Meta-analysis and systematic evaluation of the curative effect and analgesic effect of acupuncture on herpes zoster

摘要

Objective:To systematically evaluate the clinical efficacy and analgesic effect of acupuncture and moxibustion in the treatment of herpes zoster by comparing western medicine.Methods:Randomized controlled trials on acupuncture and western medicine for herpes zoster were searched from CNKI,Wanfang Database,VIP,CMB,PubMed,Embase and Cochrane library databases,and the retrieval time was from January 2010 to July 2020.RevMan5.3 software was used for Meta analysis.Results:A total of 30 randomized controlled studies were included,involving a total of 4292 patients.Subgroup analysis was conducted according to different intervention measures in the experimental group.The results showed that:(1)The total effective rate of the subgroup analysis showed that the combined effect of acupuncture treatment alone RR=1.10,95%CI[1.05,1.15],P<0.0001.Results:RR=1.16,95%CI[0.86,1.57],P=0.33.It suggests that the therapeutic effect of acupuncture and moxibustion on herpes zoster is superior to that of western medicine,but acupuncture and western medicine treatment cannot improve the clinical efficacy of western medicine.However,due to the unstable meta-analysis of acupuncture and western medicine treatment in the subgroup,the results need to be treated with caution and further clinical verification is still needed.(2)VAS score improvement analysis showed that the combined effect of acupuncture alone RR=2.20,95%CI[1.53,2.87],P<0.00001.RR=1.12,95%CI[0.39,1.85],P=0.002,suggesting that acupuncture is significantly better than western medicine in improving the pain of shingles,and western medicine combined with acupuncture can improve the analgesic effect.(3)The subgroup analysis of sequelae incidence showed that the combined effect amount of acupuncture alone on sequelae incidence at 30 days was RR=0.34,95%CI[0.25,0.48],P<0.00001,and the combined effect amount of acupuncture combined with western medicine was RR=0.18,95%CI[0.05,0.69],P=0.01.Incidence of sequelae at 60 days RR=0.38,95%CI[0.23,0.62],P=0.0001;The incidence of post-herpetic neuralgia treated with acupuncture alone at 90 days RR=0.39,95%CI[0.20,0.74],P=0.004,suggesting that the incidence of post-herpetic neuralgia treated with acupuncture is significantly lower than that treated with western medicine,and western medicine combined with acupuncture can reduce the incidence of post-herpetic neuralgia.(4)The time analysis of the onset of pain relief showed that the combined effect of acupuncture alone RR=-2.32,95%CI[-2.48,-2.17],P<0.00001.RR=-2.39,95%CI[-2.70,-2.09],P<0.00001,suggesting that the onset time of acupuncture and moxibustion was shorter than that of western medicine,and western medicine combined with acupuncture and moxibustion could accelerate the onset time of analgesia.(5)The time analysis of pain relief showed that the combined effect of acupuncture alone RR=-10.80,95%CI[-12.49,-9.01],P<0.00001.RR=-5.98,95%CI[-11.55,-0.41],P=0.04,suggesting that acupuncture treatment of herpes zoster can significantly reduce the pain time,combined with western medicine can shorten the pain time.Conclusion:Acupuncture and moxibustion treatment of herpes zoster in the total effective rate,pain relief and the incidence of post-neurosis is significantly better than western medicine;Acupuncture and moxibustion combined with western medicine can improve the analgesic effect and reduce the incidence of post-neurosis.In view of the low overall quality of the literature included in this study,further clinical validation is needed for this conclusion.