Clinical effect of catgut implantation at acupoints for the treatment of simple obesity

Chen, Xia; Huang, Wei; Wei, Dan; Ding, De-Guang; Yang, Jiao; Pan, Hong-Ling; Jin, Yingxue; Zheng, Yi-Wei; Zhang, Yanji; Zhang, Yingrong; Liu, Yiran; Zhou, Zhongyu

doi:10.1097/md.0000000000023390

“…Obesity is a chronic disease due to excessive accumulation or abnormal distribution of fat in the body [ 1 ]. Simple obesity is a kind of obesity caused by excessively more intake than consumption, excluding other diseases or medical factors [ 2 ]. Simple obesity is now an epidemic health problem, leading to higher incidence of other diseases.…”

Section: Introductionmentioning

confidence: 99%

Network Meta-Analysis of Acupoint Catgut Embedding in Treatment of Simple Obesity

Wang

¹

,

Li

²

,

Gou

³

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Objective. To evaluate the clinical efficacy of acupoint catgut embedding in the treatment of simple obesity through network meta-analysis. Methods. PubMed, Cochrane, Embase, China National Knowledge Infrastructure (CNKI), Wanfang, and VIP database (VIP) were searched by using computer from 2011 to August 2021, and 35 RCT studies were retrieved. The quality of the literature was evaluated using the modified Jadad scoring table, and Stata 15.0 software was used for traditional meta-analysis and network meta-analysis. Results. Thirty-five RCTs (3040 cases in total) were included. Acupoint embedding, acupuncture, electroacupuncture, TCM, acupoint embedding + acupuncture, acupoint embedding + exercise diet therapy, acupoint embedding + TCM, exercise diet therapy, acupoint embedding + moxibustion, and acupoint embedding + cupping were investigated in the studies. The results of network meta-analysis were as follows: in terms of total effective rate, acupoint catgut embedding was superior to acupuncture, electroacupuncture, and exercise diet therapy ( P < 0.05 ); electroacupuncture, acupoint catgut embedding + acupuncture, acupoint catgut embedding + exercise diet therapy, acupoint catgut + TCM, acupoint catgut + moxibustion, and acupoint catgut + cupping were superior to acupuncture ( P < 0.05 ); acupoint catgut + moxibustion was superior to electroacupuncture ( P < 0.05 ); acupoint catgut + TCM, acupoint catgut + moxibustion, and acupoint catgut + cupping were superior to TCM treatment ( P < 0.05 ); and electroacupuncture, acupoint catgut, acupoint catgut + acupuncture, acupoint catgut + exercise diet therapy, acupoint catgut + TCM, acupoint catgut embedding + moxibustion, and acupoint catgut embedding + cupping were superior to sports diet therapy ( P < 0.05 ). Regarding weight loss, acupuncture treatment was superior to acupoint catgut embedding therapy ( P < 0.05 ); acupoint catgut embedding + exercise diet therapy, acupoint catgut embedding + TCM, acupoint catgut embedding + moxibustion, and acupoint catgut embedding + cupping were superior to acupuncture and electroacupuncture treatment ( P < 0.05 ); acupoint catgut embedding + exercise diet therapy, acupoint catgut embedding + TCM, and acupoint catgut embedding + moxibustion were superior to TCM treatment ( P < 0.05 ); and acupoint catgut embedding, acupoint catgut embedding + acupuncture, catgut embedding + exercise diet therapy, acupoint catgut embedding + TCM, acupoint catgut embedding + moxibustion, and acupoint catgut embedding + cupping were superior to exercise diet therapy ( P < 0.05 ). In terms of BMI reduction, acupoint catgut embedding + moxibustion and acupoint catgut embedding + cupping were more evident than acupuncture treatment ( P < 0.05 ); and acupoint catgut embedding + moxibustion was more evident than electroacupuncture treatment ( P < 0.05 ). Conclusion. Acupoint catgut embedding and its combination with other therapies are the first choice for the treatment of simple obesity.

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“…A total of 5872 patients with obesity were involved in this meta-analysis, with sample sizes ranging from 21 to 200, and the duration of treatment was from 12 days to 6 months. Fifty-five trials included patients with simple obesity; [ 15 , 22 , 23 , 25 – 28 , 32 – 34 , 36 – 41 , 43 – 46 , 49 – 51 , 54 , 56 – 59 , 61 – 63 , 65 – 67 , 69 – 73 , 75 – 80 , 82 – 90 , 92 ] six included patients with abdominal obesity; [ 14 , 31 , 47 , 52 , 68 , 74 ] one included a patient with central obesity; [ 24 ] one included a patient with lower body obesity; [ 91 ] the remaining ten trials did not mention the type of obesity. [ 29 , 30 , 35 , 42 , 48 , 53 , 55 , 60 , 64 , 81 ] The other detail of treatment was showed in Supplemental Digital Content 3, http://links.lww.com/MD/H824 .…”

