The Effectiveness of Acupuncture for Osteoporosis: A Systematic Review and Meta-Analysis

To summarize the existing evidence and evaluate the efficacy of acupuncture as a clinical treatment for osteoporosis. Six English and four Chinese databases were searched from their inception to April 2017. Randomized controlled trials were included, in which warm acupuncture, needling or electroacupuncture were compared with sole Western medicine with osteoporosis. All the data were assessed and extracted by two authors independently. The bias risk assessment recommended by the Cochrane Collaboration's tool was used to assess the quality of the selected studies. This meta-analysis was conducted by using RevMan 5.3. Pooled analyses were calculated by standardized mean difference (SMD) and 95% confidence interval (CI). Heterogeneity was assessed by I-2 test. Thirty-five studies involving 3014 patients were located. Meta-analysis showed that warm acupuncture could increase the bone mineral density of lumar (SMD = 0.93, 95% CI = 0.65, 1.21, P < 0.00001) and femur (MD = 0.11, 95% CI = 0.05, 0.16, P = 0.0002), the level of serum calcium (MD = 0.18, 95% CI = 0.13, 0.24, P < 0.00001) and estradiol (SMD = 0.65, 95% CI = 0.32, 0.98, P = 0.0001), relieve pain (MD = -1.64, 95% CI = -2.69, -0.59, P = 0.002), decrease the level of serum alkaline phosphatase (MD = -7.8, 95% CI = -14.17, -0.84, P = 0.03) compared with sole Western medicine. Electroacupuncture could relieve pain (MD = -1.32, 95% CI = -2.15, -0.48, P = 0.002), increase the level of serum calcium (MD = -0.12, 95% CI = - 0.16,-0.09, P < 0.00001) and decrease the level of serum alkaline phosphatase (MD = -3.63, 95% CI = -6.60, -0.66, P = 0.02) compared with sole Western medicine. Needling could relieve pain (MD = -2.27, 95% CI = -3.11, -1.43, P < 0.00001) compared with sole Western medicine. This present systematic review indicated that acupuncture could be an effective therapy for treating osteoporosis. Warm acupuncture seemed to more effective than electroacupuncture and needling for osteoporosis in comparison to sole Western medicine.