Parker Shefton, Zhang Claire Shuiqing, Yu Jason Jingjie, Lu Chuanjian, Zhang Anthony Lin, Xue Charlie C
a School of Health and Biomedical Sciences , China-Australia International Research Centre for Chinese Medicine, RMIT University , Melbourne , Australia.
b Guangdong Provincial Academy of Chinese Medical Sciences and Guangdong Provincial Hospital of Chinese Medicine , Guangzhou , China.
J Dermatolog Treat. 2017 Feb;28(1):21-31. doi: 10.1080/09546634.2016.1178377. Epub 2016 Jul 1.
Psoriasis is a chronic inflammatory skin disorder and the efficacy and safety of Chinese herbal medicine (CHM) treatments is unclear. This review evaluates oral CHM for psoriasis vulgaris clinical trial evidence.
The Cochrane Library, PubMed, EMBASE, CINAHL, AMED, CBM, CNKI, CQVIP and Wanfang databases were searched from inception to June 2015. Randomised controlled trials (RCTs) of oral CHM compared to placebo data were included and analysed using Review Manager 5.2.
Seven studies were included, no study utilised identical CHM intervention. Four studies data were subgrouped (decoction or capsule/pill) and pooled in meta-analysis to evaluate treatment effective rate for PASI60 or above (RR: 2.74 [0.92, 8.21] I=65%). Another five studies were subgrouped and evaluated for PASI score change, (MD -7.00 [-10.74, -3.27] I=98%). Only one study presented Dermatology Life Quality Index data, which favoured CHM (MD: -4.08 [-7.56, -0.60]). Two studies presented data on psoriasis-related inflammatory cell-signalling protein tumour necrosis factor-a (TNF-a) (MD: -4.92 [-5.31, -4.53]). No serious adverse events were reported.
While CHMs appear to be safe and may have benefit for psoriasis, variation between CHM interventions, outcome measures and the quality of included studies limit the conclusions of this review. Further rigorous RCTs utilising reliable, validated symptom and QoL outcome measures are recommended.
银屑病是一种慢性炎症性皮肤病，中药治疗的疗效和安全性尚不清楚。本综述评估口服中药治疗寻常型银屑病的临床试验证据。
检索Cochrane图书馆、PubMed、EMBASE、CINAHL、AMED、CBM、CNKI、CQVIP和万方数据库，检索时间从建库至2015年6月。纳入口服中药与安慰剂对照的随机对照试验（RCT），并使用Review Manager 5.2进行分析。
纳入7项研究，没有研究采用相同的中药干预措施。4项研究的数据按亚组（汤剂或胶囊/丸剂）分类，并汇总进行荟萃分析，以评估银屑病面积和严重程度指数（PASI）改善60%及以上的治疗有效率（风险比：2.74 [0.92, 8.21]，I² = 65%）。另外5项研究按亚组分类并评估PASI评分变化（平均差 -7.00 [-10.74, -3.27]，I² = 98%）。只有1项研究提供了皮肤病生活质量指数数据，结果支持中药治疗（平均差：-4.08 [-7.56, -0.60]）。2项研究提供了银屑病相关炎性细胞信号蛋白肿瘤坏死因子-α（TNF-α）的数据（平均差：-4.92 [-5.31, -4.53]）。未报告严重不良事件。
虽然中药似乎安全，可能对银屑病有益，但中药干预措施、结局指标以及纳入研究的质量存在差异，限制了本综述的结论。建议进一步开展严谨的RCT，采用可靠、经过验证的症状和生活质量结局指标。
