Acupuncture therapy for bronchial asthma: an overview of systematic reviews_Chinese Journal of Evidence-Based Medicine

Authors：

LIU Yilin , XU Guixing , HUANG Liuyang , TIAN Hao , ZHOU Zhuo , HUANG Fengyuan ,  LIANG Fanrong

Chengdu University of Traditional Chinese Medicine, Chengdu 610075, P. R. China;

Corresponding author：

LIANG Fanrong, Email: acuresearch@126.com

Keywords：

Acupuncture therapy; Bronchial asthma; Overview of systematic reviews; AMSTAR 2; GRADE

DOI：

10.7507/1672-2531.202201010

Video：

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Objective To evaluate the quality of methodology and evidence of the systematic reviews and meta-analyses (SRs/MAs) of acupuncture therapy for bronchial asthma. Methods CNKI, CBM, VIP, WanFang Data, PubMed, The Cochrane Library and Web of Science databases were electronically searched to collect SRs/MAs of acupuncture therapy for bronchial asthma from inception to October 31, 2021. Four reviewers independently screened literature, extracted data, and applied the AMSTAR 2 to evaluate the quality of methodology of the included studies and the GRADE system to assess the certainty of evidence for outcomes. Results A total of 14 SRs/MAs were included and their main conclusions were that acupuncture therapy was beneficial in improving the clinical efficacy of bronchial asthma treatment. The evaluation of AMSTAR 2 showed that the methodological quality of all studies was all extremely low. The evidence grading of GRADE system showed that, in the total of 59 outcomes, 7 were graded as medium-level, 24 as low-level, 28 as extremely low-level, and none was graded as high-level. Conclusion The current evidence shows the advantages of acupuncture therapy for bronchial asthma but the reliability of SRs/MAs is low. High-quality clinical studies are still needed to verify the efficacy of acupuncture therapy for bronchial asthma.

Citation： LIU Yilin, XU Guixing, HUANG Liuyang, TIAN Hao, ZHOU Zhuo, HUANG Fengyuan, LIANG Fanrong. Acupuncture therapy for bronchial asthma: an overview of systematic reviews. Chinese Journal of Evidence-Based Medicine, 2022, 22(8): 955-963. doi: 10.7507/1672-2531.202201010 Copy

