| ObjectiveCombined with the quantitative ranking of reticular meta-analysis and the qualitative induction of previous literature,the optimal solution of acupuncture and moxibustion treatment of herpes zoster best interventions was worked out.Through clinical prospective randomized controlled study,the clinical efficacy and safety of the optimal regimen for the treatment of acute herpes zoster were observed,and the clinical evidence was strengthened and applied.MethodsSearch the database at home and abroad,get the Chinese and English literature of the clinical trial of acupuncture and moxibustion treatment of herpes zoster,through PubMed Medical Literature Retrieval Service System(1966-2015),Cochrane Library(-2015.12),EMBASE(1992-2015),PubMed Medical Literature Retrieval Service System(1966-2015),Cochrane Library(-2015.12),EMBASE(1974-2015.12)and other databases,access to acupuncture treatment of herpes zoster in Chinese and English periodicals.Through the pre-prepared literature screening criteria,the clinical randomized controlled literatures were screened and the basic characteristics and methodological quality of the included literatures were evaluated.According to the JADAD scale and the Cochrane bias risk scale,a high quality and low biased literature was screened for reticular meta-analysis.Using STATA12.0 and WinBUGSl.4 software to compare the curative effect of different acupuncture and moxibustion interventions in the literature by direct and indirect comparison,the best interventions were selected by quantitative sequencing,and the operation details of acupuncture were summarized qualitatively according to the relevant literature information,Evidence-based optimization of acupuncture and moxibustion treatment of herpes zoster.Collected in April 2016 to November 2016 from the Guangzhou University of Traditional Chinese Medicine First Affiliated Hospital outpatient diagnostic criteria,included in the standard and exclusion criteria screening qualified acute herpes zoster cases as the object of study.Through the random number table,64 patients were randomly divided into treatment group(n-31)and control group(n=33).The patients in the treatment group were treated with valacyclovir hydrochloride(300mg/time,2 times/day),and the vitamin B1 was treated with the control group.The treatment group was treated with acupuncture and moxibustion once daily for 5 days after continuous treatment.(10mg/time,3 times/day).10 days for a course of treatment,both groups were treated after a course of treatment outcome.In the course of treatment,the morphological changes of herpes,pain intensity,pain relief time,duration of pain,and herpes zoster comprehensive score were observed on the 1st,3rd,5th day and the 11th day after the start of the study.On the 22nd day,30 days,60 days were followed up to observe the occurrence of postherpetic neuralgia.At the end of the study,the overall efficacy of the two groups,herd shape and pain of the timeliness,pain intensity,the occurrence of posterior neuralgia and safety evaluation.Results1.According to the basic information,research object,sample size,intervention measures,treatment cycle and outcome index of RCT literature,the basic information of 174 RCT literatures was extracted.The results show that,as of December 2015,the official published in the Journal of acupuncture treatment of herpes zoster RCT literature from 1994 to 2000,8 to 2011 2015,106,was increasing year by year trend.Acupuncture intervention measures a total of 62 species,can be divided into three categories:Acupuncture combined with drugs 46,accounting for 26.4%;comprehensive acupuncture 110,accounting for 63.2%;single acupuncture 18,10.3%.99.4%of RCTs were published in Chinese magazines in Chinese.Only 0.6%of RCTs were published in English magazines.Only one of them was Italian nationals and the remaining 173 RCTs were Chinese.85.1%of the RCT authors’ units are hospitals.34 RCT received funding from the Fund,accounting for 19.5%,and most of the funding projects funded by the government or units.74.1%of RCT samples were<100 cases,and 26.4%of the RCT reported informed consent of the study subjects.After incorporating the RCT literature methodologies for evaluation,174 random RCTs were randomized,randomized to 56,32.2%,of which 47 were random numbers,2 were closed envelopes,4 were drawn and 2 were used Method,one with stratified random.17 RCT studies have mentioned hidden subgroups,2 with occluded envelopes,and 15 randomly concealed by central groups.Only 11 RCT studies refer to blindness,which details the blind RCT only 8.To ensure the robustness of reticular meta-analysis,to increase the persuasiveness of the study results,using the JADAD scale and bias risk tool.The modified JADAD scale score ≧ 4 is divided into high quality,low bias risk ≧ 3 low bias,the inclusion of RCT for further screening,and ultimately can be included in