PDF(Pubmed)
Abstract：
Background: Psoriasis vulgaris (PV) is a longstanding, inflammatory, immune-responsive skin condition. Chinese herbal medicine injections (CHMIs) have been utilized for treating PV in Asian countries. This study aims to conduct a thorough systematic review and meta-analysis to comprehensively appraise the efficacy of CHMIs in treating PV. Methods: Seven databases were searched for randomized controlled trials that evaluated the effect of CHMIs in treating PV, ranging from 2004 to June 2022. The meta-analysis was undertaken based on outcome measures, treatment options, and treatment durations using Review Manager 5.4. The primary outcome measure of this study was a 60% or higher reduction in the Psoriasis Area and Severity Index score (PASI 60). A descriptive analysis was performed for the assessment of adverse events. Results: This systematic review incorporated 33 studies, comprising 3,059 participants. The main findings indicated significant differences based on the PASI 60 (RR = 1.30, 95% CI: 1.24 to 1.37, Z = 10.72, p < 0.00001), PASI 30 (RR = 1.25, 95% CI: 1.13 to 1.38, Z = 4.48, p < 0.00001), and PASI 20 (RR = 1.28, 95% CI: 1.13 to 1.45, Z = 3.82, p = 0.0001) outcome measures. Evaluating the treatment options, CHMIs in combination with monotherapies like narrowband ultraviolet B (NB-UVB) and the acitretin capsule (AC) showed a greater reduction in PASI 60 (RR = 1.33, 95% CI: 1.25 to 1.43, Z = 8.32, p < 0.00001). In terms of treatment duration, no significant difference was observed when the duration extended beyond 56 days. Furthermore, the results suggested that CHMIs might reduce the incidence of adverse events in the treatment of PV. Conclusion: This systematic review revealed preliminary clinical evidence supporting the use of CHMIs for treating PV, considering outcome measures, treatment options, and treatment durations. However, due to the low methodological quality and limited sample size of the included studies, there is an urgent need for high-quality, multi-center and larger-scale studies of CHMIs for PV to provide robust evidence for their clinical application. Systematic Review Registration: [https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=326531], identifier [CRD42022326531].
摘要：
背景：寻常型银屑病(PV)是一种由来已久的疾病，炎症，免疫反应性皮肤状况。在亚洲国家，中草药注射剂（CHMI）已用于治疗PV。本研究旨在进行全面的系统评价和荟萃分析，以全面评估CHMI治疗PV的疗效。方法：在七个数据库中搜索随机对照试验，以评估CHMI治疗PV的效果。从2004年到2022年6月。荟萃分析是根据结果衡量标准进行的，治疗方案,和使用审查管理器5.4的治疗持续时间。这项研究的主要结果指标是牛皮癣面积和严重程度指数评分（PASI60）减少60％或更高。对不良事件的评估进行了描述性分析。结果：本系统综述纳入了33项研究，包括3,059名参与者。主要发现表明基于PASI60的显着差异（RR=1.30，95％CI：1.24至1.37，Z=10.72，p<0.00001），PASI30（RR=1.25，95%CI：1.13至1.38，Z=4.48，p<0.00001），和PASI20（RR=1.28，95％CI：1.13至1.45，Z=3.82，p=0.0001）结局指标。评估治疗方案，CHMI与窄带紫外线B（NB-UVB）和阿曲汀胶囊（AC）等单一疗法组合显示PASI60的降低更大（RR=1.33，95％CI：1.25至1.43，Z=8.32，p<0.00001）。就治疗时间而言，当持续时间超过56天时,没有观察到显著差异.此外，结果表明,CHMI可降低PV治疗中不良事件的发生率.结论：本系统评价揭示了支持使用CHMI治疗PV的初步临床证据，考虑到结果衡量标准，治疗方案,和治疗持续时间。然而,由于纳入研究的方法学质量低，样本量有限，迫切需要高质量的，对PV的CHMI进行多中心和更大规模的研究，为其临床应用提供有力的证据。系统审查注册：[https://www。crd.约克。AC.uk/PROSPERO/display_record。php?RecordID=326531],标识符[CRD42022326531]。
