Clinical effect of catgut implantation at acupoints for the treatment of simple obesity: A multicentre randomized controlled trial

Xia Chen, Wei Huang, Dan Wei, De-Guang Ding, Yang Jiao, Hong-Ling Pan, Yi-Ting Jin, Yi-Wei Zheng, Yan-Ji Zhang, Ying-Rong Zhang, Yi-Ran Liu, Zhong-Yu Zhou, Xia Chen, Wei Huang, Dan Wei, De-Guang Ding, Yang Jiao, Hong-Ling Pan, Yi-Ting Jin, Yi-Wei Zheng, Yan-Ji Zhang, Ying-Rong Zhang, Yi-Ran Liu, Zhong-Yu Zhou

Abstract

Background: Catgut implantation at acupoints (CIA) is a subtype of acupuncture that has been widely used to treat simple obesity, but evidence for its effectiveness remains scarce. The aim of this study is to evaluate the efficacy and safety of treating simple obesity with CIA.

Objective: This clinical trial aims to evaluate the effectiveness and safety of CIA used for treatment of simple obesity.

Methods: This is a multicentre, randomized, parallel, sham-controlled clinical trial. A total of 216 patients with simple obesity will be recruited. They will be randomly assigned in a 1:1 ratio to either the CIA group or the sham control group. All treatments will be given once every 2 weeks. The primary outcome measure is the rate of waistline reduction. Secondary outcome measures are the rates of reduction of body measurements, including weight, body mass index (BMI), hipline, waist-hip-ratio (WHR) and body fat percentage (BFP), the changes in scores on scales, including the Impact of Weight on Quality of Life Questionnaire (IWQOL-Lite), Short Form 36 (SF-36), the Hospital Anxiety and Depression Scale (HAD) and the Self-Esteem Scale (SES), Outcomes will be evaluated at baseline and at weeks 4, 8, 12, 16, 28, and 40, respectively. All adverse events that occur during this study will be recorded. If any participant withdraws from the trial, an intention-to-treat analysis (ITT) will be performed.

Conclusion: This is a randomized, sham-controlled trial of CIA treatment for simple obesity. The results of this trial will provide more evidence on whether CIA is efficacious and safe for treating obesity.

Trial registration: ClinicalTrials.gov Identifier: NCT02936973. Registered on October 18, 2016.

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Flowchart for the trial.
Figure 2
Figure 2
Acupoints for catgut implantation and places for control stimulation.
Figure 3
Figure 3
The difference between CIA group and sham CIA group.

