背景:白癜风是一种毁容和毁灭性的疾病,人类会感到病痛和贬值。黄褐斑是色素沉着过度的一般状况,特别涉及面部。白癜风的色素沉着障碍(色素沉着不足或色素沉着)和黄褐斑(黑色素沉着)在世界人群中很常见(白癜风约为1%)。
目的:鉴定用于治疗白癜风和黑色素沉着症的药用植物。关于与用于治疗白癜风和黑色素沉着症的药用植物相关的危害的系统文献综述。审查和总结国家和全球个体病例安全报告数据库中包含的与这些药用植物相关的已报告药物不良反应(ADR)的信息。
方法:使用生物医学数据库(包括Medline,EMBASE,Scopus,国际药物文摘等,以确定药用植物单独或作为其他治疗的佐剂及其在白癜风和黑色素沉着症治疗中的安全性/耐受性。这次搜索的其他来源是药用植物教科书,药典和真实的网站讨论白癜风/黑色素沉着症的可能治疗方法。它还包括VigiAccess等数据库,其中包含来自ADR自发报告计划的数据。
结果:共55篇文献(47项临床试验和8例病例报告)符合纳入标准。一些试验没有报告安全性信息,有些人确实报告了,但不是很好。起泡的报告,红斑,急性肝炎和补骨脂诱变。红斑的不良反应(轻度至重度),光毒性反应,肝脏转氨酶轻度升高,胃肠道紊乱,烧伤,瘙痒,缩放,脱色斑斑,瘙痒,和使用补骨脂素的头晕。Khellin相关红斑,周围病变色素沉着过度,胃肠道紊乱,肝脏转氨酶轻度升高和体位性主诉。银杏罕见的副作用。使用Polypodiumleuotomos报告了较低程度的红斑和水肿。
结论:检索到的临床研究主要是以疗效为导向的,安全性参数是次要的,而临床试验的一般方案要求在测试疗效的临床方面之前,在安全性研究的基础上筛选药物/药用植物。因此,建议一旦确定了特定药用植物在治疗白癜风和黑色素沉着症中的安全性,就可以进行功效研究。
BACKGROUND: Vitiligo is disfiguring and devastating condition that can humans feel stigmatic and devalued. Melasma is a general condition of hyperpigmentation particularly involving the face. The pigmentation disorders of vitiligo (hypopigmentation or de-pigmentation) and melasma (
Hypermelanosis) are common among the world\'s population (around 1% for vitiligo).
OBJECTIVE: The identification of medicinal plants used in the treatment of vitiligo and
hypermelanosis. A systematic literature review on harms associated with the medicinal plants used in the treatment of vitiligo and
hypermelanosis. To review and summarize information on reported adverse drug reactions (ADRs) associated with these medicinal plants contained in (where access is available) national and global individual case safety report databases.
METHODS: A systematic review of the literature with special reference to all types of clinical trial and case reports using biomedical databases including Medline, EMBASE, Scopus, International Pharmaceutical Abstracts and so forth to identify medicinal plants alone or as an adjuvant with other treatments and their safety/tolerability in the treatment of vitiligo and
Hypermelanosis. Other sources of this search were medicinal plants text books, pharmacopoeias and authentic websites discussing possible treatments for vitiligo/
hypermelanosis. It also included databases such as VigiAccess containing data from spontaneous reporting schemes for ADRs.
RESULTS: A total of 55 articles (47 clinical trials and 8 case reports) met the inclusion criteria. Some trials did not reported safety information, some did report, but not very well. Reports of blistering, erythema, acute hepatitis and mutagenesis with Psoralea corylifolia. Adverse effects of erythema (mild to severe), phototoxic reactions, mild raise in liver transaminases, gastrointestinal disturbances, burns, itching, scaling, depigmented macules, pruritis, and giddiness with the use of psoralens. Khellin-related erythema, perilesional hyperpigmentation, gastrointestinal disturbances, mild raise in liver transaminases and orthostatic complaints. Infrequent side effects with Ginkgo biloba. Lower grade of erythema and edema reported with the use of Polypodium leucotomos.
CONCLUSIONS: Primarily the retrieved clinical studies were efficacy oriented and safety parameters were secondary in priority whilst the general protocol of clinical trials requires the screening of drugs/medicinal plants on the basis of safety studies before testing the clinical aspects of efficacy. Thereby it is recommended that efficacy studies may be followed once the safety has been established for a particular medicinal plant in treating vitiligo and hypermelanosis.