1.Research Advances of Traditional Chinese Medicine Diagnosis and Treatment of Metabolic Dysfunction-Associated Steatotic Liver Disease:Overview and Prospects
Liang DAI ; Guang JI ; Xianbo WANG ; Li ZHANG ; Hanchen XU ; Xudong TANG
Journal of Traditional Chinese Medicine 2026;67(4):386-391
The pathogenesis of metabolic dysfunction-associated steatotic liver disease (MASLD) is fundamentally rooted in spleen deficiency and is closely associated with phlegm turbidity, damp-heat and blood stasis. Clinically, liver constraint with spleen deficiency and internal retention of damp turbidity represent the predominant traditional Chinese medicine (TCM) syndrome patterns. Researches have indicated intrinsic connections between the syndrome patterns and biological indicators such as gut microbiota and metabolic profiles. Regarding treatment, classical famous formulas, modern empirical formulas, and newly developed TCM drugs show positive effects in regulating glucose and lipid metabolism, improving insulin resistance, and alleviating metabolic inflammation, exhibiting multi-target mechanisms of action; acupuncture and other external therapies also provide adjunctive value. Nevertheless, current researches still have limitations such as the lack of high-quality clinical evidence and insufficient systematic elucidation of the uncerlying mechanisms. Future efforts should focus on conducting high-quality TCM clinical trials with hard endpoint outcomes such as hepatic histology outcomes, and utilizing modern technologies like multi-omics to elucidate TCM's mechanisms of action, thereby advancing the position of TCM as a first-line therapeutic strategy for MASLD.
2.Shenxiao Tongluo Prescription Alleviates Kidney Injury in Diabetic Rats via PGC-1α/SIRT3/HIF-1α Pathway
Cangcang XU ; Xianbing GUO ; Guang LI ; Wenhao JIAO ; Yang ZHAO ; Yingjun DING
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(17):108-116
ObjectiveTo investigate the mechanisms of mitochondrial dynamics and metabolic reprogramming in the treatment of diabetic nephropathy (DN) by Shenxiao Tongluo prescription via the peroxisome proliferator-activated receptor γ coactivator-1α (PGC-1α)/sirtuin-3 (SIRT3)/hypoxia-inducible factor-1α (HIF-1α) signaling pathway. MethodsSixty-five SD rats were randomized into a sham group (10 rats) and a modeling group (55 rats), and the modeling rats underwent left nephrectomy and intraperitoneal injection of streptozotocin (35 mg·kg-1) to prepare a DN model. After successful modeling, the rats were randomized into model, empagliflozin (10 mg·kg-1), and low-, medium-, and high-dose (7.656, 15.312, 30.624 g·kg-1, respectively) Shenxiao Tongluo prescription groups. The urine microalbumin (UmAlb), blood urea nitrogen (BUN), and serum creatinine (SCr) levels of rats in each group were assessed after continuous gavage for 8 weeks. The corresponding kits were used to measure the levels of lactate, superoxide dismutase (SOD), and malondialdehyde (MDA) in the kidney tissue. Hematoxylin-eosin staining, Masson staining, and periodic acid-Schiff staining were performed to observe the pathological changes in the kidney tissue. Transmission electron microscopy was employed to observe mitochondrial morphology. Immunohistochemistry was employed to determine the expression levels of dynamin-related protein 1 (DRP1) and pyruvate kinase M2 (PKM2) in the kidney tissue. Western blot was adopted to assess the protein levels of PGC-1α, SIRT3, HIF-1α, dynamin-related protein 1 (Drp1), optic atrophy 1 (OPA1), hexokinase 2 (HK2), and pyruvate kinase M2 (PKM2) in the kidney tissue. ResultsCompared with the sham group, the model group showed elevated levels of UmAlb, BUN, SCr, lactate, and MDA, decreased SOD level (P<0.05), glomerular hypertrophy, thickening of the mesangial basement membrane, vacuolar degeneration of renal tubular epithelial cells, and infiltration of renal interstitial inflammatory cells, oval mitochondria with disordered, blurred or disappearing cristae, down-regulated protein levels of PGC-1α, SIRT3, and OPA1, and up-regulated protein levels of HIF-1α, DRP1, HK2, and PKM2 (P<0.05). Compared with the model group, the treatment in all the groups increased the body weight, lowered the levels of GLU, UmAlb, BUN, and MDA, raised the level of SOD, alleviated the pathological damage in the kidney tissue and mitochondrial damage, up-regulated the expression of PGC-1α, SIRT3, and OPA1, and down-regulated the expression of HIF-1α, DRP1, and PKM2 (P<0.05). Empagliflozin and Shenxiao Tongluo prescription at medium and high doses lowered the levels of SCr and lactate and down-regulated the expression of HK2 (P<0.05), which had no statistical significance in the low-dose Shenxiao Tongluo prescription group. ConclusionShenxiao Tongluo prescription may regulate mitochondrial dynamics and metabolic reprogramming by activating the PGC-1α/SIRT3/HIF-1α pathway, thereby alleviating oxidative damage in the kidney tissue and delaying the progression of DN.
