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Different Acupuncture Therapies for Postherpetic Neuralgia: An Overview of Systematic Reviews and Meta-analysis

  • Evidence-Based Integrative Medicine
  • Published:
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Abstract

Background

Postherpetic neuralgia (PHN) is the most common complication of herpes zoster infection and affects patients’ quality of life. Acupuncture therapy is regarded as a competitive method of treatment for analgesia.

Objective

To summarize evidence from systematic reviews (SRs) and evaluate the effectiveness and safety of different acupuncture therapies for treating PHN.

Methods

Eight electronic databases were searched from their inception to August 5, 2022, including 4 international electronic databases (PubMed, EMBASE, the Cochrane Library, and Web of Science) and 4 Chinese databases (Chinese Biomedical Database, China National Knowledge Infrastructure, VIP Database and Wanfang Database). Methodological quality was assessed by A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2). The Risk of Bias in Systematic Review (ROBIS) tool was used to assess the risk of bias in SRs. Evidence level was assessed by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.

Results

Totally, 7 SRs were included, including 128 studies and 9,792 patients. In AMSTAR 2, most of the SRs were of low or critically low levels since they had more than 1 critical deficiency. In ROBIS, 1 SR (14.29%) was rated as high risk, and the other 6 (85.71%) were rated as low risk. In the GRADE system, 9 outcomes (28.13%) were valued as high level, 5 (15.63%) as moderate level, 1 (3.13%) as low, and 17 (53.13%) as very low. In the effectiveness of acupuncture therapy, the group “moxibustion vs. original medical treatment” [mean difference (MD)=−1.44, 95% confidence interval (CI): −1.80 to −1.08, I2=99%, P<0.00001] was of the highest heterogeneity and the group “bloodletting vs. original medical treatment” (MD=−2.80, 95% CI: −3.14 to −2.46, I2=0, P<0.00001) was of the lowest heterogeneity. Six SRs have reported the safety of their studies and no serious events were shown in the treatment and control groups.

Conclusions

Acupuncture therapy seems to be effective in treating PHN. Despite the evidence that suggested the advantages of acupuncture therapy in relieving pain and promoting efficacy and safety, the methodological quality was quite low. Further studies should pay more attention to the quality of original studies and evidence for SRs to confirm these findings. (PROSPERO registration No. CRD42022344790)

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Authors and Affiliations

  1. The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, 310000, China

    Yun-fan Xia, Ruo-han Sun, Yi-yi Wang &  Jian-qiao Fang

  2. Department of Rehabilitation Medicine, Hangzhou Third People’s Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, 310000, China

    Shi-min Li

  3. Department of Acupuncture, the Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310000, China

    Rong-rong Li

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  1. Yun-fan Xia
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  2. Ruo-han Sun
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  3. Shi-min Li
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  6. Jian-qiao Fang
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Contributions

Xia YF, Wang YY, and Fang JQ were responsible for the conception and design of the study; Xia YF and Li SM decided on the methodology; Sun RH and Wang YY performed the formal analysis and data curation. Wang YY and Li RR conducted the resources; Fang JQ was responsible for supervision; Xia YF and Sun RH wrote the original draft; Li RR and Sun RH revised the manuscript. All authors have read and agreed to the published version of the manuscript.

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Correspondence to Jian-qiao Fang.

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The authors declare that they have no conflicts of interest.

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Supported by the Traditional Chinese Medicine Science and Technology Program of Zhejiang (No. 2022ZZ029)

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Xia, Yf., Sun, Rh., Li, Sm. et al. Different Acupuncture Therapies for Postherpetic Neuralgia: An Overview of Systematic Reviews and Meta-analysis. Chin. J. Integr. Med. (2024). https://doi.org/10.1007/s11655-023-3613-4

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