Moving cupping therapy for plaque psoriasis: A PRISMA-compliant study of 16 randomized controlled trials

BACKGROUND: Clinical treatment of plaque psoriasis typically involves a comprehensive therapy, which is expensive and unsatisfactory, and some medications have serious side effects. Moving cupping therapy has shown good clinical efficacy in the treatment of plaque psoriasis; it can significantly relieve skin inflammation and excessive thickening of plaque psoriasis and has fewer side effects. However, a comprehensive evaluation of the current clinical evidence regarding its use is lacking. METHODS: Several databases were systematically searched from inception to March 2, 2020, including PubMed, Embase, Cochrane Central Register of Controlled Trials, China Network Knowledge Infrastructure, and Wan Fang. This review included randomized controlled trials on plaque psoriasis treatment with the use of moving cupping and in combination with Chinese herbs or conventional Western medicine therapy. These trial findings were compared with the treatment results using placebo, pharmaceutical medications, or Chinese herbs. Moving cupping treatment frequency was also compared. RESULTS: Sixteen trials with 1164 participants met the inclusion criteria. Meta-analysis showed that the intervention group (moving cupping therapy) had a significant effect compared with the no-moving cupping therapy group (weighted mean difference = –1.22, 95% confidence interval [CI] [–1.58, –0.85], P < .00001 random model; I(2) = 85%). Furthermore, moving cupping (weighted mean difference = –1.19, 95% CI [–1.98, –0.39], P = .003 random model; I(2) = 85%) or combined with pharmaceutical medications (weighted mean difference = –1.55, 95% CI [–1.89, –1.20], P < .00001 random model; I(2) = 0%) were better than pharmaceutical medications alone in treating plaque psoriasis. Cupping therapy significantly improved psoriasis recurrence rate (risk ratio = 0.33, 95% CI [0.16, 0.68], P = .003 fixed model; I(2) = 28%). However, for the visual analogue score, moving cupping showed no obvious advantages (weighted mean difference = –0.27, 95% CI [–0.71, 0.17], P = .22 random model; I(2) = 64%). Moreover, studies reported that moving cupping reduced serum tumor necrosis factor-α and vascular endothelial growth factor levels more significantly than pharmaceutical medications. Moving cupping was associated with few transient adverse reactions, such as redness, itching, and local skin burning. CONCLUSION: Moving cupping therapy could be an effective treatment either alone or as a combination therapy for plaque psoriasis. However, further large-scale, rigorously designed trials are needed to confirm these findings.