针刺对二型糖尿病空腹血糖及糖化血红蛋白的影响：系统评价再评价
The Effect of Acupuncture on FPG and HbA1C in Type 2 Diabetes Mellitus: An Overview of Systematic Reviews
DOI: 10.12677/tcm.2025.144245, PDF,   
作者: 王 媛, 朱凤亚：成都中医药大学针灸推拿学院，四川 成都；吴 节*：成都中医药大学附属医院治未病中心，四川 成都
关键词: 针刺；2型糖尿病；空腹血糖；糖化血红蛋白；系统评价再评价；Acupuncture； Type 2 Diabetes Mellitus； Fasting Plasma Glucose； Hemoglobin A1c； Overview of Systematic Reviews
摘要: 背景：针刺作为2型糖尿病(Type 2 Diabetes Mellitus, T2DM)的辅助疗法日益受到关注，但现有系统综述(Systematic Reviews, SRs)在方法和结论上存在异质性，限制了其临床应用。目的：评估针刺治疗T2DM的SRs方法学质量和偏倚风险，综合其疗效和安全性证据，并提出未来研究建议。方法：系统检索中英文数据库，使用AMSTAR-2、ROBIS和GRADE工具评估方法学质量、偏倚风险和证据质量。结果：纳入8项SRs，方法学质量普遍较低，偏倚风险较高。针刺在改善空腹血糖(Fasting Plasma Glucose, FPG)、餐后2小时血糖(Hemoglobin A1c, 2hPG)和脂质代谢方面显示出潜力，但证据质量较低。结论：现有证据表明针刺对T2DM有潜在益处，但需更高质量的研究验证其疗效和安全性。
Abstract: Background: Acupuncture as an adjunctive therapy for T2DM has garnered increasing attention, but existing SRs exhibit heterogeneity in methodology and conclusions, limiting its clinical application. Objective: To evaluate the methodological quality and risk of bias in SRs on acupuncture for T2DM, synthesize evidence on its efficacy and safety, and provide recommendations for future research. Methods: Systematic searches were conducted in Chinese and English databases. The AMSTAR-2, ROBIS, and GRADE tools were used to assess methodological quality, risk of bias, and evidence quality. Results: Eight SRs were included, most of which demonstrated low methodological quality and a high risk of bias. Acupuncture showed potential in improving FPG, 2hPG, and lipid metabolism, but the quality of evidence was low. Conclusion: Current evidence suggests potential benefits of acupuncture for T2DM, but higher-quality studies are needed to validate its efficacy and safety.
文章引用：王媛, 朱凤亚, 吴节. 针刺对二型糖尿病空腹血糖及糖化血红蛋白的影响：系统评价再评价[J]. 中医学, 2025, 14(4): 1644-1658. https://doi.org/10.12677/tcm.2025.144245

参考文献

[1] Taylor, R. (2013) Type 2 Diabetes: Etiology and Reversibility. Diabetes Care, 36, 1047-1055. [Google Scholar] [CrossRef] [PubMed]
[2] Fletcher, B., Gulanick, M. and Lamendola, C. (2002) Risk Factors for Type 2 Diabetes Mellitus. The Journal of Cardiovascular Nursing, 16, 17-23. [Google Scholar] [CrossRef] [PubMed]
[3] Tripathi, P., Pandey, A., Pandey, R., Srivatava, R. and Goswami, S. (2011) Alternative Therapies Useful in the Management of Diabetes: A Systematic Review. Journal of Pharmacy and Bioallied Sciences, 3, Article No. 504. [Google Scholar] [CrossRef] [PubMed]
[4] Ogurtsova, K., Guariguata, L., Barengo, N.C., Ruiz, P.L., Sacre, J.W., Karuranga, S., et al. (2022) IDF Diabetes Atlas: Global Estimates of Undiagnosed Diabetes in Adults for 2021. Diabetes Research and Clinical Practice, 183, Article ID: 109118. [Google Scholar] [CrossRef] [PubMed]
[5] Li, Y., Teng, D., Shi, X., Qin, G., Qin, Y., Quan, H., et al. (2025)
https://pubmed.ncbi.nlm.nih.gov/32345662/
[6] Sun, H., Saeedi, P., Karuranga, S., Pinkepank, M., Ogurtsova, K., Duncan, B.B., et al. (2022) IDF Diabetes Atlas: Global, Regional and Country-Level Diabetes Prevalence Estimates for 2021 and Projections for 2045. Diabetes Research and Clinical Practice, 183, Article ID: 109119. [Google Scholar] [CrossRef] [PubMed]
[7] Magliano, D.J., et al. (2024) IDF Diabetes Atlas. International Diabetes Federation.
