Background: Bloodletting therapy is widely used to relieve acute gouty arthritis. However, limited evidence-based reports exist on the effectiveness and safety of bloodletting therapy. This systematic review aims to evaluate the feasibility and safety of bloodletting therapy in treating gouty arthritis.
Methods: Seven databases were exhaustively screened from the date of establishment to July 31, 2020, irrespective of the publication source and language. The included articles were evaluated for bias risk by using the Cochrane risk of bias assessment tool. All statistical analyses were done with Review Manager 5.3.
Results: Twelve studies involving 894 participants were included for the final analysis. Our meta-analysis revealed that bloodletting therapy was highly effective in relieving pain (MD = -1.13, 95% CI [-1.60, -0.66], P < 0.00001), with marked alterations in the total effective (RR = 1.09, 95% [1.05, 1.14], P < 0.0001) and curative rates (RR = 1.37, 95%CI [1.17, 1.59], P < 0.0001). In addition, bloodletting therapy could dramatically reduce serum C-reactive protein level (MD = -3.64, 95%CI [-6.72, -0.55], P = 0.02).
Both bloodletting therapy and Western medicine produced comparable decreases in uric acid (MD = -18.72, 95%CI [-38.24, 0.81], P = 0.06) and erythrocyte sedimentation rate (ESR) levels (MD = -3.01, 95%CI [-6.89, 0.86], P = 0.13). Lastly, we demonstrated that bloodletting therapy was safer than WM in treating AGA (RR = 0.36, 95%CI [0.13, 0.97], P = 0.04).
Conclusion: Bloodletting therapy is effective in alleviating pain and decreasing C-reactive protein level in gouty arthritis patients with a lower risk of evoking adverse reactions.