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Background: Herpes zoster (HZ) is mainly characterized by intense pain and severe skin lesions, particularly during the acute phase, which seriously affects the patient’s quality of life. Acupuncture is a widely used and effective treatment for herpes zoster. However, there are many types of acupuncture, which have different curative efficacy. This study employed a network meta-analysis (NMA) to assess and rank the clinical efficacy of different acupuncture therapies.
Methods: The database of Cochrane Library, Web of Science, PubMed, MEDLINE, Embase, China National Knowledge Infrastructure (CNKI), Chinese BioMedical Database, VIP Database, and Wanfang Database were searched from inception to December 31, 2022 to identify eligible randomized controlled trials (RCTs) of acupuncture related therapies in the treatment of acute herpes zoster. The outcome indicators measured were visual analogue scale (VAS), date of cessation of herpes increase (DCHI), effective rate (ER), postherpetic neuralgia (PHN), and adverse events (AEs). Bayesian network meta-analyses were performed using the GeMTC package (version 1.0-1) and R software (version 4.2.3).
Results: A total of 59 RCTs with 3930 patients were included. The results of this NMA were as follows: compared with pharmacotherapy, electroacupuncture (EA) + pricking and cupping (PC) shown the best efficacy to improve VAS score and reduce DCHI. In terms of effective rate, electroacupuncture + fire needle (FN) had the highest results of probability ranking. Pricking and cupping was more effective in reducing the incidence of PHN. Furthermore, this study shown that the incidence of adverse events associated with acupuncture-related therapies was acceptable.
Conclusions: This study indicated that therapies related to acupuncture were both effective and safe in treating acute herpes zoster, and could significantly reduce patients’ symptoms such as pain and skin lesions with fewer adverse events. Clinically, the selection of the appropriate therapy should be based on practical considerations.
Reference: https://pubmed.ncbi.nlm.nih.gov/38758864/