3.Shenxiao Tongluo Prescription Alleviates Kidney Injury in Diabetic Rats via PGC-1α/SIRT3/HIF-1α Pathway
Cangcang XU ; Xianbing GUO ; Guang LI ; Wenhao JIAO ; Yang ZHAO ; Yingjun DING
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(17):108-116
ObjectiveTo investigate the mechanisms of mitochondrial dynamics and metabolic reprogramming in the treatment of diabetic nephropathy (DN) by Shenxiao Tongluo prescription via the peroxisome proliferator-activated receptor γ coactivator-1α (PGC-1α)/sirtuin-3 (SIRT3)/hypoxia-inducible factor-1α (HIF-1α) signaling pathway. MethodsSixty-five SD rats were randomized into a sham group (10 rats) and a modeling group (55 rats), and the modeling rats underwent left nephrectomy and intraperitoneal injection of streptozotocin (35 mg·kg-1) to prepare a DN model. After successful modeling, the rats were randomized into model, empagliflozin (10 mg·kg-1), and low-, medium-, and high-dose (7.656, 15.312, 30.624 g·kg-1, respectively) Shenxiao Tongluo prescription groups. The urine microalbumin (UmAlb), blood urea nitrogen (BUN), and serum creatinine (SCr) levels of rats in each group were assessed after continuous gavage for 8 weeks. The corresponding kits were used to measure the levels of lactate, superoxide dismutase (SOD), and malondialdehyde (MDA) in the kidney tissue. Hematoxylin-eosin staining, Masson staining, and periodic acid-Schiff staining were performed to observe the pathological changes in the kidney tissue. Transmission electron microscopy was employed to observe mitochondrial morphology. Immunohistochemistry was employed to determine the expression levels of dynamin-related protein 1 (DRP1) and pyruvate kinase M2 (PKM2) in the kidney tissue. Western blot was adopted to assess the protein levels of PGC-1α, SIRT3, HIF-1α, dynamin-related protein 1 (Drp1), optic atrophy 1 (OPA1), hexokinase 2 (HK2), and pyruvate kinase M2 (PKM2) in the kidney tissue. ResultsCompared with the sham group, the model group showed elevated levels of UmAlb, BUN, SCr, lactate, and MDA, decreased SOD level (P<0.05), glomerular hypertrophy, thickening of the mesangial basement membrane, vacuolar degeneration of renal tubular epithelial cells, and infiltration of renal interstitial inflammatory cells, oval mitochondria with disordered, blurred or disappearing cristae, down-regulated protein levels of PGC-1α, SIRT3, and OPA1, and up-regulated protein levels of HIF-1α, DRP1, HK2, and PKM2 (P<0.05). Compared with the model group, the treatment in all the groups increased the body weight, lowered the levels of GLU, UmAlb, BUN, and MDA, raised the level of SOD, alleviated the pathological damage in the kidney tissue and mitochondrial damage, up-regulated the expression of PGC-1α, SIRT3, and OPA1, and down-regulated the expression of HIF-1α, DRP1, and PKM2 (P<0.05). Empagliflozin and Shenxiao Tongluo prescription at medium and high doses lowered the levels of SCr and lactate and down-regulated the expression of HK2 (P<0.05), which had no statistical significance in the low-dose Shenxiao Tongluo prescription group. ConclusionShenxiao Tongluo prescription may regulate mitochondrial dynamics and metabolic reprogramming by activating the PGC-1α/SIRT3/HIF-1α pathway, thereby alleviating oxidative damage in the kidney tissue and delaying the progression of DN.
