Background: Acupuncture therapy has demonstrated significant efficacy in the treatment of postherpetic neuralgia, effectively alleviating pain intensity and enhancing patients' quality of life. However, the effectiveness of collateral-pricking and bloodletting cupping combined with electroacupuncture in the treatment of postherpetic neuralgia remains a subject of controversy. We aimed to assess the efficacy and safety of collateral-pricking and bloodletting cupping combined with electroacupuncture for postherpetic neuralgia.
Methods: We identified relevant randomized controlled trials by conducting a comprehensive search in multiple databases: China National Knowledge Infrastructure, China Biomedical Literature, Wanfang Data, PubMed, Cochrane Central Register of Controlled Trials, Embase, and Web of Science. The outcome included efficacy rate, visual analog scale (VAS)scores and pittsburgh sleep quality index (PSQI) scores. We meticulously assessed the risk of bias in the included trials and performed a meta-analysis.
Results: We analyzed 9 randomized controlled trials involving 639 patients. Collateral-pricking and bloodletting cupping combined with electroacupuncture achieved a significantly higher efficacy rate (risk ratio, 1.22 [95% CI, 1.13-1.31]; P < .001), reduced theVAS scores (standardized mean difference, -1.52 [95% CI, -2.26 to -0.79]; P < .001), and improved the PSQI scores (standardized mean difference, -2.31 [95% CI, -3.97 to -0.64]; P = .007) compared with the control groups. The subgroup analysis revealed that the combined treatment of collateral-pricking and bloodletting cupping and electroacupuncture had a significantly higher total effective rate compared with the carbamazepine, electroacupuncture, and pregabalin groups (P < .05). The total efficacy rate of the collateral-pricking and bloodletting cupping combined with electroacupuncture group was superior to that of the control group, irrespective of whether 2 or 3 courses were administered (P < .05).
Conclusion: Existing evidence suggests that the combination of collateral-pricking and bloodletting cupping and electroacupuncture demonstrates efficacy in pain relief, improvement of sleep quality, and enhanced therapeutic outcomes for patients with postherpetic neuralgia. However, further validation through large-scale multicenter randomized controlled trials is warranted due to the limited quantity and quality of the included literature in this study.