Wei Wang, Wu Yuxiang, Zhang Shengyan, Li Bushuang, Cheng Zhengda, Zhao Wenjie
Beijing University of Traditional Chinese Medicine Xiamen Hospital, Xiamen, China.
Fujian University of Traditional Chinese Medicine, Fuzhou, China.
Front Med (Lausanne). 2025 May 30;12:1498795. doi: 10.3389/fmed.2025.1498795. eCollection 2025.
This study aims to systematically evaluate the clinical efficacy and safety of acupuncture in treatment for chronic spontaneous urticaria (CSU) and provide evidence to inform clinical decision-making.
A comprehensive search of eight Chinese and English databases was carried out. The search period spanned from the inception of the database up to 20 August 2024, and the search included randomized controlled trials (RCTs) on acupuncture for CSU, without language restrictions. Two independent researchers screened the resulting studies, evaluated their quality, and cross-checked their results. The extracted data were subjected to meta-analysis using RevMan 5.4 and Stata 15.
A total of 22 RCTs involving 1,867 patients were included. Meta-analysis showed that acupuncture significantly improved the overall response rate, reduced the recurrence rate, decreased the urticaria activity score, and improved the Dermatology Life Quality Index, Hamilton Depression Scale, VAS itching score, and the Chronic Urticaria Quality of Life Questionnaire scores. Acupuncture also resulted in a reduced number and size of wheals, shortened duration of flare-ups, and reduced serum IgE, IFN-, and IL-4 levels. In addition, it led to significantly reduced traditional Chinese medicine syndrome scores, all with statistical significance. Furthermore, acupuncture did not significantly increase the incidence of adverse events, which indicates good safety. However, moderate to high bias and heterogeneity were observed in the included RCTs. Based on the Grading of Recommendations, Assessment, Development, and Evaluation evidence, this study provides a moderate to low recommendation for acupuncture in the treatment for CSU although the results remain promising.
Acupuncture appears to be an effective and safe treatment for CSU. However, further high-quality RCTs are needed to confirm its clinical efficacy and safety.
本研究旨在系统评价针刺治疗慢性自发性荨麻疹（CSU）的临床疗效和安全性，为临床决策提供依据。
全面检索了8个中英文数据库。检索时间跨度从数据库建立至2024年8月20日，检索包括针刺治疗CSU的随机对照试验（RCT），无语言限制。两名独立研究人员筛选所得研究，评估其质量，并交叉核对结果。提取的数据使用RevMan 5.4和Stata 15进行荟萃分析。
共纳入22项RCT，涉及1867例患者。荟萃分析表明，针刺显著提高了总有效率，降低了复发率，降低了荨麻疹活动评分，改善了皮肤病生活质量指数、汉密尔顿抑郁量表、视觉模拟评分法瘙痒评分和慢性荨麻疹生活质量问卷评分。针刺还使风团数量和大小减少，发作持续时间缩短，血清IgE、IFN-和IL-4水平降低。此外，针刺使中医证候评分显著降低，均具有统计学意义。此外，针刺并未显著增加不良事件的发生率，表明安全性良好。然而，纳入的RCT中观察到中度至高度的偏倚和异质性。根据推荐分级、评估、制定和评价证据，本研究对针刺治疗CSU提供了中度至低度的推荐，尽管结果仍很有前景。
针刺似乎是一种治疗CSU安全有效的方法。然而，需要进一步的高质量RCT来证实其临床疗效和安全性。
