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放血疗法治疗慢性荨麻疹患者：系统评价和荟萃分析。

Bloodletting Therapy for Patients with Chronic Urticaria: A Systematic Review and Meta-Analysis.

机构信息

Beijing University of Chinese Medicine, Beijing 100029, China.

出版信息

Biomed Res Int. 2019 Apr 16;2019:8650398. doi: 10.1155/2019/8650398. eCollection 2019.

DOI:10.1155/2019/8650398
PMID:31139656
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6500668/
Abstract

BACKGROUND

Many trials have reported that bloodletting therapy is effective when treating chronic urticaria. There are currently no systematic reviews of bloodletting therapy for chronic urticaria.

OBJECTIVE

The aim of this review is to assess the effectiveness and safety of bloodletting therapy for chronic urticaria.

METHODS

A systematic review and meta-analysis of randomized controlled trials were performed. Disease activity control was assessed as the primary outcome. Response rate, recurrence rate, and adverse events were assessed as secondary outcomes.

RESULTS

Seven studies with 512 participants were included. One trial showed a significant difference between bloodletting therapy plus medicine and medicine alone in disease activity control (MD 0.67; 95% CI 0.03 to 1.31; p=0.04). Six trials (372 participants) showed a significant difference between bloodletting therapy and pharmacological medication in response rate (RR 1.10; 95% CI 0.97-1.26; P =0.15). Two studies (170 participants) showed a significant difference between bloodletting therapy plus pharmacological medication and pharmacological medication in response rate (RR 1.34; 95% CI 1.10-1.63; p=0.003). Two studies (126 participants) reported a statistically significant difference between bloodletting therapy and pharmacological medication in recurrence rate. No serious adverse events related to bloodletting therapy were reported.

CONCLUSIONS

Bloodletting therapy might be an effective and safe treatment for chronic urticaria, but the evidence is scarce. More high quality trials are needed in the future.

摘要

背景

许多试验报告称，放血疗法在治疗慢性荨麻疹方面有效。目前尚无关于放血疗法治疗慢性荨麻疹的系统评价。

目的

本综述旨在评估放血疗法治疗慢性荨麻疹的有效性和安全性。

方法

对随机对照试验进行系统评价和荟萃分析。疾病活动控制被评估为主要结局。反应率、复发率和不良事件被评估为次要结局。

结果

纳入了 7 项研究，共 512 名参与者。一项试验显示，在疾病活动控制方面，放血疗法联合药物治疗与单独药物治疗之间存在显著差异（MD 0.67；95%CI 0.03 至 1.31；p=0.04）。6 项试验（372 名参与者）显示，在反应率方面，放血疗法与药物治疗之间存在显著差异（RR 1.10；95%CI 0.97-1.26；P =0.15）。两项研究（170 名参与者）显示，在反应率方面，放血疗法联合药物治疗与药物治疗之间存在显著差异（RR 1.34；95%CI 1.10-1.63；p=0.003）。两项研究（126 名参与者）报告了放血疗法与药物治疗在复发率方面的统计学差异。未报告与放血疗法相关的严重不良事件。

结论

放血疗法可能是治疗慢性荨麻疹的一种有效且安全的治疗方法，但证据不足。未来需要更多高质量的试验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c890/6500668/8af912b68917/BMRI2019-8650398.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c890/6500668/7d6f84c1e428/BMRI2019-8650398.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c890/6500668/a4743f77b0c2/BMRI2019-8650398.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c890/6500668/cbbc1f632028/BMRI2019-8650398.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c890/6500668/52259b64abb2/BMRI2019-8650398.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c890/6500668/8af912b68917/BMRI2019-8650398.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c890/6500668/7d6f84c1e428/BMRI2019-8650398.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c890/6500668/a4743f77b0c2/BMRI2019-8650398.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c890/6500668/cbbc1f632028/BMRI2019-8650398.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c890/6500668/52259b64abb2/BMRI2019-8650398.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c890/6500668/8af912b68917/BMRI2019-8650398.005.jpg

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本文引用的文献

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Blood-Letting Therapy for Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.高血压放血疗法：随机对照试验的系统评价与荟萃分析
Chin J Integr Med. 2019 Feb;25(2):139-146. doi: 10.1007/s11655-018-3009-2. Epub 2018 Jun 25.
3
The EAACI/GA²LEN/EDF/WAO guideline for the definition, classification, diagnosis and management of urticaria.
欧洲过敏研究学会/过敏标准委员会/欧洲皮肤病学会/世界变态反应组织荨麻疹指南：定义、分类、诊断和管理。
Allergy. 2018 Jul;73(7):1393-1414. doi: 10.1111/all.13397.
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The Urticaria Activity Score-Validity, Reliability, and Responsiveness.荨麻疹活动评分的有效性、可靠性和反应性。
J Allergy Clin Immunol Pract. 2018 Jul-Aug;6(4):1185-1190.e1. doi: 10.1016/j.jaip.2017.10.001. Epub 2017 Nov 8.
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The burden of chronic spontaneous urticaria is substantial: Real-world evidence from ASSURE-CSU.慢性自发性荨麻疹负担沉重：ASSURE-CSU 的真实世界证据。
Allergy. 2017 Dec;72(12):2005-2016. doi: 10.1111/all.13209. Epub 2017 Jul 10.
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Clin Exp Allergy. 2017 May;47(5):684-692. doi: 10.1111/cea.12900. Epub 2017 Mar 2.
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Assessing Changes in Chronic Spontaneous/Idiopathic Urticaria: Comparisons of Patient-Reported Outcomes Using Latent Growth Modeling.评估慢性自发性/特发性荨麻疹的变化：使用潜在增长模型比较患者报告的结果
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ATTENTUS, a German online survey of patients with chronic urticaria highlighting the burden of disease, unmet needs and real-life clinical practice.ATTENTUS，一项针对慢性荨麻疹患者的德国在线调查，突出了疾病负担、未满足的需求和现实生活中的临床实践。
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Chin J Integr Med. 2016 Jan;22(1):42-8. doi: 10.1007/s11655-015-2109-2. Epub 2015 Jun 24.