基于“带主约束”理论探讨穴位埋线治疗围绝经期超重及肥胖疗效的Meta分析

A Meta-Analysis of the Efficacy of Acupoint Catgut Embedding Therapy for Perimenopausal Overweight and Obesity Based on the “Belt Vessel Governs Constraint” Theory

摘要: 目的：系统评价穴位埋线治疗围绝经期超重及肥胖的有效性，基于“带主约束”理论探讨穴位埋线减重的作用机制。方法：1) Meta分析：计算机检索PubMed、EMbase、The Cochrane Library、CBM、CNKI等数据库，搜集有关穴位埋线治疗围绝经期超重及肥胖的随机对照试验(randomized controlled trial, RCT)，检索时限均为建库至2025年5月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后，采用RevMan5.4和STATA15软件进行Meta分析。2) 基于Meta分析结果，分析统计穴位埋线选穴规律(局部选穴规律、归经规律等)。结果：共纳入10个RCT，包括1080例患者。Meta分析结果显示：与对照组相比，穴位埋线能降低围绝经期超重及肥胖患者体质量[MD = −3.68, 95% CI (−5.35, −2.00), P < 0.0001]、体质量指数[MD = 1.70, 95% CI (0.94, 2.46), P < 0.0001]及腰围[MD = −3.55, 95% CI (−4.99, −2.11), P < 0.00001]；穴位埋线的选穴以带脉循行理论为依据，其可能基于“带主约束”理论而发挥作用。结论：当前证据表明，穴位埋线能显著降低围绝经期超重及肥胖患者的体质量、腰围、体质量指数水平；且穴位埋线主要以“带主约束”理论为基础进行选穴进而发挥作用。

Abstract: Objective: To systematically evaluate the efficacy of acupoint catgut embedding for overweight and obesity in perimenopausal women, and to explore the mechanism of action of acupoint catgut embedding for weight loss based on the “Belt Vessel Governs Constriction” theory. Methods: 1) Meta-analysis: Randomized controlled trials (RCTs) on acupoint catgut embedding for perimenopausal overweight and obesity were retrieved from databases such as PubMed, EMbase, The Cochrane Library, CBM, and CNKI from their inception until May 2025. Two researchers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.4 and STATA 15 software. 2) Based on the Meta-analysis results, the principles of acupoint selection (including local point selection patterns and meridian tropism) were analyzed and summarized. Results: A total of 10 RCTs involving 1080 patients were included. The Meta-analysis results showed that, compared with the control group, acupoint catgut embedding significantly reduced body weight [MD = −3.68, 95% CI (−5.35, −2.00), P < 0.0001], body mass index [MD = 1.70, 95% CI (0.94, 2.46), P < 0.0001], and waist circumference [MD = −3.55, 95% CI (−4.99, −2.11), P < 0.00001] in perimenopausal overweight and obese patients. Acupoint selection for catgut embedding was based on the pathway of the Belt Vessel, and its mechanism may function through the “Belt Vessel Governs Constriction” theory. Conclusion: Current evidence indicates that acupoint catgut embedding can significantly reduce body weight, waist circumference, and body mass index levels in perimenopausal overweight and obese patients. Furthermore, acupoint catgut embedding primarily functions based on acupoint selection grounded in the “Belt Vessel Governs Constriction” theory.