Analgesic effects of different acupuncture therapies on postherpetic neuralgia:a Bayes-ian network meta-analysis / 中国药理学与毒理学杂志

ABSTRACT

OBJECTIVE To assess the effi-cacy and safety of acupuncture-related treat-ments for postherpetic neuralgia(PHN),identify the most effective acupuncture and related treat-ments.METHODS PubMed,Cochrane Central Register of Controlled Trials,Embase,Web of Science,and four Chinese databases,a clinical research registration platform,and grey literature were searched.We evaluated the risk of bias and quality in the included studies and per-formed a Bayesian multiple network meta-analy-sis.RESULTS We included 29 randomized con-trolled trials comprising 1973 patients,of which approximately 17.24%showed a high risk of bi-as.According to the Jadad scale,2,16,and 11 studies were high,medium,and low quality,respectively.The pairwise meta-analysis results revealed that the efficacy of all acupuncture-related treatments for pain relief related to PHN showed the difference was statistically significant com-pared with that of antiepileptics.The network meta-analysis results showed that pricking and cupping plus antiepileptics were the most effec-tive,followed by electroacupuncture(EA)plus antiepileptics for pain relief in patients with PHN.EA plus antiepileptics ranked the best regarding reduced Pittsburgh Sleep Quality Index and Self-Rating Depression Scale scores in patients with PHN.No results were found regarding total response rate or quality of life among this study.Acupuncture-related treatments showed a lower incidence of adverse events than that of antiepi-leptics-related treatments.CONCLUSION Acu-puncture-related therapies may be potential treat-ment options for PHN and are relatively safe.Pricking and cupping plus antiepileptics are the most effective techniques for pain relief.EA plus antiepileptics is the best approach for improving insomnia and depression symptoms of PHN.