Chronic Atrophic Gastritis Treated with Different Acupuncture and Moxibustion Therapies：a Network Meta-analysis postprint

Abstract: Background  Chronic atrophic gastritis is a common clinical precancerous lesion，which is prone to recurrent attacks and seriously affects the quality of life of patients. At present，Western medicine has limited effect in the treatment of chronic atrophic gastritis，while acupuncture has good results in the treatment of chronic atrophic gastritis，but which acupuncture therapy is the best still inconclusive. Objective  To compare the clinical efficacy among different acupuncture and moxibustion therapies on chronic atrophic gastritis by means of network Meta-analysis. Methods  The articals of randomized controlled trials for chronic atrophic gastritis treated with acupuncture and moxibustion therapies were searched from CNKI，Wanfang database，VIP database，CBM database，PubMed，Embase and Web of Science until April 30，2023 according tothe inclusion exclusion criteria. Literature quality assessment was based on ROB 2 bias assessment tool，network meta-analysis was performed using Rstudio software，and funnel plotting was used Stata software for publication bias risk assessment. Results  26 articles involving 10 interventions with a sample size of 2 068 cases were included. The results of network meta-analysis showed that in terms of clinical effective rate，there were five acupuncture therapies that were superior to conventional Western medicines，such as Western medicine combined with Acupoint injection，Catgut embedment in acupoint therapy，Western medicine combined with acupuncture，Needle warming therapy and Acupuncture（P<0.05）. The SUCRA ranking result was Western medicine combined with Acupoint injection（0.86）>Catgut embedment in acupoint therapy（0.80）>Western medicine combined with acupuncture（0.67）>Needle warming therapy and Acupuncture（0.59）>Western medicine combined with thunder-fire moxibustion（0.58）>Acupuncture（0.48）>Western medicine combined with ginger separated moxibustion（0.40）>Thunder-fire moxibustion（0.31）>Western medicine combined with electroacupuncture（0.24）>Conventional Western medicine（0.06）. In improving the efficacy of gastroscopy，there were five acupuncture therapies that were superior to conventional Western medicines，such as catgut embedment in Acupoint therapy，Needle warming therapy，Western medicine combined with acupuncture，Acupuncture and Western medicine combined with Acupoint injection（P<0.05）. The SUCRA ranking results show：Catgut embedment in acupoint therapy（0.80）>Needle warming therapy and Acupuncture（0.72）>Western medicine combined with acupuncture（0.58）>Acupuncture（0.47）>Western medicine combined with Acupoint injection（0.41）>conventional Western medicine（0.01）. In terms of pathological efficacy，there were five acupuncture therapies that were superior to conventional Western medicines，such as Catgut embedment in acupoint therapy and Needle warming therapy and Acupuncture（P<0.05）. The SUCRA ranking results show：Catgut embedment in acupoint therapy（0.79）>Western medicine combined with Acupuncture（0.59）>Needle warming therapy and Acupuncture（0.53）>Acupuncture（0.52）>Western medicine combined with Acupoint injection（0.51）>Conventional Western medicine（0.06）. Conclusion  Western medicine combined with Acupoint injection is preferred for patients with obvious clinical symptoms，while Catgut embedment in acupoint therapy is preferred for patients with no obvious symptoms. Catgut embedment in acupoint therapy can not only improve the clinical effective rate，but also improve the efficacy of gastroscopy and pathological than other acupuncture treatments.