Acupuncture for treatment of postmenopausal osteoporosis:meta-analysis,systematic evaluation and trial sequential analysis
- VernacularTitle:针灸治疗绝经后骨质疏松症的Meta分析、系统评价和试验序贯分析
- Author:
Bingbing YU
1
;
Tingting WANG
;
Junlin FANG
;
Yun GUO
;
Yingru HUANG
Author Information
- Publication Type:Journal Article
- Keywords: acupuncture; postmenopausal osteoporosis; estrogen; randomized controlled trials; meta-analysis; trial sequential analysis; systematic review
- From: Chinese Journal of Tissue Engineering Research 2025;29(29):6305-6316
- CountryChina
- Language:Chinese
- Abstract: OBJECTIVE:To assess the efficacy and safety of acupuncture in treating postmenopausal osteoporosis.METHODS:Clinical randomized controlled trials on acupuncture for postmenopausal osteoporosis were retrieved from databases including CNKI,VIP,WanFang,China Biomedical Literature Service System,Web of Science,PubMed,Embase,and Cochrane Library.The search period was from the inception of the database to July 23,2024.The quality of evidence and risk of bias of the included studies were assessed using the GRADEprofiler and the revised Cochrane risk-of-bias tool for randomized trials(RoB 2.0).Meta-analysis was performed using StataSE 15 and TSA 0.9.5,along with heterogeneity analysis,sensitivity analysis,subgroup analysis,publication bias analysis,trim-and-fill analysis,and trial sequential analysis.RESULTS:The study included 19 randomized controlled trials involving a total of 1 464 patients.(1)The meta-analysis revealed that compared with conventional therapies,acupuncture significantly increased the total effective rate(RR=1.25,95％confidence interval[1.19,1.32],P＜0.001),lumbar spine L2-L4 bone mineral density(mean difference=0.08,95％confidence interval[0.05,0.11],P＜0.001),and estrogen levels(standard mean difference=0.55,95％confidence interval[0.30,0.81],P＜0.001).Additionally,acupuncture increased bone mineral density and gonadotropin levels in the femoral neck,greater trochanter,and Ward's triangle,reduced visual analogue scale scores,and improved bone metabolism without significantly increasing the incidence of adverse events.(2)Subgroup analysis of the main outcome indicators showed no significant difference between the treatment and control groups when the body mass index was greater than 23.9 kg/m2 and the total treatment duration was 6 months.All other treatment subgroups were significantly superior to the control group.(3)Publication bias analysis indicated a significant risk of publication bias in the overall efficacy;however,a trim-and-fill analysis showed that this risk did not significantly impact the reliability of the conclusions.Publication bias analysis showed no significant risk of publication bias in the bone mineral density values of lumbar spine L2-L4 and estradiol levels.(4)The sequential analysis of the trial further confirmed that acupuncture significantly increased the overall effective rate,bone mineral density values at the lumbar spine L1-L4,and estradiol levels.CONCLUSION:Acupuncture is an effective and safe treatment for postmenopausal osteoporosis.More rigorously designed and high-quality studies are needed in the future to verify this conclusion.
