The therapeutic effects of cupping therapy in metabolic syndrome: Review

Yıl 2025, Cilt: 12 Sayı: 1, 143 - 148, 17.04.2025

Fatmaz Zehra Küçük

Öz

Metabolic syndrome (MetS) is a pathological condition characterized by the combination of number of metabolic disorders of metabolic, environmental, and/or genetic origin. These disorders, as defined by the World Health Organization, include abdominal obesity, insulin resistance, glucose metabolism disorders, high triglyceride and/or low high-density lipoprotein levels, and hypertension. The presence of at least three of these diseases is an indicator of MetS. If left uncontrolled, MetS represents a significant risk factor for morbidity and mortality on an international scale, as it increases the likelihood of developing chronic diseases such as type 2 diabetes and atherogenic cardiovascular diseases. Projections indicate that the prevalence of MetS is set to rise to approximately 53% by 2035. An assessment of the treatment of MetS reveals that, in addition to diet and exercise, various drug therapies are used to control severe obesity, dyslipidemia, type 2 diabetes and hypertension.In this context, it has become very important to search for new therapies to reduce the burden of the disease. This paper will discuss the therapeutic effects of cupping therapy in individuals with MetS. Studies have shown that cupping therapy has a significant effect on waist circumference, body weight, body mass index and lipid metabolism with moderate to high certainty, but no significant effect in MetS, but these randomized controlled trials have low heterogeneity. In order to substantiate the efficacy and safety of cupping as a treatment for MetS, it is imperative that well-designed (genomic, proteomic, metabolomic), high-quality, long-term studies are conducted, employing rigorous methodology.

Anahtar Kelimeler

Metabolic Syndrome, Cupping Therapy, Obesity, Insulin Resistance

Proje Numarası

yok

Metabolik sendromlu bireylerde kupa terapinin etkileri: Derleme’

