Clinical Medicine Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Daejeon 34054, Korea.
Herbal Medicine Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Korea.
Nutrients. 2020 Dec 25;13(1):46. doi: 10.3390/nu13010046.
Patients with Behçet's disease often use complementary and alternative medicine for treating their symptoms, and herbal medicine is one of the options. This systematic review provides updated clinical evidence of the effectiveness of herbal medicine for the treatment of Behçet's disease (BD). We searched eleven electronic databases from inception to March 2020. All randomized controlled trials (RCTs) or quasi-RCTs of BD treatment with herbal medicine decoctions were included. We used the Cochrane Handbook for Systematic Reviews of Interventions to assess the risk of bias and the grading of recommendations assessment, development and evaluation (GRADE) approach to assess the certainty of evidence (CoE). Albatross plot was also used to present the direction of effect observed. Eight studies were included. The risk of bias was unclear or low. The methodological quality was low or very low. Seven RCTs showed significant effects of herbal medicine on the total response rate (Risk ratio, RR 1.26, 95% CI 1.09 to 1.45, seven studies, very low CoE). Four RCTs showed favorable effects of herbal medicine on the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level compared with drug therapy. Herbal medicine favorably affected the ESR (MD -5.56, 95% CI -9.99 to -1.12, = 0.01, I = 96%, five studies, very low CoE). However, herbal medicine did not have a superior effect on CRP. Two RCTs reported that herbal medicine significantly decreased the recurrence rate after three months of follow-up (RR 0.23, 95% CI 0.09 to 0.63, two studies, low CoE). Our findings suggest that herbal medicine is effective in treating BD. However, the included studies had a poor methodological quality and some limitations. Well-designed clinical trials with large sample sizes are needed.
患有白塞病的患者常采用补充替代医学来治疗其症状，而草药是其中的一种选择。本系统评价提供了关于草药治疗白塞病（BD）的有效性的最新临床证据。我们从建库开始到 2020 年 3 月，检索了 11 个电子数据库。所有采用草药方剂治疗 BD 的随机对照试验（RCT）或准 RCT 均被纳入。我们使用 Cochrane 干预措施系统评价手册评估偏倚风险，采用推荐评估、制定与评价（GRADE）方法评估证据确定性（CoE）。我们还使用白尾鸢图展示观察到的效应方向。纳入了 8 项研究。偏倚风险不明确或低。方法学质量低或极低。7 项 RCT 显示草药对总反应率有显著影响（RR 1.26，95%CI 1.09 至 1.45，7 项研究，极低 CoE）。4 项 RCT 显示草药在红细胞沉降率（ESR）和 C 反应蛋白（CRP）水平方面优于药物治疗。草药对 ESR 有有利影响（MD-5.56，95%CI-9.99 至-1.12， = 0.01，I = 96%，5 项研究，极低 CoE）。然而，草药对 CRP 没有更好的作用。2 项 RCT 报道，草药在三个月随访后的复发率方面有显著降低（RR 0.23，95%CI 0.09 至 0.63，2 项研究，低 CoE）。我们的发现表明，草药在治疗 BD 方面是有效的。然而，纳入的研究方法学质量较差，存在一些局限性。需要进行设计良好、样本量大的临床试验。
