The Effectiveness of Acupuncture for Osteoporosis: A Systematic Review and Meta-Analysis

Abstract

To summarize the existing evidence and evaluate the efficacy of acupuncture as a clinical treatment for osteoporosis. Six English and four Chinese databases were searched from their inception to April 2017. Randomized controlled trials were included, in which warm acupuncture, needling or electroacupuncture were compared with sole Western medicine with osteoporosis. All the data were assessed and extracted by two authors independently. The bias risk assessment recommended by the Cochrane Collaboration's tool was used to assess the quality of the selected studies. This meta-analysis was conducted by using RevMan 5.3. Pooled analyses were calculated by standardized mean difference (SMD) and 95% confidence interval (CI). Heterogeneity was assessed by I test. Thirty-five studies involving 3014 patients were located. Meta-analysis showed that warm acupuncture could increase the bone mineral density of lumar (SMD [Formula: see text] 0.93, 95% CI [Formula: see text] 0.65, 1.21, [Formula: see text][Formula: see text]0.00001) and femur (MD[Formula: see text][Formula: see text][Formula: see text]0.11, 95% CI[Formula: see text][Formula: see text][Formula: see text]0.05, 0.16, P[Formula: see text][Formula: see text][Formula: see text]0.0002), the level of serum calcium (MD[Formula: see text][Formula: see text][Formula: see text]0.18, 95% CI[Formula: see text][Formula: see text][Formula: see text]0.13, 0.24, [Formula: see text][Formula: see text]0.00001) and estradiol (SMD[Formula: see text][Formula: see text][Formula: see text]0.65, 95% CI[Formula: see text][Formula: see text][Formula: see text]0.32, 0.98, P[Formula: see text][Formula: see text][Formula: see text]0.0001), relieve pain (MD[Formula: see text][Formula: see text][Formula: see text]-1.64, 95% CI[Formula: see text][Formula: see text][Formula: see text]-2.69, -0.59, P[Formula: see text][Formula: see text][Formula: see text]0.002), decrease the level of serum alkaline phosphatase (MD[Formula: see text][Formula: see text][Formula: see text]-7.8, 95% CI[Formula: see text][Formula: see text][Formula: see text]-14.17, -0.84, P [Formula: see text] 0.03) compared with sole Western medicine. Electroacupuncture could relieve pain (MD[Formula: see text][Formula: see text] -1.32, 95% CI[Formula: see text][Formula: see text][Formula: see text]-2.15, -0.48, P[Formula: see text][Formula: see text][Formula: see text]0.002), increase the level of serum calcium (MD[Formula: see text][Formula: see text][Formula: see text]-0.12, 95% CI [Formula: see text] -0.16,-0.09, [Formula: see text][Formula: see text]0.00001) and decrease the level of serum alkaline phosphatase (MD [Formula: see text] -3.63, 95% CI [Formula: see text] -6.60, -0.66, P [Formula: see text] 0.02) compared with sole Western medicine. Needling could relieve pain (MD [Formula: see text] -2.27, 95% CI [Formula: see text] -3.11, -1.43, [Formula: see text][Formula: see text]0.00001) compared with sole Western medicine. This present systematic review indicated that acupuncture could be an effective therapy for treating ost...

Acupuncture and moxibustion for primary osteoporosis

“…The evidence quality of the included SR/Meta-analysis was evaluated by GRADE. High quality of evidence show that warm acupuncture could increase the bone mineral density (BMD) of lumbar (SMD = 0.93, 95% CI = 0.65, 1.21), [ 30 ] BMD of the femoral neck (MD 0.14, 95% CI 0.08 to 0.21) [ 29 ] and greater trochanter (MD 0.09, 95% CI 0.04 to 0.15) [ 29 ] when compared with conventional medicine. Moderate quality of evidence shows that acupuncture plus moxibustion plus other therapies or not could improve the clinical therapeutic effect, BMD of femur, BMD of lumbar, BMD of Ward triangle, Level of serum alkaline phosphatase, Level of serum calcium, VAS pain score, and Level of E2 when compared with conventional medicine or Chinese medicine.…”

Acupuncture for osteoporosis: study protocol for a randomized controlled trial

“…Pain is one of the major symptoms of osteoporosis, and acupuncture therapy is widely used in the adjuvant therapy of osteoporosis for its obvious analgesic effect [19] . Although the Cochrane review suggested that acupuncture might be an effective treatment for osteoporosis,more favorable evidence is needed to assess its effectiveness [13] .…”

“…Cochrane evaluation also shows that acupuncture may be an effective method of preventing osteoporosis. Compared with western medicine alone, mild acupuncture is more effective than electroacupuncture and ordinary acupuncture [13], but the effectiveness and safety are still lack of high quality evidence. We have integrated warm acupuncture, skin acupuncture, and cupping as a holistic treatment in the previous clinical research, which has a certain effect on reducing patients' pain, increasing bone density, and improving quality of life, but more favorable evidence is needed.…”

Mechanisms by which electroacupuncture‑mediated histone acetylation mitigates bone loss in rats with ovariectomy‑induced osteoporosis

“…other treatments, such as bisphosphonates, denosumab and teriparatide, showed efficacy in treating PMO, but extended treatment is challenging for a portion of the population of patients with PMo due to gastrointestinal disturbance or high price (5,6). acupuncture, which is one of the most popular complementary and alternative therapies in Western countries, has been shown to be effective in improving osteoporosis in several clinical trials (7). electroacupuncture (ea) is widely used in clinics and is characterized by its precise and reproducible electrical stimulation.…”