Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences and Center of Excellence in Bioactive Resources for Innovative Clinical Applications, Chulalongkorn University, Bangkok, Thailand.
Sirindhorn College of Public Health Trang, Faculty of Public Health and Allied Health Sciences, Praboromarajchanok Institute, Trang, Thailand.
J Evid Based Integr Med. 2024 Jan-Dec;29:2515690X241271948. doi: 10.1177/2515690X241271948.
Hypertrophic scarring is an aberrant wound-healing response to reestablish dermal integrity after an injury and can cause significant abnormalities in physical, aesthetic, functional, and psychological symptoms, impacting the patient's quality of life. There is currently no gold standard for preventing and treating hypertrophic scars. Therefore, many researchers have attempted to search for antihypertrophic scar agents with greater efficacy and fewer side effects. Natural therapeutics are becoming attractive as potential alternative anti-scarring agents because of their high efficacy, safety, biocompatibility, low cost, and easy accessibility. This review demonstrates various kinds of natural product-based therapeutics, including onion, vitamin E, Gotu kola, green tea, resveratrol, emodin, curcumin, and others, in terms of their mechanisms of action, evidence of efficacy and safety, advantages, and disadvantages when used as anti-scarring agents. We reviewed the literature based on data from in vitro, in vivo, and clinical trials. A total of 23 clinical trials were identified in this review; most clinical trials were ranked as having uncertain results (level of evidence 2b; n = 16). Although these natural products showed beneficial effects in both in vitro and in vivo studies of potential anti-scarring agents, there was limited clinical evidence to support their efficacy due to the limited quality of the studies, with individual flaws including small sample sizes, poor randomization, and blinding, and short follow-up durations. More robust and well-designed clinical trials with large-scale and prolonged follow-up durations are required to clarify the benefits and risks of these agents.
增生性瘢痕是一种异常的伤口愈合反应，旨在受伤后重建真皮完整性，但可能导致身体、美观、功能和心理症状的严重异常，从而影响患者的生活质量。目前，尚无预防和治疗增生性瘢痕的金标准。因此，许多研究人员试图寻找疗效更高、副作用更少的抗增生性瘢痕药物。由于天然疗法具有高效、安全、生物相容性好、成本低、易于获取等优点，因此作为潜在的抗瘢痕药物越来越受到关注。本综述展示了各种基于天然产物的疗法，包括洋葱、维生素 E、积雪草、绿茶、白藜芦醇、大黄素、姜黄素等，涉及它们的作用机制、疗效和安全性证据、作为抗瘢痕药物的优缺点。我们根据体外、体内和临床试验的数据对文献进行了综述。本综述共确定了 23 项临床试验；大多数临床试验被评为结果不确定（证据水平 2b；n=16）。尽管这些天然产物在潜在抗瘢痕药物的体外和体内研究中显示出有益的效果，但由于研究质量有限，缺乏支持其疗效的临床证据，个别研究存在样本量小、随机分组和盲法不佳以及随访时间短等缺陷。需要进行更多设计良好、规模较大、随访时间较长的临床试验，以明确这些药物的益处和风险。
