Bloodletting therapy to manage fever caused by infectious diseases: A systematic review of randomized controlled trials

IF 1.9 4区医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE

European Journal of Integrative Medicine Pub Date : 2025-04-01 DOI:10.1016/j.eujim.2025.102441

Shuai Dong , Meng-Fang Xu , Xin-Hao Li , Ye-Xin Zhang , Nicola Robinson , Xin-Xin Yang , Hui-Juan Cao

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Abstract

Introduction

Bloodletting therapy (BLT), a traditional Chinese medicine (TCM) non-pharmaceutical therapy, may have a good antipyretic effect, but the evidence has not been evaluated. The aim of this systematic review was to assess the antipyretic effect and safety of TCM BLT used in patients with infections.

Methods

The protocol of this review was registered in PROSPERO (No.CRD42023411059). We included randomized controlled trials (RCTs) comparing BLT alone or in combination with another therapy to controls (no treatment or usual care). A search of CNKI, Wanfang, VIP, Sinomed, Cochrane Library, PubMed, and Embase databases was conducted up to March 2023. Cochrane Risk of Bias 2.0 tool and GRADE were used for assessing methodological quality of included trials and certainty of evidence.

Result

Fourteen RCTs (1419 participants) were included. BLT (either used alone or as add on therapy) was superior to drugs alone in increasing antipyretic rate and lowering the body temperature only for adults. For children or when combined with pediatric Tuina or herbal medicine, its advantages were not shown. The fever clearance time may be shortened (Mean Difference (MD)=-7.59 h, 95 %CI -12.73 h to -2.44 h, 194 participants, I²=69 %, 3 trials, P = 0.004) and the commencement of fever abatement (MD=-1.48 h, 95 %CI -2.02 h to -0.94 h, 134 participants, I²=0 %, 2 trials, P < 0.00001) improved when used as an adjunctive treatment with pediatric Tuina. Safety of BLT to treat fever was still unclear since few trials reported this relevant outcome. Certainty of evidence was very low.

Conclusion

The long-term (24hrs+) antipyretic effect of BLT alone and combined with drugs may be better than that of drugs alone for adults. For children combining BLT and pediatric Tuina/herbal medicine was no better in increasing antipyretic rate compared to pediatric Tuina/herbal medicine alone. Current evidence does not provide firm conclusions about the safety of BLT.

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来源期刊

European Journal of Integrative Medicine INTEGRATIVE & COMPLEMENTARY MEDICINE-

CiteScore

4.70

自引率

4.00%

发文量

102

审稿时长

33 days

期刊介绍： The European Journal of Integrative Medicine (EuJIM) considers manuscripts from a wide range of complementary and integrative health care disciplines, with a particular focus on whole systems approaches, public health, self management and traditional medical systems. The journal strives to connect conventional medicine and evidence based complementary medicine. We encourage submissions reporting research with relevance for integrative clinical practice and interprofessional education. EuJIM aims to be of interest to both conventional and integrative audiences, including healthcare practitioners, researchers, health care organisations, educationalists, and all those who seek objective and critical information on integrative medicine. To achieve this aim EuJIM provides an innovative international and interdisciplinary platform linking researchers and clinicians. The journal focuses primarily on original research articles including systematic reviews, randomized controlled trials, other clinical studies, qualitative, observational and epidemiological studies. In addition we welcome short reviews, opinion articles and contributions relating to health services and policy, health economics and psychology.