Acupuncture for Primary Osteoporosis: Evidence, Potential Treatment Prescriptions, and Mechanisms

Haixiong Lin; Xiaotong Wang; Yingjie Mo; Chunni Lin; Nenggui Xu; Feng Huang; Yongjun Chen

doi:10.1155/2019/2705263

Acupuncture for Primary Osteoporosis: Evidence, Potential Treatment Prescriptions, and Mechanisms

Evid Based Complement Alternat Med. 2019 Jun 12:2019:2705263. doi: 10.1155/2019/2705263. eCollection 2019.

Authors

Haixiong Lin¹, Xiaotong Wang², Yingjie Mo^{1

3}, Chunni Lin⁴, Nenggui Xu², Feng Huang^{1

5}, Yongjun Chen²

Affiliations

¹ The First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510405, China.
² South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou 510006, China.
³ Dongguan Hospital of Traditional Chinese Medicine, Dongguan 523127, China.
⁴ School of Foreign Languages, Xinhua College of Sun Yat-sen University, Dongguan 523133, China.
⁵ The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, China.

Abstract

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/β-catenin, and MAPK pathways, such as LRP5, β-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.