| Objective:To assess the effectiveness and safety of electroacupuncture in animal models of hyperlipidemia and atherosclerosis,so as to provide evidence for acupuncture prevention and treatment of hyperlipidemia and atherosclerosis.Material and method:Databases CNKI,Wan Fang,VIP,CBM,Pubmed,EMBASE and The Cochrane Library were searched for studies concerning the effect of electroacupuncture in animal models of hyperlipidemia and atherosclerosis.In addition,we searched manual,such as Chinese Acupuncture & Moxibustion,Journal of Clinical Acupuncture and Moxibustion and the bibliographic sections of identified papers.Language restrictions are Chinese and English and retrieval time limited from March 1998 to March 2018.The two members of the project group respectively screened the documents,extracted information and checked according to the pre-formulated exclusion criteria and information extraction tables.During the period of disagreement,the group is negotiated by the staff or by the third party(tutor).The quality evaluation of the included literatures is referred to CAMARADES quality evaluation standard list,combined with hyperlipidemia and atherosclerosis experiment.Meta-analysis was performed by using Revman5.3 software.Due to the differences in multiple studies,the heterogeneity of Meta analysis is large.Therefore,we choose standardized mean difference(SMD)as the combined statistics and use random effect model instead of fixed effect model to analyze continuous variables in multiple studies.The funnel map evaluates the publication bias.Pre designated subgroup analysis includes animal model,animal species,sex subgroups,intervention acupoints and feed during intervention.Results: 1 A total of 1855 potentially relevant articles were retrieved.After excluded,29 studies involving 1487 animals were included.2 The average score of Methodological quality assessment was 5.1.3 Meta analysis results of main indexes: 3.1 TC level Meta analysis of the TC levels reported in 26 studies showed that: Compared with the control group,electroacupuncture can significantly reduce the content of TC,and there is a significant difference between the electroacupuncture treatment group and the control group [SMD-2.29,95%CI(-2.94,-1.64),P<0.00001];The results of Meta analysis in 10 studies showed that: There is no significant difference between the electroacupuncture group and the drug group in reducing the TC content [SMD 0.07,95%CI(-0.41,0.55),P=0.78].3.2 TG level Meta analysis of the TG levels reported in 26 studies showed that: Compared with the control group,electroacupuncture can significantly reduce the content of TG,and there is a significant difference between the electroacupuncture treatment group and the control group [SMD-1.30,95%CI(-1.76,-0.84),P<0.00001];The results of Meta analysis in 10 studies showed that: There is no significant difference between the electroacupuncture group and the drug group in reducing the TG content [SMD 0.10,95%CI(-0.26,0.46),P=0.59].3.3 HDL-C level Meta analysis of the HDL-C levels reported in 26 studies showed that: Compared with the control group,electroacupuncture can increase the content of HDL-C,and there is a significant difference between the electroacupuncture treatment group and the control group [SMD 0.55,95%CI(0.06,1.04),P=0.03];The results of Meta analysis in 10 studies showed that: There is no significant difference between the electroacupuncture group and the drug group in increasing the HDL-C content [SMD 0.09,95%CI(-0.26,0.43),P=0.63].3.4 LDL-C level Meta analysis of the LDL-C levels reported in 26 studies showed that: Compared with the control group,electroacupuncture can significantly reduce the content of LDL-C,and there is a significant difference between the electroacupuncture treatment group and the control group [SMD-2.64,95%CI(-3.29,-1.99),P<0.00001];The results of Meta analysis in 10 studies showed that: There is no significant difference between the electroacupuncture group and the drug group in reducing the LDL-C content [SMD-0.12,95%CI(-0.60,0.36),P=0.62].4 Meta analysis results of secondary indicators: 4.1 Weight The Meta analysis of the 7 studies showed that: Compared with the model group,the body weight of the experimental animals decreased significantly after electroacupuncture treatment,and the difference was statistically significant [SMD-1.84,95%CI(-2.62,-1.07),P<0.00001].4.2 AI index The Meta analysis of the 3 studies showed that compared with the model group,the AI index decreased significantly after electroacupuncture treatment,and the difference was statistically significant.[SMD-4.88,95%CI(-8.12,-1.63),P=0.003].4.3 ET level The Meta analysis of the 6 studies showed that compared with the model group,the ET content decreased significantly after electroacupuncture treatment,and the difference was statistically significant [SMD-1.45,95%CI(-2.19,-0.71),P=0.0001].4.4 NO level The Meta analysis of the 6 studies showed that compared with the model group,the NO content increased significantly after electroacupuncture treatment,and the difference was statistically significant [SMD 1.44,95%CI(0.86,2.02),P<0.00001].Conclusion: 1 According to the limited evidence,electroacupuncture treatment of HLP and AS animal model can significantly reduce the content of TC,TG,LDL-C and increasing the content of HDL-C.Compared with drug treatment,it has the same curative effect but better safety.2 According to the limited evidence,after electroacupuncture intervention of hyperlipidemia and atherosclerotic animal models,the body weight,AI index,plasma ET level of the experimental animals decreased significantly,and the serum level of NO was significantly increased,which was beneficial to restore the body's balance of NO and ET.3 The quality of the study is low and the bias risk exists,so the strength of the evidence is reduced.Meanwhile there are limitations in this study.Therefore,the reliability of the conclusion may be disputed and should be treated with caution and need more evidence of high quality. |
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