https://pubmed.ncbi.nlm.nih.gov/35914061/
[8] Vaidya, V., Gangan, N. and Sheehan, J. (2015) Impact of Cardiovascular Complications among Patients with Type 2 Diabetes Mellitus: A Systematic Review. Expert Review of Pharmacoeconomics & Outcomes Research, 15, 487-497. [Google Scholar] [CrossRef] [PubMed]
[9] Zheng, Y., Ley, S.H. and Hu, F.B. (2017) Global Aetiology and Epidemiology of Type 2 Diabetes Mellitus and Its Complications. Nature Reviews Endocrinology, 14, 88-98. [Google Scholar] [CrossRef] [PubMed]
[10] Quinn, L. (2002) Mechanisms in the Development of Type 2 Diabetes Mellitus. The Journal of Cardiovascular Nursing, 16, 1-16. [Google Scholar] [CrossRef] [PubMed]
[11] Cavender, M.A., Steg, P.G., Smith, S.C., Eagle, K., Ohman, E.M., Goto, S., et al. (2015) Impact of Diabetes Mellitus on Hospitalization for Heart Failure, Cardiovascular Events, and Death: Outcomes at 4 Years from the Reduction of Atherothrombosis for Continued Health (REACH) Registry. Circulation, 132, 923-931. [Google Scholar] [CrossRef] [PubMed]
[12] Tesch, G.H. (2017) Diabetic Nephropathy—Is This an Immune Disorder? Clinical Science, 131, 2183-2199. [Google Scholar] [CrossRef] [PubMed]
[13] Rodriguez-Poncelas, A., Miravet-Jiménez, S., Casellas, A., Barrot-De La Puente, J.F., Franch-Nadal, J., López-Simarro, F., et al. (2015) Prevalence of Diabetic Retinopathy in Individuals with Type 2 Diabetes Who Had Recorded Diabetic Retinopathy from Retinal Photographs in Catalonia (Spain). British Journal of Ophthalmology, 99, 1628-1633. [Google Scholar] [CrossRef] [PubMed]
[14] Bansal, D., Gudala, K., Muthyala, H., Esam, H.P., Nayakallu, R. and Bhansali, A. (2014) Prevalence and Risk Factors of Development of Peripheral Diabetic Neuropathy in Type 2 Diabetes Mellitus in a Tertiary Care Setting. Journal of Diabetes Investigation, 5, 714-721. [Google Scholar] [CrossRef] [PubMed]
[15] da Rocha Fernandes, J., Ogurtsova, K., Linnenkamp, U., Guariguata, L., Seuring, T., Zhang, P., et al. (2016) IDF Diabetes Atlas Estimates of 2014 Global Health Expenditures on Diabetes. Diabetes Research and Clinical Practice, 117, 48-54. [Google Scholar] [CrossRef] [PubMed]
[16] (1998) Intensive Blood-Glucose Control with Sulphonylureas or Insulin Compared with Conventional Treatment and Risk of Complications in Patients with Type 2 Diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. The Lancet, 352, 837-853.
https://pubmed.ncbi.nlm.nih.gov/9742976/
[17] Collins, F.M. (2002) Current Treatment Approaches to Type 2 Diabetes Mellitus: Successes and Shortcomings. The American Journal of Managed Care, 8, S460-S471.
[18] Landgraf, R., Aberle, J., Birkenfeld, A.L., Gallwitz, B., Kellerer, M., Klein, H., et al. (2019) Therapy of Type 2 Diabetes. Experimental and Clinical Endocrinology & Diabetes, 127, S73-S92. [Google Scholar] [CrossRef] [PubMed]
[19] 中国2型糖尿病防治指南(2020年版) [EB/OL]. 中华糖尿病杂志.
https://ras.cdutcm.edu.cn:7080/s/com/yiigle/rs/G.https/cmaid/1315489, 2024-10-13.
