A Network Meta-analysis Of The Efficacy And Safety Of Acupuncture Therapy In The Treatment Of Chronic Eczema

Purpose:1.To understand the research progress of acupuncture therapy for chronic eczema and the application of evidence-based medicine in the field of traditional Chinese medi cine,and provide direction and basis for further clinical research applications.2.The method of network meta-analysis was used to systematically evaluate the ef ficacy and safety of different acupuncture treatments for chronic eczema,and provide evidence-based medical evidence for clinical application.Material and method:We electronically searched databases including PubMed,EMbase,The Cochrane Li brary(2018,7),CBM,CNKI and WanFang Data,VIP,Web of Science from inception to 28 July 2018,to collect RCTs about acupuncture and moxibustion therapy,and th e references of the included literatures were traced to supplement and obtain relevant l iteratures.According to inclusion criteria and exclusion criteria,literatures were screened and data were extracted by 2 independent researchers.Methodological quality evaluati on was conducted according to the bias risk assessment tool provided by Cochrane Ha ndbook 5.1.0.RevMan5.3 software,OpenBUGS software and Stata14.0 software were used for statistical analysis.Results:Participants included 34 articles,total 2177 cases of patients with chronic eczema,involving 15 kinds of interventions,meta-analysis results showed that a total of 34 documents against 45 group were reported after treatment to heal and number had ma rked effect,14 articles were a total of 19 control group reported before and after treat ment of skin lesion score,13 articles were control group reported before and after tre atment of pruritus score.Except for acupuncture,conventional therapy + acupuncture,P hlebotomy + moxibustion,all acupuncture and its combination therapy are better than conventional therapy,acupuncture combined therapy is better than single acupuncture t herapy;In terms of the improvement of skin lesion score,fire acupuncture,convention al treatment + moxibustion,fire acupuncture + moxibustion,fire acupuncture + Phlebo tomy,Phlebotomy + moxibustion are all superior to conventional therapy,and acupunc ture + Phlebotomy is superior to acupuncture;In terms of the improvement of pruritus score,fire acupuncture,conventional treatment + Phlebotomy,conventional treatment+ auricular point,fire acupuncture + moxibustion,and fire acupuncture + Phlebotomy are superior to conventional treatment.The results of network meta-analysis showed tha t: in general,combined acupuncture therapy was superior to acupuncture alone or con ventional moxibustion alone,and the improvement rate of fire acupuncture,convention al treatment + Phlebotomy,acupuncture + Phlebotomy,fire acupuncture + moxibustion,fire acupuncture + Phlebotomy,acupuncture + Phlebotomy + moxibustion was superior to conventional treatment.Fire acupuncture + Phlebotomy is superior to conventional treatment,acupuncture,fire acupuncture,Phlebotomy;Acupuncture + Phlebotomy is sup erior to conventional treatment and acupuncture;No statistical significance was found among the other interventions.The top 3 SUCRAs increasing penetrance ranking: fire a cupuncture + Phlebotomy,acupuncture + Phlebotomy + moxibustion,acupuncture + Phl ebotomy.Conclusion:1.Excessive use of acupuncture and moxibustion may cause damage to the skin barrier and make chronic eczema more difficult to heal,so the effect of acupuncture a nd moxibustion and its combination therapy on chronic eczema is superior to that of conventional therapy through reticular Meta analysis.Among them the fire needle pric king collaterals treatment chronic eczema the cure and the obvious efficiency is the be st.2.After descriptive analysis,it was found that the recurrence rate and the incide nce of adverse reactions in acupuncture group and its combined treatment group were lower than those in routine treatment group during the follow-up period after treatmen t.3.The recommended treatment frequency is 1/5-7 days.The scab falls off at the site to be applied.Acupoint selection is mainly at Ashi point in the lesion area.Acu point differentiation is mainly based on bladder meridian,spleen meridian,stomach me ridian,Ren meridian and Du meridian.Acupoint selection should be few or not many,so as to ensure the curative effect and reduce the burden of patients.