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Research on Chinese medicine and dermatology

Last updated: 11 March, 2017
by Davina Martin, Chinese Dermatology

 

Chinese herbal medicine for atopic dermatitis: A systematic review.

Chinese herbal medicine significantly improved symptom severity of atopic dermatitits and was reported as well tolerated. However, the poor quality of studies did not allow for valid conclusions to support its tolerability and routine use.”

JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY
Publication Date Jun 04, 2013

Diseases : Dermatology , Dermatology – Atopic dermatitis Treatments : Herbal medicine

Authors Hsiewe Ying Tan, Anthony Lin Zhang, DaCan Chen, Charlie Changli Xue, George Binh Lenon

Keywords allergy; alternative and complementary medicine; atopic dermatitis; Chinese herbal medicine; eczema; systematic review

Abstract

Objective: We systematically evaluated the clinical evidence of the efficacy and safety of oral Chinese herbal medicine for AD.
Methods: Searches were conducted on major electronic databases using the following key words: “randomized controlled trials,” “atopic dermatitis,” “traditional Chinese medicine,” “traditional East Asian medicine,” “herbal medicine,” “Chinese herbal drugs,” “medicinal plants,” “phytotherapy,” “Kampo medicine,” and “Korean traditional medicine.” The results were screened to include English/Chinese randomized controlled trials. A metaanalysis was conducted on suitable outcome measures.
Results: Seven randomized controlled trials were included (1 comparing Chinese herbal medicine and Western medicine with Western medicine alone; 6 comparing Chinese herbal medicine with placebo). Combined Chinese herbal medicine with Western medicine was superior to Western medicine alone. Three placebo controlled trials showed significant treatment efficacy and 2 showed significantly reduced concurrent therapy with Chinese herbal medicine. No abnormalities in safety profile or severe adverse events were reported.
Limitations: A metaanalysis of all included studies could not be conducted because of study heterogeneity.

Conclusions: Chinese herbal medicine significantly improved symptom severity of AD and was reported as well tolerated. However, the poor quality of studies did not allow for valid conclusions to support its tolerability and routine use. Additional studies addressing the methodologic issues are warranted to determine the therapeutic benefit of Chinese herbal medicine for AD.

 

Chinese herbal medicine for atopic eczema: an overview of clinical evidence

In a review of studies which took place after 2013 (when the systematic review above was published) and up to 2016, the authors found: oral use of a Chinese Herbal Medicine formulation may improve health-related quality of life of children with moderate or severe atopic eczema.”

Sherman X. Gu, Anthony L. Zhang, Meaghan E. Coyle, Dacan Chen & Charlie C. Xue

Published online: 18 Aug 2016

Atopic eczema (AE), or atopic dermatitis, is a common inflammatory skin disease. As conventional medicines for moderate and severe AE patients have been reported to be associated with unwanted side effects, many patients with AE have sought other therapies. Chinese herbal medicine (CHM) is one of the most commonly used complementary therapies with a long history of being applied for the treatment of AE. Clinical evidence for CHM for AE in systematic reviews and randomised controlled trials (RCTs) published from 2013 to 2016 was reviewed. Findings from the Cochrane systematic review suggested that oral use of a CHM formulation may improve health-related quality of life (HRQoL) of children with moderate or severe AE. The benefit on improvement of AE requires further high-quality clinical studies.

 

Is Oral Chinese Herbal Medicine Beneficial for Psoriasis Vulgaris? A Meta-Analysis of Comparisons with Acitretin.

The meta-analysis indicated that oral CHM was effective for psoriasis vulgaris as follows: (1) Oral CHM is neither superior nor inferior to acitretin, and (2) oral CHM could produce add-on effects when combined with acitretin. Oral CHM itself appeared safe for treating psoriasis vulgaris and possibly could reduce the common adverse events seen with acitretin.”

J Altern Complement Med. 2016 Mar;22(3):174-88. doi: 10.1089/acm.2014.0212. Epub 2016 Feb 26.

Zhang CS1, Yang L2, Zhang AL1, May BH1, Yu JJ2, Guo X2, Lu C2, Xue CC1,2.

BACKGROUND: Psoriasis vulgaris is a chronic disease that significantly affects patient’s quality of life and poses an economic burden. Acitretin is a second-generation retinoid used for psoriasis in clinical practice. Orally administered Chinese herbal medicine (CHM), alone or combined with acitretin, has been used for the clinical management of psoriasis vulgaris. This systematic review evaluates the efficacy of oral CHM in comparison with acitretin and the add-on effect of oral CHM to acitretin.

