Department of Dermatology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China; School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Department of Dermatology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Ann Palliat Med. 2021 Oct;10(10):10804-10820. doi: 10.21037/apm-21-2523.
BACKGROUND: Acupuncture therapy is a method of piercing needles into acupoints to treat diseases with/without corresponding manipulations, which could serve as a useful supplementary therapy for psoriasis. The present study aimed to outline and sum up current evidence from systematic reviews (SRs)/meta-analyses (MAs) that investigate the clinical efficacy of acupuncture on psoriasis. METHODS: A comprehensive search involving eight electronic databases was conducted from the date of inception to July 2021, and grey literatures were manually searched. The research was selected according to prespecified inclusion criteria and relevant data were obtained. The methodological quality of the included SRs was scrutinized using the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2) tool. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used to appraise the reporting quality of the included SRs. Risk of Bias in Systematic Reviews (ROBIS) was selected for the evaluation of bias risk of the included SRs. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was applied to determine the quality of evidence from primary outcome measures. RESULTS: After screening, seven SRs/MAs met the inclusion criteria, including two English and five Chinese articles. All of the SRs were published between 2015 and 2020. Based on AMSTAR-2, the quality of all SRs was rated as dangerously low. Using the PRISMA-A checklist, major reporting flaws were observed in the financial statements, protocols, and registrations of the included literature. According to the ROBIS tool, two SRs/MAs were classed as low bias risk. Using the GRADE tool, this review contained 27 outcomes, with only one being classified as high-quality evidence, seven moderate-quality evidences, and 19 as low-quality evidence. The present research results advocated acupuncture therapy as a supplementary treatment for psoriasis patients; however, the evidence should still be treated with caution due to certain limitations. CONCLUSIONS: Our overview suggests that acupuncture could be used as a complementary therapy to produce effective clinical result for psoriasis. Nonetheless, considering the poor quality of SRs/Mas that advocate these findings, studies with more rigorous design, larger populations samples and of higher quality are called for to provide stronger evidence for definitive conclusions.
背景：针灸疗法是一种针刺穴位并用/不用相应手法来治疗疾病的方法，可作为银屑病的一种有效辅助治疗方法。本研究旨在概述和总结目前系统评价（SR）/荟萃分析（MA）的证据，这些研究调查了针灸治疗银屑病的临床疗效。
方法：从建库日期到 2021 年 7 月，全面检索了 8 个电子数据库，并手动检索灰色文献。根据预设的纳入标准选择研究，并获取相关数据。使用评估系统评价的方法学质量 2 版（AMSTAR-2）工具对纳入的 SR 进行方法学质量评估。采用系统评价和荟萃分析报告的首选条目（PRISMA）对纳入的 SR 进行报告质量评价。偏倚风险评估工具（ROBIS）用于评价纳入的 SR 偏倚风险。对主要结局测量的证据质量采用推荐评估、制定与评价（GRADE）进行分级。
结果：经过筛选，有 7 项 SR/MA 符合纳入标准，包括 2 篇英文文献和 5 篇中文文献。所有 SR 均发表于 2015 年至 2020 年。根据 AMSTAR-2，所有 SR 的质量均被评为危险低。使用 PRISMA-A 清单，观察到纳入文献的财务报表、方案和注册存在主要报告缺陷。根据 ROBIS 工具，有 2 项 SR/MA 被归类为低偏倚风险。使用 GRADE 工具，本综述包含 27 个结局，仅有 1 个被归类为高质量证据，7 个为中等质量证据，19 个为低质量证据。本研究结果主张针灸疗法可作为银屑病患者的辅助治疗方法；然而，由于存在一定的局限性，仍应谨慎对待这些证据。
结论：本综述结果表明，针灸可能作为一种补充疗法，为银屑病患者带来有效的临床疗效。然而，考虑到支持这些发现的 SR/MA 质量较差，需要设计更严谨、纳入更大样本量和更高质量的研究，以提供更有力的证据得出明确的结论。
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