References

    1. He L, Gao XA, Yu L. Forty cases of simple obesity treated by acupuncture. J Tradit Chin Med 2006;26:24–5.
    1. Tam CS, Lecoultre V, Ravussin E. Brown adipose tissue: mechanisms and potential therapeutic targets. Circulation 2012;125:2782–91.
    1. Levine JA. Obesity in China: causes and solutions. Nalt Med J China 2008;11:1043–50.
    1. Canale MP, Manca di Villahermosa S, Martino G, et al. Obesity-related metabolic syndrome: mechanisms of sympathetic overactivity. Int J Endocrinol 2013;2013:865–965.
    1. Dhoot J, Tariq S, Erande A, et al. Effect of morbid obesity on in-hospital mortality and coronary revascularization outcomes after acute myocardial infarction in the United States. Am J Cardiol 2013;111:1104–10.
    1. Leblanc ES, O’Connor E, Whitlock EP, et al. Effectiveness of primary care-relevant treatments for obesity in adults: a systematic evidence review for the U.S. Preventive Services Task Force Ann Intern Med 2011;155:434–47.
    1. Leblanc E, O’Connor E, Whitlock EP, et al. References - screening for and management of obesity and overweight in adults - NCBI Bookshelf[J]. Agency for Healthcare Research & Quality; 2011.
    1. Hsu CH, Hwang KC, Chao CL, et al. Effects of electroacupuncture in reducing weight and waist circumference in obese women: a randomized crossover trial. Int J Obes (Lond) 2005;29:1379–84.
    1. Nourshahi M, Ahmadizad S, Nikbakht H, et al. The effects of triple therapy (acupuncture, diet and exercise) on body weight: a randomized, clinical trial. Int J Obes (Lond) 2009;33:583–7.
    1. Darbandi S, Darbandi M, Mokarram P, et al. Effects of body electroacupuncture on plasma leptin concentrations in obese and overweight people in Iran: a randomized controlled trial. Alternat Ther Health Med 2013;19:24–31.
    1. Yan R, Bai J, Zhang Y, et al. Long-term therapeutic effects of simple obesity treated by catgut implantation at acupoint. Chin J Aesthetic Med 2010;19:422–4.
    1. Guo T, Ren Y, Kou J, et al. Acupoint catgut embedding for obesity: systematic review and meta-analysis. Evid Based Complement Alternat Med 2015;2015:401914.
    1. Liao JQ, Song X, Chen Y, et al. Clinical randomized controlled trials of acupoint catgut-embedding for simple obesity: a meta-analysis. Zhongguo Zhen Jiu 2014;34:621–6.
    1. Guo T, Ren Y, Kou J, et al. Acupoint catgut embedding for obesity: systematic review and meta-analysis. Evidence-based Complement Alternat Med 2015;2015:401914.
    1. Huang LC, Pan WY. Comparation of effect and cost-benefit analysis between acupoint catgut-embedding and electroacupuncture on simple obesity. Zhongguo Zhen Jiu 2011;31:883–6.
    1. Cochrane AL. Effectiveness and efficiency: random reflections on health services. London: NuffiledProvincal Hospitals Trust; 1972.
    1. Scheen AJ, Finer N, Hollander P, et al. RIO-Diabetes Study Group Efficacy and tolerability of rimonabant in overweight or obese patients with type 2 diabetes: a randomised controlled study. Lancet 2006;368:1660–72.
    1. Preljevic VT, Østhus TB, Sandvik L, et al. Screening for anxiety and depression in dialysis patients: comparison of the Hospital Anxiety and Depression Scale and the Beck Depression Inventory. J Psychosom Res 2012;73:139–44.
    1. Van Gaal LF, Rissanen AM, Scheen AJ, et al. RIO-Europe Study Group Effects of the cannabinoid-1 receptor blocker rimonabantonweight reduction and cardiovascular risk factors in overweight patients: 1-year experience from the RIO-Europe study. Lancet 2005;365:1389–97.
    1. Rosenberg M. Society and the adolescent self-image. Princeton, NJ: Princeton University Press; 1965.
    1. World Health Organization Regional Office for the Western Pacific. The Asia-Pacific perspective: redefining obesity and its treatment. Sydney: Health Communications Australia; 2000.
    1. Astrup A, Madsbad S, Breum L, et al. Effect of tesofensine on bodyweight loss, body composition, and quality of life in obese patients: a randomised, double-blind, placebo-controlled trial. Lancet 2008;372:1906–13.
    1. Hunt K, Wyke S, Gray CM, et al. A gender-sensitised weight loss and healthy living programme for overweight and obese men delivered by Scottish Premier League football clubs (FFIT): a pragmatic randomised controlled trial. Lancet 2014;383:1211–21.
    1. Gadde KM, Allison DB, Ryan DH, et al. Effects of low-dose, controlled-release, phentermine plus topiramate combination on weight and associated comorbidities in overweight and obese adults (CONQUER): a randomised, placebo-controlled, phase 3 trial. Lancet 2011;377:1341–52.
    1. Sjöström L, Rissanen A, Andersen T, et al. Randomised placebo-controlled trial of orlistat for weight loss and prevention of weight regain in obese patients. European Multicentre Orlistat Study Group. Lancet 1998;352:167–72.
    1. Jebb SA, Ahern AL, Olson AD, et al. Primary care referral to a commercial provider for weight loss treatment versus standard care: a randomised controlled trial. Lancet 2011;378:1485–92.
    1. Astrup A, Rössner S, Van Gaal L, et al. Effects of liraglutide in the treatment of obesity: a randomised, double-blind, placebo-controlled study. Lancet 2009;374:1606–16.
    1. MacPherson H, White A, Cummings M, et al. Standards for reporting interventions in controlled trials of acupuncture: the STRICTA recommendations. J Altern Complement Med 2002;8:85–9.
    1. Ralph JL, Von Ah D, Scheett AJ, et al. Diet assessment methods: a guide for oncology nurses. Clin J Oncol Nurs 2011;15:E114–21.
    1. James WP, Astrup A, Finer N, et al. Effect of sibutramine on weight maintenance after weight loss: a randomised trial. STORM Study Group. Sibutramine Trial Obesity Reduction Maintenance Lancet 2000;356:2119–25.
    1. Zhang XP, Jia CS, Wang JL, et al. Acupoint catgut-embedding therapy: superiorities and principles of application. Zhongguo Zhen Jiu 2012;32:947–51.
    1. Li X, Zhang Q, Jiang L, et al. Clinical effect of catgut implantation at acupoints for allergic rhinitis: study protocol for a randomized controlled trial. Trials 2013;14:1–8.
    1. Huang W, Wei D, Yang TY, et al. Clinical observation on the therapeutic effect of acupoint catgut - embedding integrated with diet and exercise for simple obesity. J Clin Acupuncture Moxibustion 2015;31:1–3.
    1. Wei He, Zhongyu Zhou, Jiakang Li, et al. Auricular acupressure plus exercise for treating primary obese women: a randomized controlled clinical trial. Med Acupuncture 2012;24:227–32.
    1. Witt CM, Huang WJ, Lao L, et al. Which research is needed to support clinical decision-making on integrative medicine? - can comparative effectiveness research close the gap? Chin J Integr Med 2012;18:723–9.
    1. Witt CM, Aickin M, Baca T, et al. Effectiveness guidance document (EGD) for acupuncture research - a consensus document for conducting trials. BMC Complement Altern Med 2012;12:148.
    1. Treweek S, Zwarenstein M. Making trials matter: pragmatic and explanatory trials and the problem of applicability. Trials 2009;10:37.

Source: PubMed

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