[Shallow needling with filiform fire-needle for pruritus of neurodermatitis: a randomized controlled trial]

To observe the clinical efficacy of shallow needling with filiform fire-needle for pruritus symptoms of neurodermatitis (ND).

A total of 86 patients with ND pruritus were randomly divided into an observation group(43 cases) and a control group (43 cases). The control group was treated with topical halometasone cream using a stepwise dose reduction method for 4 weeks; the observation group was treated with shallow needling using filiform fire-needle, with the stimulation area covering 90% of the lesion area, twice a week for 4 weeks. Peak pruritus numerical rating scale(PP-NRS) and eczema area and severity index (EASI) scores were assessed before treatment, after 2 and 4 weeks of treatment,and at 4 and 8 weeks of follow-up in the two groups. The PP-NRS response rate was calculated, and subgroup analysis of PP-NRS scores was performed. At 8 time points within 4 weeks of treatment, the pain caused by fire-needle was evaluated using the visual analogue scale (VAS), and correlation analysis was conducted between VAS scores and the differences between pre-treatment and post-treatment PP-NRS scores.

After 2 and 4 weeks of treatment and at 4 and 8 weeks of follow-up, PP-NRS and EASI scores in both groups were lower than those before treatment (P<0.05). At 4 and 8 weeks of follow-up, PP-NRS scores in the observation group were lower than those in the control group (P<0.01), and the PP-NRS response rate was higher than that in the control group (P<0.05). Subgroup analysis showed that PP-NRS scores of patients with excess pattern and deficiency pattern in both groups after 2 and 4 weeks of treatment and 4 and 8 weeks of follow-up were lower than those before treatment (P<0.05); in the observation group, PP-NRS scores of patients with excess patterns at 4 weeks of follow-up, and PP-NRS score of patients with deficiency pattern after 4 weeks of treatment and 8 weeks of follow-up, were lower than those in the control group (P<0.05). At each time point within 4 weeks of treatment, the VAS scores of fire-needle-induced pain were positively correlated with the differences in PP-NRS scores (r =0.316-0.425, P<0.05).

The Shallow needling with filiform fire-needle can effectively improve pruritus symptoms in patients with ND, and repair skin lesions. It is more persistent in patients with deficiency pattern and is related to the degree of pain caused by fire-needle.