1.	赵霞, 汪受传, 韩新民, 等. 小儿哮喘中医诊疗指南. 中医儿科杂志, 2008, 4(3): 4-6.
2.	GBD 2015 Chronic Respiratory Disease Collaborators. Global, regional, and national deaths, prevalence, disability-adjusted life years, and years lived with disability for chronic obstructive pulmonary disease and asthma, 1990-2015: a systematic analysis for the global burden of disease study 2015. Lancet Respir Med, 2017, 5(9): 691-706.
3.	李为民, 罗汶鑫. 我国慢性呼吸系统疾病的防治现状. 西部医学, 2020, 32(1): 1-4.
4.	Barnes PJ. New therapies for asthma: is there any progress. Trends Pharmacol Sci, 2010, 31(7): 335-343.
5.	Bleecker ER, Menzies-Gow AN, Price DB, et al. Systematic literature review of systemic corticosteroid use for asthma management. Am J Respir Crit Care Med, 2020, 201(3): 276-293.
6.	中华医学会呼吸病学分会哮喘病组. 支气管哮喘防治指南(2020年版). 中华结核和呼吸杂志, 2020, 43(12): 1023-1048.
7.	Xu YD, Cui JM, Wang Y, et al. Proteomic analysis reveals the deregulation of inflammation-related proteins in acupuncture-treated rats with asthma onset. Evid Based Complement Alternat Med, 2012, 2012: 850512.
8.	Xu YD, Wei Y, Wang Y, et al. Exogenous S100A8 protein inhibits PDGF-induced migration of airway smooth muscle cells in a RAGE-dependent manner. Biochem Biophys Res Commun, 2016, 472(1): 243-249.
9.	王宇, 孙婧, 金融, 等. 针刺对哮喘大鼠气道重建模型气道平滑肌细胞T型钙通道蛋白表达的影响. 中国针灸, 2012, 32(6): 534-540.
10.	邵素菊, 权春分, 邵素霞, 等. “邵氏五针法”治疗急性发作期哮病: 多中心随机对照研究. 中国针灸, 2013, 33(9): 774-778.
11.	陶欢, 杨乐天, 平安, 等. 随机或非随机防治性研究系统评价的质量评价工具AMSTAR2解读. 中国循证医学杂志, 2018, 18(1): 101-108.
12.	张方圆, 沈傲梅, 曾宪涛, 等. 系统评价方法学质量评价工具AMSTAR2解读. 中国循证心血管医学杂志, 2018, 10(1): 14-18.
13.	Guyatt HG, Oxman DA, Vist G, 等. GRADE指南: Ⅳ. 证据质量分级—研究的局限性(偏倚风险). 中国循证医学杂志, 2011, 11(4): 456-463.
14.	Guyatt HG, Oxman DA, Kunz R, 等. GRADE指南: Ⅶ. 证据质量评价—不一致性. 中国循证医学杂志, 2011, 11(12): 1444-1451.
15.	Guyatt HG, Oxman DA, Kunz R, 等. GRADE指南: Ⅷ. 证据质量评价—间接性. 中国循证医学杂志, 2011, 11(12): 1452-1458.
16.	Guyatt HG, Oxman DA, Kunz R, 等. GRADE指南: Ⅵ. 证据质量评价—不精确性(随机误差). 中国循证医学杂志, 2011, 11(12): 1435-1443.
17.	Guyatt HG, Oxman DA, Montori V, 等. GRADE指南: Ⅴ. 证据质量评价—发表偏倚. 中国循证医学杂志, 2011, 11(12): 1430-1434.
18.	章荣, 任凯. 穴位埋线治疗支气管哮喘的系统评价. 医学信息(医药版), 2009, (2): 4.
19.	于璐, 张燕, 陈程, 等. 针灸治疗哮喘随机对照临床研究文献Meta分析. 中国针灸, 2010, 30(9): 787-792.
20.	胡成想, 李素荷. 穴位埋线疗法治疗支气管哮喘的系统评价. 安徽中医药大学学报, 2014, 33(3): 70-73.
