Acupuncture at Zusanli (ST36) for Experimental Sepsis: A Systematic Review.

Fang Lai,Xuelian Yin,Chengzhi Lai,Yang Ren,Ruifeng Zeng,Jun Li,Guorong Liang,Caixia Tan,Jiansen Li,Rui Chen,Chunmei Yang

doi:10.1155/2020/3620741

Abstract

Background Sepsis is a global major health problem with high mortality rates. More effective therapy is needed for treating sepsis. Acupuncture has been used for various diseases, including severe infection, in China for more than 2,000 years. Previous studies reported that acupuncture at Zusanli (ST36) might be effective in treating sepsis, but the efficacy and the quality of evidence remain unclear since there is no systematic review on acupuncture at ST36 for sepsis. Methods Seven databases were searched from the inception of each database up to May 2019. Ultimately, 54 studies using acupuncture at ST36 for the treatment of experimental sepsis were identified in both English and Chinese literature with systematic review procedures. Results Acupuncture might be useful in reducing injuries induced by sepsis in cardiac, lung, kidney, liver, gastrointestinal tract, and immune system. Its potential mechanisms for antisepsis might include reducing oxidative stress and inflammation, improving microcirculatory disturbance, and maintaining the immune balance mediated by dopamine. However, the positive findings should be interpreted with caution due to poor methodological quality and publication bias. Conclusion Acupuncture at ST36 might be a promising complementary strategy for controlling sepsis inflammation, yet further studies are needed.

Highlights

Sepsis is a systemic clinical syndrome induced by inflammatory response from severe infections. e overwhelming inflammatory responses to sepsis may cause multiple organ failure as a result [1,2,3,4], which makes sepsis the leading cause of mortality in noncoronary Intensive Care Units in the world nowadays [5, 6]
We identified studies of acupuncture at ST36 in sepsis animal models from PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL) in e Cochrane Library, EMBASE, Chinese National Knowledge Infrastructure (CNKI), VIP Database, Wanfang Data, and Chinese Biomedical Literature Database (CBM) by using the terms “ST36” OR “zusanli” OR “Tzusanli” OR “Electroacupuncture” OR “Electroacupuncture” OR “EA” OR “acupuncture” OR “acupuncture electric stimulation” OR “AES” AND “sepsis” OR “septicemia” OR “septic shock” OR “endotoxic shock” OR “toxic shock” OR “bloodstream infection” OR “blood stream infection” in English or in Chinese, when appropriate, without language restrictions
Study Selection. 4417 papers were retrieved from the seven above-mentioned databases. 4179 papers were excluded with at least one of the following reasons: (1) being a case report or review; (2) not being an animal research; and (3) not focusing on sepsis. 238 articles remained after going through the titles and abstracts, of which 164 records were removed for being duplicates

Summary

Introduction

Sepsis is a systemic clinical syndrome induced by inflammatory response from severe infections. e overwhelming inflammatory responses to sepsis may cause multiple organ failure as a result [1,2,3,4], which makes sepsis the leading cause of mortality in noncoronary Intensive Care Units in the world nowadays [5, 6]. Sepsis is a systemic clinical syndrome induced by inflammatory response from severe infections. Acupuncture is one important therapeutic method in traditional Chinese medicine (TCM). Systematic reviews of preclinical animal data may help predicting the magnitude and direction of therapeutic effects in human trials [22], identifying potential candidates worthy of further basic research, precluding unnecessary study replication, and contributing to refinement in animal experimentation [23, 24]. Previous studies reported that acupuncture at Zusanli (ST36) might be effective in treating sepsis, but the efficacy and the quality of evidence remain unclear since there is no systematic review on acupuncture at ST36 for sepsis. 54 studies using acupuncture at ST36 for the treatment of experimental sepsis were identified in both English and Chinese literature with systematic review procedures. Acupuncture at ST36 might be a promising complementary strategy for controlling sepsis inflammation, yet further studies are needed

Methods

Results

Discussion

Conclusion