4.Effects of Non-invasive Light Flicker on Functional Properties of Primary Visual Cortex in Adult Mice
Xue-Qi LI ; Yi-Feng ZHOU ; Guang-Wei XU
Progress in Biochemistry and Biophysics 2025;52(9):2360-2375
ObjectiveAs the central hub of the classical visual pathway, the primary visual cortex not only encodes and processes visual information but also establishes dense neural circuit connections with higher-order cognitive brain regions. Numerous studies have shown that 40 Hz flicker stimulation can induce γ oscillations in the brain and significantly improve learning and cognitive impairments in patients with neurodegenerative diseases. Moreover, flickering light phenomena naturally occur in daily environments. Given that the primary visual cortex serves as the brain’s first cortical hub for receiving visual input, it is essential to comprehensively understand how non-invasive light flicker stimulation modulates its information processing mechanisms. This study systematically investigates the effects of non-invasive light flicker stimulation at different frequencies on the functional properties of neurons in the primary visual cortex of adult mice, aiming to uncover how such stimulation modulates this region and, consequently, affects overall brain function. MethodsThree groups of adult mice (approximately 12 weeks old) were exposed to light flicker stimulation at frequencies of 20 Hz, 40 Hz, and 60 Hz, respectively, for a duration of two months. A control group was exposed to the same light intensity without flickering. Following the stimulation period, in vivo multi-channel electrophysiological recordings were conducted. During these recordings, anesthetized mice were presented with various types of moving sinusoidal light gratings to assess the effects of different flicker frequencies on the functional properties of neurons in the primary visual cortex. ResultsThe experimental results demonstrate that two months of light flicker stimulation at 20 Hz, 40 Hz, and 60 Hz enhances the orientation tuning capabilities of neurons in the primary visual cortex. Specifically, 40 Hz and 60 Hz stimulation improved contrast sensitivity, whereas 20 Hz had no significant effect. Further analysis revealed that all three frequencies reduced neuronal response variability (as measured by the Fano factor), increased the signal-to-noise ratio, and decreased noise correlation (rsc) between neurons. ConclusionNon-invasive light flicker stimulation enhances orientation tuning (e.g., orientation bias index) and contrast sensitivity (e.g., contrast threshold and C50) in neurons of the primary visual cortex. This enhancement is likely due to improved information processing efficiency, characterized by reduced neuronal variability and increased signal-to-noise ratio. These findings suggest that the primary visual cortex can achieve precise and efficient information encoding in complex lighting environments by selectively adapting to different flicker frequencies and optimizing receptive field properties. This study provides new experimental evidence on how various types of light flicker influence visual perception and offers insights into the mechanisms through which specific frequencies enhance brain function.
5.CXCR3 counteracts cisplatin-induced muscle atrophy by regulating E3 ubiquitin ligases, myogenic factors, and fatty acid β-oxidation pathways.
Miao-Miao XU ; Xiao-Guang LIU ; Li-Ming LU ; Zhao-Wei LI
Acta Physiologica Sinica 2025;77(2):255-266
This study aims to explore the role and mechanism of CXC chemokine receptor 3 (CXCR3) in cisplatin-induced skeletal muscle atrophy. Wild-type mice were divided into two groups: cisplatin group and control group (treated by normal saline). The results showed that, compared to the control group, the expression levels of CXCR3 mRNA and protein were significantly up-regulated in the skeletal muscle of the cisplatin group, suggesting that CXCR3 may play an important role in the model of cisplatin-induced skeletal muscle atrophy. To further investigate its role and potential mechanisms, CXCR3 knockout mice and wild-type mice were treated with cisplatin to induce skeletal muscle atrophy. The results revealed that CXCR3 knockout not only failed to alleviate cisplatin-induced skeletal muscle atrophy, but also further reduced body weight, skeletal muscle mass, and muscle fiber cross-sectional area. Further analysis showed that, in the cisplatin-induced muscle atrophy model, CXCR3 knockout significantly up-regulated the expression levels of E3 ubiquitin ligases in skeletal muscle and down-regulated the expression levels of myogenic regulatory factors. To explore the molecular mechanism by which CXCR3 gene deletion exacerbated cisplatin-induced skeletal muscle atrophy, transcriptomic sequencing was performed on the atrophied skeletal muscles of wild-type and CXCR3 knockout mice. The results showed that, compared to wild-type mice, 14 genes were significantly up-regulated and 12 genes were significantly down-regulated in the skeletal muscle of CXCR3 knockout mice. Gene set enrichment analysis (GSEA) revealed a significant enrichment of genes related to fatty acid β-oxidation. Quantitative real-time PCR validation results were consistent with the transcriptomic sequencing results. These findings suggest that CXCR3 may counteract cisplatin-induced skeletal muscle atrophy by up-regulating E3 ubiquitin ligases, down-regulating myogenic regulatory factors, and enhancing the recruitment of fatty acid β-oxidation-related genes.
