Background:

2

Postherpetic neuralgia (PHN) is the most common complication of herpes zoster infection and affects patients' quality of life. Acupuncture therapy is regarded as a competitive method of treatment for analgesia.

Objective:

2

To summarize evidence from systematic reviews (SRs) and evaluate the effectiveness and safety of different acupuncture therapies for treating PHN.

Methods:

2

Eight electronic databases were searched from their inception to August 5

2022

including 4 international electronic databases (PubMed

EMBASE

the Cochrane Library

and Web of Science) and 4 Chinese databases (Chinese Biomedical Database

China National Knowledge Infrastructure

VIP Database and Wanfang Database). Methodological quality was assessed by A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2). The Risk of Bias in Systematic Review (ROBIS) tool was used to assess the risk of bias in SRs. Evidence level was assessed by the Grading of Recommendations Assessment

Development

and Evaluation (GRADE) approach.

Results:

2

Totally

7 SRs were included

including 128 studies and 9

792 patients. In AMSTAR 2

most of the SRs were of low or critically low levels since they had more than 1 critical deficiency. In ROBIS

1 SR (14.29%) was rated as high risk

and the other 6 (85.71%) were rated as low risk. In the GRADE system

9 outcomes (28.13%) were valued as high level

5 (15.63%) as moderate level

1 (3.13%) as low

and 17 (53.13%) as very low. In the effectiveness of acupuncture therapy

the group "moxibustion

vs

. original medical treatment" [mean difference (MD)=–1.44

95% confidence interval (CI): –1.80 to –1.08

I

2

=99%

P

<

0.00001

]

was of the highest heterogeneity and the group "bloodletting

vs

. original medical treatment" (MD=–2.80

95% CI: –3.14 to –2.46

I

2

=0

P

<

0.00001) was of the lowest heterogeneity. Six SRs have reported the safety of their studies and no serious events were shown in the treatment and control groups.

Conclusions:

2

Acupuncture therapy seems to be effective in treating PHN. Despite the evidence that suggested the advantages of acupuncture therapy in relieving pain and promoting efficacy and safety

the methodological quality was quite low. Further studies should pay more attention to the quality of original studies and evidence for SRs to confirm these findings. (PROSPERO registration No. CRD42022344790)