OBJECTIVE:To evaluate the clinical efficacy and safety of external application of Chinese herbal medicine(ex-CHM)for psoriasis vulgaris(PV).METHODS:Different search portals,including the China National Knowledge Infrastructure Database,China Science and Technology Journal Database,Wanfang,SinoMed,clinicaltrials,PubMed,Cochrane Library,and Cochrane Central Register of Controlled Trials,were searched for randomized controlled trials(RCTs)that compared the ex-CHM intervention with other treatment protocols for PV,with available data as of November 25,2020.The Review Manager 5.3 software was used for analysis.RESULTS:Nineteen RCTs involving 1988 participants were included,of which twelve RCTs qualified for the Meta-analysis.The results showed that the addition of CHM bath to narrow-band ultraviolet B(NB-UVB)had a higher response rate[RR=1.29;95％CI(1.19,1.40);P＜0.000 01];lower psoriasis area severity index(PASI)[MD=-3.15;95％CI(-4.79,-1.52);P=0.000 2)],adverse reactions rate[RR=0.32;95％C/(0.15,0.66);P=0.002],and recurrence rate[RR=0.48;95％CI(0.30,0.79);P=0.004]than NB-UVB alone.The addition of CHM fumigation to NB-UVB also showed a higher response rate[RR=1.29;95％CI(1.11,1.49);P=0.000 7]and lower adverse reactions rate[RR=0.44;95％CI(0.24,0.79);P=0.006].In addition,CHM bath could reduce the adverse reactions induced by 308 nm excimer laser and improve patients'quality of life better than phototherapy.CHM fumigation could improve the efficacy of calcipotriol ointment and reduce the adverse reactions.CHM fumigation combined with external washing plus acitretin showed better results than using acitretin alone.No statistical difference was observed between CHM external washing and calcipotriol ointment or CHM ointment and retinoic acids.CONCLUSIONS:Current evidence showed that CHM bath and fumigation appeared to be efficient and safe for PV treatment.However,no definite conclusion could be drawn due to the low quality of included studies and thus more well-designed studies are needed for further assessment.

LIN Yi;LI Xun;WANG Zi;ZHENG Xiaoran;HANG Haiyan;LI Lingling

Department of Dermatology,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China;Centre for Evidence-Based Chinese Medicine,Beijing University of Chinese Medicine,Beijing 100029,China

中医杂志（英文版）

[1]LIN Yi;LI Xun;WANG Zi;ZHENG Xiaoran;HANG Haiyan;LI Lingling-.Efficacy and safety of external application of Chinese herbal medicine for psoriasis vulgaris:a systematic review of randomized controlled trials)[J].中医杂志（英文版）,2022(04):493-504

calcipotriol,acitretin

Efficacy,safety,external,application,Chinese,herbal,medicine,psoriasis,vulgaris,systematic,review,randomized,controlled,OBJECTIVE,To,evaluate,efficacy,CHM,PV,METHODS,Different,portals,including,China,National,Knowledge,Infrastructure,Database,Technology,Journal,Wanfang,SinoMed,clinicaltrials,Cochrane,Library,Central,Register,Controlled,Trials,were,searched,RCTs,that,compared,intervention,treatment,protocols,available,data,November,Review,Manager,software,used,analysis,RESULTS,Nineteen,involving,participants,included,which,twelve,qualified,results,showed,addition,bath,narrow,band,ultraviolet,NB,UVB,had,higher,response,rate,RR,lower,area,severity,PASI,MD,adverse,reactions,recurrence,than,alone,fumigation,also,could,reduce,induced,by,excimer,laser,improve,patients,quality,life,better,phototherapy,ointment,combined,washing,plus,using,statistical,difference,observed,between,retinoic,acids,CONCLUSIONS,Current,evidence,appeared,efficient,However,definite,conclusion,drawn,due,studies,thus,more,well,designed,needed,further,assessment

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