Systematic Evaluation Of Acupoint Injection In Treatment Of Herpes Zoster And Postherpetic Neuralgia

Objective: To evaluate the therapeutic effect and safety of acupoint injection in treatment of herpes zoster and postherpetic neuralgia.Methods: Randomized controlled studies of acupuncture point injection as the main therapeutic measure for the treatment of Herpes Zoster and postherpetic neuralgia was obtained from The CNKI,Wanfang,VIP,CBM,EMBASE,Pub Med,Cochrane Library and other databases,with the time limited from self-established database to November 30,2020.Endnote X8 was used for documentation and data collection.The included literatures was evaluated by Cochrane Review Handbook 5.3.0,and employ Revman5.3.5 and Stata14 to data analysis,the GRADE system to evaluate the quality of evidence.Results: There are 17 studies,including 16 references and 1406 patients 1.Results of the meta-analysis :After the treatment of Herpes Zoster using acupuncture point injection as the main therapeutic measure,Compared with the control group,The cure rate is higher(RR=1.72,95%CI[1.50,1.97],P<0.00001),Skin lesion heals earlier(MD=-1.73,95%CI[-2.69,-0.77],P =0.0004),Pain relieves earlier(RR=-2.06,95%CI[-2.41,-1.72],P<0.00001),Herpes stops earlier(MD=-1.06,95%CI[-1.41,-0.70],P<0.000 01),The changes in VAS scores before and after treatment are more obvious(MD=0.87,95%CI[0.59,1.15],P<0.00001),The incidence of PHN is lower(RR= 0.32,95%CI[0.19,0.54],P<0.0001),The difference was statistically significant;The incidence of adverse reactions in acupoint injection group was the same as that in western medicine group(RR=1.09,95%CI[0.53,2.25],P =0.82).2.According to the GRADE,cure rate,the Skin lesion healing time,Pain relief time,changes in VAS scores before and after treatment,the incidence of PHN,Herpes stop time,and incidence of adverse reactions were all of low quality evidence.A total of 14 studies,15 references and 1076 patients were included.1.Results of the metaanalysis :(1)After the treatment of postherpetic neuralgia using acupuncture point injection as the main therapeutic measure,Compared with the western medicine group,The effectiveness is higher(RR=1.38,95%CI[1.22,1.58],P<0.000 01),The difference was statistically significant.(2)After the treatment of postherpetic neuralgia using acupuncture point injection as the main therapeutic measure,Compared with traditional Chinese medicine group,The changes in VAS scores before and after treatment are more obvious(MD=1.87,95%CI[0.95,2.80],P<0.0001),The difference was statistically significant.(3)After the treatment of postherpetic neuralgia using acupuncture point injection as the main therapeutic measure,Compared with the acupuncture group,The effectiveness is higher(RR=1.13,95%CI[1.04,1.22],P =0.00 4),The changes in VAS scores before and after treatment are more obvious(MD=1.45,95%CI[1.36,1.53],P<0.000 01),Pain relieves earlier(SMD=-0.56,95%CI[-0.93,-0.20],P=0.003),The difference was statistically significant;The recurrence rate in the acupoint injection group was similar to that in acupuncture group.According to the GRADE,the effectiveness and changes in VAS scores before and after treatment were low quality evidence,and the recurrence rate and time to pain relief were high quality evidence.Conclusion:(1)After the treatment of Herpes Zoster using acupuncture point injection as the main therapeutic measure,Compared with the control group,The cure rate is highe,Skin lesion heals earlier,Pain relieves earlier,Herpes stops earlier,The changes in VAS scores before and after treatment are more obvious,The incidence of PHN is lower,The difference was statistically significant;The incidence of adverse reactions in the acupoint injection group was the same as that in the western medicine group.(2)After the treatment of postherpetic neuralgia using acupuncture point injection as the main therapeutic measure,Compared with the western medicine group,The effectiveness is higher,The difference was statistically significant.(3)After the treatment of postherpetic neuralgia using acupuncture point injection as the main therapeutic measure,Compared with traditional Chinese medicine group,The changes in VAS scores before and after treatment are more obvious,The difference was statistically significant.(4)After the treatment of postherpetic neuralgia using acupuncture point injection as the main therapeutic measure,Compared with the acupuncture group,The effectiveness is higher,The changes in VAS scores before and after treatment are more obvious,Pain relieves earlier,The difference was statistically significant;The recurrence rate in the acupoint injection group was similar to that in acupuncture group.It should be noted that,Due to the particularity of the operation,it is difficult to implement blind method in included clinical studies.The literature lacks a detailed description of random methods and hidden grouping.Therefore,the quality evaluation is mostly low and there is a certain risk of correlation bias.And GRADE Ratings were mostly of low quality,etc.All these indicate that the results of meta-analysis should be strictly interpreted.There is still a need for a large number of high-quality randomized controlled trials with more scientific and rigorous design,more detailed description and sufficient sample size to further study and validate the above results.