| Objective:The related literatures were summarized through Meta analysis,and the correlation between serum interleukin-6（IL-6）inflammatory markers and chronic urticaria（CU）was clarified.A clinical trial was designed based on the results of Meta analysis.It was confirmed through clinical research that acupuncture treatment can reduce serum inflammatory indexes IL-6,C-reactive protein（CRP）and immunoglobulin E（Ig E）in CU patients,relieve the itching symptoms of patients,and improve clinical efficacy.Methods:1.Chinese databases such as CNKI,Wanfang Digital Journal Full-text Database（Wangfang）,VIP,Sinomed,and English databases such as Pub Med and Web of Science were searched.In addition,trace the relevant references in the literature.Collect case-control studies on IL-6 and CU.The retrieval time range was from the self-built database to January 31,2021.According to the inclusion criteria and exclusion criteria,the included literature was finally determined.The included literature was evaluated by newcastle-ottawa Scale（NOS）,and Review Manager5.4 software was used to analyze its heterogeneity and sensitivity.2.A total of 40 CU patients who met the inclusion criteria and passed the exclusion criteria screening in the department of Dermatology and Acupuncture of Wuhan First Hospital from March 1,2021 to September 1,2021 were collected as the research objects.The patients were randomly divided into acupuncture group and non-acupoint sham acupuncture group,with 20 patients in each group.During the treatment period,patients in both groups were given treatment once every other day,3 times a week for 4 weeks.Urticaria activity score（UAS7）and serum IL-6,Ig E and CRP values of patients before and after treatment were recorded in 2 groups.Results:1.The Meta analysisAn information extraction table was constructed based on the basic information,sample number,average course of disease and research indicators of the included literatures to study the difference of serum IL-6 between the CU patients group and the healthy control group.Finally,10 literatures were screened and included for meta-analysis.The results were as follows: SMD=1.50,95% CI（0.61,2.40）,Z=3.28,P=0.001,The results suggested that P < 0.05,and IL-6 serological levels were associated with CU activity.2.Design a randomized controlled study（1）General data: 40 CU cases were collected and randomly divided into two groups.There were no statistically significant differences in age,gender and course of disease between the two groups（all P>0.05）,and the baseline data of the two groups were comparable.（2）Efficacy indicatorsIntra-group comparison: Compared with before treatment,UAS7 score,serum CRP,Ig E and IL-6 in 2 groups after 4 weeks of treatment were decreased,and the differences were statistically significant（P < 0.05）;Compared with 4 weeks after treatment,UAS7 scores in both groups increased at the end of follow-up compared with 4 weeks after treatment,but there was no statistical significance in acupuncture group（P> 0.05）,and there was statistical significance in nonacupoint sham acupuncture group（P<0.05）.Comparison between groups: UAS7 scores,serum IL-6,total Ig E,and CRP in the two groups before treatment were not statistically significant（P>0.05）.After 4 weeks of treatment and at the end of the follow-up period,the UAS7 score of the acupuncture group was significantly different from that of the non-acupoint sham acupuncture group（P<0.05）.Compared with the non-acupoint sham acupuncture group,the difference was statistically significant（P<0.05）.（3）Clinical efficacy: After the treatment period,the total effective rate of acupuncture group was 90%,and that of non-acupoint sham acupuncture group was 70%,with statistically significant difference.Therefore,the clinical effect of acupuncture on CU is better than that of non-point sham acupuncture group.（4）Safety evaluation: Subcutaneous hematoma occurred in 3patients in the acupuncture group,and subsided spontaneously after routine treatment.There were no serious adverse reactions in non-point acupuncture group.Conclusion:1.Based on meta-analysis,it was found that l L-6 was correlated with the pathogenesis of CU,and the level of IL-6was proportional to the severity of CU,indicating that IL-6was involved in the pathogenesis of CU.2.Based on the results of meta-analysis,a randomized controlled trial was designed for acupuncture treatment of CU,and it was found that acupuncture treatment and non-acupoint sham acupuncture treatment could relieve the clinical symptoms and reduce the levels of serum IL-6,total Ig E and CRP in patients with CU.However,acupuncture is obviously superior to non-acupoint sham acupuncture in improving clinical symptoms,reducing serum IL-6,total Ig E and CRP levels and long-term efficacy,and the effective rate of acupuncture treatment is higher than non-acupoint sham acupuncture treatment.In addition,acupuncture has the advantages of economic safety,convenience and so on,which is worth popularizing. |
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