Wu Man-Ning, Zhou Li-Jia-Ming, Zhou Dong-Mei
Department of Dermatology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China.
Front Pharmacol. 2022 Sep 6;13:971715. doi: 10.3389/fphar.2022.971715. eCollection 2022.
Psoriasis represents the chronic, recurrent and inflammatory disorder. The Traditional Chinese Medicine Xiyanping injection (XYP) is extensively applied in China for treating diverse inflammatory disorders, such as bronchitis, viral pneumonia or upper respiratory tract infection. XYP may offer a potential treatment for psoriasis vulgaris (PV). This study focused on analyzing whether XYP combined with acitretin was effective and safe. The present meta-analysis was carried out in line with guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). This systematic review was registered in PROSPERO (CRD42022333273). Besides, relevant randomized controlled trials (RCTs) that compared XYP plus acitretin with acitretin alone for treating PV were searched from several databases from their inception till May 2022. In addition, this work utilized RevMan5.4 to conduct risk assessment as well as meta-analysis. This meta-analysis selected altogether 10 RCTs including 815 subjects. Upon quality assessment, the RCTs mainly had low or unclear risk. According to our meta-analysis results, relative to acitretin monotherapy, XYP plus acitretin increased the total clinical effective rate, as evidenced by Psoriasis area and severity index score (PASI)-20, PASI-30 and PASI-60 in patients with PV [risk ratio (RR) = 1.23 Z = 4.87, < 0.00001, 95% confidence interval (CI): 1.13-1.34; RR = 1.29, Z = 3.89, = 0.009, 95% CI: 1.07 to 1.55; and RR = 1.31, Z = 3.89, = 0.0001, 95% CI: 1.14-1.49]; the reduced levels of TNF-α, MCP-1 and RANTES, the alleviated side effects resulting from acitretin like itchiness (RR = 0.54, 95% CI: 0.4 to 0.74, = 3.94, < 0.0001), and the increased levels of aminotransferases and dyslipidemia (RR = 0.5, 95%CI = 0.29, 0.86, = 0.01; and RR = 0.41, 95% CI = 0.23, 0.75, = 0.004). As suggested in the present meta-analysis, XYP combined with acitretin effectively and safely treats PV. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022333273, identifier PROSPERO 2022 CRD42022333273.
银屑病是一种慢性、复发性炎症性疾病。中药喜炎平注射液（XYP）在中国被广泛用于治疗多种炎症性疾病，如支气管炎、病毒性肺炎或上呼吸道感染。XYP可能为寻常型银屑病（PV）提供一种潜在的治疗方法。本研究旨在分析XYP联合阿维A是否有效和安全。本荟萃分析是按照系统评价和荟萃分析的首选报告项目（PRISMA）指南进行的。该系统评价已在国际前瞻性系统评价注册库（PROSPERO）注册（注册号：CRD42022333273）。此外，从多个数据库自创建至2022年5月检索了比较XYP加阿维A与单用阿维A治疗PV的相关随机对照试验（RCT）。此外，本研究利用RevMan5.4进行风险评估和荟萃分析。本荟萃分析共纳入10项RCT，包括815名受试者。经质量评估，这些RCT的风险主要为低风险或不明确风险。根据我们的荟萃分析结果，相对于阿维A单药治疗，XYP加阿维A提高了总临床有效率，这在PV患者的银屑病面积和严重程度指数评分（PASI）-20、PASI-30和PASI-60中得到体现[风险比（RR）=1.23，Z = 4.87, < 0.00001, 95%置信区间（CI）：1.13 - 1.34；RR = 1.29，Z = 3.89， = 0.009，95% CI：1.07至1.55；RR = 1.31，Z = 3.89， = 0.0001，95% CI：1.14 - 1.49]；降低了肿瘤坏死因子-α（TNF-α）、单核细胞趋化蛋白-1（MCP-1）和调节激活正常T细胞表达和分泌因子（RANTES）的水平，减轻了阿维A引起的副作用，如瘙痒（RR = 0.54，95% CI：0.4至0.74， = 3.94， < 0.0001），并降低了转氨酶升高和血脂异常的水平（RR = 0.5，95% CI = 0.29，0.86， = 0.01；RR = 0.41，95% CI = 0.23，0.75， = 0.004）。如本荟萃分析所示，XYP联合阿维A能有效且安全地治疗PV。https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022333273，标识符PROSPERO 2022 CRD42022333273 。
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