Animals
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Cisplatin/adverse effects*
;
Muscular Atrophy/physiopathology*
;
Mice
;
Receptors, CXCR3/metabolism*
;
Ubiquitin-Protein Ligases/metabolism*
;
Mice, Knockout
;
Oxidation-Reduction
;
Fatty Acids/metabolism*
;
Muscle, Skeletal/metabolism*
;
Mice, Inbred C57BL
;
Male
6.Exercise preconditioning alleviates motor deficits in MPTP-induced Parkinsonian mice by improving mitochondrial function.
Miao-Miao XU ; Dan-Ting HU ; Qiao ZHANG ; Xiao-Guang LIU ; Zhao-Wei LI ; Li-Ming LU
Acta Physiologica Sinica 2025;77(3):419-431
Parkinson's disease (PD) is a common neurodegenerative disorder mainly related to mitochondrial dysfunction of dopaminergic neurons in the midbrain substantia nigra. This study aimed to investigate the effects of exercise preconditioning on motor deficits and mitochondrial function in a 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced PD mouse model. Eight-week-old male C57BL/6J mice were randomly divided into four groups: sedentary + saline (SS), sedentary + MPTP (SM), exercise + saline (ES), and exercise + MPTP (EM) groups. Mice in the ES and EM groups received 4 weeks of treadmill training, and then SM and EM groups were treated with MPTP for 5 days. Motor function was assessed by behavioral tests, and morphological and functional changes in dopaminergic neurons and mitochondria in the substantia nigra of the midbrain were evaluated using immunohistochemistry, Western blot, and transmission electron microscopy technology. The results showed that, compared with the SM group, the EM group exhibited significantly improved motor ability, up-regulated protein expression levels of tyrosine hydroxylase (TH) and dopamine transporter (DAT) in the midbrain, and down-regulated protein expression of α-synuclein (α-Syn) in the mitochondria of substantia nigra. Compared with the SM group, the EM group showed up-regulated protein expression levels of mitochondrial fusion proteins, including optical atrophy protein 1 (OPA1) and mitofusin 2 (MFN2), and biogenesis-related proteins, including peroxisome proliferator activated receptor gamma coactivator 1α (PGC-1α) and mitochondrial transcription factor A (TFAM), while the protein expression levels of dynamin-related protein 1 (DRP1) and mitochondrial fission protein 1 (FIS1) were significantly down-regulated. Compared with the SM group, the EM group showed significantly reduced damage to substantia nigra mitochondria, restored mitochondrial membrane potential and ATP production, and decreased levels of reactive oxygen species (ROS). These results suggest that 4-week treadmill pre-training can alleviate MPTP-induced motor impairments in PD mice by improving mitochondrial function, providing a theoretical basis for early exercise-based prevention of PD.
Animals
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Male
;
Physical Conditioning, Animal/physiology*
;
Mice
;
Mice, Inbred C57BL
;
Mitochondria/physiology*
;
Dopaminergic Neurons
;
MPTP Poisoning/physiopathology*
;
Substantia Nigra
;
Peroxisome Proliferator-Activated Receptor Gamma Coactivator 1-alpha
;
1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine
7.Hydrogen sulfide ameliorates hypoxic pulmonary hypertension in rats by inhibiting aerobic glycolysis-pyroptosis.
