Efficacy of oral traditional Chinese medicine combined with fire needling in treating psoriasis vulgaris: a meta-analysis

Abstract

This meta-analysis investigates the efficacy of oral traditional Chinese medicine (TCM) combined with fire needling in the treatment of psoriasis vulgaris. Fifteen randomized controlled trials (RCTs) were included, evaluating key outcomes such as overall response rate (ORR), Psoriasis Area and Severity Index (PASI) scores, TCM syndrome scores, and pruritus severity scores. The results indicated that the combination of oral TCM and fire needling significantly improved the ORR (odds ratio (OR) 3.49, 95% confidence interval (CI) [2.48, 4.93], p < 0.0001) and significantly reduced PASI scores (mean difference (MD) - 5.31, 95% CI [- 7.37, - 3.25], p < 0.0001). In addition, it improved TCM syndrome scores (MD - 3.43, 95% CI [- 5.41, - 1.46], p < 0.0001) and reduced pruritus severity scores (MD - 0.77, 95% CI [- 0.90, - 0.65], p < 0.0001). Sensitivity analysis confirmed the robustness of the findings, and no significant publication bias was detected. The GRADE assessment indicated that evidence quality for ORR and PASI scores was moderate, while the quality for TCM syndrome and pruritus severity scores was low. Overall, this meta-analysis demonstrates that combining oral TCM with fire needling is an effective and reliable treatment for psoriasis vulgaris, with potential for broader clinical application. Future studies should focus on enhancing the rigor of RCTs and standardizing treatment protocols to further validate these findings.

Keywords: Evidence quality; Fire needling; Meta-analysis; Oral traditional Chinese medicine; Psoriasis Area and Severity Index score; Psoriasis vulgaris.