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口服中药联合光疗治疗白癜风:一项随机对照试验的系统评价和荟萃分析

Oral Chinese herbal medicine in combination with phototherapy for vitiligo: A systematic review and meta-analysis of randomized controlled trials.

作者信息

Chen Yu-Jung, Chen Yi-Yang, Wu Ching-Yuan, Chi Ching-Chi

机构信息

Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan; Center for Evidence-Based Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan.

Center for Evidence-Based Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan; Division of Hemato-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan.

出版信息

Complement Ther Med. 2016 Jun;26:21-7. doi: 10.1016/j.ctim.2016.02.009. Epub 2016 Feb 18.

Abstract

AIMS

The aim of this study was to assess the effects of oral Chinese herbal medicine (CHM) combined with phototherapy for vitiligo.

METHODS

We undertook a meta-analysis of relevant randomized controlled trials (RCTs) and searched eight bibliographic databases from inception to December 2015.

RESULTS

A total of 5 RCTs with 513 participants which assessed the efficacy of oral CHM in combination with narrow-band ultraviolet B (NB-UVB) in treating vitiligo were included. The meta-analysis revealed a superior effectiveness in those receiving oral CHM plus NB-UVB when compared to phototherapy alone (risk difference 0.22, 95% confidence interval 0.14 to 0.29, P<0.00001). Only mild adverse events were reported without significant renal or liver function impairment.

CONCLUSIONS

The current evidence demonstrates that oral CHM in combination with NB-UVB has a superior effectiveness in terms of repigmentation rate of vitiligo when compared to NB-UVB alone. Although the overall quality of included trials was low, oral CHM in combination with NB-UVB may be an alternative option of treatment for vitiligo. As to safety, there were only mild adverse events reported without significant renal or liver function impairment. However, there is limited available evidence of long-term follow-up and poor methodological quality of the available trials. Well-designed RCTs of adequate length and sample size that include life quality as an outcome are warranted.

摘要

目的

本研究旨在评估口服中药联合光疗治疗白癜风的效果。

方法

我们对相关随机对照试验进行了荟萃分析,并检索了从数据库建立至2015年12月的八个文献数据库。

结果

共纳入5项随机对照试验,涉及513名参与者,这些试验评估了口服中药联合窄谱中波紫外线(NB-UVB)治疗白癜风的疗效。荟萃分析显示,与单纯光疗相比,接受口服中药加NB-UVB治疗的患者疗效更佳(风险差异0.22,95%置信区间0.14至0.29,P<0.00001)。仅报告了轻微不良事件,未出现明显的肾功能或肝功能损害。

结论

目前的证据表明,与单纯NB-UVB相比,口服中药联合NB-UVB在白癜风复色率方面具有更好的疗效。尽管纳入试验的整体质量较低,但口服中药联合NB-UVB可能是治疗白癜风的一种替代选择。关于安全性,仅报告了轻微不良事件,未出现明显的肾功能或肝功能损害。然而,长期随访的现有证据有限,且现有试验的方法学质量较差。有必要开展设计良好、长度和样本量足够、将生活质量作为一项指标的随机对照试验。

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