针灸治疗黄褐斑的有效性和安全性：随机对照试验的荟萃分析。

IF 1.9 4区医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE

Explore-The Journal of Science and Healing Pub Date : 2025-01-01 DOI:10.1016/j.explore.2024.103108

Jiayu Su , Tingwei Quan , Tianrong Liao , Yu Luo , Xin Fan , Mingfu Pan , Hongzhen Tang

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引用次数: 0

摘要

背景：治疗黄褐斑仍然具有挑战性。我们进行了一项荟萃分析来评估针灸作为一种治疗选择的有效性和安全性。方法：检索截至2024年1月2日的3个英文和4个中文数据库。主要结局是总有效率，次要结局包括皮肤病变面积和颜色评分、病变总评分和不良反应。使用偏倚风险工具评估研究质量，并使用Review Manager 5.4对数据进行分析。GRADE方法评估证据的确定性。结果：本研究包括22项研究，1644名受试者。结果表明，针灸治疗明显优于西药及其他治疗方法（风险比[RR] = 1.21, 95%可信区间[CI] (1.18, 1.30), P < 0.00001, I²= 34%）。针刺能有效缩小皮损面积（平均差值[MD] = -0.35, 95% CI (-0.52, -0.19), P < 0.0001, I²= 93%），使皮肤颜色变浅（MD = -0.45, 95% CI (-0.58, -0.31), P < 0.00001, I²= 89%），降低皮损总分（MD = -1.00, 95% CI (-1.29, -0.70), P < 0.00001, I²= 79%）。针灸的不良反应很少发生。在17项研究中指出，最常见的针刺部位是面部病变区域。最常使用的穴位是三音交（SP6）（n = 8），其次是合谷（LI4）（n = 7）和雪海（SP10）（n = 7），其他常用的穴位还有天枢（ST25）、足三里（ST36）、太中（LR3）、中脘（RN12）。除主要结局外，所有次要结局均被评为极低质量。结论：针灸治疗可有效减少黄褐斑病变面积和颜色，降低病变评分。针刺疗法似乎是黄褐斑安全有效的治疗选择；然而，由于潜在的出版和区域偏倚，结果应谨慎解释。注册:CRD42024503394。

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Effectiveness and safety of acupuncture for melasma: A meta-analysis of randomized controlled trials

Background

Treating melasma remains challenging. We conducted a meta-analysis to assess the effectiveness and safety of acupuncture as a treatment option.

Methods

We searched three English and four Chinese databases up to January 2, 2024. The primary outcome was the total effective rate, while secondary outcomes included skin lesion area and color scores, total lesion score, and adverse effects. Study quality was assessed using the risk of bias tool, and data were analyzed with Review Manager 5.4. The GRADE approach evaluated evidence certainty.

Results

This study included 22 studies with 1644 participants. Findings indicate that acupuncture significantly outperforms Western medicine and other treatments (risk ratio [RR] = 1.21, 95 % confidence interval [CI] (1.18, 1.30), P < 0.00001, I² = 34 %). Acupuncture effectively reduces the area of skin lesions (mean difference [MD] = −0.35, 95 % CI (−0.52, −0.19), P < 0.0001, I² = 93 %), lightens color (MD = −0.45, 95 % CI (−0.58, −0.31), P < 0.00001, I² = 89 %), and lowers the total score of skin lesions (MD = -1.00, 95 % CI (−1.29, −0.70), P < 0.00001, I² = 79 %). Adverse reactions were infrequent with acupuncture. The most common needling sites were in the facial lesion area, noted in 17 studies. Sanyinjiao (SP6) was the most frequently used acupoint (n = 8), followed by Hegu (LI4) (n = 7) and Xuehai (SP10) (n = 7). Other commonly used acupoints included Tianshu (ST25), Zusanli (ST36), Taichong (LR3), and Zhongwan (RN12). All secondary outcomes, except for the primary outcome, were rated as very low quality.

Conclusion

This review confirms that acupuncture therapy effectively reduces the area and color of melasma lesions and lowers lesion scores. Acupuncture therapy appears to be a safe and effective treatment option for melasma; however, results should be interpreted cautiously due to potential publication and regional biases.

Registration

CRD42024503394.

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来源期刊

Explore-The Journal of Science and Healing 医学-全科医学与补充医学

CiteScore

3.00

自引率

8.30%

发文量

179

审稿时长

25 days

期刊介绍： EXPLORE: The Journal of Science & Healing addresses the scientific principles behind, and applications of, evidence-based healing practices from a wide variety of sources, including conventional, alternative, and cross-cultural medicine. It is an interdisciplinary journal that explores the healing arts, consciousness, spirituality, eco-environmental issues, and basic science as all these fields relate to health.