Dayanand Nayak Deeksha, Amuthan Arul, Ballambat Sathish Pai, Kabbekodu Shama Prasada, Devi Vasudha
Department of Pharmacology, Melaka Manipal Medical College, Manipal Academy of Higher Education, Manipal, 576104, India.
Department of Dermatology, Venerology and Leprosy, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, 576104, India.
Chin J Integr Med. 2023 Jan;29(1):69-73. doi: 10.1007/s11655-022-3519-y. Epub 2022 Jul 12.
To examine data from studies supporting the clinical efficacy of medical approaches from India traditional systems of medicines like Ayurveda, Unani, Siddha, and Homeopathy for psoriasis using outcome indicators employed in clinical practice and research.
Searches were conducted between December 2019 and September 2020 in databases PubMed, Scopus, Web of Science and Ovid Medline using search terms including traditional, complementary, psoriasis, Kushtha, Ayurveda, Siddha, Unani, Homeopathy and clinical. Controlled trials, case series and case reports published from India were included.
Data of 17 selected studies were extracted. Treatment efficacy in terms of improvement in Psoriasis Area and Severity Index (PASI) score or/and percentage reduction in score (PASI 50, PASI 75 and PASI 90) or/and patient-reported outcomes using instruments like Dermatology Life Quality Index and Psoriasis Disability Index were noted. All studies reported good improvement as per the study specific outcome. However, study characteristics, including study design, sample size, follow-up period, inclusion and exclusion criteria were heterogeneous, and the choice of outcome measures was not adequate to conclude the effectiveness of intervention. The use of some herbs as common ingredients in several formulations across different systems of medicines were noted in analyzing individual formulation.
Future studies must incorporate a comprehensive study design with specific outcome measures like PASI, PASI 75, PASI 90, quality of life parameters, compliance to medications, adverse reactions, remission period, relapse rate and cost-effectiveness with long term follow-up. The currently available evidence on the roles of these herbs at molecular level in psoriasis is preliminary.
使用临床实践和研究中采用的结果指标，审查支持印度传统医学体系（如阿育吠陀医学、尤纳尼医学、悉达医学和顺势疗法）治疗银屑病的医学方法临床疗效的研究数据。
于2019年12月至2020年9月期间，在PubMed、Scopus、科学网和Ovid Medline数据库中进行检索，检索词包括传统、补充、银屑病、库什塔病、阿育吠陀医学、悉达医学、尤纳尼医学、顺势疗法和临床。纳入印度发表的对照试验、病例系列和病例报告。
提取了17项选定研究的数据。记录了银屑病面积和严重程度指数（PASI）评分改善情况或/和评分降低百分比（PASI 50、PASI 75和PASI 90）或/和使用皮肤病生活质量指数和银屑病残疾指数等工具的患者报告结果方面的治疗效果。所有研究均报告根据研究特定结果有良好改善。然而，研究特征，包括研究设计、样本量、随访期、纳入和排除标准存在异质性，且结果测量方法的选择不足以得出干预效果的结论。在分析单个配方时，注意到不同医学体系的几种配方中使用了一些草药作为常见成分。
未来的研究必须纳入全面的研究设计，采用PASI、PASI 75、PASI 90等特定结果测量方法、生活质量参数、药物依从性、不良反应、缓解期、复发率和成本效益，并进行长期随访。目前关于这些草药在银屑病分子水平作用的现有证据是初步的。
