Efficacy and safety of wet cupping in the treatment of neurodermatitis: a systematic review and meta-analysis.

IF 3.1 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Frontiers in Medicine Pub Date : 2024-12-19 eCollection Date: 2024-01-01 DOI:10.3389/fmed.2024.1478073
Yan Zhai, You-Yi Hui, Ze-Fei Jiang, Lin Ding, Jie Cheng, Tang Xing, Han Zhai, Hong Zhang
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引用次数: 0

Abstract

Background: Neurodermatitis is a chronic skin condition characterized by intense itching and skin thickening due to neurological dysfunction. Its persistent nature poses a challenge to effective treatment, significantly impacting patients' quality of life. Wet cupping therapy is increasingly being used in clinics to manage neurodermatitis, so it is imperative to assess the evidence regarding its effectiveness and safety.

Objective: This review aimed to evaluate the efficacy and safety of wet cupping therapy in patients with neurodermatitis.

Methods and analysis: Randomized controlled trials (RCTs) investigating wet cupping for neurodermatitis were identified through searches of eight electronic databases and three clinical trial registration platforms from inception to March 2024, using predefined search terms. Included studies underwent quality appraisal using the Cochrane Collaboration's Risk of Bias Assessment tool. The quality of evidence was assessed independently by two reviewers using the Grading of Recommendations Assessment, Development, and Evaluation System (GRADE). Meta-analysis and publication bias assessment were conducted using ReviewManager 5.4 and STATA 17.0 software, respectively.

Results: This review encompassed 19 studies, comprising 6 types of comparisons and involving 1,505 participants. The findings revealed no significant difference in the total effective rate between wet cupping alone and high-potency steroids (n = 269, RR = 1.13, 95% CI [0.90, 1.41], p = 0.29, I2 = 83%). However, wet cupping combined with medication or moxibustion exhibited superior efficacy compared to medication alone (n = 272, RR = 1.28, 95% CI [1.16, 1.41], p < 0.00001, I2 = 43%) and (n = 534, RR = 1.22, 95% CI [1.14, 1.30], p < 0.00001, I2 = 0%). Wet cupping groups demonstrated lower recurrence rates (n = 266, RR = 0.31, 95% CI [0.16, 0.60], p = 0.0005, I2 = 0%) and a reduced incidence of adverse events (n = 673, RR = 0.44, 95% CI [0.21, 0.90], p = 0.02, I2 = 36%). Furthermore, wet cupping alone or combined with moxibustion effectively lowered the levels of inflammatory factors compared to medication: TNF-α (n = 120, MD = -6.99, 95% CI [-8.13, -5.85], p < 0.00001, I2 = 0%), IL-1β (n = 120, MD = -5.28, 95% CI [-6.91, -3.65], p < 0.00001, I2 = 48%), and IL-6 (n = 180, MD = -8.61, 95% CI [-13.24, -3.99], p = 0.0003, I2 = 81%).

Conclusion: The efficacy of wet cupping therapy is comparable to that of high-potency steroids. Its combined use with medication or moxibustion appears to enhance effectiveness, reduce recurrence rates, and improve safety. However, due to the overall low grade of evidence for the identified outcomes and poor methodological quality, caution is advised when interpreting and applying these findings in clinical practice.

Systematic review registration: https://www.crd.york.ac.uk/prospero, identifier: CRD42024524398.

湿罐治疗神经性皮炎的疗效和安全性:一项系统综述和荟萃分析。
背景:神经性皮炎是一种以神经功能障碍引起的强烈瘙痒和皮肤增厚为特征的慢性皮肤病。其持续性对有效治疗构成挑战,显著影响患者的生活质量。湿罐疗法越来越多地被用于临床治疗神经性皮炎,因此有必要评估其有效性和安全性的证据。目的:评价湿罐治疗神经性皮炎的疗效和安全性。方法与分析:使用预设检索词,通过对8个电子数据库和3个临床试验注册平台的检索,从建立到2024年3月,确定了研究湿罐治疗神经性皮炎的随机对照试验(rct)。纳入的研究使用Cochrane协作的偏倚风险评估工具进行质量评估。证据质量由两名审稿人使用分级建议评估、发展和评价系统(GRADE)独立评估。meta分析和发表偏倚评估分别使用ReviewManager 5.4和STATA 17.0软件进行。结果:本综述包括19项研究,包括6种类型的比较,涉及1505名参与者。结果显示,单纯湿拔罐与高效类固醇的总有效率无显著差异(n = 269,RR = 1.13,95% CI [0.90, 1.41], p = 0.29,I2 = 83%)。然而,湿拔火罐结合药物或艾灸展出效果优于单独用药(n = 272 RR = 1.28,95%可信区间[1.16,1.41],p 2 = 43%)和(n = 534 RR = 1.22,95%可信区间[1.14,1.30],p 2 = 0%)。湿拔火罐团体证明低复发率(n = 266 RR = 0.31,95%可信区间[0.16,0.60],p = 0.0005,I2 = 0%)和不良事件的发生率降低(n = 673 RR = 0.44,95%可信区间[0.21,0.90],p = 0.02,I2 = 36%)。此外,湿拔火罐单独或结合艾灸有效降低炎症因子的水平相比,药物:TNF -α(n = 120,MD = -6.99,95%可信区间[-8.13,-5.85],p 2 = 0%),il - 1β(n = 120,MD = -5.28,95%可信区间[-6.91,-3.65],p 2 = 48%),和il - 6 (n = 180,MD = -8.61,95%可信区间[-13.24,-3.99],p = 0.0003,I2 = 81%)。结论:湿罐治疗与高效类固醇治疗的疗效相当。它与药物或艾灸联合使用似乎可以提高有效性,降低复发率并提高安全性。然而,由于所确定结果的证据等级总体较低,方法学质量较差,建议在临床实践中解释和应用这些发现时要谨慎。系统评价注册:https://www.crd.york.ac.uk/prospero,标识符:CRD42024524398。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Frontiers in Medicine
Frontiers in Medicine Medicine-General Medicine
CiteScore
5.10
自引率
5.10%
发文量
3710
审稿时长
12 weeks
期刊介绍: Frontiers in Medicine publishes rigorously peer-reviewed research linking basic research to clinical practice and patient care, as well as translating scientific advances into new therapies and diagnostic tools. Led by an outstanding Editorial Board of international experts, this multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide. In addition to papers that provide a link between basic research and clinical practice, a particular emphasis is given to studies that are directly relevant to patient care. In this spirit, the journal publishes the latest research results and medical knowledge that facilitate the translation of scientific advances into new therapies or diagnostic tools. The full listing of the Specialty Sections represented by Frontiers in Medicine is as listed below. As well as the established medical disciplines, Frontiers in Medicine is launching new sections that together will facilitate - the use of patient-reported outcomes under real world conditions - the exploitation of big data and the use of novel information and communication tools in the assessment of new medicines - the scientific bases for guidelines and decisions from regulatory authorities - access to medicinal products and medical devices worldwide - addressing the grand health challenges around the world
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