The First College of Clinical Medicine, Nanjing University of Chinese Medicine, 138 Xianlin Avenue, Qixia District, Nanjing City, Jiangsu Province, China.
BMC Complement Altern Med. 2019 May 10;19(1):103. doi: 10.1186/s12906-019-2513-9.
Chinese herbal bath therapy (CHBT) is a traditional external therapy that has been used for the treatment of uremic pruritus (UP) in China. We conducted a meta-analysis to evaluate the efficacy and safety of CHBT for UP.
We searched seven databases for studies published since database inception to September 1, 2018. Randomized trials evaluating CHBT for UP were collected. The therapeutic effects of CHBT were measured by the pruritus level (via the visual analogue scale (VAS) or the symptom score scale) and the total effective rate. We combined studies using mean difference (MD) for continuous outcomes and using risk ratio for dichotomous data, both with 95% confidence intervals. RevMan V.5.3 software was used to assess the data reported and perform the meta-analysis.
Seventeen articles including 970 patients were identified. All participants were haemodialysis (HD) patients. CHBT is administered by immersing the whole body in a prepared herbal water bath. On average, an herbal bath prescription included 11 Chinese herbs. The mean treatment duration was 4.7 weeks. Compared with basic treatment (HD or haemoperfusion (HP)) and adding a control of sham CHBT, clear hot water bath, or calamine lotion, CHBT plus basic treatment reduced the VAS score (MD = - 2.38; 95% confidence intervals [CI], - 3.02 to - 1.74; P < 0.00001) and the symptom score (MD = - 8.42; 95% confidence intervals [CI], - 12.47 to - 4.36; P < 0.00001) and had a higher total effectiveness rate (risk ratio [RR] = 1.46; 95% CI, 1.31 to 1.63; P < 0.00001).
In conclusion, CHBT could be a complementary therapy for improving pruritic symptoms in uraemia patients. More rigorously designed, multicentre, prospective RCTs are warranted to further identify the efficacy and safety of CHBT.
Systematic review registration: [PROSPERO registration: CRD42018108506 ].
中药浴疗法（CHBT）是一种传统的外治疗法，已在中国用于治疗尿毒症瘙痒症（UP）。我们进行了一项荟萃分析，以评估 CHBT 治疗 UP 的疗效和安全性。
我们检索了自数据库成立至 2018 年 9 月 1 日发表的七个数据库中的研究。收集了评估 CHBT 治疗 UP 的随机试验。通过视觉模拟量表（VAS）或症状评分量表来衡量 CHBT 的治疗效果瘙痒水平和总有效率。我们使用均数差（MD）对连续结果进行合并研究，并使用风险比（RR）对二分类数据进行合并，置信区间均为 95%。使用 RevMan V.5.3 软件评估报告的数据并进行荟萃分析。
共纳入 17 篇文献，包括 970 例患者。所有参与者均为血液透析（HD）患者。CHBT 通过将整个身体浸入准备好的草药浴水中进行。平均而言，草药浴处方包括 11 种中草药。治疗时间平均为 4.7 周。与基础治疗（HD 或血液灌流（HP））和添加假 CHBT、清水浴或炉甘石洗剂对照相比，CHBT 加基础治疗可降低 VAS 评分（MD=-2.38；95%置信区间 [CI]，-3.02 至-1.74；P<0.00001）和症状评分（MD=-8.42；95%置信区间 [CI]，-12.47 至-4.36；P<0.00001），总有效率更高（RR=1.46；95%CI，1.31 至 1.63；P<0.00001）。
总之，CHBT 可能是改善尿毒症患者瘙痒症状的辅助治疗方法。需要进行更严格设计、多中心、前瞻性 RCT 以进一步确定 CHBT 的疗效和安全性。
系统评价注册：[PROSPERO 注册：CRD42018108506]。
