Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China.
Jining Hospital of Traditional Chinese Medicine, Jining, Shandong, China.
Medicine (Baltimore). 2023 Oct 13;102(41):e35327. doi: 10.1097/MD.0000000000035327.
Treating vitiligo in clinical practice is challenging. Furthermore, oral drugs used in Western medicine have considerable side effects and are unsuitable for long-term treatment. In contrast, Chinese patent medicines (CPMs) are more suitable for long-term oral vitiligo treatment, but medical evidence of their efficacy and safety is lacking. Therefore, in this study, the efficacy and safety of CPMs were evaluated and ranked using a Bayesian network meta-analysis.
Seven Chinese and English databases were searched for all relevant articles published up to February 2023. The Bayesian network meta-analysis method was used to analyze the extracted data to evaluate efficacy and safety.
Six common CPMs for treating vitiligo were selected in our study, and 48 targeted articles and 4446 patients were included. This study showed that Qubai Babuqi tablets (QT) were the most effective for short-term treatment of vitiligo, and that vitiligo capsules or pills (VCP) were the most effective for long-term treatment, together with compound Quchong Banjiuju pills (QP). In terms of surface area under the cumulative ranking curve (SUCRA) values, the order of efficacy of each treatment was as follows: QT (92.18%) > Taohong Qingxue pills (TP) (63.81%) > VCP (55.53%) > QP (50.72%) > Bailing tablets or capsules (BTC) (49.01%) > Baishi pills (BP) (35.69%)>routine therapy (RT) (3.1%) in terms of total effective rate and QT (92.05%) > VCP (71.50%) > QP (66.60%) > TP (42.95%) > BTC (39.66%) > BP (36.60%)>RT (0.6%) in terms of improvement rate. In addition, the safety of the 6 CPMs did not significantly differ in terms of adverse effects. The SUCRA values indicated that QT performed slightly worse than other drugs.
In treating vitiligo, QT is most effective but only suitable for short-term administration owing to its poor safety. VCP and QP could be used as first-choice long-term medications. TP may positively affect repigmentation in patients with limited lesion areas.
临床治疗白癜风具有挑战性。此外,西医中使用的口服药物副作用较大,不适合长期治疗。相比之下,中成药(CPM)更适合长期口服治疗白癜风,但缺乏疗效和安全性的医学证据。因此,本研究采用贝叶斯网络荟萃分析方法评估和排名 CPM 的疗效和安全性。
检索了截至 2023 年 2 月所有相关的中文和英文数据库,提取数据并采用贝叶斯网络荟萃分析方法进行分析,以评估疗效和安全性。
本研究共纳入 6 种治疗白癜风的常用 CPM,涉及 48 项针对性研究和 4446 例患者。研究结果表明,短期治疗白癜风,曲比布齐片(QT)疗效最佳;长期治疗白癜风,白癜风胶囊或丸剂(VCP)和复方驱白巴布期片(QP)疗效最佳。基于累积排序概率曲线下面积(SUCRA)值,每种治疗方法的疗效排序如下:QT(92.18%)>桃红清血丸(TP)(63.81%)>VCP(55.53%)>QP(50.72%)>百灵片或胶囊(BTC)(49.01%)>白蚀丸(BP)(35.69%)>常规治疗(RT)(3.1%)(总有效率)和 QT(92.05%)>VCP(71.50%)>QP(66.60%)>TP(42.95%)>BTC(39.66%)>BP(36.60%)>RT(0.6%)(改善率)。此外,6 种 CPM 在不良反应方面安全性无显著差异。SUCRA 值表明 QT 的表现略逊于其他药物。
治疗白癜风时,QT 虽然疗效最佳,但由于安全性较差,仅适合短期给药。VCP 和 QP 可作为长期治疗的首选药物。TP 可能对皮损面积较小的患者的复色有积极影响。