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Wet cupping therapy for treatment of herpes zoster: a systematic review of randomized controlled trials

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Abstract

Wet cupping is a traditional Chinese medicine therapy commonly used in treating herpes zoster in China, and clinical studies have shown that wet cupping may have beneficial effect on herpes zoster compared with Western medication. We included randomized controlled trials (RCTs) on wet cupping for herpes zoster. We searched PubMed, the Cochrane Library (Issue 3, 2008), China Network Knowledge Infrastructure (CNKI), Chinese Scientific Journals Fulltext Database VIP, and Wan Fang Database. All searches ended in February 2009. Two authors extracted data and assessed the trials' quality independently. RevMan 5.0.18 software (The Cochrane Collaboration, The Nordic Cochrane Centre, Copenhagen, Denmark) was used for data analysis with effect estimate presented as relative risk (RR) and mean difference (MD) with a 95% confidence interval (CI). Eight RCTs involving 651 patients were included, and the methodological quality of trials was generally fair in terms of randomization, blinding, and intention-to-treat analysis. Meta-analyses showed wet cupping was superior to medication in the number of cured patients (RR 2.49, 95% CI 1.91 to 3.24, P < .00001), the number of patients with improved symptoms (RR 1.15, 95% CI 1.05 to 1.26, P = .003), and reducing the incidence rate of postherpetic neuralgia (RR 0.06, 95% CI 0.02 to 0.25, P = .0001). Wet cupping plus medication was significantly better than medication alone on number of cured patients (RR 1.93, 95% CI 1.23 to 3.04, P = .005) but demonstrated no difference in symptom improvement (RR 1.00, 95% CI 0.92 to 1.08, P = .98). There were no serious adverse effects related to wet cupping therapy in the included trials. Wet cupping appears to be effective in the treatment of herpes zoster. However, further large, rigorously designed
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... Recent evidence suggests that Al-Hijamah therapy increases endogenous opioid production in the brain, which enhances pain management by inducing systemic comfort and relaxation [12]. Al-Hijamah is effective in treating various medical ailments, including headache, facial paralysis, asthma, musculoskeletal pain, cellulitis, skin diseases, fibrositis, cervical spondylosis, gouty arthritis, hyperlipidaemia, and immune system modulation [13][14][15]. Al-Hijamah therapy may also prevent the onset of cardiovascular diseases in hypertensive individuals by lowering systolic blood pressure [16]. It has the potential to reduce low-density lipoprotein (LDL) and total cholesterol levels, improving the prevention of atherosclerosis and cardiovascular diseases [17]. ...
... The significantly increased WBCs, neutrophil, and lymphocyte counts are still within acceptable reference ranges, indicating that skin infections are not adverse effects of wet cupping. Given that Al-Hijamah acts as an immunomodulatory regulator [14,22], the current findings further support the use of wet cupping therapy in treating herpes zoster, a viral infection, and cellulitis, a bacterial skin infection. In addition, physical exercises reinforce cellular immunity, but sustained high-intensity exercises can suppress the immune system. ...
... It has been suggested that Al-Hijamah therapy can stimulate immune cells, enhance the circulation of blood and lymphatic cells, relieve pain symptoms, remove the body's waste and toxins, aid in endothelial cell repair, and induce muscle relaxation [12][13][14][15]. Since the quantity and functionality of RBCs and haemoglobin determine how much oxygen is delivered to tissues [29], the results of this study demonstrate that RBC counts and haemoglobin concentrations are significantly impacted by wet cupping. ...
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Background/objective The practice of complementary and alternative medicine has significantly gained acceptance worldwide, such as Al-Hijama, also known as cupping therapy. Despite the growing popularity of therapeutic cupping among athletes, little is known about the impact of cupping therapy on sports fields. The current study was designed to explore the effect of wet cupping therapy on the haematological and inflammatory parameters in Jordanian national team players. Methods The procedure was carried out at a specialized centre for cupping in Amman on the morning of the 19th Rajab. The data were obtained from 14 healthy male participants aged between 21 and 22 years. The haematological and inflammatory parameters were assessed by comparing venous blood components before and after four weeks of wet cupping. Results Complete blood count (CBC) analysis of venous blood samples four weeks after wet cupping showed a significant increase in the values of total white blood cells (WBCs), neutrophils, lymphocytes, red blood cells (RBCs), haematocrit, and haemoglobin as compared with venous blood samples before cupping. Blood film examination of venous blood samples post-cupping revealed normocytic normochromic RBCs; WBCs and platelets were unremarkable. Analysis of inflammatory markers post cupping showed a significant decrease in the monocyte/lymphocyte ratio (MLR) and platelet/lymphocyte ratio (PLR) but no differences in neutrophil/lymphocyte ratio (NLR). Conclusion The findings of this study suggest that wet cupping has an indispensable influence on haematological and immunological parameters in athletes, where it reinforces cellular immunity, generates younger blood cells, and reduces inflammation markers. It is probable, therefore, that cupping improves sports performance and achievement. The evidence from this research adds to a growing body of literature on cupping therapy in sports.