[20] Wei, J., Wang, Q., Zheng, H. and Wei, F. (2018) Research Progress on Non-Drug Treatment for Blood Glucose Control of Type 2 Diabetes Mellitus. Chinese Journal of Integrative Medicine, 24, 723-727. [Google Scholar] [CrossRef] [PubMed]
[21] Vencio, S., Caiado-Vencio, I., Caiado, A., Morgental, D., Dantas, L.S. and Caiado-Vencio, R. (2021) Acute Effect of Acupuncture on Glycemic Control in Type 2 Diabetes Measured by Continuous Glucose Monitoring: A Pilot Study. Medical Acupuncture, 33, 65-70. [Google Scholar] [CrossRef] [PubMed]
[22] Xue, N., Zhang, J., Xia, Z., et al. (2017) Effect and Postoperative Reactions of Acupoint Catgut Embedding for Prediabetes. Chinese Acupuncture & Moxibustion, 37, 586-590.
[23] Bacelar de Assis, B., de Cássia Lopes Chaves, E., de Sousa, L., Machado Chianca, T.C., Carvalho Borges, J.B., Silva Vilela Terra, A.M., et al. (2021) The Effects of Auricular Acupuncture on Vascular Parameters on the Risk Factors for Diabetic Foot: A Randomized Clinical Trial. Complementary Therapies in Clinical Practice, 44, Article ID: 101442. [Google Scholar] [CrossRef] [PubMed]
[24] Gong, M., Cao, C., Chen, F., Li, Q., Bi, X., Sun, Y., et al. (2016) Electroacupuncture Attenuates Hepatic Lipid Accumulation via Amp-Activated Protein Kinase (AMPK) Activation in Obese Rats. Acupuncture in Medicine, 34, 209-214. [Google Scholar] [CrossRef] [PubMed]
[25] Shen, W., Wang, Y., Lu, S., Hong, H., Fu, S., He, S., et al. (2014) Acupuncture Promotes White Adipose Tissue Browning by Inducing UCP1 Expression on DIO Mice. BMC Complementary and Alternative Medicine, 14, Article No. 501. [Google Scholar] [CrossRef] [PubMed]
[26] Zhang, S., Cui, Y., Sun, Z.R., et al. (2024) Research Progress on the Mechanism of Acupuncture on Type Ⅱ Diabetes Mellitus. Acupuncture Research, 49, 641-649.
[27] American Diabetes Association (2019) 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2020. Diabetes Care, 43, S14-S31. [Google Scholar] [CrossRef] [PubMed]
[28] 陈俊陶, 陈天帷, 冯袁辉, 等. 针刺治疗2型糖尿病的Meta分析与GRADE证据评价[J]. 中国临床研究, 2023, 36(2): 303-310.
[29] 刘美君, 刘志诚, 徐斌, 等. 针灸治疗2型糖尿病合并抑郁症的Meta分析[J]. 浙江中医药大学学报, 2016, 40(1): 54-59.
[30] 王丽华, 黄伟, 张艳佶, 等. 针刺治疗肥胖伴2型糖尿病疗效的系统评价和Meta分析[J]. 中华中医药学刊, 2018, 36(8): 1882-1888.
[31] 邢春国, 孙志, 马永春, 等. 针灸疗法对2型糖尿病患者胰岛功能影响的Meta分析[J]. 南京中医药大学学报, 2015, 31(4): 397-400.
[32] 郑启艳, 杨会生, 项蓉蓉, 等. 针灸治疗2型糖尿病的Meta分析[J]. 上海针灸杂志, 2016, 35(5): 618-622.
[33] Chen, C., Liu, J., Sun, M., Liu, W., Han, J. and Wang, H. (2019) Acupuncture for Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Complementary Therapies in Clinical Practice, 36, 100-112. [Google Scholar] [CrossRef] [PubMed]
[34] Li, S., Chen, J., Liu, M., Wang, Y., Zhou, X. and Sun, X. (2021) Effect and Safety of Acupuncture for Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of 21 Randomised Controlled Trials. Chinese Journal of Integrative Medicine, 28, 463-471. [Google Scholar] [CrossRef] [PubMed]
[35] Wang, Y., Xu, G., Wan, R., Zhou, X., Ma, L., Liu, B., et al. (2022) Acupuncture in Treating Obesity Combined with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials. Complementary Therapies in Clinical Practice, 49, Article ID: 101658. [Google Scholar] [CrossRef] [PubMed]