Efficacy and safety of Chinese herbal medicine for atopic dermatitis: Evidence from eight high-quality randomized placebo-controlled trials

Abstract

Background: The use of Chinese herbal medicine (CHM) for the treatment of atopic dermatitis (AD) has gained attention. This quantitative study systematically evaluated the efficacy and safety of CHM for the treatment of AD in eight high-level clinical trials, resulting in a high level of clinical evidence.Methods: Several databases were searched, including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), the Chongqing VIP Chinese Science (VIP), and Wanfang Database. High-quality randomized controlled trials (RCTs) comparing CHM with placebo were included. The 95% confidence interval (CI) of the risk ratio (RR) was calculated using software (RevMan 5.3) and a meta-analysis was performed. Evidence level evaluation using GRADE Profiler 3.6.Results: In total, 662 patients (322 in the experimental group and 340 in the control group) were included. The response rate of the Eczema Area and Severity Index (EASI) −90 was higher in the CHM group than in the placebo group (RR, 3.72; 95% CI, 1.76 to7.83; p = 0.01). Furthermore, the scoring of atopic dermatitis (SCORAD) (RR, −10.20), body surface area (BSA) (RR, −2.01), surface damage score (RR, −2.25), visual analog scale (VAS) (RR, −1.90), and sleep score (RR, −2.16), improvement of investigator’s global assessment (IGA) (RR, 2.94) improved in the CHM group. The results showed no statistical difference between CHM and placebo (MD, −0.47; 95% CI, −1.30, 0.37; p = 0.27) in improving the Dermatology Life Quality Index (DLQI) or children’s DLQI (CDLQI). There was also no significant difference in the IgE level between the two groups (MD, −62.76; 95% CI, −809.58, 684.05; p = 0.87). However, the adverse events (AEs) rate was slightly higher in patients treated with CHM than in those treated with placebo (RR, 1.42; 95% CI, 1.06–1.90; p = 0.02).Conclusion: CHM improved the size and severity of the skin lesions and sleep quality in patients with AD. Comparing the adverse effects between the two groups, CHM is safe. However, CHM does not improve the quality of life or the patient’s IgE levels.

Factors affecting the use of herbal medicines for weight loss in overweight and obese adolescents

“…Several studies have reported that HM relieves stress and treats anxiety, depression, and suicide ideation (29)(30)(31). In addition, the effects of HM on chronic allergic diseases have been reported by previous studies (32)(33)(34). Furthermore, it has been reported that HM remarkably increases the neuroprotective effect and cognition and learning abilities through the induction and secretion of nerve growth factor (35).…”

Fangji Dihuang formulation ameliorated DNCB-induced atopic dermatitis-like skin lesions by IL-17 signaling pathway: integrating network analysis and experimental validation

“…We use the CB Dock2 online tool for molecular docking (Liu et al, 2022). The CCL17 protein structure can be downloaded from PubChem, and the MOL2 structure files for plant medicinal ingredients can be downloaded from the TCMSP website or PubChem.…”

“…Chinese herbal therapy, as one of the complementary and alternative therapies, has a well-developed theoretical basis. According to several systematic reviews, Chinese herbal therapy can improve the size and severity of skin lesions, as well as sleep quality in AD patients ( Cai et al, 2022 ; Li et al, 2022 ). Fangji Dihuang formulation (FJDHF), recorded in the ‘Synopsis of Golden Chamber’, is composed of five botanical drugs: Stephaniae Tetrandrae Radix, Cinnamomi Ramulus , Rehmanniae Radix, Saposhnikoviae Radix , and Glycyrrhiza uralensis Fisch.…”

The immunomodulatory activity of Orthosiphon aristatus against atopic dermatitis: Evidence-based on network pharmacology and molecular simulations

“…Furthermore, clinical studies have also reported the safety of OA as one of the components of Chinese HM. 18 Unfortunately, to our knowledge, there has yet to be a study investigating the potential of OA in modulating inflammation in AD and explaining the underlying mechanism of its bioactivity. Thus, this study aimed to explore the potential activity of OA against AD by regulating immunoactivity.…”