... Five studies (23,26,28,30,31) contained less than ten original studies, while twelve (85.7%) studies (23-30, 32-35) had a combined total sample of over 500 participants. The majority of studies, eight (57.1%) in total (23,26,(29)(30)(31)(33)(34)(35), were conducted in China, followed by two (25,28) in Korea, and one each in Germany (24), Brazil (27), Australia (32), and Iran (22). ...
... Five studies (23,26,28,30,31) contained less than ten original studies, while twelve (85.7%) studies (23-30, 32-35) had a combined total sample of over 500 participants. The majority of studies, eight (57.1%) in total (23,26,(29)(30)(31)(33)(34)(35), were conducted in China, followed by two (25,28) in Korea, and one each in Germany (24), Brazil (27), Australia (32), and Iran (22). The included studies investigated various conditions, including low back pain (n = 4), neck pain (n = 3), knee osteoarthritis (n = 2), chronic back pain (n = 1), migraine (n = 1), chronic pain (n = 1), pain-related conditions (n = 1), musculoskeletal pain (n = 1), and herpes zoster (n = 1). ...
... One high-quality study (24) and one moderate-quality study (26) were included. However, five studies (22, 23,25,27,32) were rated as critically low quality, and seven studies (28)(29)(30)(31)(33)(34)(35) were rated as low quality. The primary reasons for these downgraded ratings were noted as the absence of registration and protocols (item 2), poor information regarding the source of funding for the original studies in the systematic review and meta-analysis (item 10), and an inadequate explanation of the risk of bias when discussing the results of the review (item 13). ...
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Objective Cupping therapy is an ancient technique of healing used to treat a variety of ailments. An evidence-mapping study was conducted to summarize the existing evidence of cupping therapy for pain-related outcomes and indicate the effect and the quality of evidence to provide a comprehensive view of what is known. Methods PubMed, Cochrane Library, Embase, and Web of Science were searched to collect the meta-analyses investigating the association between cupping therapy and pain-related outcomes. The methodological quality was assessed by using the AMSTAR 2 tool. Significant outcomes (p < 0.05) were assessed using the GRADE system. The summary of evidence is presented by bubble plots and human evidence mapping. Results Fourteen meta-analyses covering five distinct pain-related conditions were identified and assessed for methodological quality using the AMSTAR 2, which categorized the quality as critically low (36%), low (50.0%), moderate (7%), and high (7%). In accordance with the GRADE system, no high-quality evidence was found that demonstrates the efficacy of cupping therapy for pain-related outcomes. Specifically, for neck pain, there were two moderate-quality, four low-quality, and two very low-quality evidence, while only one very low-quality evidence supports its efficacy in treating herpes zoster and one low-quality evidence for chronic back pain. Additionally, for low back pain, there were two moderate-quality, one low-quality, and four very low-quality evidence, and for knee osteoarthritis, three moderate-quality evidence suggest that cupping therapy may alleviate pain score. Conclusion The available evidence of very low-to-moderate quality suggests that cupping therapy is effective in managing chronic pain, knee osteoarthritis, low back pain, neck pain, chronic back pain, and herpes zoster. Moreover, it represents a promising, safe, and effective non-pharmacological therapy that warrants wider application and promotion. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021255879, identifier: CRD42021255879.
...  Hot cups are sealed and Lett for fire five to fifteen minutes  Since the cups are shifted, fixed capping is assumed. [20] is sometimes referred to as gliding dynamic and moving cupping [21,22] Using weak suction a cup is removed over the desired massage region after oil has been applied to the skin cupping [23] you may use olive oil, Peppermint oil& lavender oil among other kinds of oils appropriate for all ages including the young and old power of Suction the second category and it encompassing consist of pulsatile cupping "treatment as well as mild medium & vigorous powerful, cupping [24] . The degree of negative pressure within the cups used to perform cupping determines how this category of cupping techniques. ...