Yuan CHENG ; Yun-Na TIAN ; Man HUANG ; Jun-Peng XU ; Wen-Jie CAO ; Xu-Guang JIA ; Li-Yi YOU ; Wan-Tie WANG
Acta Physiologica Sinica 2025;77(3):465-471
The present study aimed to explore whether hydrogen sulfide (H2S) improved hypoxic pulmonary hypertension (HPH) in rats by inhibiting aerobic glycolysis-pyroptosis. Male Sprague-Dawley (SD) rats were randomly divided into normal group, normal+NaHS group, hypoxia group, and hypoxia+NaHS group, with 6 rats in each group. The control group rats were placed in a normoxic (21% O2) environment and received daily intraperitoneal injections of an equal volume of normal saline. The normal+NaHS group rats were placed in a normoxic environment and intraperitoneally injected with 14 μmol/kg NaHS daily. The hypoxia group rats were placed in a hypoxia chamber, and the oxygen controller inside the chamber maintained the oxygen concentration at 9% to 10% by controlling the N2 flow rate. An equal volume of normal saline was injected intraperitoneally every day. The hypoxia+NaHS group rats were also placed in an hypoxia chamber and intraperitoneally injected with 14 μmol/kg NaHS daily. After the completion of the four-week modeling, the mean pulmonary artery pressure (mPAP) of each group was measured using right heart catheterization technique, and the right ventricular hypertrophy index (RVHI) was weighed and calculated. HE staining was used to observe pathological changes in lung tissue, Masson staining was used to observe fibrosis of lung tissue, and Western blot was used to detect protein expression levels of hexokinase 2 (HK2), pyruvate dehydrogenase (PDH), pyruvate kinase isozyme type M2 (PKM2), nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3), GSDMD-N-terminal domain (GSDMD-N), Caspase-1, interleukin-1β (IL-1β) and IL-18 in lung tissue. ELISA was used to detect contents of IL-1β and IL-18 in lung tissue. The results showed that, compared with the normal control group, there were no significant changes in all indexes in the normal+NaHS group, while the hypoxia group exhibited significantly increased mPAP and RVHI, thickened pulmonary vascular wall, narrowed lumen, increased collagen fibers, up-regulated expression levels of aerobic glycolysis-related proteins (HK2 and PKM2), up-regulated expression levels of pyroptosis-related proteins (NLRP3, GSDMD-N, Caspase-1, IL-1β, and IL-18), and increased contents of IL-1β and IL-18. These changes of the above indexes in the hypoxia group were significantly reversed by NaHS. These results suggest that H2S can improve rat HPH by inhibiting aerobic glycolysis-pyroptosis.
Animals
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Rats, Sprague-Dawley
;
Male
;
Hypertension, Pulmonary/metabolism*
;
Glycolysis/drug effects*
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Hydrogen Sulfide/therapeutic use*
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Hypoxia/complications*
;
Rats
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Pyroptosis/drug effects*
8.Research progress in effect of traditional Chinese medicine on aerobic glycolysis in colorectal cancer.
Xu MA ; Sheng-Long LI ; Guang-Rong ZHENG ; Da-Cheng TIAN ; Gang-Gang LU ; Jie GAO ; Yu-Qi AN ; Li-Yuan CAO ; Liang LI ; Xiao-Yong TANG
China Journal of Chinese Materia Medica 2025;50(6):1496-1506
Colorectal cancer(CRC) is a common malignant tumor worldwide. Due to the treatment intolerance and side effects, CRC rank the top among various cancers regarding the incidence and mortality rates. Therefore, exploring new therapies is of great significance for the treatment of CRC. Aerobic glycolysis(AEG) plays an important role in the microenvironment formation, proliferation, metastasis, and recurrence of CRC and other tumor cells. It has been confirmed that intervening in the AEG pathway can effectively curb CRC. The active ingredients and compound prescriptions of traditional Chinese medicine(TCM) can effectively inhibit the proliferation, metastasis, and drug resistance and regulate the apoptosis of tumor cells by modulating AEG-associated transport proteins [eg, glucose transporters(GLUT)], key enzymes [hexokinase(HK) and phosphofructokinase(PFK)], key genes [hypoxia-inducible factor 1(HIF-1) and oncogene(c-Myc)], and signaling pathways(MET/PI3K/Akt/mTOR). Accordingly, they can treat CRC, reduce the recurrence, and improve the prognosis of CRC. Although AEG plays a key role in the development and progression of CRC, the specific mechanisms are not yet fully understood. Therefore, this article delves into the intrinsic connection of the targets and mechanisms of the AEG pathway with CRC from the perspective of tumor cell glycolysis and explores how active ingredients(oxymatrine, kaempferol, and dioscin) and compound prescriptions(Quxie Capsules, Jiedu Sangen Decoction, and Xianlian Jiedu Prescription) of TCM treat CRC by intervening in the AEG pathway. Additionally, this article explores the shortcomings in the current research, aiming to provide reliable targets and a theoretical basis for treating CRC with TCM.
Humans
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Colorectal Neoplasms/genetics*
;
Drugs, Chinese Herbal/therapeutic use*
;
Glycolysis/drug effects*
;
Animals
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Medicine, Chinese Traditional
;
Signal Transduction/drug effects*
9.Exploring in vivo existence forms of Notoginseng Radix et Rhizoma in rats.
