Efficacy and safety of Chinese herbal medicine in the treatment of chronic pruritus: A systematic review and meta-analysis of randomized controlled trials.
Efficacy and safety of Chinese herbal medicine in the treatment of chronic pruritus: A systematic review and meta-analysis of randomized controlled trials.
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DOI：
10.3389/fphar.2022.1029949
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发表时间：
2022
影响因子：
5.6
通讯作者：
中科院分区：
文献类型：
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作者：
背景：慢性瘙痒症（CP）是皮肤及全身性疾病的常见和加重症状。虽然临床报道中草药治疗慢性瘙痒症是安全有效的，但缺乏证据证明。因此，本文对中药治疗慢性瘙痒症的疗效和安全性进行了综述。 方法：检索了9个数据库中自数据库成立至2022年4月20日的相关随机对照试验（RCT）。选择比较中药或中药与常规西药联合治疗与西药干预治疗慢性瘙痒症的随机对照试验。我们评估了中草药治疗对慢性瘙痒症患者瘙痒程度、皮肤病生活质量指数（DLQI）评分、有效率、复发率和不良事件发生率的影响。使用科克伦协作工具评价每项试验的偏倚风险。使用RevMan软件（版本5.3）进行荟萃分析，以确定比较效应。 结果如下：纳入24项随机对照试验，与安慰剂相比，来自一项研究的中等质量证据显示，中草药与视觉模拟评分（VAS）降低相关（MD：-2.08; 95%CI =-2.34至1.82）。与西药治疗相比，8项研究的低至中等质量证据表明，中药治疗与视觉模拟评分降低有关，4项研究表明，中药治疗与皮肤病生活质量指数降低有关（MD =-1.80，95%CI =-2.98至-0.62），7项研究表明中草药与改善有效率相关（RR：1.26; 95%CI = 1.19-1.34）。与中西医结合治疗相比，16项研究表明中药治疗与视觉模拟评分降低有关，4项研究表明中药治疗与皮肤病生活质量指数降低有关（MD =-2.37，95%CI =-2.61 ~-2.13），13项研究显示中药治疗可提高有效率（RR：1.28; 95%CI = 1.21-1.36）。使用中草药或西药治疗的不良事件发生率无显著差异。 结论：中药联合西药治疗慢性瘙痒症的疗效优于单纯西药治疗。然而，只有少数关于慢性瘙痒症的良好研究，因此，需要高质量的研究来验证本研究的结论。
Background: Chronic pruritus (CP) is a common and aggravating symptom associated with skin and systemic diseases. Although clinical reports suggest that Chinese herbal medicine (CHM) is safe and effective in Chronic pruritus treatment, evidence to prove it is lacking. Therefore, in this review, we evaluated the therapeutic effects and safety of Chinese herbal medicine for the treatment of Chronic pruritus. Methods: Nine databases were searched for relevant randomized controlled trials (RCTs) from the inception of the database to 20 April 2022. The randomized controlled trials that compared the treatment of Chinese herbal medicine or a combination of Chinese herbal medicine and conventional western medicine treatment (WM) with western medicine treatment intervention for patients with Chronic pruritus were selected. We evaluated the effects of treatment with Chinese herbal medicine on the degree of pruritus, the Dermatology Life Quality Index (DLQI) score, response rate, recurrence rate, and incidence of adverse events in patients with Chronic pruritus. The risk of bias in each trial was evaluated using the Cochrane Collaboration tool. The RevMan software (version 5.3) was used for performing meta-analyses to determine the comparative effects. Results: Twenty-four randomized controlled trials were included, compared with placebo, moderate-quality evidence from one study showed that Chinese herbal medicine was associated with reduced visual analogue scale (VAS) (MD: −2.08; 95% CI = −2.34 to −1.82). Compared with western medicine treatment, low-to moderate-quality evidence from 8 studies indicated that Chinese herbal medicine was associated with reduced visual analogue scale, 4 studies indicated that Chinese herbal medicine was associated with reduced Dermatology Life Quality Index (MD = −1.80, 95% CI = −2.98 to −.62), and 7 studies indicated that Chinese herbal medicine was associated with improved Effective rate (RR: 1.26; 95% CI = 1.19–1.34). Compared with combination of Chinese herbal medicine and western medicine treatment, 16 studies indicated that Chinese herbal medicine was associated with reduced visual analogue scale, 4 studies indicated that Chinese herbal medicine was associated with reduced Dermatology Life Quality Index (MD = −2.37, 95% CI = −2.61 to −2.13), and 13 studies indicated that Chinese herbal medicine was associated with improved Effective rate (RR: 1.28; 95% CI = 1.21–1.36). No significant difference in the occurrence of adverse events in using Chinese herbal medicine or western medicine treatment was reported. Conclusion: The efficacy of Chinese herbal medicine used with or without western medicine treatment was better than western medicine treatment in treating chronic pruritus. However, only a few good studies are available regarding Chronic pruritus, and thus, high-quality studies are necessary to validate the conclusions of this study.
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影响因子：
2.9
作者：
Schneider, Gudrun;Staender, Sonja;Kahnert, Stefan;Pereira, Manuel Pedro;Mess, Christian;Huck, Volker;Agelopoulos, Konstantin;Frank, Gina;Schneider, Stefan W.
通讯作者：
Schneider, Stefan W.
影响因子：
3.7
作者：
Moher D;Shamseer L;Clarke M;Ghersi D;Liberati A;Petticrew M;Shekelle P;Stewart LA;PRISMA-P Group
通讯作者：
PRISMA-P Group
影响因子：
6.5
作者：
Hay, Roderick J.;Johns, Nicole E.;Naghavi, Mohsen
通讯作者：
Naghavi, Mohsen
影响因子：
5.4
作者：
Mehrbani, Mehrzad;Choopani, Rasool;Mehrabani, Mehrnaz
通讯作者：
Mehrabani, Mehrnaz
影响因子：
--
作者：
Bian, Zhao-Xiang;Tian, Hao-Yao;Song, Li
通讯作者：
Song, Li