Tang Qingti, Yang Hongjie, Liu Xiarong, Zou Yu, Lv Xintong, Chen Kai
Department of Dermatology, The Affiliated Hospital of Chengdu University, Chengdu, China.
Department of Radiology, The Sixth People's Hospital of Chengdu, Chengdu, China.
Evid Based Complement Alternat Med. 2021 Dec 6;2021:9628319. doi: 10.1155/2021/9628319. eCollection 2021.
Melasma is an acquired disorder of facial pigmentation. Its etiology is multifactorial; thus, the management is usually challenging. As a complementary therapy, herbal drugs are often used in the management of melasma. This work was aimed to investigate the efficacy and safety of herbal drugs on melasma in female patients.
This study followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search was conducted, and all randomised controlled trials (RCTs) on the use of oral herbal drugs as complementary therapy for melasma in female patients were included. A meta-analysis was conducted according to the guidelines of the Cochrane Collaboration using Review Manager 5.4.
Ten eligible trials, with 1015 female melasma patients, were included. All of the included RCTs had some concerns for risk of bias for different reasons, especially for that most of included trials were unblinded. Pooled data suggested phytotherapy plus routine therapy had significantly better efficacy on melasma than routine therapy, in terms of response rate (OR: 4.49, 95% CI: 3.25 to 6.20, < 0.00001), reduction of skin lesion score (SMD: -0.56, 95% CI: -0.79 to -0.33, < 0.00001), and improvement of serum E2 levels (SMD: -1.58, 95% CI: -2.62 to -0.55, 0.003). In addition, there was no significant difference in the incidence of AEs between phytotherapy plus routine therapy and routine therapy (OR: 0.92, 95% CI: 0.53 to 1.58; p 0.76). Overall, herbal drugs used as an adjunct to routine therapy significantly enhanced the efficacy for the treatment of melasma but with a comparable safety profile.
These findings have implications for recommending herbal drugs as a viable complementary treatment option for melasma.
黄褐斑是一种获得性面部色素沉着紊乱疾病。其病因是多因素的，因此，治疗通常具有挑战性。作为一种辅助疗法，草药常被用于黄褐斑的治疗。本研究旨在探讨草药对女性黄褐斑患者的疗效和安全性。
本研究遵循系统评价和Meta分析的首选报告项目（PRISMA）指南。进行了全面检索，纳入了所有关于口服草药作为女性黄褐斑辅助疗法的随机对照试验（RCT）。根据Cochrane协作网指南，使用Review Manager 5.4进行Meta分析。
纳入了10项符合条件的试验，共1015例女性黄褐斑患者。所有纳入的RCT均因不同原因存在一些偏倚风险问题，尤其是大多数纳入试验未设盲。汇总数据表明，就有效率（OR：4.49，95%CI：3.25至6.20，P<0.00001）、皮肤病变评分降低（SMD：-0.56，95%CI：-0.79至-0.33，P<0.00001）和血清E2水平改善（SMD：-1.58，95%CI：-2.62至-0.55，P=0.003）而言，植物疗法加常规疗法治疗黄褐斑的疗效显著优于常规疗法。此外，植物疗法加常规疗法与常规疗法的不良事件发生率无显著差异（OR：0.92，95%CI：0.53至1.58；P=0.76）。总体而言，草药作为常规疗法的辅助手段可显著提高黄褐斑的治疗效果，且安全性相当。
这些发现为推荐草药作为黄褐斑可行的辅助治疗选择提供了依据。
