中药面膜辅助治疗黄褐斑临床疗效Meta分析及用药规律探讨

Meta-analysis of Therapeutic Efficacy of TCM Masque for Chloasma And Investigation on the Regularity of Prescription Selection and Medicine Use

目的:系统评价中药面膜辅助治疗黄褐斑的疗效与安全性,探讨中药面膜中的用药规律,为临床诊疗提供参考。方法:计算机检索中国期刊全文数据库、维普数据库、万方数据库及Pubmed等,收集中药面膜单独或联合常规治疗方法,对比常规治疗方案治疗黄褐斑的随机对照试验(Randomized controlled trials,RCT)研究,依据Cochrane Reviewer Handbook 5.1中文献质量评价条例评价后,采用ReviewManagerSoftware5.3统计软件对数据进行荟萃分析,对临床试验中使用的中药进行频次和药味统计分析。结果:共纳入13项RCT,合计1 036例患者。Meta分析结果显示,试验组患者的总有效率[RR=1.24,95%CI(1.15,1.33),P<0.00001]、两组患者复发率比较[RR=0.23,95%CI(0.10,0.53),P<0.001],结果显示试验组临床有效率高,复发率低,差异具有统计学意义。试验组与对照组在治疗期间均有部分患者有皮肤泛红不适等轻度不良反应,两组比较无统计学意义。删除纳入的13项RCT中的重复方剂后,共纳入10首方剂,共包含29味药,药材出现总频次为94次。其中,使用频次最高的药味主要是白芷、茯苓、当归、红花、白芨、三七、白附子等,以活血、清热类药物使用频率最多,药材性味以辛、甘、苦三种为主。结论:中药面膜辅助治疗黄褐斑临床疗效明确,复发率低,用药以活血及清热药为主。

Objective To systematically evaluate the efficacy and safety of TCM mask for treatment of chloasma, to investigate the rules of drugs used in TCM masks. Methods Retrieved from CNKI,VIP, Wanfang Database, Pubmed, etc,randomized controlled trials(RCT) about clinical efficiency and adverse drug reactions of chloasma in TCM mask alone or combined with conventional drugs(test group) vs. conventional treatment(control group) in the treatment of chloasma were included. Metaanalysis was conducted by using Review Manager Software 5.3 after data extraction of studies were evaluated with Cochrane Reviewer Handbook 5.1.0.Frequency statistics were conducted among included prescriptions. Results A total of 13 RCTs were included, totaling 1036 patients. Meta-analysis showed that the clinical effective rate of patients in the experimental group [RR=1.24, 95% CI(1.15, 1.33), P<0.00001], the recurrence rate of the two groups was compared [RR=0.23, 95% CI(0.10,0.53), P<0.001] were significantly better than the control group, and the difference was statistically significant. Some adverse drug reactions happened in the experimental group and the control group during the treating time.There were 10 prescriptions were collected after the repeated prescriptions were deleted.Above prescriptions were add up by statistical analysis;there were 29 ingredients in the clinical studies,and the total frequency for these drugs is 94. The most frequently used medicinal ingrediants are Dahurian angelica, Poria cocos, Angelica sinensis, safflower, Bletilla striata, Panax notoginseng, rhizoma typhonii, etc,and the higher frequency of the ingredients was blood circulation and heat-clearing drugs, and the medicinal properties are symplectic, sweet and bitter. the Lord. Conclusion The clinical efficacy and recurrence rate of Chinese medicine mask in the treatment of chloasma is clear.The main drugs are blood circulation and heat-clearing drugs.