the reticular meta-analysis of a total of 12 articles.The curative effect of 12 high-quality literatures was analyzed by STATA 12.0 and WinBUGS 1.4 software.Through the quantitative sorting,acupuncture treatment of herpes zoster interventions preferred results:fire needle + cupping>spiked +cotton moxibustion>fire needle + mild moxibustion>electroacupuncture +spikes>electroacupuncture + acupuncture + thorn + cupping>electricity Needle + Acupuncture + Fire Needles>Electroacupuncture + Acupuncture + Shop Cotton Moxibustion>Western Medicine.To summarize the details of the operation of the fire needle + cupping through the qualitative analysis of the literature,to develop a herpes zoster acupuncture evidence-based optimization program.2.A prospective randomized controlled trial was conducted to compare the efficacy and safety of the evidence-based optimization program group and the drug group in the treatment of acute herpes zoster.General information:64 cases were collected,4 cases were lost,the actual completion of 60 cases.There was no significant difference between the two groups in age,sex and basic diagnosis(from discomfort,pain and blister to time of treatment,and allergy occurred)(P>0.05).The baseline data of the two groups were comparable.Herd shape and pain changes in the timeliness:The time of callus and scab was 3.32 + 1.19 days and 4.13± 1.48 days,respectively,which were shorter than those of western medicine group(P<0.05)· The scab time was 11.81±5.01 days in the treatment group and 11.55 ± 2.91 days in the control group,the difference was not statistically significant(P>0.05).The mean duration of pain in the treatment group was 2.45 ± 0.85 days,compared with 3.73 ± 1.40 days in the control group,the difference was statistically significant(P<0.05).The duration of pain in the treatment group was 16.1 ±12.78 days,compared with the control group 24.27 ± 18.66 days,the difference was statistically significant(P<0.05),suggesting that pain relief and shorten the duration of pain,evidence-based optimization program is better than Western medicine.Pain visual analogue scale:There was significant difference in the visual analogue scale(VAS)between the two groups at the 3rd,5th,11th and 22th day after treatment(P<0.05).Compared with the western medicine group,the VAS score curve of the treatment group was more significant at the 3rd and 5th day,the difference was statistically significant(P<0.05).Indicating that the two groups of treatment of herpes zoster can reduce the VAS score,improve pain symptoms,and optimize the program compared to Western medicine can quickly relieve pain.Overall efficacy score:In addition to the baseline,the two groups at the rest of the time points of the comprehensive efficacy score were different,and the difference was statistically significant(P<0.05).The difference of the comprehensive curative effect between the two groups was statistically significant(P<0.05)at the 3rd,5th,11th and 22th day after treatment.According to the trend of each visit point of view can be seen in the observation period of 5 days,the treatment group optimization program than the Western medicine in the comprehensive efficacy of more advantages.The incidence of postherpetic neuralgia occurred:the first 30 days of follow-up treatment,the treatment group 1 case of postherpetic neuralgia,the control group of 9 patients with postherpetic neuralgia,the difference between the two groups was statistically significant(P<0.05).There was no significant difference between the two groups(P<0.05).There was no significant difference between the two groups in the treatment group(P<0.05).Suggesting that compared with Western medicine can reduce the occurrence of postherpetic neuralgia.The total effective rate was 84.5%in the control group,and the difference was statistically significant(P<0.05).The control group).Safety analysis:the two groups of patients in the course of treatment were no adverse reactions.Conclusion:As a result of the network-meta analysis,the outcome of different acupuncture and moxibustion treatment of herpes zoster sequencing index were sorted out,it is clear that the current fire needle + cupping is the best intervention for the treatment of herpes zoster.In order to further demonstrate the effectiveness and safety of the treatment of herpes zoster in the treatment of herpes zoster,the results show that the evidence-based optimization program based on the mesh-based Meta construction(fire needle+ cupping)can effectively treat the acute phase Herpes,shorten the time of shorting and scab,in the initial treatment stage can quickly relieve nerve pain,shorten the pain time,reduce the occurrence of postherpetic neuralgia.Compared with conventional treatment,evidence-based optimization program quick onset,high safety,simple operation,worthy of clinical application. |
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