火针为主治疗带状疱疹随机对照试验Meta分析

Meta-analysis of Randomized Controlled Trials for Herpes Zoster Mainly Treated with Fire Needle Therapy

【目的】对近10年火针为主治疗带状疱疹临床研究进行疗效和安全性的系统评价。【方法】通过中国知网(CNKI)、中国生物医学文献数据库(CBM)、重庆维普(VIP)、万方数据库和PubMed、荷兰医学文摘数据库(Embase)、美国临床医学期刊全文数据库(Ovid)、Cochrane图书馆(CL,Issue4,2006)中的Cochrane系统评价资料库(CDSR)及Cochrane对照试验注册资料库(CCTR)等中、英文数据库检索2007～2017年火针为主治疗带状疱疹的相关文献,使用RevMan5.3版进行统计分析。【结果】共检索到701篇文献,其中14篇符合纳入标准,使用改良后的Jadad评分标准对研究文献进行质量评价,评分显示所纳入研究文献均为中低质量文献。Meta分析结果显示,火针为主的治疗组在有效率[OR=4.66,95%CI(3.02,7.19)]和降低后遗神经痛发生率[OR=0.14,95%CI(0.07,0.26)]方面优于常规西药治疗的对照组,差异有统计学意义(P <0.000 01);但在缓解带状疱疹疼痛视觉模拟评分(VAS)[95%CI(-1.62,-1.31)]方面优势不明显。【结论】火针为主的治疗方法是治疗带状疱疹的安全有效方法,在总有效率、后遗神经痛发生率方面优于西医治疗方法,在即时止痛方面有优于西医西药的趋势,但VAS评分方面优势不明显。

Objective To evaluate the clinical efficacy and safety of clinical trials for herpes zoster mainly treated with fire needle therapy in recent 10 years. Methods We retrieved the clinical trials for herpes zoster mainly treated with fire needle therapy from Chinese databases of CNKI,Chinese biomedical literature database(CBM),Weipu database(VIP),Wanfang database,as well as English databases of PubMed,Embase,the full text database of the Journal of clinical medicine in the United States(Ovid),Cochrane system evaluation database(CDSR)and Cochrane controlled trial registry database(CCTR)in the Cochrane library(CL,Issue 4,2006)issued in the year of 2007 ~ 2017,and then made the quality evaluatin with RevMan 5.3 version. Results A total of 701 articles were obtained,and 14 trials met the inclusion criteria. The quality of the research literature was evaluated by the improved Jadad scoring system,and the results showed that the included trials were in low quality. The results of the Meta-analysis showed that the treatment group(mainly treated with fire needle therapy)had a higher overall effective rate [OR = 4.66,95%CI(3.02,7.19)] and showed stronger effect on decreasing the incidence of postherpetic neuralgia [OR=0.14, 95% CI(0.07, 0.26)] than the control group (treated with western medicine), the differences being significant(P < 0.000 01), while had no obvious advantages on deccreasing the visual analogue scale(VAS)scores of herpes zoster pain[95%CI(-1.62,-1.31)]. Conclusion The fire needle therapy is safe and effective for the treatment of herpes zoster,and it is superior to western medicine in terms of enhancing overall effective rate and decreasing the incidence of postherpetic neuralgia. It has a tendency to be superior to western medicine in immediate pain relief,but the advantage of relieving VAS scores is not obvious.