中药外治法治疗带状疱疹的系统评价与Meta分析
External Therapy of Chinese Medicine for Herpes Zoster: A Systematic Review and Meta-Analysis.
作者信息
Wu Liu, Chen Yong, Man Tianming, Jin Long, Xu Zhangmeng, Lv Lizeyu, Luo Jian, Zhu Tianmin
机构信息
School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
出版信息
Evid Based Complement Alternat Med. 2022 Mar 10;2022:3487579. doi: 10.1155/2022/3487579. eCollection 2022.
BACKGROUND
Herpes zoster (HZ) is a common skin disease that has a huge impact on the quality of life of sufferers. Antiviral therapy is a conventional treatment, but it still has limitations. This review evaluates the safety and efficacy of acupuncture in the treatment of HZ.
METHODS
We identified randomized controlled trials from multiple electronic sources (including Embase, PubMed, Cochrane, Web of Knowledge, China National Knowledge Infrastructure (CNKI), and China Biology Medicine Disc (CBM)) and reference lists of relevant articles and extracted data and assessed risk of bias (Cochrane's Risk of Bias tool). Pooled data are expressed as standardized mean differences (SMDs), with 95% confidence intervals (CI) (random-effects model).
RESULTS
We included 15 trials (1811 participants) comparing acupuncture to medicine. Ten studies involving 1424 patients provided these data for the meta-analysis. The results showed that acupuncture as a control group had a higher clinical cure rate than Western medicine therapy ( = 1424, 95% Cl 2.19-3.14, = 0%). Eleven studies used the visual analog scale (VAS), but only nine provided specific data, which we used as a continuous variable for data extraction. The meta-analysis also showed an SMD of -2.64 ( = 646, 95% CI -3.79-1.48, = 97%) which showed great heterogeneity. Meta-analysis showed a significant reduction in the incidence of PHN in those who received acupuncture compared to pharmacotherapy (OR = 0.35, 95% CI 0.04-2.86, = 52%) which showed moderate heterogeneity. Economic indicators suggest that acupuncture costs less and has fewer adverse reactions.
CONCLUSIONS
This review compares acupuncture therapy with conventional treatment and finds that the curative effects of acupuncture are exact, with fewer side effects. However, with the risk of bias and imprecision of the studies included, a concrete conclusion is difficult to draw. Thus, well-designed, rigorous studies are warranted in the future.
背景
带状疱疹(HZ)是一种常见的皮肤病,对患者的生活质量有巨大影响。抗病毒治疗是一种传统疗法,但仍有局限性。本综述评估了针灸治疗HZ的安全性和有效性。
方法
我们从多个电子资源(包括Embase、PubMed、Cochrane、Web of Knowledge、中国知网(CNKI)和中国生物医学文献数据库(CBM))以及相关文章的参考文献列表中识别随机对照试验,并提取数据和评估偏倚风险(Cochrane偏倚风险工具)。汇总数据以标准化均数差(SMD)表示,95%置信区间(CI)(随机效应模型)。
结果
我们纳入了15项将针灸与药物进行比较的试验(1811名参与者)。10项涉及1424例患者的研究提供了这些数据用于荟萃分析。结果显示,作为对照组的针灸组临床治愈率高于西医治疗(=1424,95%Cl 2.19 - 3.14,=0%)。11项研究使用了视觉模拟量表(VAS),但只有9项提供了具体数据,我们将其作为连续变量进行数据提取。荟萃分析还显示SMD为 -2.64(=646,95%CI -3.79 - 1.48,=97%),显示出很大的异质性。荟萃分析显示,与药物治疗相比,接受针灸治疗的患者带状疱疹后神经痛(PHN)的发生率显著降低(OR = 0.35,95%CI 0.04 - 2.86,=52%),显示出中度异质性。经济指标表明,针灸成本更低,不良反应更少。
结论
本综述将针灸疗法与传统治疗进行了比较,发现针灸疗效确切,副作用更少。然而,鉴于所纳入研究存在偏倚风险和不精确性,难以得出确切结论。因此,未来有必要进行设计良好、严谨的研究。