ObjectiveTo assess the therapeutic effect and safety of fire needle therapy in the treatment of herpes zoster pain.MethodsWe collected randomized controlled trials about treatment of herpes zoster pain mainly by fire needle therapy(published from the date of establishment of each database to Dec 1 of 2018)from databases of CNKI

Wanfang

VIP

Chinese Biomedical Document Service System(SinoMed)

PubMed

Embase

Cochrane Library by using key words of"fire needle""burnt needle""red-hot needle""herpes zoster""postherpetic neuralgia"and"herpetic neuralgia". Then

we conducted Meta-analysis and sequential analysis about the outcomes of studies met our inclusion criteria using RevMan5.3.5 and TSA0.9.10 Beta softwares and employed GRADE profiler 3.6.1 to grade the quality of evidence.ResultsA total of 25 studies including 2 024 patients were brought into the present analysis. Outcomes of the qualitative analysis indicated that the fire needle therapy has a higher effective rate than the western medicine group. Meta-analysis showed that after the treatment mainly with fire needle therapy

1)the VAS score is evidently lower[WMD=-0.96

95% CI(-1.22

-0.71)

P<0.000 01]

2)the duration of 30% pain relief is obviously shorter[WMD=-1.82

95% CI(-2.46

-1.18)

P<0.000 01]

3)the duration of pain is evidently shorter{fire needle combined with electroacupuncture[WMD=-11.53

95% CI(-14.57

-8.48)

P<0.000 01];fire needle combined with cupping[WMD=-4.75

95% CI(-7.99

-1.51)

P=0.004];pure fire needle therapy[WMD=-1.82

95% CI(-2.46

-1.18)

P<0.000 01]

and 4)the occurrence rate of post-herpetic neuralgia is considerably lower[RR=0.16

95% CI(0.09

0.30)

P<0.000 01]. The occurrence and management of adverse events were not mentioned in all the included studies

suggesting no safety problem of the therapy

but the publication bias has not been taken seriously.ConclusionIn the treatment of herpes zoster pain

fire needle as the main treatment approach can significantly relieve pain

shorten the pain duration

and reduce the incidence of post-herpetic neuralgia.