梅花针治疗带状疱疹后遗神经痛有效性和安全性Meta分析

A Meta-analysis of efficacy and safety of treating post herpetic neuralgia by percussopunctator

背景:笔者发现在临床运用梅花针叩刺带状疱疹后遗神经痛效果明显,可有效缓解患者疼痛,故通过系统检索相关文献,发现国内已有较多个梅花针治疗带状疱疹后遗神经痛的临床试验文章发表,但结论尚不统一。目的:本研究对梅花针治疗带状疱疹后遗神经痛的有效性和安全性作出总结,或许能为后期研究提供参考。方法:全面检索国内外数据库,包括中国知网、PubMed、万方数据库、Embase、维普数据库。检索时间范围为自建库至2022年4月。搜索涉及梅花针治疗带状疱疹后遗神经痛的随机对照试验。由两名研究者独立对所有文献进行筛选,对筛选后的文章进行质量分析,并对最终纳入的文献使用RevMan5.3软件进行分析。结果:最终纳入11个随机对照试验,共计898例患者。Meta分析结果显示:在改善视觉模拟疼痛评分表评分方面,单用梅花针[SMD=-0.40(-0.84,0.05),P=0.08]、梅花针+西药[SMD=-1.71(-1.98,-1.44),P <0.01]、梅花针+拔罐[SMD=-1.29(-2.19,-0.39),P <0.01]、梅花针+中药内服[SMD=-0.69(-0.99,-0.39),P <0.01]、梅花针+中药外敷[SMD=-1.68(-2.07,-1.28),P <0.01]均可有效降低患者视觉模拟疼痛评分表评分,改善疼痛症状。结论:证据表明,单用梅花针或联合其他疗法治疗可改善带状疱疹后遗神经痛患者的疼痛程度,提高患者睡眠质量。但本次研究纳入文献数量有限,后期还需更多大样本研究进行更深层次验证。

Background:The author found that percussopunctator is effective on post herpetic neuralgia and can effectively relieve the pain of patients.It is found that there are many clinical trials of percussopunctator in the treatment of post herpetic neuralgia in China,but the conclusion is not unified.Objective:To summarize the efficacy and safety of percussopunctator in the treatmentB of post herpetic neuralgia,which may provide reference for later research.Methods:A comprehensive search of domestic and foreign databases,including CNKI,PubMed,Wanfang database,Embase,VIP database.The search time range is from the establishment of the database to April 2022.Randomized controlled trials of percussopunctator in the treatment of post herpetic neuralgia have been searched.Two researchers independently screened all the articles,analyzed the quality of the selected articles,and analyzed the final included articles using RevMan5.3.Results:Eleven randomized controlled trials were included,totaling 898 patients.The results of Meta-analysis showed that percussopunctator alone[SMD=-0.40(-0.84,0.05),P=0.08],percussopunctator plus western medicine[SMD=-1.71(-1.98,-1.44),P<0.01],percussopunctator plus cupping[SMD=-1.29(-2.19,-0.39),P<0.01],and percussopunctator plus oral administration of TCM medicine[SMD=-0.69(-0.99,-0.39),P<0.01],percussopunctator plus external application of TCM medicine[SMD=-1.68(-2.07,-1.28),P<0.01]could effectively reduce the score of visual analog pain scale and improve the pain symptoms of patients.Conclusion:The evidence shows that percussopunctator alone or combined with other treatments can improve the pain degree and sleep quality of patients with post herpetic neuralgia.However,the number of literature included in this study is limited,and more large sample studies are needed for deeper verification in the later stage.