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摘要：
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摘要：目的 系统性评价针灸治疗非酒精性脂肪性肝病（non-alcoholic fatty liver disease，NAFLD）的
临床疗效。方法 以“针灸”“脂肪肝”“非酒精性脂肪肝”为中文检索词，“acupuncture”“fatty
liver”“non-alcoholic fatty liver”为英文检索词，通过计算机检索Embase、Web of science、Pubmed、
Sinomed 、The Cochrane Library、CNKI、VIP及WanFang Data数据库中针灸治疗NAFLD的随机对照试
验。根据纳入排除标准筛选文献，采用Jadad量表对文献质量进行评估，采用RevMan 5.3进行Meta分
析。评估针灸治疗NAFLD的有效性以及对胆固醇（total cholesterol，TC）、甘油三酯（triglyceride，
TG）、丙氨酸氨基转移酶（alanine aminotransferase，ALT）和天门冬氨酸氨基转移酶（aspartate
aminotransferase，AST）的影响。结果 共纳入12篇符合条件的文献，总计1295例患者，其中治疗
组676例，对照组619例。Meta分析表明，治疗组患者治疗总有效率显著高于对照组（RR = 1.25，
95%CI：1.17～1.33；P ＜ 0.001）。治疗组患者TC和TG水平显著低于对照组，差异均有统计学意义
（MD = 1.03，95%CI：0.78～1.28，P ＜ 0.001；MD = 0.75，95%CI：0.36～1.13，P = 0.0001），针
灸联合西药亚组患者TC和TG显著低于单纯针灸亚组（MD = 1.01，95%CI：0.78～1.12，P ＜ 0.001；
MD = 0.77，95%CI：0.67～0.87，P ＜ 0.001）。治疗组ALT和AST水平显著低于对照组（MD =
17.19，95%CI：-2.26～36.63，P = 0.04；MD = 20.80，95%CI：1.53～40.06，P = 0.03）。治疗组和对
照组患者均无明显不良反应。结论 针灸治疗NAFLD安全有效，能够有效改善患者影像学及生物化学
指标。
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Abstract: Objective To evaluate the clinical efficacy of acupuncture on the treatment of non-alcoholic fatty
liver diseases (NAFLD) systematically. Methods Databases (Embase, Web of science, Pubmed, Sinomed,
The Cochrane Library, CNKI, VIP and WanFang Data) were searched to identify diagnostic randomized
and controlled trials on the treatment of NAFLD with acupuncture, the key words were “acupuncture”
“fatty liver” and “non-alcoholic fatty liver” in Chinese and English. The studies were screened according to
inclusion exclusion criteria and were evaluated by Jadad scale. Meta analysis was operated by RevMan5.3.
The clinical effects, total cholesterol (TC), triglyceride (TG), alanine aminotransferase (ALT) and aspartate
aminotransferase (AST) levels were evaluated. Results A total of 12 studies and 1295 patients were included,
there were 676 cases in treatment group and 619 cases in control group. Meta analysis showed that the
effective rate of patients in treatment group was significantly higher than that of control group (RR = 1.25,
95%CI: 1.17～1.33；P ＜ 0.001). TC and TG levels of patients in treatment group were significantly lower
than those of control group, the difference were statistically significant (MD = 1.03, 95%CI: 0.78～1.28, P ＜
0.001; MD = 0.75, 95%CI: 0.36～1.13, P = 0.0001). TC and TG levels of patients in acupuncture combined
with western medicine subgroup were significantly lower than those of acupuncture subgroup (MD = 1.01,
95%CI: 0.78～1.12, P ＜ 0.001; MD = 0.77, 95%CI: 0.67～0.87, P ＜ 0.001). ALT and AST levels of patients
in treatment group were significantly lower than those of control group (MD = 17.19, 95%CI: -2.26～36.63, P =
0.04; MD = 20.80, 95%CI: 1.53～40.06, P = 0.03). There were no significant adverse reactions in treatment
group and control group. Conclusions Acupuncture is effective and safe on the treatment of NAFLD, which
can effectively improve the imaging and biochemistry indicators.
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