Öz

Metabolik Sendrom (MetS), metabolik, çevresel ve/veya genetik kökenli bir dizi metabolik bozukluğun bir araya gelmesiyle karakterize bir patolojik durumdur. Dünya Sağlık Örgütü tarafından tanımlanan bu bozukluklar arasında; abdominal obezite, insülin direnci, glukoz metabolizması bozuklukları, yüksek trigliserid ve/veya düşük high-density lipoprotein (HDL-C) seviyeleri ve hipertansiyon bulunmaktadır. Tanımlanan hastalıklardan en az üç tanesinin bireyde bulunması MetS göstergesidir. MetS kontrol altına alınmadığı takdirde; Tip 2 diyabet, aterojenik kardiyovasküler hastalıklar gibi kronik hastalıkların oluşmasına zemin hazırladığından dolayı uluslararası düzeyde önemli bir morbidite ve mortalite nedenidir. MetS insidansının 2035'te yaklaşık %53'e yükselmesi öngörülmektedir. Toplum sağlığını ciddi anlamda etkileyen MetS tedavisi değerlendirildiğinde temel olarak; diyet ve egzersizin yanında, şiddetli obezite, dislipidemi, Tip 2 diyabet ve hipertansiyonu kontrol altında tutmak için çeşitli farmasötik tedaviler kullanılmaktadır. Hastalığın ağır yükünü azaltmak için bu bağlamda yeni tedavilerin araştırılması çok önemli hale gelmiştir. Ülkemizin On İkinci Kalkınma Planı’nda (2024-2028) yer alan, Geleneksel ve Tamamlayıcı Tıp Uygulamalarının etkinliğinin önemini ön plana çıkarmak amacından hareketle, non-farmakolojik tamamlayıcı tedavi yöntemlerinden Kupa Terapinin MetS’li bireylerde terapötik etkileri ele alınmıştır. Literatür, Kupa Terapinin; bel çevresi, vücut ağırlığı, beden kitle indeksi ve lipit metabolizması üzerinde orta ila yüksek kesinlikte anlamlı bir etkiye sahip olduğunu göstermektedir fakat, MetS’de; toplam yağ yüzdesi, kan basıncı, toplam kolesterol, trigliserit, HDL-C, açlık kan şekeri üzerinde anlamlı bir etkisi bulunmadığı sonuçları çıkarılmıştır ama bu randomize kontrollü çalışmalar düşük düzeyde heterojenliğe sahip çalışmalardır. Bu bağlamda kupa terapinin MetS’de etkinliğini ve güvenliğini ortaya koymak için bu popülasyonda iyi tasarlanmış (genomik, proteomik, metabolomik boyutlarda), yüksek kaliteli, titiz metodolojiye sahip, uzun vadeli randomize kontrollü çalışmalara ihtiyaç duyulmaktadır.
Kaynakça:
Abbasi, N., & Najafi, R. (2023). Cupping Therapy as an Anti-inflammation Therapy and Immunomodulator in Cancer Patients. Journal of Gastrointestinal Cancer, 54(1), 3-5.
Ahmed, S. M., Madbouly, N. H., Maklad, S. S., & Abu-Shady, E. A. (2005). Immunomodulatory effects of blood letting cupping therapy in patients with rheumatoid arthritis. Egypt J Immunol, 12(2), 39-51.
Ansarimoghaddam, A., Adineh, H. A., Zareban, I., Iranpour, S., HosseinZadeh, A., & Kh, F. (2018). Prevalence of metabolic syndrome in Middle-East countries: Meta-analysis of cross-sectional studies. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 12(2), 195-201.
Bamfarahnak, H., Azizi, A., Noorafshan, A., & Mohagheghzadeh, A. (2014). A tale of Persian cupping therapy: 1001 potential applications and avenues for research. Forschende Komplementärmedizin/Research in Complementary Medicine, 21(1), 42-47.
Bashiri, H., Bozorgomid, A., & Shojaeimotlagh, V. (2020). Efficacy of Hijamat (wet cupping therapy) in Iranian patients with nonalcoholic fattyliver disease: a controlled clinical trial. Turkish journal of medical sciences, 50(2), 354-359.
Chen, L., Wang, Y., & Liu, T. (2021). Cupping intervention on simple obesity based on inflammation correlation. Acta Chin Med.
Choi, T. Y., Ang, L., Ku, B., Jun, J. H., & Lee, M. S. (2021). Evidence map of cupping therapy. Journal of clinical medicine, 10(8), 1750.
Complementary, N. C. f., & Health, I. (2021). NCCIH strategic plan FY 2021–2025: mapping the pathway to research on whole person health. In: National Institute of Health Bethesda, MD.
Ehrampoush, E., Homayounfar, R., Davoodi, S. H., Zand, H., Askari, A., & Kouhpayeh, S. A. (2016). Ability of dairy fat in inducing metabolic syndrome in rats. Springerplus, 5, 1-8.
Engin, A. (2017). The definition and prevalence of obesity and metabolic syndrome. Obesity and lipotoxicity, 1-17.
Fahed, G., Aoun, L., Bou Zerdan, M., Allam, S., Bou Zerdan, M., Bouferraa, Y., & Assi, H. I. (2022). Metabolic syndrome: updates on pathophysiology and management in 2021. International journal of molecular sciences, 23(2), 786.
Farahmand, S. K., Gang, L. Z., Saghebi, S. A., Mohammadi, M., Mohammadi, S., Mohammadi, G., Ferns, G. A., Zadeh, M. G., Razmgah, G. G., & Ramazani, Z. (2012). The effects of wet cupping on coronary risk factors in patients with metabolic syndrome: a randomized controlled trial. The American journal of Chinese medicine, 40(02), 269-277.
Franchini, M., Targher, G., Montagnana, M., & Lippi, G. (2008). The metabolic syndrome and the risk of arterial and venous thrombosis. Thrombosis Research, 122(6), 727-735.
Gisondi, P., Fostini, A. C., Fossà, I., Girolomoni, G., & Targher, G. (2018). Psoriasis and the metabolic syndrome. Clinics in dermatology, 36(1), 21-28.

