Acupuncture for Primary Osteoporosis: Evidence, Potential Treatment Prescriptions, and Mechanisms
Acupuncture for Primary Osteoporosis: Evidence, Potential Treatment Prescriptions, and Mechanisms
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DOI：
10.1155/2019/2705263
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发表时间：
2019-01-01
影响因子：
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通讯作者：
Chen, Yongjun
中科院分区：
文献类型：
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作者：
Lin, Haixiong;Wang, Xiaotong;Chen, Yongjun
针灸治疗骨质疏松症（OP）的临床试验和荟萃分析已经发表。然而，从这些研究中识别证据仍然是一个挑战。我们对中国生物医学（CBM）、VIP数据库、万方数据、中国知网（CNKI）、PubMed、Springer、科克伦图书馆和Embase进行了系统检索，以识别截至2018年10月31日的相关试验、系统综述和/或荟萃分析。提取数据以使用Veritas图评估方法学质量，并使用传统中医药遗传支持系统（TCMISS）探索潜在的针灸处方。此外，基于已发表的研究，总结了通过数据挖掘确定的核心穴位的潜在机制。共纳入218项临床试验和10项荟萃分析，涉及212个针灸处方，102个穴位，13条经络，3条奇经，1个阿是穴。发表年份、研究类型、多系统评价2、系统评价和荟萃分析的首选报告项目、异质性和发表偏倚的平均Veritas评分分别为5.5、7.2、6、5.6、5.8和7.5。Pan等人的研究获得了8.67分的最高Veritas评分。最常用的经络是BL。穴位组合BL 23与BL 20、BL 23与GV 4、BL 23与ST 36使用频率较高。核心穴位关联网络为穴位BL 23、BL 20、ST 36、GV 4、SP 6、CV 4和KI 3。核心穴的潜在机制涉及上调OPG/RANKL、Wnt/β-catenin和MAPK通路中成员的表达，如LRP 5、β-catenin、Runx 2和OPG。总之，我们的Veritas图使针灸师能够评估与针灸治疗原发性OP相关的荟萃分析质量的关键属性，并提高与针灸相关的循证医学的质量。数据挖掘分析揭示了经络、穴位组合、核心穴位与针刺治疗原发性OP的潜在机制之间的关联网络。
Many clinical trials and meta-analyses related to acupuncture for osteoporosis (OP) have been published. However, identifying the evidence from these studies still remains a challenge for acupuncturists. We conducted a systematic search of the Chinese Biomedical Medicine (CBM), VIP Database, Wanfang Data, China National Knowledge Infrastructure (CNKI), PubMed, Springer, Cochrane Library, and Embase to identify relevant trials, systematic reviews, and/or meta-analyses up to October 31, 2018. Data were extracted to assess the methodological quality using Veritas plots and to explore potential acupuncture prescriptions using the Traditional Chinese Medicine inheritance support system (TCMISS). In addition, potential mechanisms of core acupoints identified by data mining were summarized based on published studies. A total of 218 clinical trials and ten meta-analyses were included, involving 212 acupuncture prescriptions, 102 acupoints, 13 meridians, three extra meridians, and one Ashi point. The mean Veritas score of publication year, type of study, Assessment of Multiple Systematic Reviews 2, Preferred Reporting Items for Systematic Reviews and Meta-Analyses, heterogeneity, and publication bias were 5.5, 7.2, 6, 5.6, 5.8, and 7.5, respectively. The study of Pan et al. received the highest Veritas score of 8.67 points. The most frequently used meridian was BL. Acupoint combinations BL23 and BL20, BL23 and GV4, and BL23 and ST36 were used frequently. The core acupoints association networks were acupoints BL23, BL20, ST36, GV4, SP6, CV4, and KI3. The potential mechanisms of core acupoints involved upregulated expression of members in OPG/RANKL, Wnt/-catenin, and MAPK pathways, such as LRP5, -catenin, Runx2, and OPG. In conclusion, our Veritas plots enable acupuncturists to evaluate key attributes of meta-analysis quality related to acupuncture for primary OP and to improve the quality of evidence-based medicine relating to acupuncture. Data mining analysis revealed an association network of meridians, acupoint combinations, core acupoints, and the underlying mechanisms of acupuncture for primary OP.