针刺疗法治疗急性带状疱疹的疗效和安全性：PRISMA 系统评价和网络荟萃分析。

BACKGROUND: Herpes zoster (HZ) is mainly characterized by intense pain and severe skin lesions, particularly during the acute phase, which seriously affects the patient's quality of life. Acupuncture is a widely used and effective treatment for HZ. However, there are many types of acupuncture, which have different curative efficacy. This study employed a network meta-analysis (NMA) to assess and rank the clinical efficacy of different acupuncture therapies. METHODS: The database of Cochrane Library, Web of Science, PubMed, MEDLINE, Embase, China National Knowledge Infrastructure (CNKI), Chinese BioMedical Database, VIP Database, and Wanfang Database were searched from inception to December 31, 2022 to identify eligible randomized controlled trials (RCTs) of acupuncture related therapies in the treatment of acute HZ. The outcome indicators measured were visual analogue scale (VAS), date of cessation of herpes increase (DCHI), effective rate (ER), postherpetic neuralgia (PHN), and adverse events (AEs). Bayesian network meta-analyses were performed using the GeMTC package (version 1.0-1) and R software (version 4.2.3). RESULTS: A total of 59 RCTs with 3930 patients were included. The results of this NMA were as follows: compared with pharmacotherapy, electroacupuncture (EA) + pricking and cupping (PC) shown the best efficacy to improve VAS score and reduce DCHI. In terms of ER, EA + fire needle (FN) had the highest results of probability ranking. PC was more effective in reducing the incidence of PHN. Furthermore, this study shown that the incidence of AEs associated with acupuncture-related therapies was acceptable. CONCLUSIONS: This study indicated that therapies related to acupuncture were both effective and safe in treating acute HZ, and could significantly reduce patients' symptoms such as pain and skin lesions with fewer adverse events. Clinically, the selection of the appropriate therapy should be based on practical considerations. However, due to the limitations of this study, more high-quality trials are required to evaluate the efficacy and safety of acupuncture-related therapy for the treatment of acute HZ.

背景：带状疱疹（HZ）主要表现为剧烈疼痛和严重皮损，尤其是在急性期，严重影响患者的生活质量。针灸是治疗 HZ 的一种广泛应用且有效的方法。然而，针灸有多种类型，其疗效也不同。本研究采用网络荟萃分析（NMA）来评估和排名不同针灸疗法的临床疗效。

方法：从 Cochrane 图书馆、Web of Science、PubMed、MEDLINE、Embase、中国知网（CNKI）、中国生物医学文献数据库、维普数据库和万方数据库中检索从建库至 2022 年 12 月 31 日的针灸相关疗法治疗急性 HZ 的随机对照试验（RCT），纳入研究。结局指标包括视觉模拟评分（VAS）、疱疹停止增加日期（DCHI）、有效率（ER）、带状疱疹后神经痛（PHN）和不良事件（AEs）。采用 GeMTC 包（版本 1.0-1）和 R 软件（版本 4.2.3）进行贝叶斯网络荟萃分析。

结果：共纳入 59 项 RCT，包含 3930 例患者。本 NMA 的结果如下：与药物治疗相比，电针（EA）+刺络拔罐（PC）在改善 VAS 评分和缩短 DCHI 方面疗效最佳。在 ER 方面，EA+火针（FN）的概率排名最高。PC 降低 PHN 发生率的效果更好。此外，本研究表明与针灸相关疗法相关的不良反应发生率可接受。

结论：本研究表明，针灸相关疗法治疗急性 HZ 既有效又安全，能显著减轻疼痛和皮损等症状，且不良反应少。临床上，应根据实际情况选择合适的疗法。但是，由于本研究的局限性，需要更多高质量的试验来评估针灸相关疗法治疗急性 HZ 的疗效和安全性。