Effectiveness of Acupuncture for Diabetic Nephropathy:  A Systematic Review and Meta-Analysis of Randomized  Controlled Trials

Cui  Wu; Yuandong  Li; Chunli  Piao; Jiuru  Wu

doi:10.18502/ijph.v53i11.16942

Cui Wu College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
Yuandong Li College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
Chunli Piao Department of Endocrinology, Shenzhen Hospital (Fu Tian) of Guangzhou University of Chinese Medicine, Shenzhen, China
Jiuru Wu College of Acupuncture and Tuina, Changchun University of Chinese Medicine, Changchun, China

DOI: https://doi.org/10.18502/ijph.v53i11.16942

Keywords: Acupuncture; Diabetic nephropathies; Systematic review

Abstract

Background: This systematic review and meta-analysis aimed to explore the effectiveness of acupuncture for patients with diabetic nephropathy (DN).

Methods: Nine online databases were searched: China National Knowledge Infrastructure, China Science and Technology Journal Database, Wanfang Data Knowledge Service Platform, Chinese BioMedical Literature Database, China Clinical Trial Centre, Embase, PubMed, the Cochrane Library, and Web of Science. The search period was from the establishment of the database to 1 September 2023. The quality of the literature was evaluated using the Cochrane Risk of Bias Assessment Tool, and the data were analyzed using STATA/MP17 and Review Manager 5.3 software.

Results: A total of 221 articles were identified, and 13 studies were included. The total sample size was 899, including 452 and 447 cases in the experimental and control groups, respectively. The meta-analysis showed that acupuncture combined with modern medical treatment was effective in improving urinary albumin excretion rate, 24 h urinary microalbumin, serum creatinine, blood urea nitrogen, fasting plasma glucose, 2 h postprandial plasma glucose, total cholesterol, high-density lipoprotein cholesterol, hypersensitive C-reactive protein, and interleukin-6 in patients with DN. Adverse events were reported in only one trial; therefore, this review cannot yet conclude on the safety of acupuncture intervention in DN.

Conclusion: The clinical efficacy of acupuncture combined with modern medicine in DN is superior to that of modern medicine alone. To better evaluate the efficacy and safety of acupuncture intervention for DN, more rigorously designed large-sample, multicentre, randomized controlled trials are needed to provide evidence support in the future.