Department of Clinical Pharmacy, The General Hospital of Western Theater Command, Chengdu, China.
Department of Information, Medical Support Center, The General Hospital of Western Theater Command, Chengdu, China.
Medicine (Baltimore). 2023 Oct 27;102(43):e35533. doi: 10.1097/MD.0000000000035533.
Vitiligo is an acquired chronic depigmentary disorder affecting approximately 0.5% to 1% of individuals worldwide. The compound glycyrrhizin (CG), a complementary medicine, has been reported for treatment of vitiligo, but the evidence has not been systematically evaluated. We systematically assessed the efficacy and safety of CG in combination with conventional therapy for the treatment of vitiligo.
We searched Embase, Web of Science, PubMed, The Cochrane Library, Chinese BioMedical Literature Database (CBM), Wanfang Data, China National Knowledge Infrastructure (CNKI), and VIP information from inception to July 2022. Randomized controlled trials comparing CG combined with conventional therapy with conventional therapy alone for vitiligo were included in our analysis. The primary outcome was treatment response, which defined as >50% repigmentation rate of vitiligo after treatment. The secondary outcome was incidence of adverse events. Meta-analysis was performed using the Review Manager 5.4 software. Statistical heterogeneity was evaluated with chi-square and I2 statistics, dichotomous data were expressed as risk ratios (RR) with 95% confidence intervals using the Mantel-Haenszal method.
Thirty-nine studies enrolling with 3994 participants were subjected to this review. The results of our meta-analysis indicated that addition of CG had superior effectiveness on repigmentation rate than phototherapy (RR = 1.28; P < .001), immunosuppressant (RR = 1.76; P < .001), traditional Chinese medicine (RR = 1.38; P < .001), combination of phototherapy and immunosuppressant (RR = 1.42; P < .001), and combination of phototherapy and traditional Chinese medicine (RR = 1.37; P < .001). In addition, CG did not increase the incidence of adverse events for vitiligo (RR = 0.79; P = .05).
CG as a complementary medicine has a potential benefit in treatment of vitiligo. However, since the methodological flaws in the studies we included, more high-quality randomized controlled trials are warranted.
白癜风是一种获得性慢性色素减退性疾病，影响全球约 0.5%至 1%的人群。甘草酸（CG）作为一种补充药物，已被报道可用于治疗白癜风，但证据尚未得到系统评估。我们系统评估了 CG 联合常规疗法治疗白癜风的疗效和安全性。
我们检索了 Embase、Web of Science、PubMed、The Cochrane Library、中国生物医学文献数据库（CBM）、万方数据、中国知网（CNKI）和维普信息，检索时间从建库至 2022 年 7 月。纳入 CG 联合常规疗法与单纯常规疗法治疗白癜风的随机对照试验。主要结局为治疗后白癜风的复色率>50%。次要结局为不良反应发生率。采用 Review Manager 5.4 软件进行荟萃分析。采用卡方检验和 I2 统计量评估统计学异质性，二分类数据采用 Mantel-Haenszel 法表示风险比（RR）及其 95%置信区间。
共纳入 39 项研究，3994 名参与者。荟萃分析结果表明，与光疗（RR=1.28；P<.001）、免疫抑制剂（RR=1.76；P<.001）、中药（RR=1.38；P<.001）、光疗联合免疫抑制剂（RR=1.42；P<.001）和光疗联合中药（RR=1.37；P<.001）相比，CG 联合常规疗法的复色率更高。此外，CG 并未增加白癜风不良反应的发生率（RR=0.79；P=0.05）。
CG 作为一种补充药物，在治疗白癜风方面具有潜在益处。但是，鉴于我们纳入的研究存在方法学缺陷，需要更多高质量的随机对照试验。