Anahtar Kelimeler

Metabolik Sendrom, Kupa Terapi, Obezite, İnsülin Direnci

Etik Beyan

Derleme niteliğinde bir makale olduğundan etik kurul oluru gerekmemiştir.

Destekleyen Kurum

yok

Proje Numarası

yok

Teşekkür

yok

Kaynakça

• Abbasi, N., & Najafi, R. (2023). Kanser hastalarında anti-inflamasyon terapisi ve immünomodülatör olarak kupa terapisi. Journal of Gastrointestinal Cancer, 54, 3–5. https://doi.org/10.1007/s12029-021-00701-2
• Ahmed, S. M., Madbouly, N. H., Maklad, S. S., & Abu-Shady, E. A. (2005). Immunomodulatory effects of bloodletting cupping therapy in patients with rheumatoid arthritis. Egyptian Journal of Immunology, 12(2), 39–51.
• Ansarimoghaddam, A., Adineh, H. A., Zareban, I., Iranpour, S., Hosseinzadeh, A., & Kh, F. (2018). Prevalence of metabolic syndrome in Middle-East countries: Meta-analysis of cross-sectional studies. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 12(2), 195–201. https://doi.org/10.1016/j.dsx.2017.11.004
• Bahar, A., Kashi, Z., Kheradmand, M., Hedayatizadeh-Omran, A., Moradinazar, M., Ramezani, F., ... & Moosazadeh, M. (2020). Prevalence of metabolic syndrome using International Diabetes Federation, National Cholesterol Education Panel-Adult Treatment Panel III and Iranian criteria: Results of Tabari cohort study. Journal of Diabetes & Metabolic Disorders, 19(1), 205–211. https://doi.org/10.1007/s40200-020-00492-6
• Bamfarahnak, H., Azizi, A., Noorafshan, A., & Mohagheghzadeh, A. (2014). A tale of Persian cupping therapy: 1001 potential applications and avenues for research. Forschende Komplementärmedizin/Research in Complementary Medicine, 21(1), 42–47. https://doi.org/10.1159/000358505
• Bashiri, H., Bozorgomid, A., & Shojaeimotlagh, V. (2020). Efficacy of Hijamat (wet cupping therapy) in Iranian patients with nonalcoholic fatty liver disease: A controlled clinical trial. Turkish Journal of Medical Sciences, 50(2), 354–359. https://doi.org/10.3906/sag-1911-85
• Chen, L., Wang, Y., & Liu, T. (2021). Cupping intervention on simple obesity based on inflammation correlation. Acta Chinica Medicinae.
• Choi, T. Y., Ang, L., Ku, B., Jun, J. H., & Lee, M. S. (2021). Evidence map of cupping therapy. Journal of Clinical Medicine, 10(8), 1750. https://doi.org/10.3390/jcm10081750
• Ehrampoush, E., Homayounfar, R., Davoodi, S. H., Zand, H., Askari, A., & Kouhpayeh, S. A. (2016). Ability of dairy fat in inducing metabolic syndrome in rats. SpringerPlus, 5, Article 1-8. https://doi.org/10.1186/s40064-016-2395-7 Engin, A. (2017). The definition and prevalence of obesity and metabolic syndrome. In Obesity and lipotoxicity (pp. 1–17). Springer. https://doi.org/10.1007/978-3-319-48382-5_1
• Fahed, G., Aoun, L., Bou Zerdan, M., Allam, S., Bou Zerdan, M., Bouferraa, Y., & Assi, H. I. (2022). Metabolic syndrome: Updates on pathophysiology and management in 2021. International Journal of Molecular Sciences, 23(2), 786. https://doi.org/10.3390/ijms23020786
