Applications of leech therapy in medicine: a systematic review
Hosseini M, Jadidi A, Derakhshan Barjoei MM, Salehi M (2024) · Frontiers in Medicine · n=12
Характеристика исследования
- Дизайн
- PRISMA-compliant systematic review of clinical trials of leech therapy across all indications (PubMed/Scopus/Web of Science through April 2023); Arak University of Medical Sciences and Shahid Beheshti University, Iran
- Размер выборки (n)
- 12
- Вмешательство
- Whole-leech (Hirudo medicinalis and regional species) therapy across heterogeneous indications including knee OA, varicose veins, infertility, diabetes/lipid metabolism, hypertension
- Компаратор
- Standard care, sham, or pharmacological comparators across the 12 included trials (heterogeneous)
- Первичная конечная точка
- Qualitative synthesis of efficacy and adverse-event patterns of leech therapy across clinical conditions
- Основной результат
- 12 trials met inclusion criteria; review concludes leech therapy has 'successful outcomes' across hormonal/metabolic complications, cardiovascular conditions, and inflammatory diseases; complications acknowledged but described as manageable with preventive measures; authors call for higher-quality RCTs
- Длительность наблюдения
- Variable across included trials
- PMID
- 39351007
Ключевые выводы
- 12 clinical trials of leech therapy across all indications (through April 2023)
- Authors note efficacy signals in metabolic, cardiovascular, and inflammatory conditions
- Cochrane bias analysis identified considerable heterogeneity in methods and risk of bias
- Complications acknowledged: localized pain, mild bleeding, occasional infection
- Authors call for larger high-quality RCTs across indications
Ограничения
- Wide indication scope prevents condition-specific GRADE pooling
- Mixed inclusion of low-quality trials weakens overall confidence
- Limited to English-language databases; missed substantial Russian, Turkish, Persian, Hindi/Sanskrit-language hirudotherapy literature
- Cochrane bias tool used without explicit risk-of-bias table per indication
- 12 trials is a small base for multi-indication conclusions
Клиническое значение
Hosseini 2024 is a useful contemporary snapshot of the leech-therapy clinical literature but should not be used in isolation to support specific indication claims. For ASH clinicians and researchers, the review reinforces (1) the persistent quality gap between hirudotherapy and pharmacologic comparator literatures, (2) the need for trial-quality standardization (CONSORT-compliant reporting), and (3) the value of indication-specific systematic reviews (e.g., Lauche 2014 for knee OA, Rajaram 2024 for breast surgery) over broad multi-indication reviews.
Связанные исследования
Effectiveness of leech therapy in osteoarthritis of the knee: a randomized, controlled trial
Michalsen A, Klotz S, Lüdtke R, Moebus S, Spahn G, Dobos GJ (2003)
Leech therapy for symptomatic treatment of knee osteoarthritis: results and implications of a pilot study
Andereya S, Stanzel S, Maus U, Mueller-Rath R, Mumme T, Miltner O (2006)
Comparison of modern leech therapy with intra-articular hyaluronic acid injections for symptomatic relief of knee osteoarthritis
Andereya S, Stanzel S, Maus U, Mueller-Rath R, Mumme T, Miltner O, Andereya S (2008)
A systematic review and meta-analysis of medical leech therapy for osteoarthritis of the knee
Lauche R, Cramer H, Langhorst J, Dobos G (2014)