Abstract
Purpose: We performed a systematic review to evaluate the beneficial effect and safety of acupoint injection compared with non-acupoint injection with the same medicine for chronic hepatitis B (CHB). Methods: We searched six English and Chinese electronic databases until October 2014 for randomised controlled trials (RCTs). Two authors independently selected trials and extracteddata.Datawere analyzedusingRevMan5.2 software. Results: A total of 8 RCTs involving 1193 participants with CHB were identified. The methodological quality of the trials was poor. Six trials (75%) injected Chinese herbal medicine Ganyanling, Oxymatrine, Polyporusus Bellatus, or Huangqi injection, and the remaining two trials injected antiviral drugs ( -interferon or polyinosinic-polycytidylic acid (poly I:C)). The acupoints included Zusanli (ST36), Ganshu (BL18), Yanglingquan (GB34), Sanyinjiao (SP6), Pishu (BL20), etc. On the basis of routine treatment (diammonium glycyrrihizinate, potassium magnesium aspartate, Potenline, vitamins, etc., intravenously or orally), five trials compared acupoint injection with non-acupoint intramuscular injection (IM), of which one trial showed acupoint injection was superior to IM of poly I: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 showed acupoint injection of oxymatrine had beneficial effect on ALT level (U/L) (MD -20.10, 95% CI -27.99 to -12.21; n=2). Three trials found that acupoint injection was significantly superior to IM in improving HBV-DNA, ALT and AST level. Five trials reported adverse effects, and no severe adverse effects were reported in acupoint injection groups. Conclusion: Acupoint injection applied alone or in combination with routine treatment appears to be effective and safe compared with IM for viral and biochemical response for CHB. However, owing to poor methodological quality of included trials, potential promising findings must be interpreted cautiously and further rigorous RCTs are warranted in the future. Contact: Li-Qiong Wang, qiongqiong.624@163.com
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