毫火针治疗白癜风疗效与安全性Meta分析

Meta-Analysis of Efficacy and Safety of Filiform Fire Needling in the Treatment of Vitiligo

目的:系统评价毫火针法治疗白癜风的临床疗效。方法:计算机检索CNKI、WanFang、VIP、CBM、PubMed、Cochrane Library和EMbase数据库,时限从建库起至2019年12月。检索以毫火针为主治疗白癜风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:共纳入中文文献10篇,共有患者1156例。采用固定效应模型对总有效率进行Meta分析,结果显示试验组总有效率(RR=1.29,95%CI[1.21,1.38],Z=7.58,P<0.00001)优于对照组,差异具有统计学意义,且从干预措施与疗程的不同分别进行亚组分析进一步确切了结论。采用随机效应模型对两组的安全性进行分析,结果显示RR=0.94,95%CI[0.44,1.98],Z=0.17,P=0.87,说明毫火针组的安全性明显高于西医常规治疗组的结论并不确切。结论:毫火针治疗白癜风较常规治疗具有明显优势,结果较稳定,但前者安全性与后者相比优势不明显,由于纳入文献的样本较少且质量不齐,其结论需进一步验证。

Objective:To systematically evaluate the clinical efficacy of filiform fire needling in the treatment of vitiligo.Methods:Relevant literature of randomized controlled trials focusing on the treatment of vitiligo with filiform fire needling were retrieved from the databases from CNKI,WanFang,VIP,CBM,PubMed,Cochrane Library and EMbase from the establishment of the database to December 2019.Data were extracted and literature quality was evaluated based on the Cochrane bias risk assessment method.Meta analysis was performed by using Rev Man5.3 and Stata15 statistical software.Results:A total of 10 pieces of Chinese literature were included,involving 1,156 patients.Meta-analysis was performed by using a fix-effect model,and the results showed that the total effective rate of the experimental group was better than that of the control group,the difference was statistically significant(RR=1.29,95%CI[1.21,1.38],Z=7.58,P<0.00001),which was further verified by different interventions and different treatment courses by sub-group analysis.The safety of the two groups was analyzed by using a random-effect model,and the results showed it was not exactly accurate that the safety of filiform fire needling was higher than that of routine western medication(RR=0.94,95%CI[0.44,1.98],Z=0.17,P=0.87).Conclusion:The treatment of vitiligo with filiform fire needling has obvious advantages over conventional treatment,and the results are stable.However,filiform fire needling has few advantages in the safety than the conventional treatment.The conclusions need to be further verified due to the small number of samples and the uneven quality of the included literature.