Efficacy and safety of external application of Chinese herbal medicine for psoriasis vulgaris:a systematic review of randomized controlled trials
Efficacy and safety of external application of Chinese herbal medicine for psoriasis vulgaris:a systematic review of randomized controlled trials
复制标题
中药外敷治疗寻常型银屑病的疗效和安全性：随机对照试验的系统评价
DOI：
10.19852/j.cnki.jtcm.20220617.001
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发表时间：
2022
影响因子：
2.6
通讯作者：
Li Lingling
中科院分区：
文献类型：
--
作者：
Lin Yi;Li Xun;Wang Zi;Zheng Xiaoran;Hang Haiyan;Li Lingling
目的：评价中药外用治疗寻常型银屑病的临床疗效和安全性。方法：检索中国国家知识基础设施数据库、中国科技期刊数据库、万方、SinoMed、临床试验、PubMed、Cochrane图书馆、Cochrane中央对照试验数据库，检索随机对照试验(RCT)，比较中药外用治疗寻常型银屑病与其他治疗方案的疗效和安全性。结果：纳入19篇随机对照试验，共19篇结果表明，在窄带紫外线B(NB-UVB)中加入CHM浴有较高的应答率[RR=1.29；不良反应发生率[RR=0.32；95%CI(0.15，0.66)；P=0.002]；复发率[RR=0.48；95%CI(0.30，0.79)]；中药熏蒸加中药熏蒸的有效率较高[RR=1.29；95%CI(1.11，1.49)；P=0.000 7]，不良反应发生率较低[RR=0.44，95%CI(0.24，0.79)；此外，中药外洗可以减少308nm准分子激光的不良反应，改善患者的生活质量，优于光疗。中药熏蒸可以提高钙泊三醇软膏的疗效，减少不良反应。中药熏蒸联合外洗加阿维A治疗效果好于单独使用阿维A。中药外洗与钙泊三醇软膏或中药软膏与维甲酸相比无统计学差异。结论：现有证据表明，中药沐浴和熏蒸治疗PV是有效和安全的。但由于纳入研究的质量较低，尚不能得出确切结论，因此需要更多精心设计的研究来进一步评估。
OBJECTIVE:To evaluate the clinical efficacy and safety of external application of Chinese herbal medicine (ex- CHM) for psoriasis vulgaris (PV).METHODS:Different search portals,including the China National Knowledge Infrastructure Database,China Science and Technology Journal Database,Wanfang,SinoMed,clinicaltrials,PubMed,Cochrane Library,and Cochrane Central Register of Controlled Trials,were searched for randomized controlled trials (RCTs) that compared the ex-CHM intervention with other treatment protocols for PV,with available data as of November 25,2020.The Review Manager 5.3 software was used for analysis.RESULTS:Nineteen RCTs involving 1988 participants were included,of which twelve RCTs qualified for the Meta-analysis.The results showed that the addition of CHM bath to narrow-band ultraviolet B (NB-UVB) had a higher response rate [RR = 1.29;95% CI (1.19,1.40);P <0.000 01];lower psoriasis area severity index (PASI) [MD = -3.15;95% CI (-4.79,-1.52);P = 0.000 2)],adverse reactions rate [RR = 0.32;95% CI (0.15,0.66);P = 0.002],and recurrence rate [RR = 0.48;95% CI (0.30,0.79);P= 0.004] than NB-UVB alone.The addition of CHM fumigation to NB-UVB also showed a higher response rate [RR = 1.29;95% CI (1.11,1.49);P = 0.000 7] and lower adverse reactions rate [RR = 0.44;95% CI (0.24,0.79);P=0.006].In addition,CHM bath could reduce the adverse reactions induced by 308 nm excimer laser and improve patients' quality of life better than phototherapy.CHM fumigation could improve the efficacy of calcipotriol ointment and reduce the adverse reactions.CHM fumigation combined with external washing plus acitretin showed better results than using acitretin alone.No statistical difference was observed between CHM external washing and calcipotriol ointment or CHM ointment and retinoic acids.CONCLUSIONS:Current evidence showed that CHM bath and fumigation appeared to be efficient and safe for PV treatment.However,no definite conclusion could be drawn due to the low quality of included studies and thus more well-designed studies are needed for further assessment.