21.	张赛男, 王煦喆, 陈果, 等. 穴位埋线治疗支气管哮喘的临床研究文献Meta分析. 针灸临床杂志, 2016, 32(10): 74-78.
22.	陈新宇, 舒华, 吴治谚, 等. 热敏灸治疗支气管哮喘临床疗效的系统评价. 针灸临床杂志, 2016, 32(5): 51-55.
23.	李孟媛, 王洪峰, 王朝辉. 针灸治疗支气管哮喘临床研究文献的Meta分析. 时珍国医国药, 2018, 29(8): 2046-2048.
24.	陈晓东, 居尚, 童画, 等. 自血疗法治疗哮喘病疗效的系统评价及Meta分析. 长春中医药大学学报, 2019, 35(1): 58-61.
25.	梁汝圣, 远颖. 穴位埋线治疗咳嗽变异性哮喘的Meta分析. 中国城乡企业卫生, 2020, 35(3): 7-12.
26.	Shen FY, Lee MS, Jung SK. Effectiveness of pharmacopuncture for asthma: a systematic review and meta-analysis. Evid Based Complement Alternat Med, 2011, 2011: 678176.
27.	Xiong J, Liu Z, Chen R, et al. Effectiveness and safety of heat-sensitive moxibustion on bronchial asthma: a meta-analysis of randomized control trials. J Tradit Chin Med, 2014, 34(4): 392-400.
28.	Bang M, Chang S, Kim JH, et al. Pharmacopuncture for asthma: a systematic review and a meta-analysis of randomized controlled trials. Eur J Integr Med, 2017, 11: 6-17.
29.	Cui W, Sun W, Mao YQL, et al. Evaluation of catgut implantation at acupoints for asthma: a systematic review and meta-analysis. Trad Med Modern Med, 2018, 1(2): 123-132.
30.	Jiang C, Jiang L, Qin Q. Conventional treatments plus acupuncture for asthma in adults and adolescent: a systematic review and meta-analysis. Evid Based Complement Alternat Med, 2019, 2019: 9580670.
31.	Xiong J, Qi W, Yang H, et al. Acupuncture treatment for cough-variant asthma: a meta-analysis. Evid Based Complement Alternat Med, 2021, 2021: 6694936.
32.	Cook DJ, Mulrow CD, Haynes RB. Systematic reviews: synthesis of best evidence for clinical decisions. Ann Intern Med, 1997, 126(5): 376-380.
33.	叶静, 李涓, 周俊, 等. 针灸治疗脑卒中后肩手综合征的meta分析的再评价. 中国康复医学杂志, 2020, 35(2): 189-194.
34.	Schulz KF, Altman DG, Moher D. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. J Pharmacol Pharmacother, 2010, 1(2): 100-107.
35.	MacPherson H, Altman DG, Hammerschlag R, et al. Revised standards for reporting interventions in clinical trials of acupuncture (STRICTA): Extending the CONSORT statement. J Evid Based Med, 2010, 3(3): 140-155.
36.	银子涵, 徐桂兴, 杨晗, 等. 针灸治疗带状疱疹及其后遗症的系统评价再评价. 世界科学技术-中医药现代化, 2020, 22(8): 2772-2779.
37.	崔学超, 王刚. 针刺治疗支气管哮喘研究进展. 中国呼吸与危重监护杂志, 2013, 12(4): 416-422.
38.	周新, 张旻. 中国支气管哮喘防治指南(2020年版)解读. 诊断学理论与实践, 2021, 20(2): 138-143.