• Farahmand, S. K., Gang, L. Z., Saghebi, S. A., Mohammadi, M., Mohammadi, S., Mohammadi, G., Ferns, G. A., Zadeh, M. G., Razmgah, G. G., & Ramazani, Z. (2012). The effects of wet cupping on coronary risk factors in patients with metabolic syndrome: A randomized controlled trial. The American Journal of Chinese Medicine, 40(2), 269–277. https://doi.org/10.1142/S0192415X12500180
• Franchini, M., Targher, G., Montagnana, M., & Lippi, G. (2008). The metabolic syndrome and the risk of arterial and venous thrombosis. Thrombosis Research, 122(6), 727–735. https://doi.org/10.1016/j.thromres.2008.02.008 Gisondi, P., Fostini, A. C., Fossà, I., Girolomoni, G., & Targher, G. (2018). Psoriasis and the metabolic syndrome. Clinics in Dermatology, 36(1), 21–28. https://doi.org/10.1016/j.clindermatol.2017.09.005
• Helfer, G., & Wu, Q.-F. (2018). Chemerin: A multifaceted adipokine involved in metabolic disorders. Journal of Endocrinology, 238(2), R79–R94. https://doi.org/10.1530/JOE-18-0020
• Hirode, G., & Wong, R. J. (2020). Trends in the prevalence of metabolic syndrome in the United States, 2011–2016. JAMA, 323(24), 2526–2528. https://doi.org/10.1001/jama.2020.4501
• Husain, N. R. N., Hairon, S. M., Zain, R. M., Bakar, M., Bee, T. G., & Ismail, M. S. (2020). The effects of wet cupping therapy on fasting blood sugar, renal function parameters, and endothelial function: A single-arm intervention study. Oman Medical Journal, 35(2), Article e108. https://doi.org/10.5001/omj.2020.27
• Kassi, E., Pervanidou, P., Kaltsas, G., & Chrousos, G. (2011). Metabolic syndrome: Definitions and controversies. BMC Medicine, 9, Article 48. https://doi.org/10.1186/1741-7015-9-48
• Kim, T. H., Kang, J. W., Kim, K. H., Lee, M. H., Kim, J. E., Kim, J. H., ... & Hong, K. E. (2012). Cupping for treating neck pain in video display terminal (VDT) users: A randomized controlled pilot trial. Journal of Occupational Health, 54(6), 416–426. https://doi.org/10.1539/joh.12-0121-OA
• Li, T., Li, Y., Lin, Y., & Li, K. (2016). Significant and sustaining elevation of blood oxygen induced by Chinese cupping therapy as assessed by near-infrared spectroscopy. Biomedical Optics Express, 8(1), 223–229. https://doi.org/10.1364/BOE.8.000223
• Lim, S., & Eckel, R. H. (2014). Pharmacological treatment and therapeutic perspectives of metabolic syndrome. Reviews in Endocrine and Metabolic Disorders, 15, 329–341. https://doi.org/10.1007/s11154-014-9290-0 McCracken, E., Monaghan, M., & Sreenivasan, S. (2018). Pathophysiology of the metabolic syndrome. Clinics in Dermatology, 36(1), 14–20. https://doi.org/10.1016/j.clindermatol.2017.09.004
• Mendonça, F. M., de Sousa, F. R., Barbosa, A. L., Martins, S. C., Araújo, R. L., Soares, R., & Abreu, C. (2015). Metabolic syndrome and risk of cancer: Which link? Metabolism, 64(2), 182–189. https://doi.org/10.1016/j.metabol.2014.10.008
• Mohamed, S. M., Shalaby, M. A., El-Shiekh, R. A., El-Banna, H. A., Emam, S. R., & Bakr, A. F. (2023). Metabolic syndrome: Risk factors, diagnosis, pathogenesis, and management with natural approaches. Food Chemistry Advances, 3, Article 100335. https://doi.org/10.1016/j.focha.2023.100335