Section: Resultsmentioning

confidence: 99%

“…All included studies were divided into seven groups based on the intervention and comparison groups: ACE versus MA (n = 30), [ 14 , 22 , 27 , 29 , 31 , 32 , 34 , 37 , 44 , 45 , 48 – 51 , 56 – 58 , 60 – 62 , 64 , 69 , 72 , 73 , 76 , 84 , 85 , 88 – 90 ] ACE versus EA (n = 25), [ 15 , 25 , 28 , 30 , 36 , 39 – 41 , 43 , 46 , 47 , 52 – 54 , 59 , 63 , 65 , 71 , 74 , 79 , 82 , 83 , 86 , 87 , 91 ] ACE plus MA versus MA (n = 6), [ 26 , 31 , 38 , 42 , 50 , 78 ] ACE plus EA versus EA (n = 10), [ 23 , 24 , 33 , 47 , 54 , 67 , 70 , 75 , 80 , 92 ] ACE plus AA versus AA (n = 2), [ 35 , 77 ] ACE...…”

Section: Resultsmentioning

confidence: 99%

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Comparing acupoint catgut embedding and acupuncture therapies for simple obesity: A systematic review and meta-analysis

Zhao

¹

,

Kim

²

,

Son

³

2022

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Background: This systematic review aimed to assess the effectiveness and safety of acupoint catgut embedding (ACE), which is widely used in simple obese patients. Methods: Nine electronic databases and 2 trial registries were searched from inception to September 2021 without language limitations. All randomized controlled trials involving ACE therapies for simple obesity were included. Assessment of Cochrane’s risk of bias and meta-analysis, as well as GRADE evaluation, were also performed. Results: A total of 73 randomized clinical trials involving 5872 participants were included. The overall risk of bias was high or unclear. ACE showed higher efficacy in total effective rate, body mass index, and body weight than manual acupuncture. In addition, ACE is more beneficial in total effective rate than electroacupuncture (EA). Moreover, combination therapy of ACE with EA is more effective in total body mass index and body weight than EA alone. Conclusions: Despite some potential improvement, the evidence regarding the effectiveness and efficacy of ACE for simple obesity is inconclusive due to the poor quality of evidence. Further well-designed randomized controlled trials are needed to confirm the effectiveness of ACE for simple obesity.

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“…e participating sites included the Hubei Provincial Hospital of TCM (IRB Approval ID: HBZY2016-C20-01), Dongzhimen Hospital Beijing University of Chinese Medicine (IRB Approval ID: DZMEC-KY-2017-15), and the First Hospital of Hunan University of Chinese Medicine (IRB Approval ID: HN-LL-KY-2017-001-01). e study protocol was approved by the institutional review boards of the three hospitals [21]. Written informed consent was obtained from all participants.…”

Section: Methodsmentioning

confidence: 99%

Effect of Acupoint Catgut Embedding for Middle-Aged Obesity: A Multicentre, Randomised, Sham-Controlled Trial

Chen

¹

,

Huang

²

,

Wei

³

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Objectives. This study aimed to examine the efficacy and safety of acupoint catgut embedding (ACE) for obesity over a 16-week treatment period using sham stimulation as the control. Methods. A multicenter, randomised, parallel, sham-controlled trial was conducted from February 10, 2017, to May 15, 2018. Men with waistlines ≥85 cm and women with ≥80 cm at three sites were randomised to receive eight sessions (over 16 weeks) of ACE (n = 108) or sham ACE (n = 108) with skin penetration at sham acupoints. The catgut was embedded once every two weeks using two alternating sets of acupoints. The follow-up lasted for an additional 24 weeks. The primary outcome was the percentage waistline reduction from baseline to week 16. Results. We included 216 individuals in the intention-to-treat analysis. At 16 weeks, the rate of waistline reduction was 8.80% (95% confidence interval (CI), 7.93% to 9.66%) in the ACE group and 4.09% (95% CI, 3.18% to 5.00%) in the sham control group, with a between-group difference of 4.71% (95% CI, 3.47% to 5.95%; P < 0.0001). This difference persisted throughout the entire follow-up period (between-group difference after 24-week additional weeks, 4.94% (95% CI, 3.58% to 6.30%); P < 0.001). The subgroup analyses of waistline by sex (male/female) revealed treatment effects of 1.93 (95% CI, −0.37 to 4.23, P = 0.1) in the male group and 3.19 (95% CI, 1.99 to 4.39, P < 0.001) in the female group. The adverse event analysis suggested that ACE and laboratory tests confirmed the safety of ACE. Discussion. ACE for 16 weeks could decrease the waistline and weight and was safe for the treatment of obesity. Further research is needed to evaluate the long-term efficacy and sex differences. This trial is registered with NCT02936973.

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Clinical effect of catgut implantation at acupoints for the treatment of simple obesity

Cited by 4 publications

References 26 publications

Network Meta-Analysis of Acupoint Catgut Embedding in Treatment of Simple Obesity

Network Meta-Analysis of Acupoint Catgut Embedding in Treatment of Simple Obesity

Comparing acupoint catgut embedding and acupuncture therapies for simple obesity: A systematic review and meta-analysis

Effect of Acupoint Catgut Embedding for Middle-Aged Obesity: A Multicentre, Randomised, Sham-Controlled Trial

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