... ~ 107 ~ Warm cupping also known as moxa cupping [29] performed using, dried herb [21] when a When a therapist uses a need. Moxa is normally warmed and them it is covered with a cup. ...
... As described in Persian medicine, WCT involves superficial scarification of the congested skin followed by brief suction to facilitate bloodletting [10]. According to previous reports, WCT is an effective therapeutic technique for treating various conditions, including neck pain, low back pain, carpal tunnel syndrome, herpes zoster, and knee osteoarthritis [11][12][13][14][15]. This method is also applicable for treating acute and chronic inflammation, as well as diseases of the immune system. ...
Article
Background/aim: Asthma is an inflammatory disease of the lungs. Cupping therapy is a traditional method used in Persian medicine for treating various ailments. This study aimed to evaluate the anti-asthmatic effects of wet cupping therapy (WCT) in patients with mild to moderate asthma. Materials and methods: This is a randomized clinical trial conducted on 103 asthma patients who were referred to Loghman Hakim Hospital, Tehran, Iran. The diagnosis of the disease was confirmed by a pulmonologist based on the patient's history and clinical examinations. The patients who were treated with common asthma medications were assigned to intervention and control groups. The intervention group underwent one session of WCT in the region between two shoulders on one of the 17th, 19th, and 21st days of the lunar month. The clinical signs of all patients were gathered based on the asthma control test questionnaire before the intervention and in the first, second, fourth, sixth, and eighth weeks after the intervention. The scores of the five questionnaire items and the mean total treatment score (MTTS) were compared between the two groups. Additionally, the satisfaction scores of the participants in the two groups were compared. Results: Of 103 patients, 82 patients completed the study. The mean total treatment score (MTTS) was not significantly different between the control and intervention groups at the beginning of the study (p = 0.06). In the intervention group, the MTTS was 11.44 before WCT, while it was significantly increased (24.24) eighth week after the intervention (p < 0.001). However, the MTTS in the intervention group was significantly higher than the control group in the first week (p <0.001). In addition, at the end of the trial, the subjects' satisfaction scores in the WCT and control groups were 7.48 and 4.53, respectively (p < 0.001). Conclusion: Wet cupping therapy can be an efficient therapeutic method to ameliorate respiratory complications of asthma patients.
... CT is reported to treat a variety of diseases due to the effects of multiple types of stimulation 39 suggested that CT appears to be effective for various medical conditions, in particular herpes zoster and associated pain and acne, facial paralysis, and cervical spondylosis 40 . CT is often used for lowering blood pressure and prevents the development of cardio vascular diseases CVDs in healthy people 41 . ...
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Piezo proteins are ion channel proteins found in various cells of the human body which detect mechanical forces and convert them into electrical signals that can be interpreted by the nervous system. Recent research has shown that these proteins play an important role in a number of physiological processes, including touch sensation, hearing, proliferation, pain modulation and blood pressure regulation. Further research is ongoing to understand the importance of piezo proteins in human health and disease, that could lead to develop the newer therapies for a wide range of conditions. Some physical therapies including Cupping therapy (CT) (Hijama), a well-known regimental therapy in Greco-Arab (Unani) and Chinese medicine, is reported to treat a variety of diseases like, blood pressure and prevents cardiovascular diseases. It is also effective in treating oral and genital ulceration, musculoskeletal pain, nonspecific low back pain, neck pain, fibromyalgia, headache and migraine. Besides various theories hypothesized to explain mechanism of cupping therapy, the piezo protein gates intruded by this therapy may be the best feasible way to understand the mechanism of action of cupping. This novel hypothetical mechanism could pave the way for more researches in medical field especially in chronic ailments. Key words: Cupping, Human Health, Pain, Piezo protein, Unani
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Cupping, as one of the characteristic therapies of traditional Chinese medicine, has been applied for more than 2000 years and has a unique curative effect in clinic. With the evolution of the times, the types and operation techniques of cupping method are also iterating. In the process of its inheritance and development, cupping technology is also known by more and more people. Starting from the development and efficacy of cupping method, this paper introduces the clinical operation steps and precautions of cupping method in detail, and lists the representative diseases such as lumbar muscle strain, herpes zoster, and ankylosing spondylitis, to provide reference for clinical application.
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