Acupoint injection versus non-acupoint injection for chronic hepatitis B: a systematic review of randomised trials

摘要

Purpose: We performed a systematic review to evaluatethe beneficial effect and safety of acupoint injection comparedwith non-acupoint injection with the same medicinefor chronic hepatitis B (CHB).Methods: We searched six English and Chinese electronicdatabases until October 2014 for randomised controlled trials(RCTs). Two authors independently selected trials andextracted data. Datawere analyzed using RevMan5.2 software.Results: A total of 8 RCTs involving 1193 participants withCHB were identified. The methodological quality of the trialswas poor. Six trials (75%) injected Chinese herbal medicineGanyanling, Oxymatrine, Polyporusus Bellatus, or Huangqiinjection, and the remaining two trials injected antiviraldrugs ( -interferon or polyinosinic-polycytidylic acid (polyI:C)). The acupoints included Zusanli (ST36), Ganshu (BL18),Yanglingquan (GB34), Sanyinjiao (SP6), Pishu (BL20), etc. Onthe basis of routine treatment (diammonium glycyrrihizinate,potassium magnesium aspartate, Potenline, vitamins, etc.,intravenously or orally), five trials compared acupoint injectionwith non-acupoint intramuscular injection (IM), of whichone trial showed acupoint injection was superior to IM of polyI:C in improving HBsAg (RR 3.00, 95%CI 1.60 to 5.63) and HBeAg(RR 6.22, 95% CI 2.31 to 16.78) and a meta-analysis showedacupoint injection of oxymatrine had beneficial effect on ALTlevel (U/L) (MD -20.10, 95% CI -27.99 to -12.21; n=2). Three trialsfound that acupoint injection was significantly superior to IMin improving HBV-DNA, ALT and AST level. Five trials reportedadverse effects, and no severe adverse effects were reportedin acupoint injection groups.Conclusion: Acupoint injection applied alone or in combinationwith routine treatment appears to be effective and safecompared with IM for viral and biochemical response for CHB.However, owing to poor methodological quality of includedtrials, potential promising findings must be interpreted cautiouslyand further rigorous RCTs are warranted in the future.