Luo Yue, Chen Jiale, Kuai Le, Zhang Ying, Ding Xiaojie, Luo Ying, Ru Yi, Xing Meng, Li Hongjin, Sun Xiaoying, Li Bin, Li Xin
Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China.
Front Pharmacol. 2021 Jan 22;11:599433. doi: 10.3389/fphar.2020.599433. eCollection 2020.
Chinese herbal medicine (CHM) provides a theoretical basis for the treatment of psoriasis with considerable benefits and a low toxicity. The purpose of this quantitative study was to show high-quality evidence of the efficacy and safety of CHM for the treatment of psoriasis to promote its clinical application. Several databases were systematically searched including PubMed, Embase, Cochrane Central Register of Controlled Trials, China Network Knowledge Infrastructure, Chinese Scientific Journals Database, and Wan Fang Database. High-quality randomized controlled trials that compared CHM with non-CHM interventions were included. The RevMan5.3 software was used to calculate risk ratios (RR) at 95% confidence intervals (CI) and conduct the meta-analysis. Altogether, 1,215 patients participated in this study, including 711 in the experimental group and 504 in the control group. The psoriasis area severity index (PASI) score of the CHM group was significantly lower than that of the placebo group (MD, -4.02; 95% CI, -6.71 to -1.34; = 0.003). To achieve PASI-60 and PASI-75, the arrival rate of the CHM group was higher than that of the placebo group (PASI-60: RR, 3.52; 95% CI, 1.17 to 10.61; = 0.03; PASI-75: RR, 9.87; 95% CI, 3.11 to 31.31; = 0.0001). Furthermore, the efficacy rate was higher in patients receiving CHM than in those receiving placebo (RR, 1.72; 95% CI, 1.01 to 2.93; = 0.04). The results suggested a greater impact of CHM in improving the dermatology life quality index (DLQI) of patients (MD, -2.12; 95% CI, -3.75 to -0.49; = 0.01). Regarding pruritus severity, there was no significant difference between the two groups (MD, -1.90; 95% CI, -3.79 to -0.01; = 0.05). The meta-analysis revealed that the recurrence rate (RR, 0.74; 95% CI, 0.32 to 1.71; = 0.48) and proportion of adverse events (RR, 1.36; 95% CI, 0.95 to 1.93; = 0.09) associated with using CHM were similar to those associated with using a placebo. CHM appears safe and effective in the treatment of psoriasis and has a great positive impact on the DQLI of patients; however, CHM could not completely eliminate skin lesions, improve pruritus severity, and reduce the recurrence rate.
中草药（CHM）为银屑病的治疗提供了理论依据，疗效显著且毒性低。这项定量研究的目的是提供高质量证据，证明中草药治疗银屑病的有效性和安全性，以促进其临床应用。我们系统检索了多个数据库，包括PubMed、Embase、Cochrane对照试验中心注册库、中国知网、维普中文科技期刊数据库和万方数据库。纳入了比较中草药与非中草药干预措施的高质量随机对照试验。使用RevMan5.3软件计算95%置信区间（CI）的风险比（RR）并进行荟萃分析。共有1215例患者参与本研究，其中试验组711例，对照组504例。中草药组的银屑病面积和严重程度指数（PASI）评分显著低于安慰剂组（MD，-4.02；95%CI，-6.71至-1.34；P = 0.003）。为达到PASI-60和PASI-75，中草药组的达标率高于安慰剂组（PASI-60：RR，3.52；95%CI，1.17至10.61；P = 0.03；PASI-75：RR，9.87；95%CI，3.11至31.31；P = 0.0001）。此外，接受中草药治疗的患者的有效率高于接受安慰剂治疗的患者（RR，1.72；95%CI，1.01至2.93；P = 0.04）。结果表明，中草药对改善患者的皮肤病生活质量指数（DLQI）有更大影响（MD，-2.12；95%CI，-3.75至-0.49；P = 0.01）。关于瘙痒严重程度，两组之间无显著差异（MD，-1.90；95%CI，-3.79至-0.01；P = 0.05）。荟萃分析显示，与使用中草药相关的复发率（RR，0.74；95%CI, 0.32至1.71；P = 0.48）和不良事件发生率（RR，1.36；95%CI，0.95至1.93；P = 0.09）与使用安慰剂相似。中草药在治疗银屑病方面似乎是安全有效的，并且对患者的DQLI有很大的积极影响；然而，中草药不能完全消除皮肤病变、改善瘙痒严重程度和降低复发率。
