A Systematic Review Of Randomized Controlled Trials Of Fire Needle Therapy In The Treatment Of Stable Vitiligo

Purpose:To systematically evaluate the clinical efficacy and safety of fire needle therapy in the treatment of stable vitiligo and to explore the clinical prospect of fire needle therapy in the treatment of stable vitiligo by summarizing and evaluating the literature of clinical randomized controlled trials(RCT)of fire needle therapy in the treatment of stable vitiligo.Materials and methods:The Chinese and English clinical literatures on fire needle therapy for stable vitiligo published from CBM,CNKI,WANFANG,VIP,PubMed,EMBASE and Cochrane Library databases to 2018 were retrieved by computer.According to inclusion criteria and exclusion criteria,data extraction and methodological quality analysis were carried out for the included literature,and meta-analysis of outcome indicators was carried out with Review Man 5.3 software,and the rules of acupuncture were summarized.Results:A total of 20 RCTs were included,of which 5 were self-controlled trials in 261 cases and the remaining 15 were 977 cases.Compared with the control group,the total effective rate was:(1)Fire needle therapy alone: RR = 1.03,95% CI [0.93,1.15];(2)Combined fire needle therapy: RR = 1.22,95% CI [1.16,1.29].(3)Descriptive analysis of liver and kidney deficiency type: 2 studies showed that the total effective rate of fire needle treatment group was better than that of control group,with statistical difference(P=0.001,P=0.02);another study showed that there was no difference between fire needle treatment group and control group,but there was no statistical difference(P=0.69).(4)Qi stagnation and blood stasis type: RR = 1.15,95% CI [0.77,1.72].The obvious cure rate was as follows:(1)Fire needle therapy alone: RR = 1.39,95% CI [1.02,1.90];(2)Combined fire needle therapy: RR= 1.62,95% CI [1.46,1.80].(3)Liver and kidney insufficiency: RR = 2.56,95% CI [0.64,10.29].(4)Descriptive analysis of Qi stagnation and blood stasis type: 1 study showed that the fire needle group was better than the control group,the difference was statistically significant(P=0.008);1 study showed that there was no difference in the fire needle group and the control group,but there was no significant difference(P=0.19).Skin lesion area before and after treatment: SMD=-0.49,95% CI [-0.73,-0.26].Compared with 308 nm excimer phototherapy alone,the average number of treatments was SMD=-2.01,95% CI [-2.34,-1.68].Four of the 17 studies reported adverse reactions showed that there were no obvious adverse reactions in fire needle therapy in the experimental group.The other studies mentioned that the adverse reactions were mild and could be alleviated by temporary suspension of treatment or symptomatic treatment.Conclusion:1.Combination of fire needle therapy can improve the total effective rate and marked cure rate of stable vitiligo,and accelerate the reduction of skin lesion area;2.Compared with 308 nm excimer phototherapy alone,the combination of fire needle therapy can significantly reduce the average number of treatments;3.Fire needle therapy for stable vitiligo has no serious adverse reactions and is safe.