放血疗法治疗急性痛风性关节炎的疗效：系统评价和荟萃分析。
The efficacy of bloodletting therapy in patients with acute gouty arthritis: A systematic review and meta-analysis.
机构信息
Acupuncture and Moxibustion College, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, China.
Acupuncture and Moxibustion College, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, China; Acupuncture & Chronobiology Key Laboratory of Sichuan Province, Chengdu, Sichuan, 610075, China; Institute of Acupuncture and Homeostasis Regulation, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, China.
出版信息
Complement Ther Clin Pract. 2022 Feb;46:101503. doi: 10.1016/j.ctcp.2021.101503. Epub 2021 Nov 11.
BACKGROUND
Bloodletting therapy (BLT) is widely used to relieve acute gouty arthritis (AGA). However, limited evidence-based reports exist on the effectiveness and safety of BLT. This systematic review aims to evaluate the feasibility and safety of BLT in treating AGA.
METHODS
Seven databases were exhaustively screened from the date of establishment to July 31, 2020, irrespective of the publication source and language. The included articles were evaluated for bias risk by using the Cochrane risk of bias assessment tool. All statistical analyses were done with Review Manager 5.3.
RESULTS
Twelve studies involving 894 participants were included for the final analysis. Our meta-analysis revealed that BLT was highly effective in relieving pain (MD = -1.13, 95% CI [-1.60, -0.66], P < 0.00001), with marked alterations in the total effective (RR = 1.09, 95% [1.05, 1.14], P < 0.0001) and curative rates (RR = 1.37, 95%CI [1.17, 1.59], P < 0.0001). In addition, BLT could dramatically reduce serum C-reactive protein (CRP) level (MD = -3.64, 95%CI [-6.72, -0.55], P = 0.02). Both BLT and Western medicine (WM) produced comparable decreases in uric acid (MD = -18.72, 95%CI [-38.24, 0.81], P = 0.06) and erythrocyte sedimentation rate (ESR) levels (MD = -3.01, 95%CI [-6.89, 0.86], P = 0.13). Lastly, we demonstrated that BLT was safer than WM in treating AGA (RR = 0.36, 95%CI [0.13, 0.97], P = 0.04).
CONCLUSION
BLT is effective in alleviating pain and decreasing CRP level in AGA patients with a lower risk of evoking adverse reactions.
背景
放血疗法（BLT）广泛用于缓解急性痛风性关节炎（AGA）。然而，目前关于 BLT 的有效性和安全性的循证报告有限。本系统评价旨在评估 BLT 治疗 AGA 的可行性和安全性。
方法
从建立日期到 2020 年 7 月 31 日，全面筛选了 7 个数据库，无论其来源和语言如何。使用 Cochrane 偏倚风险评估工具评估纳入研究的偏倚风险。所有统计分析均使用 Review Manager 5.3 进行。
结果
共有 12 项研究涉及 894 名参与者被纳入最终分析。我们的荟萃分析表明，BLT 在缓解疼痛方面非常有效（MD=-1.13，95%CI[-1.60，-0.66]，P<0.00001），总有效率（RR=1.09，95%CI[1.05，1.14]）和治愈率（RR=1.37，95%CI[1.17，1.59]）均有显著改善（P<0.0001）。此外，BLT 还可以显著降低血清 C 反应蛋白（CRP）水平（MD=-3.64，95%CI[-6.72，-0.55]，P=0.02）。BLT 和西药（WM）在降低尿酸（MD=-18.72，95%CI[-38.24，0.81]）和红细胞沉降率（ESR）水平（MD=-3.01，95%CI[-6.89，0.86]）方面也具有相当的作用（P=0.13）。最后，我们证明 BLT 在治疗 AGA 方面比 WM 更安全（RR=0.36，95%CI[0.13，0.97]，P=0.04）。
结论
BLT 可有效缓解 AGA 患者的疼痛并降低 CRP 水平，且不良反应发生率较低。
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