系统评价针灸治疗慢性湿疹(CE)的有效性和安全性, 为针灸治疗慢性湿疹提供循证依据. 检索PubMed,Cochrane图书馆,中国知网(China National Knowledge Infrastructure, CNKI),维普数据库(WeiPu Database, VIP Data),万方数据库(Wanfang Data)和中国生物医学文献数据库(China Biology Medicine disc, CBM)数据库中的随机对照试验, 检索时间为自建库至2025年4月23日.检索研究的对照组采用假针灸,不予治疗或常规西药治疗.干预组采用针灸治疗或在对照组基础上联合针灸治疗.运用Rev Man5.4.0软件对数据进行meta分析. 最终纳入53篇随机对照试验, meta分析结果显示, 与假针灸,不予治疗或常规西药相比, 针灸治疗CE患者湿疹面积和严重程度指数(Eczema Area and Severity Index, EASI)评分(mean difference MD = -2.23, 95% confidence interval CI -2.61 to -1.85; P <0.00001), 瘙痒视觉模拟量表(Visual Analogue Scale, VAS)评分(standardized mean difference SMD =-1.45, 95% CI -2.04 to -0.87; P <0.00001), 皮肤病生活质量量表(Dermatology Life Quality Index, DLQI)评分(MD = -2.36, 95% CI -3.25 to -1.48; P <0.00001),血清免疫球蛋白E(immunoglobulin E, IgE)水平(SMD=-1.26, 95% CI -2.46 to -0.05; P =0.04), 总有效率(odds ratio OR=4.58, 95% CI 3.84 to 5.46; P <0.00001),复发率(OR=0.14, 95% CI 0.09 to 0.21; P <0.00001), 各项指标干预组均优于对照组, 且无严重不良反应事件. 针灸可降低慢性湿疹患者湿疹面积和严重程度, 有效改善瘙痒症状, 提高生活质量, 降低血清IgE水平, 总有效率高,复发率低,无明显不良反应, 有利于长期预后. CRD42024621431 To systemically evaluate the effectiveness and safety of acupuncture and moxibustion for chronic eczema, and to provide evidence for acupuncture and moxibustion in the treatment of chronic eczema. Randomized controlled trials (RCTs) were retrieved from PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), VIP database, Wanfang database and China Biology Medicine disc (CBM), from the inception of the database to April 23, 2025. The control group were sham acupuncture and moxibustion, no treatment, or conventional western medication. The intervention group were acupuncture and moxibustion therapy or acupuncture and moxibustion on the basis of the interventions as the control group. Meta-analysis was performed by using RevMan5.4.0 software according to Cochrane systematic evaluation method. Ultimately, 53 RCTs were included. The results of the meta-analysis showed that compared with sham acupuncture and moxibustion, no treatment, or conventional western medication, acupuncture and moxibustion treatment for eczema area and severity index (EASI) score (mean difference MD = -2.23, 95% confidence interval CI -2.61 to -1.85; P <0.00001), visual analogue scale (VAS) score (standardized mean difference SMD =-1.45, 95% CI -2.04 to -0.87; P <0.00001), dermatology life quality index (DLQI) score (MD = -2.36, 95% CI -3.25 to -1.48; P <0.00001), immunoglobulin E (IgE) (SMD=-1.26, 95% CI -2.46 to -0.05; P =0.04), the overall response rate (odds ratio OR=4.58, 95% CI 3.84 to 5.46; P <0.00001) and the recurrence rate (OR=0.14, 95% CI 0.09 to 0.21; P <0.00001) were all better than those in the control group, and there were no severe adverse events reported. Acupuncture and moxibustion can reduce the lesion area and severity of the patients with chronic eczema, effectively alleviate pruritus, improve the quality of life and decrease serum IgE. This therapy owns high overall response rate with low recurrence rate, and without severe adverse events, which is associated with a favorable long-term prognosis. CRD42024621431.
Zhao et al. (Sun,) studied this question.