刺络放血治疗带状疱疹随机对照试验meta分析

A meta-analysis of randomized controlled trials of acupuncture bloodletting for shingles

目的:系统评价刺络放血疗法治疗带状疱疹的临床疗效。方法:计算机检索CNKI、WanFang、VIP、CBM、PubMed、Cochrane Library数据库,时限从建库起至2019年12月31日。检索刺络放血治疗带状疱疹的随机对照试验相关文献,依据Cochrane偏倚风险评估方法对纳入文献进行资料提取和质量评估,用Rev Man5.3及Stata15统计软件进行Meta分析。结果:(1)共纳入中文文献21篇,共有患者1533例;(2)采用固定效应模型进行Meta分析,结果显示实验组总有效率[OR=5.11,95%CI(3.48,7.50),Z=8.33,P<0.00001]优于对照组,差异具有统计学意义;(3)采用随机效应模型对VAS评分分析[MD=-2.23,95%CI(-2.46,-1.99),P<0.0001];(4)采用随机效应模型进行分析后遗神经痛发生率[OR=0.21,95%CI(0.09,0.51),Z=3.48,P=0.0005]。结论:刺络放血对于治疗带状疱疹的疗效及VAS评分、症状缓解情况、后遗神经痛发生率等方面均有优势。

Objective To evaluate the clinical efficacy of acupuncture bloodletting therapy for herpes zoster.Methods The related literature on randomized controlled trials of spinal bloodletting for shingles in CNKI,WanFang,VIP,CBM,PubMed,and Cochrane Library databases was searched and collected with the retrieval time until December 31,2019.Data were extracted and evaluated based on the Cochrane bias risk assessment method.Moreover,a meta analysis was performed using Rev Man5.3 and Stata15 statistical software.Results A total of 21 studies were included,with 1533 patients;A meta-analysis was performed using a fixed effect model,and the results showed that the total effective rate of the experimental group(OR=5.11,95%CI(3.48,7.50),Z=8.33,P<0.00001),which was better than that of the control group with statistically significant difference.Moreover,VAS score was measured using a random effect model(MD=-2.23,95%CI(-2.46,-1.99),P<0.0001).The incidence of neuralgia was analyzed using a random effect model(OR=0.21,95%CI(0.09,0.51),Z=3.48,P=0.0005).Conclusion The bloodletting can impove VAS scores,symptomatic relief,and the incidence of sequela neuralgia in the treatment of shingles.