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Oral C hinese herbal medicine combined with pharmacotherapy for psoriasis vulgaris: a systematic review
Author(s) -
Zhang Claire Shuiqing,
Yu Jason Jingjie,
Parker Shefton,
Zhang Anthony Lin,
May Brian,
Lu Chuanjian,
Xue Charlie Changli
Publication year - 2014
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1111/ijd.12607
Subject(s) - acitretin , medicine , pharmacotherapy , psoriasis , randomized controlled trial , adverse effect , dermatology , traditional medicine
Clinically, oral C hinese herbal medicine ( CHM ) is widely used in the treatment of psoriasis. This review evaluates the effects of oral CHM in combination with pharmacotherapy for psoriasis vulgaris. The C ochrane L ibrary, P ub M ed, E mbase, CINAHL , CNKI , and CQVIP were searched from their inceptions to N ovember 2012. Randomized controlled trials ( RCT s) investigating CHM plus pharmacotherapy compared to pharmacotherapy were included. Data were analyzed using R eview M anager 5.1.0. Seventeen RCT s were included, conducted in C hina, and employed a diversity of both herbal medicines and pharmacotherapies. When the meta‐analyses were restricted to studies that used a well‐known pharmacotherapy as the comparator with 60% or greater clinical improvement in psoriasis as the outcome, five studies used oral acitretin, one used topical calcipotriol, and one used topical clobetasol propionate as control interventions. At the end of treatment, there was a benefit for the pooled result of the five studies that compared CHM plus acitretin with acitretin alone and no serious adverse events were reported. However, none of these studies was blind, so there is considerable risk of bias in this result. In addition, there was inadequate reporting of longer‐term results, so it remains unclear whether the reported effect could be maintained or whether the prolonged use of the CHM in conjunction with acitretin would be safe. The main plants used in these studies, R ehmannia glutinosa root, S alvia miltiorrhiza root, and L ithospermum erythrorhizon root, have shown anti‐inflammatory and/or antiproliferative effects in experimental studies. These actions may at least partially explain the observed results.