Meng-Ge FENG ; Lin-Han XIANG ; Jing ZHANG ; Wen-Hui ZHAO ; Yang LI ; Li-Li LI ; Guang-Xue LIU ; Shao-Qing CAI ; Feng XU
China Journal of Chinese Materia Medica 2025;50(9):2539-2562
The study aims to elucidate the existence forms(original constituents and metabolites) of Notoginseng Radix et Rhizoma in rats and reveal its metabolic pathways. After Notoginseng Radix et Rhizoma was administered orally once a day for seven consecutive days to rats, all urine and feces samples were collected for seven days, while the blood samples were obtained 6 h after the last administration. Using the ultra high performance liquid chromatography-quadrupole time-of-flight tandem mass spectrometry(UHPLC-Q-TOF-MS/MS) technique, this study identified 6, 73, and 156 existence forms of Notoginseng Radix et Rhizoma in the rat plasma, urine, and feces samples, respectively. Among them, 101 compounds were identified as new existence forms, and 13 original constituents were identified by comparing with reference compounds. The metabolic reactions of constituents from Notoginseng Radix et Rhizoma were mainly deglycosylation, dehydration, hydroxylation, hydrogenation, dehydrogenation, acetylation, and amino acid conjugation. Furthermore, the possible in vivo metabolic pathways of protopanaxatriol(PPT) in rats were proposed. Through comprehensive analysis of the liquid chromatography-mass spectrometry(LC-MS) data, isomeric compounds were discriminated, and the planar chemical structures of 32 metabolites were clearly identified. According to the literature, 48 original constituents possess antitumor and cardiovascular protective bioactivities. Additionally, 32 metabolites were predicted to have similar bioactivities by SuperPred. This research lays the foundation for further exploring the in vivo effective forms of Notoginseng Radix et Rhizoma.
Animals
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Rats
;
Drugs, Chinese Herbal/pharmacokinetics*
;
Rhizome/metabolism*
;
Male
;
Rats, Sprague-Dawley
;
Chromatography, High Pressure Liquid
;
Panax notoginseng/chemistry*
;
Tandem Mass Spectrometry
;
Feces/chemistry*
10.Effectiveness of Acupuncture in Improving Quality of Life for Patients with Advanced Cancer: A Systematic Review and Meta-Analysis.
Xin YU ; Si-Yao GONG ; Qin LUO ; Gui-Xing XU ; Hao TIAN ; Qian LI ; Ming CHEN ; Sha YANG ; Shu-Guang YU
Chinese journal of integrative medicine 2025;31(4):360-371
OBJECTIVE:
To investigate the effect of acupuncture on advanced cancer patients by meta-analysis.
METHODS:
Nine databases (the Cochrane Central Register of Controlled Trials, MEDLINE, Web of Science, Embase, China National Knowledge Infrastructure, the Cumulative Index to Nursing and Allied Health Literature, Chinese Biomedical Literature Database, China Science and Technology Journal Database, and WanFang Data) were searched for randomized controlled trials (RCTs) on acupuncture in advanced cancer patients published from inception to February 13, 2023 and updated to June 1, 2023. Primary outcomes were quality of life (QOL), while secondary outcomes were pain, fatigue, and adverse events (side effects). Data synthesis was performed using RevMan V.5.3 to calculate pooled effect sizes. RoB-2 was used for the risk of bias, and the quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) tool.
RESULTS:
Totally 17 RCTs involving 1,178 participants were included, 15 of which were pooled for meta-analysis. Most studies demonstrated some concern for the overall risk of bias. The pooled data indicated that acupuncture was associated with improved QOL [mean difference (MD)=6.67, 95% confidence interval (CI): 5.09 to 8.26], pain (MD=-1.18, 95% CI -2.28 to -0.08), and adverse events (risk ratio=0.30, 95% CI: 0.26 to 0.57) compared with control groups. Fatigue outcome was not included. Heterogeneity was substantial, and GRADE evidence was very low for both QOL and pain.
CONCLUSIONS
Acupuncture could benefit patients with advanced cancer and is considered safe compared with usual care. However, the evidence regarding QOL and pain outcomes requires further validation. It is crucial to encourage the development of high-quality studies to strengthen this evidence. (Registry No. CRD42023423539).
Humans
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Acupuncture Therapy
;
Neoplasms/therapy*
;
Quality of Life
;
Randomized Controlled Trials as Topic
;
Treatment Outcome

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