火针治疗带状疱疹后遗神经痛疗效及安全性的Meta分析

The Efficacy and Safety of Fire Needling in the Treatment of Postherpetic Neuralgia:A Meta-analysis

【目的】系统评价火针治疗带状疱疹后遗神经痛的疗效与安全性,为临床决策提供循证依据。【方法】计算机检索中国知网期刊全文数据库(CNKI)、万方学术期刊全文数据库(Wanfang)、维普中文科技期刊数据库(VIP)、中国生物医学文献数据库(SinoMed)、中华医学期刊全文数据库、美国生物医学信息检索系统(PubMed)、荷兰医学文摘(Embase)、国际循证医学图书馆(Cochrane Library)、科学网(Web of Science)等各大数据库中关于火针治疗带状疱疹后遗神经痛的随机对照试验。运用Cochrane偏倚风险评估工具对纳入的文献进行偏倚风险评估,运用Rev-man 5.4软件对纳入研究的总有效率、愈显率、疼痛视觉模拟量表(VAS)评分、睡眠质量评分、抑郁状态评分及不良反应发生率进行Meta分析。【结果】Meta分析结果显示,火针疗法治疗带状疱疹后遗神经痛在临床总有效率[OR=6.89,95%CI(3.58,13.25),P<0.00001]、愈显率[OR=5.19,95%CI(3.38,7.98),P<0.00001]、VAS评分[MD=-1.01,95%CI(-1.28,-0.75),P<0.00001]、睡眠质量评分[MD=-1.66,95%CI(-2.38,-0.94),P<0.00001]、抑郁状态评分[SMD=-2.69,95%CI(-3.37,-2.01),P<0.00001]、不良反应发生率[OR=0.07,95%CI(0.01,0.39),P=0.002]方面均优于对照组。【结论】火针疗法可有效缓解带状疱疹后遗神经痛患者的疼痛症状,疗效较好且相对安全,但本研究纳入文献量少,研究质量较低,未来还需要更多高质量研究进一步验证。

Objective To systematically evaluate the efficacy and safety of fire needling in the treatment of postherpetic neuralgia(PHN)and to provide an evidence-based basis for clinical decision-making.Methods Randomized controlled trials of fire needling in the treatment of PHN were searched in major databases such as the computer search of CNKI,Wanfang,VIP,SinoMed,Chinese Medical Journal Full-text Database,PubMed,Embase,Cochrane Library,Web of Science.The risk of bias was assessed using the Cochrane Risk of Bias Assessment Tool,and Meta-analysis was performed using Rev-man 5.4 software to determine the total effective rate,healing rate,pain visual analogue scale(VAS)scores,sleep quality scores,depression status scores and incidence of adverse effects in the included studies.Results Meta-analysis results showed that fire needling therapy for PHN was effective in terms of total effective rate[OR=6.89,95%CI(3.58,13.25),P<0.00001],healing rate[OR=5.19,95%CI(3.38,7.98),P<0.00001],VAS score[MD=-1.01,95%CI(-1.28,-0.75),P<0.00001],sleep quality score[MD=-1.66,95%CI(-2.38,-0.94),P<0.00001],depressive state score[SMD=-2.69,95%CI(-3.37,-2.01),P<0.00001],incidence of adverse reactions[OR=0.07,95%CI(0.01,0.39),P=0.002]were superior to the control group.Conclusion Fire needling is effective in relieving pain symptoms in patients with PHN with good efficacy and relative safety,but the small amount of literature included in this study and the low quality of the study require further validation by more high-quality studies in the future.