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[穴位埋线疗法治疗寻常型银屑病的不良事件/不良反应:一项系统评价]

[Adverse events/adverse reactions of acupoint catgut embedding therapy for psoriasis vulgaris: a systematic review].

作者信息

Luo Ya, Yao Dan-Ni, Lu Chuan-Jian

机构信息

The Second School of Clinical Medicine of Guangzhou University of Chinese Medicine, Guangzhou 510405, China.

The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120.

出版信息

Zhen Ci Yan Jiu. 2022 Apr 25;47(4):369-76. doi: 10.13702/j.1000-0607.20210077.

Abstract

OBJECTIVE

To systematically review the occurrence of adverse events/adverse reactions (AEs/ARs) induced by acupoint catgut embedding therapy for psoriasis vulgaris (PV) and its safety.

METHODS

Randomized controlled trials, controlled clinical trials, cohort studies, case-control studies, case-series, and case reports concerning the treatment of PV with acupoint catgut embedding therapy were searched from Chinese and English databases from their inception to January 7, 2021. The AEs/ARs related to acupoint catgut embedding therapy for PV were subjected to descriptive statistics, followed by the analysis of possible reasons.

RESULTS

Finally, 16 studies were included, involving 1 158 patients. A total of 79 cases were reported to present with mild to moderate AEs/ARs related to acupoint catgut embedding therapy for PV, and there were no serious AEs/ARs or death cases. The most common AEs/ARs were local redness, swelling, heat, and pain (31.65%,25/79), followed by low-grade fever and fatigue (29.11%,23/79), isomorphic reaction (16.46%,13/79), local induration (13.92%,11/79), and fainting (8.86%,7/79). In terms of embedding materials, catgut (93.67%,74/79) and lumbar puncture needles or other puncture needles (49.37%,39/79) were proved the most common AEs/ARs-inducing factors. The proportion of AEs/ARs resulting from treatment interval≤two weeks (67.09%,53/79) and treatment course≤eight weeks (55.70%,44/79) was relatively high. Because the incidence of AEs/ARs fails to be calcula-ted, it is not yet possible to accurately assess the risk and safety of acupoint catgut embedding therapy for PV.

CONCLUSION

Available evidence suggests that in the treatment of PV, acupoint catgut embedding therapy may induce a series of mild to moderate AEs/ARs, so its clinical practice deserves attention. We should strictly grasp its indications and contraindications, and prevent the occurrence of related AEs/ARs by standardizing the operation and improving the embedding materials.

摘要

目的

系统评价穴位埋线疗法治疗寻常型银屑病(PV)引起的不良事件/不良反应(AE/AR)的发生情况及其安全性。

方法

从中文和英文数据库中检索自建库至2021年1月7日有关穴位埋线疗法治疗PV的随机对照试验、对照临床试验、队列研究、病例对照研究、病例系列和病例报告。对与穴位埋线疗法治疗PV相关的AE/AR进行描述性统计,然后分析可能的原因。

结果

最终纳入16项研究,涉及1158例患者。共有79例报告出现与穴位埋线疗法治疗PV相关的轻至中度AE/AR,无严重AE/AR或死亡病例。最常见的AE/AR是局部红、肿、热、痛(31.65%,25/79),其次是低热和乏力(29.11%,23/79)、同形反应(16.46%,13/79)、局部硬结(13.92%,11/79)和晕厥(8.86%,7/79)。在埋线材料方面,羊肠线(93.67%,74/79)和腰椎穿刺针或其他穿刺针(49.37%,39/79)被证明是最常见的AE/AR诱发因素。治疗间隔≤2周(67.09%,53/79)和疗程≤8周(55.70%,44/79)导致AE/AR的比例相对较高。由于AE/AR的发生率无法计算,目前尚无法准确评估穴位埋线疗法治疗PV的风险和安全性。

结论

现有证据表明,在PV治疗中,穴位埋线疗法可能诱发一系列轻至中度AE/AR,因此其临床应用值得关注。应严格掌握其适应证和禁忌证,并通过规范操作和改进埋线材料预防相关AE/AR的发生。

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