Systematic Evaluation of Acupuncture and Combined Therapies for Treating Reflux Esophagitis

OBJECTIVE To systematically evaluate the efficacy of acupuncture in reflux esophagitis (RE). METHODS Based on retrieving the clinical randomized controlled studies on acupuncture treatment of RE in CNKI， WANFANG， VIP， CBM， PubMed， Embase and Cochrane Library databases up to May 2019， the related literature was extracted and evaluated with Meta-analysis on Rev Man5.3. RESULTS A total of 13 studies with 1 120 patients were included. In terms of reducing the recurrence rate， acupuncture alone or combination of acupuncture and medicine was superior to Western medicine [acupuncture alone: RR=0.21， 95%CI(0.05， 0.87); acupuncture + Liujun Shugan Decoction: RR=0.44， 95%CI(0.27， 0.71); acupuncture + Banxia Xiexin Decoction: RR=0.29， 95%CI(0.14， 0.60); acupuncture + Xuanfu Daizhe Decoction and Zuojin Pill: RR=0.40， 95%CI(0.26， 0.62); acupuncture + self-prescribed Chinese medicine + microwave hyperthermia: RR=0.24， 95%CI(0.08， 0.66)]. In terms of endoscopic efficiency， electroacupuncture combined with Western medicine was better than Western medicine alone[RR=1.23， 95%CI(1.06， 1.41)]. In terms of reducing the symptom scores， the combination of acupuncture and medicine was more effective than Western medicine [acupuncture + Chinese medicine: RR=-1.73， 95%CI(-3.21， -0.25)， acupuncture + Chinese medicine + Western medicine: RR=-4.93， 95%CI(-5.52， -4.34)]. The adverse reactions of acupuncture combined with medicine were less than those of Western medicine alone.CONCLUSION In the treatment of RE， acupuncture combined with medicinal could obtain higher efficacy and lower recurrence while the efficacy of acupuncture alone is still unclear. Thus， there is an urgent need to standardize the efficacy of acupuncture in the treatment of RE and improve the quality of research. More high-quality randomized controlled trials are still needed in the future to validate the effectiveness of acupuncture for RE.