Yu Yunfeng, Wu Jingyi, Hu Gang, Deng Juan, Yang Xinyu, Yu Rong
School of Traditional Chinese Medicine, Hunan University of Chinese Medicine, Changsha, Hunan Province, China.
The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan Province, China.
Int J Surg. 2025 Oct 1;111(10):7285-7300. doi: 10.1097/JS9.0000000000002887. Epub 2025 Jul 1.
The benefits and risks of manual acupuncture for treating chronic spontaneous urticaria (CSU) remain unclear. To address this gap, this systematic review and meta-analysis aimed to evaluate the efficacy and safety of manual acupuncture for treating CSU.
Seven major databases were searched for relevant literature published up to 1 January 2025. Studies were selected based on pre-specified criteria, and relevant information was extracted. A meta-analysis was conducted using Review Manager 5.3.
Six randomized controlled trials involving 615 participants were included. Compared with sham or non-acupuncture, a 4-week manual acupuncture treatment significantly reduced the values of the urticaria activity score over 7 days (weighted mean difference [WMD] -3.43; 95% confidence interval [CI] -5.27 to -1.60; P = 0.0002), Dermatology Life Quality Index (WMD -2.16; 95% CI -3.78 to -0.54; P = 0.009), Pittsburgh Sleep Quality Index (WMD -1.25; 95% CI -1.69 to -0.81; P < 0.00001), Hamilton Anxiety Rating Scale (WMD -2.97; 95% CI -4.05 to -1.89; P < 0.00001), and Hamilton Depression Rating Scale (WMD -2.55; 95% CI -3.43 to -1.66; P < 0.00001). These improvements remained significantly different at 4-weeks post-treatment. Although manual acupuncture was associated with an increased incidence of subcutaneous hemorrhage (risk ratio 4.52; 95% CI 1.06 to 19.29; P = 0.04), no significant effect on the incidence of total adverse events, dizziness, fatigue, or acupuncture-related pain was observed.
Manual acupuncture has the potential to improve skin symptoms, emotional well-being, sleep quality, and overall quality of life in patients with CSU, without increasing the risk of adverse events, potentially serving as a beneficial complementary therapy.
手动针刺治疗慢性自发性荨麻疹（CSU）的益处和风险尚不清楚。为填补这一空白，本系统评价和荟萃分析旨在评估手动针刺治疗CSU的疗效和安全性。
检索了七个主要数据库，以查找截至2025年1月1日发表的相关文献。根据预先设定的标准选择研究，并提取相关信息。使用Review Manager 5.3进行荟萃分析。
纳入了六项涉及615名参与者的随机对照试验。与假针刺或非针刺相比，为期4周的手动针刺治疗显著降低了7天内的荨麻疹活动评分值（加权平均差[WMD]-3.43；95%置信区间[CI]-5.27至-1.60；P = 0.0002）、皮肤病生活质量指数（WMD -2.16；95% CI -3.78至-0.54；P = 0.009）、匹兹堡睡眠质量指数（WMD -1.25；95% CI -1.69至-0.81；P < 0.00001）、汉密尔顿焦虑量表（WMD -2.97；95% CI -4.05至-1.89；P < 0.00001）和汉密尔顿抑郁量表（WMD -2.55；95% CI -3.43至-1.66；P < 0.00001）。这些改善在治疗后4周时仍有显著差异。虽然手动针刺与皮下出血发生率增加相关（风险比4.52；95% CI 1.06至19.29；P = 0.04），但未观察到对总不良事件、头晕、疲劳或针刺相关疼痛发生率有显著影响。
手动针刺有潜力改善CSU患者的皮肤症状、情绪健康、睡眠质量和总体生活质量，且不增加不良事件风险，可能是一种有益的辅助治疗方法。
