Liang Shuang, Huang Kai-Yu, Zhang Lian, Li Mei, Gu Hai-Hong, Chen Ning-Gang
Department of Acupuncture, Ningbo Hospital of Traditional Chinese Medicine, Affiliated Hospital of Zhejiang Chinese Medical University, Ningbo, Zhejiang, China.
Dermatology Medical Cosmetology Center, Ningbo Hospital of Traditional Chinese Medicine, Affiliated Hospital of Zhejiang Chinese Medical University, Ningbo, Zhejiang, China.
BMJ Open. 2024 Dec 5;14(12):e084788. doi: 10.1136/bmjopen-2024-084788.
Atopic dermatitis is a chronic, relapsing, inflammatory skin disease that impacts patients' quality of life and imposes substantial economic burdens on their families. Acupuncture holds promise as a viable treatment option for atopic dermatitis. This review aimed to evaluate the effect of acupuncture on atopic dermatitis.
Systematic review and meta-analysis.
PubMed, Embase, CENTRAL, the China National Knowledge Infrastructure, WanFang and VIP databases were searched through 17 September 2023, together with an updated search on 15 October 2024.
We included randomised controlled trials (RCTs) about acupuncture for atopic dermatitis. The primary outcome was the SCORing Atopic Dermatitis (SCORAD) score. The secondary outcomes were the eczema area and severity index (EASI) score, the visual analogue scale (VAS) score for pruritus, the dermatology life quality index (DLQI) score, serum IgE level and adverse events (AEs).
Two independent reviewers conducted separate searches of the databases, assessed eligible articles for inclusion and employed the Cochrane Collaboration's tool for assessing the risk of bias. The analyses were performed using RevMan 5.3 and Stata 13.0 software. The mean difference (MD) with 95% CI was employed to analyse continuous outcomes.
Eight studies with 463 participants were included. The meta-analysis indicated significant differences in the SCORAD score (MD=-10.61, 95% CI -17.77 to -3.45, p=0.004), the VAS score for pruritus (MD=-14.71, 95% CI -18.20 to -11.22, p<0.00001) and the DLQI score (MD=-2.37, 95% CI -3.57 to -1.18, p<0.0001), but no significant differences in the EASI score (MD=-3.95, 95% CI -8.35 to 0.45, p=0.08) and the IgE level (MD=-160.22 U/mL, 95% CI -334.13 to 13.68, p=0.07) between treatment and control. The differences in the SCORAD score and the VAS score for pruritus reached minimal clinically important differences. No serious AEs were reported.
Acupuncture might be an effective and safe treatment for atopic dermatitis. Due to the limited quantity and quality of the included studies, it is recommended to conduct multicentre, large-scale and high-quality RCTs to further confirm the findings.
CRD42023470643.
特应性皮炎是一种慢性、复发性炎症性皮肤病，会影响患者的生活质量，并给其家庭带来沉重的经济负担。针灸有望成为治疗特应性皮炎的一种可行选择。本综述旨在评估针灸对特应性皮炎的疗效。
系统评价和荟萃分析。
检索了截至2023年9月17日的PubMed、Embase、CENTRAL、中国知网、万方和维普数据库，并于2024年10月15日进行了更新检索。
我们纳入了关于针灸治疗特应性皮炎的随机对照试验（RCT）。主要结局是特应性皮炎评分（SCORAD）。次要结局包括湿疹面积和严重程度指数（EASI）评分、瘙痒视觉模拟量表（VAS）评分、皮肤病生活质量指数（DLQI）评分、血清IgE水平和不良事件（AE）。
两名独立评价者分别检索数据库，评估符合纳入标准的文章，并采用Cochrane协作网的偏倚风险评估工具。使用RevMan 5.3和Stata 13.0软件进行分析。采用95%CI的平均差（MD）分析连续性结局。
纳入8项研究，共463名参与者。荟萃分析表明，治疗组与对照组在SCORAD评分（MD=-10.61，95%CI -17.77至-3.45，p=0.004）、瘙痒VAS评分（MD=-14.71，95%CI -18.20至-11.22，p<0.00001）和DLQI评分（MD=-2.37，95%CI -3.57至-1.18，p<0.0001）方面存在显著差异，但在EASI评分（MD=-3.95，95%CI -8.35至0.45，p=0.08）和IgE水平（MD=-160.22 U/mL，95%CI -334.13至13.68，p=0.07）方面无显著差异。SCORAD评分和瘙痒VAS评分的差异达到了最小临床重要差异。未报告严重不良事件。
针灸可能是治疗特应性皮炎的一种有效且安全的方法。由于纳入研究的数量和质量有限，建议开展多中心、大规模和高质量的RCT以进一步证实这些结果。
PROSPERO注册号：CRD42023470643。
