Luo Ying, Qian Wei, Dai Ting, Ru Yi, Sun Xiaoying, Kuai Le, Liu Liu, Xing Meng, Zheng Qi, Zhang Ying, Chen Xi, Zhao Huaibo, Li Bin, Li Xin
Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China.
Ningbo Municipal Hospital of TCM, Ningbo, Zhejiang 315012, China.
Evid Based Complement Alternat Med. 2020 Aug 27;2020:8492097. doi: 10.1155/2020/8492097. eCollection 2020.
Fire needle therapy has been reported as an effective treatment for vitiligo. However, current clinical evidence has not been systematically evaluated. The aim of this study was to determine whether fire needle therapy is effective and safe for treating vitiligo.
Seven databases were searched until October 2019 for randomized controlled trials on fire needle therapy, with and without conventional treatments, versus any type of conventional therapy for treating vitiligo. The RevMan 5.3.5 software was used to perform meta-analysis of the included studies.
Forty-seven trials comprising 3618 patients were included. Fire needle combined with conventional vitiligo treatments had a higher efficacy (risk ratio (RR): 1.55, 95% confidence interval (CI): 1.46-1.65, < 0.00001 and RR: 1.41, 95% CI: 1.24-1.61, < 0.00001, respectively) and a greater effect on restoring the color of the area of the skin lesion (mean difference (MD): 3.40, 95% CI: 2.11-4.69, < 0.00001), increasing the pigment point of vitiligo (MD: 0.83, 95% CI: 0.54-1.13, < 0.00001) and improving the cytokine level (MD: 8.10, 95% CI: 6.94-9.27, < 0.00001) and effectual time (MD: -4.76, 95% CI: -7.33 to -2.19, =0.0003) than traditional methods. Limb lesions (RR: 1.60, 95% CI: 1.31-1.95, < 0.00001) were more effectively treated when the treatments included fire needles, whereas the therapeutic effect of fire needles on either the head and neck (RR: 1.13, 95% CI: 0.78-1.64, =0.52) or torso lesions (RR: 1.22, 95% CI: 0.82-1.81, =0.33) was not significantly different compared to that without fire needles. No statistically significant differences in adverse effects (RR: 1.15, 95% CI: 0.89-1.49, =0.28) and recurrence rates (RR: 0.90, 95% CI: 0.17-4.92, =0.91) during the follow-up period were observed between treatment with and without fire needles.
Fire needle therapy combined with other conventional treatments is useful in treating vitiligo. Further studies with larger sample sizes should be performed to make a conclusive judgment. This trial is registered with CRD42018094918.
火针疗法已被报道为治疗白癜风的一种有效方法。然而，目前的临床证据尚未得到系统评价。本研究的目的是确定火针疗法治疗白癜风是否有效和安全。
检索了7个数据库，直至2019年10月，查找关于火针疗法（无论是否联合传统治疗）与任何类型传统疗法治疗白癜风的随机对照试验。使用RevMan 5.3.5软件对纳入研究进行荟萃分析。
纳入了47项试验，共3618例患者。火针联合传统白癜风治疗方法在疗效（风险比（RR）：分别为1.55，95%置信区间（CI）：1.46 - 1.65，P < 0.00001和RR：1.41，95%CI：1.24 - 1.61，P < 0.00001）、恢复皮肤病变区域颜色（平均差（MD）：3.40，95%CI：2.11 - 4.69，P < 0.00001）、增加白癜风色素点（MD：0.83，95%CI：0.54 - 1.13，P < 0.00001）、改善细胞因子水平（MD：8.10，95%CI：6.94 - 9.27，P < 0.00001）和起效时间（MD： - 4.76，95%CI： - 7.33至 - 2.19，P = 0.0003）方面均优于传统方法。当治疗包括火针时，肢体病变（RR：1.60，95%CI：1.31 - 1.95，P < 0.00001）的治疗效果更佳，而火针对于头颈部病变（RR：1.13，95%CI：0.78 - 1.64，P = 0.52）或躯干病变（RR：1.22，95%CI：0.82 - 1.81，P = 0.33）的治疗效果与不使用火针相比无显著差异。在随访期间，使用火针与不使用火针治疗的不良反应（RR：1.15，95%CI：0.89 - 1.49，P = 0.28）和复发率（RR：0.90，95%CI：0.17 - 4.92，P = 0.91）无统计学显著差异。
火针疗法联合其他传统治疗方法对治疗白癜风有效。应进行更大样本量的进一步研究以做出确定性判断。本试验已在CRD42018094918注册。
