Rédacteur : Claude Pernice
Peptic Ulcer
Ulcère gastro-duodénal
| Articles connexes: - évaluation thérapeutique - conduites thérapeutiques - pathologie - acupuncture expérimentale - qigong - |
| ☆☆☆ | 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. Generic Acupuncture
1.1.1. Tian 2017 ☆
Tian Y, Yan YN, Guan HY, Ma JJ, Wang ZY, Ma HF, Xing ZH. [Systematic Evaluation and Meta-analysis on Acupuncture for Peptic Ulcer]. Zhen Ci Yan Jiu. 2017; 42(3): 275-82. [168525].
| Objective | To systematically evaluate the clinical efficacy of acupuncture for peptic ulcer. |
| Methods | Randomized controlled trials of acupuncture for peptic ulcer were searched from China National Knowledge Infrastructure (CNKI), WanFang Database, Chinese Scientific and Technological Journals (VIP), China Biomedicine (CBM), PubMed and the Cochrane Library from the establishment time of databases to September, 2016. Data extraction and quality evaluation were implemented for the literature which met the inclusive criteria. The RevMan 5.3 software was used to make Meta-analysis. |
| Results | Sixteen papers including 1 570 patients of peptic ulcer were included. The results of Meta-analysis showed that there was no statistical significance between acupuncture and western medicine in the effective rate, the healing rate of ulcer area and the HP negative rate (all P>0.05); the recurrence rate of acupuncture was significantly lower than that of western medicine[RR=0.35, 95%CI (0.14, 0.84), P<0.05]. Acupuncture plus western medicine was significantly different from simple western medicine in the effective rate, the healing rate of ulcer area and the recurrence rate[RR=1.20,95% CI (1.04, 1.38), P=0.01; RR=1.29, 95% CI (1.06, 1.58), P=0.01;RR=0.27, 95% CI (0.16, 0.45), P<0.00001]. The analysis of evidence grade (GRADE) pre-sented that the healing rate of ulcer area and the HP negative rate of acupuncture were “low grade”, and others were “extremely low grade”. |
| Conclusions | Acupuncture combined with western medicine has some advantages for peptic ulcer compared with the conventional western medicine, which needs further confirmation due to the lower evidence grade. Larger samples, randomized controlled trials with high quality are highly recommended. |
1.1.2. Cheng 2011 ☆☆
Cheng Chen, Hai-Fu Cui, Fu-Chun Wang. [A meta-analysis of randomized controlled trials assessing efficacy and safety of acupuncture and moxibustion in the treatment of peptic ulcer]. World Chinese Journal of Digestology. 2011;22:2399-240. [187062].
| Objectives | To evaluate the efficacy and safety of acupuncture and moxibustion in the treatment of peptic ulcer (gastric and duodenal ulcers). |
| Methods | The Wan Fang, VIP, CNKI and PubMed databases were searched to retrieve randomized controlled trials RCTs assessing theeff icacy and safety of acupuncture and moxibustion versus conventional therapy in the treatment of peptic ulcer. The quality of the included studies was evaluated using the Jadad score. Statistical analysis was carried out using RevMan 4. 2. |
| Results | Ten studies involving a total of 1122 patients were included. The results of metaanalysis showed significant differences between patients undergoing acupuncture and moxibustion and those undergoing conventional therapy in terms of total response rate [total RR = 1. 10, 95%CI (1. 05, 1. 16), Z = 4. 02, P < 0. 0001], conversion rate from H. pylori positive to negative status [total RR = 1. 12, 95%CI (1. 03, 1. 21), Z = 2. 71, P = 0. 007], and recurrence rate [total OR = 0. 42, 95%CI (0. 24, 0. 74), Z = 3. 05, P = 0. 002], but demonstrated no significant difference in the healing efficiency between the two groups [total RR = 1. 02, 95%CI (0. 97, 1. 08), Z = 0. 75, P = 0. 45]. |
| Conclusions | Acupuncture and moxibustion are effective in the treatment of peptic ulcer in the immediate and long term. |
