School of Health Sciences, and Traditional and Complementary Medicine Research Program, Health Innovations Research Institute, RMIT University, PO Box 71, Bundoora, VIC, 3083, Australia.
Br J Dermatol. 2013 Oct;169(4):769-82. doi: 10.1111/bjd.12557.
Patients with psoriasis frequently use preparations of plant extracts. Physicians need to be aware of the current evidence concerning these products. This review evaluates the efficacy and safety of preparations of plant extracts used topically for psoriasis. Searches were conducted in PubMed, Embase, the Cochrane library, two Chinese databases and article reference lists. Randomized controlled trials investigating extracts of single plants were included. Preparations of multiple plants and combinations of plant extracts plus conventional therapies were excluded. Two authors conducted searches, extracted data and assessed risk of bias. Outcomes used in meta-analyses were: clinical efficacy, Psoriasis Area and Severity Index score, and quality of life and symptom scores. The 12 included studies investigated extracts of: Mahonia aquifolium (n = 5), Aloe vera (n = 3), indigo naturalis (n = 2), kukui nut oil (n = 1) and Camptotheca acuminata nut (n = 1). Methodological quality was variable. Six studies provided data suitable for meta-analysis of clinical efficacy, and five were vs. placebo (relative risk 3·37, 95% confidence interval 1·36-8·33). Experimental studies indicate components of indigo naturalis, Mahonia and Camptotheca have anti-inflammatory, antiproliferative and other actions of relevance to psoriasis. The clinical trial evidence provides limited support for preparations containing extracts of M. aquifolium, indigo naturalis and Aloe vera for the topical management of plaque psoriasis based on multiple studies. No serious adverse events were reported. Because of the small size of most studies and methodological weaknesses, strong conclusions cannot be made. The magnitudes of any effects cannot be measured with accuracy, so it is difficult to assess the clinical relevance of these preparations.
患者经常使用植物提取物制剂治疗银屑病。医生需要了解这些产品的当前证据。本文评估了局部应用于银屑病的植物提取物制剂的疗效和安全性。在 PubMed、Embase、Cochrane 图书馆、两个中文数据库和文章参考文献列表中进行了检索。纳入了单种植物提取物的随机对照试验。多种植物制剂和植物提取物加常规疗法的组合被排除在外。两位作者进行了检索、提取数据和评估偏倚风险。荟萃分析中使用的结果包括：临床疗效、银屑病面积和严重程度指数评分以及生活质量和症状评分。纳入的 12 项研究调查了以下提取物：熊果属植物（n=5）、芦荟（n=3）、靛蓝天然物（n=2）、 kukui 坚果油（n=1）和喜树果（n=1）。方法学质量各不相同。6 项研究提供了适合临床疗效荟萃分析的数据，其中 5 项与安慰剂相比（相对风险 3.37，95%置信区间 1.36-8.33）。实验研究表明，靛蓝天然物、熊果属和喜树果的成分具有抗炎、抗增殖等与银屑病相关的作用。临床试验证据为含有熊果属、靛蓝天然物和芦荟提取物的制剂提供了有限的支持，用于斑块状银屑病的局部治疗，这是基于多项研究得出的结论。没有报告严重不良事件。由于大多数研究的规模较小且存在方法学缺陷，因此无法得出强有力的结论。由于大多数研究的规模较小且存在方法学缺陷，无法准确测量任何效应的幅度，因此很难评估这些制剂的临床相关性。