METHODS: Five English databases and four Chinese databases were searched from their inceptions to May 2014. Included randomized, controlled trials (RCTs) were published in English or Chinese, compared oral CHM or the combination of oral CHM and acitretin with acitretin, and used Psoriasis Area and Severity Index (PASI) as the outcome measure.

RESULTS: A total of 25 RCTs were included in this review: 8 studies compared oral CHM with acitretin, 12 compared the combination with acitretin alone, and 5 were three-arm studies that compared both with acitretin.

CONCLUSION: The meta-analysis indicated that oral CHM was effective for psoriasis vulgaris as follows: (1) Oral CHM is neither superior nor inferior to acitretin, and (2) oral CHM could produce add-on effects when combined with acitretin. Oral CHM itself appeared safe for treating psoriasis vulgaris and possibly could reduce the common adverse events seen with acitretin. However, the long-term effect and safety of oral CHM could not be assessed. Further research should consider including a placebo control and using outcome measures according to international guidelines to evaluate CHM, as well as include follow-ups to monitor longer-term efficacy and safety.

 

An overview of acupuncture for psoriasis vulgaris, 2009–2014

In a 2016 review summarizing the literature  between 2009 and 2014, the authors found: “The conclusion is that acupuncture therapies for psoriasis are simple, convenient, and effective, with long-lasting therapeutic effects as well as minimal side effects and toxicity.”

Yu Xiang, Xing Wu, Chuanjian Lu & Kaiyi Wang

Published online: 15 Sep 2016

https://doi.org/10.1080/09546634.2016.1224801

Psoriasis is a chronic, proliferative, and inflammatory skin disease which affects around 2–3% of the global population. Current pharmacotherapy is effective, however medication with safe and long-lasting therapeutic effects is needed. Acupuncture for psoriasis is widely used in China as well as other Asian countries, and is gradually becoming accepted globally. To determine the characteristics and advantages of acupuncture treatment for psoriasis, and to improve the clinical outcomes of this disease in the future, this review summarizes literature on acupuncture treatment for psoriasis published between 2009 and 2014.

Databases search was conducted with the China National Knowledge Infrastructure (CNKI), MEDLINE, and PubMed databases over a time period ranging from January 2009 to December 2014. The condition term was “psoriasis” and the key intervention terms were “needling”, “moxibustion”, “auriculotherapy”, “cupping and bloodletting therapy”, “catgut embedding therapy”, “point-injection therapy”, “traditional Chinese medicine fumigation therapy”, “fire needling therapy”, and “vesiculation moxibustion”. Languages were limited to English and Chinese. Therapeutic mechanisms, therapy, therapeutic characteristics, advantages and limits of acupuncture for psoriasis are discussed.

The conclusion is that acupuncture therapies for psoriasis are simple, convenient, and effective, with long-lasting therapeutic effects as well as minimal side effects and toxicity.

 

Psoriasis Successfully Treated with Traditional Chinese Herb

“Topical Qing Dai  ointment was a novel, safe, and effective therapy for plaque-type psoriasis.”

7 March 2009

Clinical assessment of patients with recalcitrant psoriasis in a randomized, observer- blind, vehicle-controlled trial using The Chinese Medicine Qing Dai (indigo naturalis).
Lin YK, Chang CJ, Chang YC, Wong WR, Chang SC, Pang JH.

OBJECTIVE: To evaluate the efficacy and safety of treatment with Qing Dai  in
patients with recalcitrant plaque-type psoriasis.

DESIGN: Randomized, observer- blind, vehicle-controlled, intrapatient comparison study.

SETTING: Ambulatory department of a hospital.

PARTICIPANTS: Forty-two outpatients with chronic plaque psoriasis were enrolled in the study from May 1, 2004, to April 30, 2005.

INTERVENTION: The patients applied either Qing Dai  ointment or vehicle
ointment topically to each of 2 bilaterally symmetrical psoriatic plaque lesions for 12 weeks (depending on the date of enrollment in the study).

MAIN OUTCOME MEASURES: The outcomes were assessed using the following criteria: the sum of erythema, scaling, and induration scores and the clearing percentage of the target plaque lesion assessed by 2 blinded observers.

RESULTS: Significant reductions in the sum of scaling, erythema, and induration scores (P < .001) (mean score, 6.3 after Qing Dai  treatment vs 12.8 in control subjects) and plaque area percentage (P < .001) (mean percentage, 38.5% after Qing Dai  treatment vs 90% in controls) were achieved with topical application of Qing Dai  ointment. Approximately 31 of 42 patients (74%) experienced clearance or near clearance of their psoriasis in the Qing Dai ointment-treated lesion.

