Effect of acupuncture in eczema: An overview of systematic reviews.

BACKGROUND: Eczema is a common chronic relapsing inflammatory skin disease, which is characterized by intense itching. Acupuncture can be effective for eczema, and it is thus regarded as a common complementary treatment. OBJECTIVE: The intention of this overview is to methodically appraise and synthesize evidence about systematic reviews/meta-analyses (SRs/MAs) on acupuncture in eczema. METHODS: We searched for SRs/MAs of acupuncture with eczema in eight databases. We evaluated the methodological quality by Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), the reporting quality with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020 Checkist), and the evidence quality according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. RESULTS: A total of 7 SRs/MAs were included. According to AMSTAR-2, all the SRs/MAs included were categorized as critically low-quality. According to the PRISMA 2020 checklist, none of the reviews completed all the 27 items, thus their compliance was relatively weak. On the base of GRADE system, 2 of the 12 outcomes were rated as moderate, and 5 outcomes were rated as low-quality, while the others were regarded as very low-quality. CONCLUSION: Compared with the control group, the included reviews of the acupuncture group were more effective and safer; however, the conclusion should be treated cautiously because the quality of evidence was not high enough to support it. In order to improve the quality, more rigorous, standardized, and comprehensive SRs/MAs need designing in the future.

Efficacy of Longdan Xiegan Decoction on the Treatment of Eczema: A Systematic Review and Meta-Analysis.

BACKGROUND: Longdan Xiegan decoction (LDXGD) has been widely used in the treatment of eczema. In recent years, randomized controlled trials (RCTs) of LDXGD for the treatment of eczema have gradually increased. Most of the results show that LDXGD is effective in treating eczema. However, whether these conclusions are reliable or not requires meta-analysis. OBJECTIVE: This study aimed to systematically evaluate the clinical efficacy of LDXGD in the treatment of eczema. MATERIALS AND METHODS: Seven electronic databases, including PubMed, Excerpta Medica Database (EMBASE), Cochrane Library, Chinese Biomedical Literature on Disc (CBM), China National Knowledge Infrastructure (CNKI), WanFang, and Chinese Science and Technology Periodical Database (VIP) were systematically searched from their inception until January 2021. Risk of bias was assessed using criteria from the Cochrane Collaboration and meta-analysis was conducted on the screened literature data using Review Manage (RevMan 5.3). Then, to assess the quality of evidence, the GRADE criteria was adopted. RESULTS: 14 RCTs with 1080 participants were identified. Meta-analysis indicated that compared with western medicine (WM), the cure rate and the total effective rate of LDXGD in treating eczema were higher. Meanwhile, the recurrence rate and the levels of interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor (TNF-α) after treatment were lower. The adverse reaction was reported in 5 out of 14 studies without significant statistical difference. According to GRADE criteria, the quality of evidence was low for all outcomes except for the cure rate (moderate-quality evidence) and the total effective rate (moderate-quality evidence). CONCLUSION: The clinical efficacy of LDXGD in the treatment of eczema was more effective compared with the one of conventional WM alone. However, due to the limitation of the quality of the included studies, additional studies are required to further confirm these results.