The Efficacy And Safety Of Fire Needle For Flat Wart

Objectives To evaluate the efficacy and safety of fire needle for flat wart.Methods Computer searched for randomized controlled trials of fire needle for the treatment of flat wart published in various databases until November 01,2019,including the Cochrane Central Register of Controlled Trials(The Cochrane Library),Pubmed,EMBASE,Sino Med,CNKI,Wanfang Database,VIP.In accordance with the International Cochrane Handbook 5.1manual for data extraction and literature methodological quality evaluation.The data were entered into Rev Man 5.3 software and Stata 13.1 software for relevant analysis.Result(1)Twenty-three trials fulfilling the inclusion criteria were identified,with a total of2154 subjects,all of which were single-center studies.We consider the risk of bias in the included trials high.(2)Fire needle VS other therapies: 4 trials compared fire needle therapy with 0.1%Divita cream,meta-analysis showed that the cure rate(RR 3.18,95% CI 1.66 to 6.09)and effective rate(RR 0.15,95% CI 0.07 to 0.29)of fire needle therapy were all higher than Divita cream,and the recurrence rate was lower(3 months follow-up,RR 0.18,95% CI 0.06 to 0.59);One trial compared fire needle therapy and tazarotene gel combined with recombinant human interferon α-2b gel,the recovery rate(RR 2.31,95% CI 1.44 to 3.69)and effectiveness(RR1.20,95% CI 1.00 to 1.44)of fire acupuncture therapy was higher;In terms of cure rate and effectiveness,9 trials compared fire needle with liquid nitrogen freezing,photodynamics respectively,Chinese medicine mask,polymyocyte injection,transfer factor capsules combined with phthalobutan tincture,Zhihou granule,eliminate-warts Lotion,mild moxibustion,recombinant human interferon α-2b gel,and the results showed no significant statistical differences between the groups.In terms of recurrence rate,aggregated data from 5studies,the results showed that fire needle therapy reduced recurrence rate within 3 months of follow-up(RR 0.30,95%CI 0.16 to 0.58);One trail reported the recurrence in subjects at 6 months of follow-up,meta-analysis showed that there was no significant difference between groups(RR 0.40,95%CI 0.08 to 1.90).In terms of adverse reactions,aggregated data from 6studies and the results showed that adverse reactions were less frequent with imiquimod(RR0.45,95%CI 0.33 to 0.61).(3)Fire needle combined with other therapies VS other therapies: In terms of cure rate,aggregated data from 14 studies and the results showed that combined fire needle was more advantageous(RR 1.78,95% CI 1.56 to 2.03);In terms of effective rate,aggregated data from15 studies and the results showed that combined fire needle therapy was more advantageous(RR 1.16,95% CI 1.12 to 1.21);Aggregated data from 6 studies and the results showed that combined fire needle therapy reduced recurrence rate within 3 months of follow-up(RR 0.24,95%CI 0.15 to 0.40);One trail reported the recurrence in subjects at 6months of follow-up,meta-analysis showed that there was no significant difference between groups(RR 0.09,95%CI 0.01 to 1.57);One trail reported the recurrence in subjects after1-year of follow-up,the results showed that there was no statistical difference between groups(RR 0.55,95% CI 0.10 to 2.87).In terms of adverse reactions,aggregated data from 8studies and the results showed no significant statistical differences between groups(RR 0.94,95% CI 0.67 to 1.30).In terms of IL-2,IL-10,and INF-γ in serum,aggregated data from 2studies and the results showed significant statistical differences among the groups(MD 5.35,95% CI 3.65 to 7.05;MD 1.76,95% CI 1.05 to 2.47;MD 8.30,95% CI 6.49 to 10.12).Conclusion Fire needle therapy can be used as an alternative treatment for flat wart.But this meta-analysis including only limited literature,in addition,the sample size is generally small and the risk of bias is high,thence more large-scale and well-designed RCTs are warranted.