The Efficacy and Safety of Acupuncture in the Treatment of Neurodermatitis: A Systematic Review and Meta-Analysis

Abstract

Background. Neurodermatitis is a common chronic inflammatory skin disease associated with neurological dysfunction. This study aimed to explore the efficacy and safety of acupuncture and moxibustion in the treatment of neurodermatitis through meta-analysis. Methods. We comprehensively searched 9 databases, including PubMed, Cochrane Library, EMBASE, Web of Science, Scopus, China National Knowledge Infrastructure (CNKI), Wanfang Database, China Science and Technology Journal Database (VIP), and China Biomedicine (CBM), from their inception to November 15, 2021, for published neurological and clinical randomized controlled trials (RCTs) using acupuncture to treat dermatitis. We also searched gray literature in four databases: Chinese Clinical Trials Registry, Chinese Cochrane Center, Open Grey, and GreyNet International. Two authors independently screened the data, extracted the literature, and evaluated the quality of the literature using Cochrane 5.3.3 and Review Manager 5.4.1 software. Results. The meta-analysis included 8 studies with a total of 728 participants, including 369 patients in the treatment group and 359 patients in the control group. Compared with conventional treatment, acupuncture significantly increased the effective rate (OR: 2.90, 95% CI: 1.78∼4.75; p < 0.001 ) and decreased the recurrence rate after treatment (OR: 0.26, 95% CI: 0.12∼0.59; p = 0.001 ). Meanwhile, analysis of disease symptom scores showed that acupuncture group had a greater impact (OR: 3.51, 95% CI: 2.12∼4.91; p < 0.00001 ). Furthermore, no significant difference in the adverse reaction rate was observed. Conclusion. Acupuncture is safe and effective in treating neurodermatitis. However, the current level of research evidence is limited, and therefore, larger sample and high-quality RCTs are needed to confirm its safety and effectiveness. Protocol registration number is INPLASY2021110041.

Acupuncture for neurodermatitis: a case report

“…Whether the neurodermatitis is a first episode or a recurrent state, the pathogenesis of itch is believed to involve dysfunctional inhibition and excitation of the cerebral cortex. Acupuncture may be beneficial for the regulation of the brain network centers involved in the transmission of messages mediating the symptom of itch, as well as the repair of nerve damage and regeneration of cells 5 ; acupuncture could theoretically affect pruritic symptoms in a variety of potential ways, such as reducing the production of pruritic mediators, inhibiting the number and function of local mast cells, activating k-opioid peptide receptors and class C fibers, promoting local skin repair by improving local blood circulation or metabolic capacity, promoting repair of nerve damage and/ or enhancing fibroblast regeneration.…”

Comparison of neurodermatitis management based on effectiveness and safety

“…The effectiveness of habit reversal is majorly based on the patients' neurodermatitis severity. In one case study, the patient (Sandra) with the mildest symptoms scratched around her ankle, about 3 inches up to her leg [9]. After 6 months of the habit reversal treatment, Sandra's neurodermatitis was completely healed.…”

“…It reduces one of its most important and influential manifestations of neurodermatitis, itching. It is done by stimulating nerve fibers that will interfere with the transmission of itching [9]. Numerous studies found that acupuncture can help speed up metabolism, strengthen fiber cells, reduce local inflammation, and improve microcirculation.…”