1. 赵霞, 汪受传, 韩新民, 等. 小儿哮喘中医诊疗指南. 中医儿科杂志, 2008, 4(3): 4-6.
2. GBD 2015 Chronic Respiratory Disease Collaborators. Global, regional, and national deaths, prevalence, disability-adjusted life years, and years lived with disability for chronic obstructive pulmonary disease and asthma, 1990-2015: a systematic analysis for the global burden of disease study 2015. Lancet Respir Med, 2017, 5(9): 691-706.
3. 李为民, 罗汶鑫. 我国慢性呼吸系统疾病的防治现状. 西部医学, 2020, 32(1): 1-4.
4. Barnes PJ. New therapies for asthma: is there any progress. Trends Pharmacol Sci, 2010, 31(7): 335-343.
5. Bleecker ER, Menzies-Gow AN, Price DB, et al. Systematic literature review of systemic corticosteroid use for asthma management. Am J Respir Crit Care Med, 2020, 201(3): 276-293.
6. 中华医学会呼吸病学分会哮喘病组. 支气管哮喘防治指南(2020年版). 中华结核和呼吸杂志, 2020, 43(12): 1023-1048.
7. Xu YD, Cui JM, Wang Y, et al. Proteomic analysis reveals the deregulation of inflammation-related proteins in acupuncture-treated rats with asthma onset. Evid Based Complement Alternat Med, 2012, 2012: 850512.
8. Xu YD, Wei Y, Wang Y, et al. Exogenous S100A8 protein inhibits PDGF-induced migration of airway smooth muscle cells in a RAGE-dependent manner. Biochem Biophys Res Commun, 2016, 472(1): 243-249.
9. 王宇, 孙婧, 金融, 等. 针刺对哮喘大鼠气道重建模型气道平滑肌细胞T型钙通道蛋白表达的影响. 中国针灸, 2012, 32(6): 534-540.
10. 邵素菊, 权春分, 邵素霞, 等. “邵氏五针法”治疗急性发作期哮病: 多中心随机对照研究. 中国针灸, 2013, 33(9): 774-778.
11. 陶欢, 杨乐天, 平安, 等. 随机或非随机防治性研究系统评价的质量评价工具AMSTAR2解读. 中国循证医学杂志, 2018, 18(1): 101-108.
12. 张方圆, 沈傲梅, 曾宪涛, 等. 系统评价方法学质量评价工具AMSTAR2解读. 中国循证心血管医学杂志, 2018, 10(1): 14-18.
13. Guyatt HG, Oxman DA, Vist G, 等. GRADE指南: Ⅳ. 证据质量分级—研究的局限性(偏倚风险). 中国循证医学杂志, 2011, 11(4): 456-463.
14. Guyatt HG, Oxman DA, Kunz R, 等. GRADE指南: Ⅶ. 证据质量评价—不一致性. 中国循证医学杂志, 2011, 11(12): 1444-1451.
15. Guyatt HG, Oxman DA, Kunz R, 等. GRADE指南: Ⅷ. 证据质量评价—间接性. 中国循证医学杂志, 2011, 11(12): 1452-1458.
16. Guyatt HG, Oxman DA, Kunz R, 等. GRADE指南: Ⅵ. 证据质量评价—不精确性(随机误差). 中国循证医学杂志, 2011, 11(12): 1435-1443.
17. Guyatt HG, Oxman DA, Montori V, 等. GRADE指南: Ⅴ. 证据质量评价—发表偏倚. 中国循证医学杂志, 2011, 11(12): 1430-1434.
18. 章荣, 任凯. 穴位埋线治疗支气管哮喘的系统评价. 医学信息(医药版), 2009, (2): 4.
19. 于璐, 张燕, 陈程, 等. 针灸治疗哮喘随机对照临床研究文献Meta分析. 中国针灸, 2010, 30(9): 787-792.
20. 胡成想, 李素荷. 穴位埋线疗法治疗支气管哮喘的系统评价. 安徽中医药大学学报, 2014, 33(3): 70-73.
21. 张赛男, 王煦喆, 陈果, 等. 穴位埋线治疗支气管哮喘的临床研究文献Meta分析. 针灸临床杂志, 2016, 32(10): 74-78.
22. 陈新宇, 舒华, 吴治谚, 等. 热敏灸治疗支气管哮喘临床疗效的系统评价. 针灸临床杂志, 2016, 32(5): 51-55.
23. 李孟媛, 王洪峰, 王朝辉. 针灸治疗支气管哮喘临床研究文献的Meta分析. 时珍国医国药, 2018, 29(8): 2046-2048.
24. 陈晓东, 居尚, 童画, 等. 自血疗法治疗哮喘病疗效的系统评价及Meta分析. 长春中医药大学学报, 2019, 35(1): 58-61.
25. 梁汝圣, 远颖. 穴位埋线治疗咳嗽变异性哮喘的Meta分析. 中国城乡企业卫生, 2020, 35(3): 7-12.
26. Shen FY, Lee MS, Jung SK. Effectiveness of pharmacopuncture for asthma: a systematic review and meta-analysis. Evid Based Complement Alternat Med, 2011, 2011: 678176.
27. Xiong J, Liu Z, Chen R, et al. Effectiveness and safety of heat-sensitive moxibustion on bronchial asthma: a meta-analysis of randomized control trials. J Tradit Chin Med, 2014, 34(4): 392-400.
28. Bang M, Chang S, Kim JH, et al. Pharmacopuncture for asthma: a systematic review and a meta-analysis of randomized controlled trials. Eur J Integr Med, 2017, 11: 6-17.
29. Cui W, Sun W, Mao YQL, et al. Evaluation of catgut implantation at acupoints for asthma: a systematic review and meta-analysis. Trad Med Modern Med, 2018, 1(2): 123-132.
30. Jiang C, Jiang L, Qin Q. Conventional treatments plus acupuncture for asthma in adults and adolescent: a systematic review and meta-analysis. Evid Based Complement Alternat Med, 2019, 2019: 9580670.
31. Xiong J, Qi W, Yang H, et al. Acupuncture treatment for cough-variant asthma: a meta-analysis. Evid Based Complement Alternat Med, 2021, 2021: 6694936.
32. Cook DJ, Mulrow CD, Haynes RB. Systematic reviews: synthesis of best evidence for clinical decisions. Ann Intern Med, 1997, 126(5): 376-380.
33. 叶静, 李涓, 周俊, 等. 针灸治疗脑卒中后肩手综合征的meta分析的再评价. 中国康复医学杂志, 2020, 35(2): 189-194.
34. Schulz KF, Altman DG, Moher D. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. J Pharmacol Pharmacother, 2010, 1(2): 100-107.
35. MacPherson H, Altman DG, Hammerschlag R, et al. Revised standards for reporting interventions in clinical trials of acupuncture (STRICTA): Extending the CONSORT statement. J Evid Based Med, 2010, 3(3): 140-155.
36. 银子涵, 徐桂兴, 杨晗, 等. 针灸治疗带状疱疹及其后遗症的系统评价再评价. 世界科学技术-中医药现代化, 2020, 22(8): 2772-2779.
37. 崔学超, 王刚. 针刺治疗支气管哮喘研究进展. 中国呼吸与危重监护杂志, 2013, 12(4): 416-422.
38. 周新, 张旻. 中国支气管哮喘防治指南(2020年版)解读. 诊断学理论与实践, 2021, 20(2): 138-143.

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