupuncture and moxibustion for treatment of chronic atrophic gastritis: A metaanalysis]. World Chinese Journal of Digestology. 2014;2. [187061].
| Objectives | To evaluate the efficacy of acupuncture and moxibustion in the treatment of chronic atrophic gastritis (CAG) |
| Methods | Electronic searches of relevant randomized controlled trials (RCTs) on acupuncture and moxibustion for chronic atrophic gastritis in PubMed, WanFang Data, WeiPu Data and CNKI were performed. Studies were selected based on strict inclusive and exclusive criteria. All reviewed articels were assessed using Cochrane quality scale. Statistical analyses were performed with RevMan5. 0 software. |
| Results | A total of 11 trials involving 772 patients were included. Meta-analysis showed that compared with the medicine group, the acupuncture and moxibustion group had superiority in many aspects such as the total effective rate as well as improvements in gastroscopic findings, pathological changes, symptoms, hemoglobin and serum gastrin. |
| Conclusions | Acupuncture and moxibustion have advantages over conventional drug treatment in the management of CAG. More high-quality studies are needed to prove our finding. |
1.5. Dong 2013 ☆
Dong Lili, Liu Anguo, Wang Junyan, Yan Xingke. [Meta-analysis on randomized control clinical trials of acupuncture for acute gastritis]. Journal of Gansu College of Traditional Chinese Medicine. 2013;1:30-34. [186998].
| Objectives | To assess the efficacy of acupuncture and moxibustion therapy for acute gastritis. |
| Methods | Literature search in CNKI, Wanfang and MEDLINE databases was performed to retrieve clinic trials do-cuments about acupuncture for acute gastritis. The meta-analysis was conducted on RCT and CCT documents that read after meeting the enrolling requirements. |
| Results | Nine trials including 1161 cases of acute gastritis patients were included in this study. The findings indicates that the total effective rate in acupuncture group was significantly superior to control group, P<000001;the markedly effective rate in acupuncture group was significantly superior to control group, P<0. 00001;there was profound significant difference in the clinical cure rate measurements between two groups, P<0. 00001;there was no significant difference in the repeat rate measurements between two groups, P=0. 06. |
| Conclusions | Acupuncture and moxibustion therapy for acute gastritis is effective, especially in the total effective rate, the markedly effective rate and every time of the total effective rate improvement, but in the repeat rate it is no significant superior. |
1.6. Chen 2013 ☆
Chen Lu, Li Su-He. [Systematic Evaluation of Therapeutic Effect of Acupuncture Treatment on Chronic Gastritis]. Journal of Clinical Acupuncture and Moxibustion. 2013;29(6):17. [175321].
| Objectives | To assess the therapeutic effect and safety of acupuncture on chronic gastritis. |
| Methods | Electronic searches of PubMed, the Cochrane Library, EMBASE, of Medline, CNKI and VIP database, manual searches of Guangzhou University of Traditional Chinese Medicine Library journal database, based on the inclusion and exclusion criteria, screening the inclusion criteria of randomized controlled trials of acupuncture treatment for chronic gastritis, handbook using the Cochrane reviews 5. 0 of the literature to evaluate the quality, efficacy was evaluated by using the Review Manage 5. 1 software Meta - analysis. |
| Results | Ultimately included 13 studies, and 946 patients were included. The evaluation found that after the risk of bias assessment and documentation quality, the inclusion in the literature there was a high risk of bias and included in the literature, low quality. Meta - analysis results showed that: iiFor the treatment of chronic gastritis from the total effective rate in terms of OR =3.89,95% CI[2. 64,5. 74] , Z = 6. 86, P <0. 0001, the difference was statistically significant, suggesting that acupuncture therapy could improve the total efficiency of chronic gastritis, and the acupuncture group was better than the WM group; ② For the treatment of chronic atrophic gastritis, the total efficiency in terms of OR =4.24,95% CI was[2. 54,7.09] ,Z = 5.51 ,P <0.0001, the difference was statistically significant, suggesting that acupuncture could improve chronic atrophic gastritis, and the total effective rate in the acupuncture group was better than that in the western medicine group; ③ For chronic gastritis from the Hp clearance rate point of view, OR = 1.03,95% CI[0. 42,2.511 ,Z =0.06 ,P =0.95 >0.05, the difference was not statistically significant, suggesting that there was an insufficient evidence to prove that the acupuncture group had a better Hp clearance rate than that in the western medicine group. |
| Conclusions | Acupuncture, as a safe and effective treatment, is suitable for the treatment of chronic gastritis. |
1.7. Li 2011 ☆
Li Ying, Du Yuan-Hao, Shi Lei. [Acupuncture and moxibustion therapy for chronic superficial gastritis : a meta - analysis]. Journal of Clinical Acupuncture and Moxibustion. 2011;27(2):1. [174388].
| Objective | To assess the efficacy of acupuncture and moxibustion therapy for chronic superficial gastritis. |
| Methods | According to the requirement of evidence - based medicine ( EBM) , all relevant randomized controlled trials (RCT) about acupuncture and moxibustion treatment of chronic superficial gastritis was carried out. The trials were statistically analyzed with a special analysis software RevMan 5. 0. 23. |
| Results | A total of 10 trials involving 878 patients were included. Meta - analyses showed that the acupuncture and moxibustion therapy is better than medicine in improvement of total effective rate, symptoms (e. g. epigastralgia, epigastric distention, pantothenic acid and anorexia) , gastric mucosal blood flow, midrange in gastroscopes, but no significant differences in Hp clearance. |
| Conclusion | Acupuncture and moxibustion therapy for chronic superficial gastritis is effective, especially in total effective and symptom improvement, but still need mote high - quality studies to prove this viewpoint. |