CONCLUSION: Topical Qing Dai  ointment was a novel, safe, and effective therapy for plaque-type psoriasis.
Arch Dermatol. 2008 Nov;144(11):1457-64.

 

Oral Chinese herbal medicine in combination with phototherapy for vitiligo: A systematic review and meta-analysis of randomized controlled trials

The current evidence demonstrates that oral Chinese Herbal Medicine in combination with narrowband UVB phototherapy has a superior effectiveness in terms of repigmentation rate of vitiligo when compared to NB-UVB alone. ”

Complementary Therapies in Medicine, Volume 26, June 2016, Pages 21-27. Yu-Jung Chen, Yi-Yang Chen, Ching-Yuan Wu, Ching-Chi Chi

Highlights:

  • Oral CHM combines NB-UVB is superior to NB-UVB alone in repigmentation rate.
  • Tribulus terrestris and Psoralea corylifolia are the top 2 single herbs in each formula.
  • Most of the adverse effects from oral CHM combined NB-UVB were mild and tolerable.

Aims: The aim of this study was to assess the effects of oral Chinese herbal medicine (CHM) combined with phototherapy for vitiligo.

Methods: We undertook a meta-analysis of relevant randomized controlled trials (RCTs) and searched eight bibliographic databases from inception to December 2015.

Results: A total of 5 RCTs with 513 participants which assessed the efficacy of oral CHM in combination with narrow-band ultraviolet B (NB-UVB) in treating vitiligo were included. The meta-analysis revealed a superior effectiveness in those receiving oral CHM plus NB-UVB when compared to phototherapy alone (risk difference 0.22, 95% confidence interval 0.14 to 0.29, P < 0.00001). Only mild adverse events were reported without significant renal or liver function impairment.

Conclusions: The current evidence demonstrates that oral CHM in combination with NB-UVB has a superior effectiveness in terms of repigmentation rate of vitiligo when compared to NB-UVB alone. Although the overall quality of included trials was low, oral CHM in combination with NB-UVB may be an alternative option of treatment for vitiligo. As to safety, there were only mild adverse events reported without significant renal or liver function impairment. However, there is limited available evidence of long-term follow-up and poor methodological quality of the available trials. Well-designed RCTs of adequate length and sample size that include life quality as an outcome are warranted.

 

Herbal medicine Eriobotrya japonica formula for acne vulgaris: A systematic review

There is some evidence that Eriobotrya japonica Formula (EJF) can decrease inflammatory lesions in acne vulgaris with fewer adverse effects in the short-term. However, due to methodological limitations of the included trials, results on clinical efficacy should be interpreted with caution.”

Suzi Shu Yi Mansu, Meaghan Coyle, Kaiyi Wang, Brian May, Anthony Lin Zhang, Charlie Chang Li Xue

https://doi.org/10.1016/j.hermed.2017.09.001

Acne vulgaris is a common inflammatory skin condition characterized by comedones. Current pharmacotherapies are effective but are associated with adverse events (AEs) such as mood disorders and antibiotic resistance. The Eriobotrya japonica Formula (EJF) contains six herbs commonly used in traditional Chinese medicine clinical practice. This paper evaluates the experimental evidence and clinical efficacy of EJF for acne vulgaris.

Searches of 11 English and Chinese databases were conducted to identify eligible randomized controlled trials (RCTs). PubMed was searched for experimental evidence of herbs included in EJF. Meta-analyses were performed to analyse the clinical effects of EJF compared to pharmacotherapies.

Ingredients in EJF were reported to have an effect on inhibiting TNF-α, PPAR-γ and IL-6 cytokines. Some also inhibited P. acnes and had anti-androgenic and anti-lipogenic effects. There were 15 RCTs included in the clinical review. The number of people achieving a clinical improvement based on lesion count was higher with EJF than pharmacotherapies. The effective rate of EJF was greater than antibiotics and benzoyl peroxide (2 studies, RR: 1.47 [1.23, 1.77], I2 = 0%), and antibiotics with topical supplements (2 studies, RR: 1.77 [1.18, 2.67], I2 = 0%). There were 107 mild AEs reported in 7 trials, 33 in the intervention groups and 74 in the control groups. No serious AEs were reported.

There is some evidence that Eriobotrya japonica Formula (EJF) can decrease inflammatory lesions in acne vulgaris with fewer adverse effects in the short-term. However, due to methodological limitations of the included trials, results on clinical efficacy should be interpreted with caution.

 

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