針灸治療面部皮膚老化的有效性和安全性:基於隨機對照試驗的系統評價與Meta分析 Efficacy and Safety of Acupuncture for Facial Skin Aging- A Systematic Review and Meta-Analysis of Randomized Controlled Trials

摘要 目的:系統評價針灸治療面部皮膚老化相關表現的臨床療效與安全性,並總結現有隨機對照試驗的研究特徵。方法:計算機檢索中國知網(CNKI)、維普、萬方、SinoMed、PubMed、Cochrane Library、Web of Science 和 Embase 數據庫中關於針灸治療皮膚老化的隨機對照試驗(RCT),檢索時限為各數據庫建庫至2025年6月。由兩名研究者獨立篩選文獻、提取資料,並採用Cochrane偏倚風險評價工具進行方法學質量評價。使用R 4.4.1軟件進行Meta分析,效應量採用相對危險度(RR)及其95%置信區間(CI)表示。結果:共納入12項RCT,1109例受試者。Meta分析顯示,在有效率方面,針灸較注射填充技術(RR=1.27,95%CI:1.15-1.40)、面部護理(RR=1.08,95%CI:1.00-1.17)及假針灸(RR=2.32,95%CI:1.37-3.91)可能更具優勢;在與鐳射/光子技術聯合應用時,可提高患者滿意度。納入研究報告的不良事件多為輕度瘙癢、瘀斑或青紫,通常無需特殊處理即可緩解。取穴方案多以局部面穴聯合遠端調理穴為主。結論:現有證據提示,針灸在改善面部皮膚老化相關表現方面可能具有一定臨床獲益,但由於原始研究樣本量較小、幹預方式及結局評價異質性較大、方法學質量整體有限,相關結論仍需更多高質量研究進一步驗證。 Abstract Objective: To systematically evaluate the efficacy and safety of acupuncture for facial skin aging-related manifestations and to summarize the characteristics of currently available randomized controlled trials (RCTs). Methods: Eight Chinese and English databases, including CNKI, VIP, Wanfang, SinoMed, PubMed, Cochrane Library, Web of Science, and Embase, were searched from inception to June 2025. Two reviewers independently screened studies, extracted data, and assessed risk of bias using the Cochrane risk-of-bias tool. Meta-analysis was conducted using R 4.4.1, and effect sizes were expressed as relative risk (RR) with 95% confidence intervals (CI). Results: Twelve RCTs involving 1109 participants were included. Meta-analysis suggested that acupuncture may improve overall response rate compared with injection filling techniques (RR=1.27, 95%CI: 1.15-1.40), facial care (RR=1.08, 95%CI: 1.00-1.17), and sham acupuncture (RR=2.32, 95%CI: 1.37-3.91). Acupuncture combined with laser/photon therapy may improve patient satisfaction. Reported adverse events were generally mild and transient, mainly including pruritus, ecchymosis, and bruising. Conclusion: Current evidence suggests that acupuncture may offer certain clinical benefits for facial skin aging-related manifestations. However, the overall certainty of the evidence remains limited because of small sample sizes, considerable heterogeneity in interventions and outcome assessments, and generally suboptimal methodological quality of the included studies. More rigorously designed high-quality RCTs are needed.