• Monteiro, R., & Azevedo, I. (2010). Chronic inflammation in obesity and the metabolic syndrome. Mediators of Inflammation, 2010, Article 289645. https://doi.org/10.1155/2010/289645
• National Center for Complementary and Integrative Health (NCCIH). (2021). NCCIH strategic plan FY 2021–2025: Mapping the pathway to research on whole person health. National Institutes of Health, Bethesda, MD. https://nccih.nih.gov
• Niasari, M., Kosari, F., & Ahmadi, A. (2007). The effect of wet cupping on serum lipid concentrations of clinically healthy young men: A randomized controlled trial. The Journal of Alternative and Complementary Medicine, 13(1), 79–82. https://doi.org/10.1089/acm.2006.6203
• Oda, E. (2018). Historical perspectives of the metabolic syndrome. Clinics in Dermatology, 36(1), 3–8. https://doi.org/10.1016/j.clindermatol.2017.09.002
• Okumuş, M. (2016). Kupa tedavisi ve hacamat. Ankara Medical Journal, 16(4), 370. https://doi.org/10.17098/amj.68279
• Ouchi, N., Parker, J. L., Lugus, J. J., & Walsh, K. (2011). Adipokines in inflammation and metabolic disease. Nature Reviews Immunology, 11(2), 85–97. https://doi.org/10.1038/nri2921
• Patial, R., Batta, I., Thakur, M., Sobti, R. C., & Agrawal, D. K. (2024). Etiology, pathophysiology, and treatment strategies in the prevention and management of metabolic syndrome. Archives of Internal Medicine Research, 7, 273–283. https://doi.org/10.26502/aimr.0121
• Saklayen, M. G. (2018). The global epidemic of the metabolic syndrome. Current Hypertension Reports, 20(2), Article 12. https://doi.org/10.1007/s11906-018-0812-z
• Turk, J., & Allen, E. (1983). Bleeding and cupping. Annals of the Royal College of Surgeons of England, 65(2), 128. T.C. Sağlık Bakanlığı. (2014). Geleneksel ve Tamamlayıcı Tıp Uygulamaları Yönetmeliği. Resmî Gazete (29158). https://www.mevzuat.gov.tr
• Türkiye Endokrinoloji ve Metabolizma Derneği. (2022). Metabolik sendrom kılavuzu. Bayt Yayıncılık.
• Von Schoen-Angerer, T., Manchanda, R. K., Lloyd, I., Wardle, J., Szöke, J., Benevides, I., ... & Liu, J. (2023). Traditional, complementary and integrative healthcare: Global stakeholder perspective on WHO’s current and future strategy. BMJ Global Health, 8(12), e013150. https://doi.org/10.1136/bmjgh-2023-013150
• World Health Organization. (2013). WHO traditional medicine strategy 2014–2023. Geneva: World Health Organization. https://www.who.int/publications/i/item/9789241506096
• Wu, L. K., Chen, Y. C., Hung, C. S., Yen, C. Y., Chien, C. Y. C., Ciou, J. R., ... & Ho, T. J. (2023). The efficacy and safety of cupping as complementary and alternative therapy for metabolic syndrome: A systematic review and meta-analysis. Medicine, 102(13), e33341. https://doi.org/10.1097/MD.0000000000033341
• Yoo, S. S., & Tausk, F. (2004). Cupping: East meets West. International Journal of Dermatology, 43(9), 664–665. https://doi.org/10.1111/j.1365-4632.2004.02128.x
• Zhang, Q., Wang, X., Yan, G., Lei, J., Zhou, Y., Wu, L., ... & Li, Y. (2018). Anti-versus pro-inflammatory metabololipidome upon cupping treatment. Cellular Physiology and Biochemistry, 45(4), 1377–1389. https://doi.org/10.1159/000487596