Add-On Effect of Chinese Herbal Medicine Bath to Phototherapy for Psoriasis Vulgaris: A Systematic Review

Abstract

Psoriasis vulgaris is the most common form of psoriasis. Phototherapy has been proven effective for psoriasis, but side effects have become a concern. Chinese herbal medicine (CHM) bath combined with phototherapy has been used in clinical settings, but the additional benefit requires evaluation. This review aims to evaluate the additional benefit and safety of adding CHM bath to phototherapy for psoriasis vulgaris. Cochrane library, PubMed, Embase, CNKI, and CQVIP were searched from their inceptions to 6 August 2012. Randomized controlled trials (RCTs) comparing CHM bath plus phototherapy to phototherapy alone for psoriasis vulgaris were included. Data was analyzed using Review Manager 5.1.0. Thirteen RCTs were included in the review, and eight were included in the meta-analysis. Meta-analysis showed higher efficacy of CHM bath plus phototherapy when compared with phototherapy alone in terms of PASI 60 (RR 1.25; 95% CI: 1.18–1.32). Mild adverse events were reported in ten studies, but these could be alleviated by reducing UV dosage or applying emollient. In conclusion, CHM bath appears to be a beneficial and safe adjunctive therapy to phototherapy for psoriasis vulgaris. However, these results should be interpreted with caution due to the low methodological quality of the included studies.

Auricular acupressure as a complementary therapy for psoriasis vulgaris: study protocol for a multicenter randomized controlled trial

“…Consequently, to find more effective therapeutic methods to prevent the return of disease activity many individuals have turned their attention to treatments such as TCM. Currently, clinical experience has been accumulated for TCM treatment of psoriasis [13][14][15][16][17][18][19][50][51][52]. Most significantly, as a type of TCM, acupuncture has shown respectable efficacy and is broadly accepted internationally.…”

“…A meta-analysis reported that Chinese medicine was effective for psoriasis vulgaris since it is noninferior to acitretin and it could produce add-on effects when combined with acitretin, as well as reducing the acitretin-induced adverse events [14]. Chinese medicine combined with narrowband ultraviolet B for treating psoriasis also showed improved efficacy [15,16]. Herbal formulae or plant extract topical management were analyzed in other systematic reviews, which showed that topical herbal formulae or plant extracts could improve overall clinical symptoms [17][18][19].…”

Our Choice: study protocol for a randomized controlled trial for optimal implementation of psoriasis treatment by the integration of Chinese and western medicine

“…It is based on a completely theoretical system, which has evolved progressively in response to technological developments and lifestyle changes. A series of systematic reviews of TCM in clinical practice have indicated that this approach is effective in the treatment of psoriasis [4][5][6][7][8][9][10], and clinical and experimental data indicate that TCM can modify psoriasis by antagonizing or regulating interleukin (IL) and the IL-23/ IL-17 axis to inhibit the main causal pathways [11].…”

Traditional Chinese Medicine Use among Patients with Psoriasis in Taiwan: A Nationwide Population‐Based Study

“…It has been commonly used for dermatitis [13], gastrointestinal disease [14], rheumatoid arthritis [15], diabetic mellitus [16, 17], gynecological disorder [18], and cancer [19, 20] patients. Previous studies showed that CHM plus acitrerin had add-on effect [21] and Chinese herbal bath combined with phototherapy was superior to phototherapy alone [22] for psoriasis. Topical application of Lindioil, extract of Qing-dai (Indigo Naturalis; Baphicacanthus cusia (Nees) Bremek, Polygonum tinctorium Aiton, Isatis indigotica Fortune ex Lindl.)…”