Department of Dermatology, Jincheng People's Hospital, Jincheng, China.
Dermatol Ther. 2022 Nov;35(11):e15822. doi: 10.1111/dth.15822. Epub 2022 Oct 3.
Longdan Xiegan (LDXG) decoction, an ancient Chinese herbal formula, has been widely used in treating herpes zoster. This meta-analysis aimed to evaluate whether LDXG formula as adjuvant therapy had additional benefits in acute herpes zoster patients. Two authors independently searched PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Chinese Scientific Journal Database, and Wanfang database from their inception to July 31, 2021. Relevant randomized controlled trials (RCTs) that investigated the add-on effects of LDXG formula (decoction, capsule, or pill) in the management of acute herpes zoster were included. Nine RCTs with 821 patients were identified. A random effect model meta-analyses showed that LDXG formula plus conventional therapy significantly reduced the time to blister resolution (weighted mean difference [WMD] -1.31 days; 95% confidence intervals [CI] -1.56 to -1.06), time to crust formation (WMD -1.91 days; 95% CI -2.31 to -1.50), time to pain resolution (WMD -2.13 days; 95% CI -2.65 to -1.60), pain intensity assessed by visual analogue scale (WMD -1.13; 95% CI -2.03 to -0.24), and incidence of persistent pain (risk ratio [RR] 0.28; 95% CI 0.15-0.50) compared with the conventional therapy alone. However, the overall certainty of evidence was very low to moderate. LDXG formula as adjuvant therapy may achieve additional benefits in terms of accelerating skin healing process, relieving pain symptoms, and preventing persistent pain in acute herpes zoster patients. However, interpretation of these findings should be considered the presence of statistical heterogeneity and/or unclear risk of bias.
龙胆泻肝（LDXG）汤是一种古老的中药方剂，已广泛用于治疗带状疱疹。本荟萃分析旨在评估 LDXG 方作为辅助治疗对急性带状疱疹患者是否有额外益处。两位作者独立检索了 PubMed、Embase、Cochrane 图书馆、中国知网、中国科学期刊数据库和万方数据库，检索时间从建库至 2021 年 7 月 31 日。纳入了评估 LDXG 方（汤、胶囊或丸剂）辅助治疗急性带状疱疹的附加效应的随机对照试验（RCT）。共确定了 9 项 RCT，涉及 821 名患者。随机效应模型荟萃分析显示，LDXG 方联合常规治疗可显著缩短水疱消退时间（加权均数差 [WMD] -1.31 天；95%置信区间 [CI] -1.56 至 -1.06）、结痂形成时间（WMD -1.91 天；95% CI -2.31 至 -1.50）、疼痛缓解时间（WMD -2.13 天；95% CI -2.65 至 -1.60）、视觉模拟量表评估的疼痛强度（WMD -1.13；95% CI -2.03 至 -0.24）和持续性疼痛的发生率（风险比 [RR] 0.28；95% CI 0.15-0.50），与单独常规治疗相比。然而，证据的总体确定性为低到中等。LDXG 方作为辅助治疗可能在加速皮肤愈合过程、缓解疼痛症状和预防急性带状疱疹患者持续性疼痛方面有额外益处。然而，这些发现的解释应考虑到存在统计学异质性和/或偏倚风险不明确。
