Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China.
Department of Dermatology, Shaanxi Traditional Chinese Medicine Hospital, Xi`an, 710003, China.
Complement Ther Med. 2019 Jun;44:253-260. doi: 10.1016/j.ctim.2019.04.009. Epub 2019 Apr 28.
Moderate-severe acne treatment involves the use of isotretinoin and antibiotics as first-line therapeutics; however, these drugs have serious side effects. Fire needle therapy, which is widely used in China, has shown good clinical efficacy for treating moderate-severe acne; moreover, it has fewer side effects, hence, it can be used as a primary treatment (as an alternative to pharmaceutical medications) or in combination with pharmaceutical medications for clinical treatment. However, current clinical evidence regarding its use has not been comprehensively evaluated.
We systematically searched several databases, including PubMed, Embase, Cochrane Central Register of Controlled Trials, China Network Knowledge Infrastructure (CNKI), China Biomedical Literature Service System (SinoMed), China Science and Technology Journal Database (CQVIP), and Wanfang Data Knowledge Service Platform, from their inception time to November 22, 2018. Randomized controlled trials conducted to compare the efficacy, acne recurrence, and adverse events associated with fire needle therapy alone, or in combination with Chinese herbs or conventional pharmaceutical medication, to those of pharmaceutical treatment were selected. RevMan 5.3 software was used to calculate risk ratio (RR) with a 95% confidence interval (CI).
Ten trials, with a total of 904 participants, met the inclusion criteria. Meta-analyses showed that fire needle treatment with clindamycin or oral isotretinoin treatment had advantages over pharmaceutical medications alone in the treatment of moderate-severe acne [RR = 2.18, 95% CI (1.19, 3.99), P = 0.03 random model; I = 72%]. Moreover, the use of fire needle therapy alone in the treatment of moderate-severe acne had a better effect than pharmaceutical medications, regardless of the type of pharmaceutical medication used [RR = 2.32, 95% CI (1.77, 3.03), P < 0.00001 random model; I = 59%]. In terms of recurrence rate, there was no significant difference between fire needle and pharmaceutical medication groups [RR = 0.78, 95% CI (0.54, 1.14), P = 0.20 fixed-effect model; I = 0%]. In addition, the use of fire needles was associated with few adverse reactions, such as burning and tingling; furthermore, the adverse reactions were transient.
Fire needle therapy alone or combined with other treatments is effective for moderate-severe acne. However, further large-scale, rigorously designed trials are needed to confirm these findings.
中重度痤疮的治疗包括使用异维 A 酸和抗生素作为一线治疗药物；然而，这些药物有严重的副作用。火针疗法在中国被广泛应用于治疗中重度痤疮，具有良好的临床疗效，且副作用较少，因此可作为一线治疗（替代药物治疗）或与药物联合用于临床治疗。然而，目前关于其使用的临床证据尚未得到全面评估。
我们系统地检索了多个数据库，包括 PubMed、Embase、Cochrane 中央对照试验注册库、中国知网（CNKI）、中国生物医学文献服务系统（SinoMed）、中国科技期刊数据库（CQVIP）和万方数据知识服务平台，从建库时间到 2018 年 11 月 22 日。选择了比较火针疗法单独或联合中药或常规药物治疗与药物治疗的疗效、痤疮复发和不良反应的随机对照试验。使用 RevMan 5.3 软件计算风险比（RR）和 95%置信区间（CI）。
符合纳入标准的共有 10 项试验，共 904 名参与者。荟萃分析显示，火针治疗克林霉素或口服异维 A 酸治疗中重度痤疮的疗效优于单独药物治疗[RR=2.18，95%CI（1.19，3.99），P=0.03 随机模型；I=72%]。此外，单独使用火针治疗中重度痤疮的疗效优于药物治疗，与使用何种药物无关[RR=2.32，95%CI（1.77，3.03），P<0.00001 随机模型；I=59%]。在复发率方面，火针组和药物组无显著差异[RR=0.78，95%CI（0.54，1.14），P=0.20 固定效应模型；I=0%]。此外，火针治疗的不良反应较少，如灼热感和刺痛感，且不良反应是短暂的。
火针单独或联合其他治疗方法对中重度痤疮有效。然而，需要进一步进行大规模、严格设计的试验来证实这些发现。
