Soojin Park , Jieun Lee , Seoyeon Jun , Kyuseok Kim
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引用次数: 0
Abstract
Introduction
Alopecia areata (AA) is an autoimmune disease that degrades patients' quality of life and adversely affects mental health. Since steroid therapy (ST) has limited efficacy and a risk of recurrence, East Asian herbal medicine (EAHM) combined with ST has been suggested as an alternative treatment. Many randomized controlled trials (RCTs) have been conducted on the efficacy of EAHM combined with ST in AA treatment; however, the efficacy of EAHM combined with ST and the treatment effects of ST alone have not yet been compared. This systematic review and meta-analysis aimed to evaluate the effectiveness and safety of the combination of ST and EAHM compared to ST alone in the treatment of AA.
Methods
We searched 10 databases: PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang, KoreaMed, Korean Medical Database (KMBASE), Korean Studies Information Service System (KISS), ScienceON, and Korea Science. Bias was independently assessed using Cochrane Risk of Bias tool (RoB 2.0), and meta-analysis was conducted using Review Manager (Revman) 5.4.1 with the application of random-effect models. The primary outcome was defined as the cure rate.
Results
Fifteen studies were selected, and 1,119 participants were included in the study. According to the results of the meta-analysis, a higher cure rate (RR 1.50, 95 % CI : 1.31, 1.71, P<0.00001, I2=0 %), a higher total efficacy rate (modified Total Efficacy Rate 1 (mTER1); (RR 1.10, 95 % CI: 1,06, 1.15, P < 0.00001, I2=0 %), modified Total Efficacy Rate 2 (mTER2); (RR 1.09, 95 % CI: 1.03, 1.16, P = 0.006, I2=0 %)), and a lower recurrence rate (RR 0.28, 95 % CI: 0.16, 0.48, P<0.00001, I2=0 % %) were confirmed in the ST with EAHM group than in the ST group. Low IFN-γ levels and high IL-10 levels were identified in the ST combined with EAHM group. No serious adverse effects were observed during treatment.
Conclusions
Compared to ST alone in AA treatment, the combination treatment of ST and EAHM may effectively and safely increase the cure and total efficacy rates and may lower the recurrence rate. However, to strengthen the basis of this review, higher quality RCTs must be performed.
期刊介绍：
The European Journal of Integrative Medicine (EuJIM) considers manuscripts from a wide range of complementary and integrative health care disciplines, with a particular focus on whole systems approaches, public health, self management and traditional medical systems. The journal strives to connect conventional medicine and evidence based complementary medicine. We encourage submissions reporting research with relevance for integrative clinical practice and interprofessional education.
EuJIM aims to be of interest to both conventional and integrative audiences, including healthcare practitioners, researchers, health care organisations, educationalists, and all those who seek objective and critical information on integrative medicine. To achieve this aim EuJIM provides an innovative international and interdisciplinary platform linking researchers and clinicians.
The journal focuses primarily on original research articles including systematic reviews, randomized controlled trials, other clinical studies, qualitative, observational and epidemiological studies. In addition we welcome short reviews, opinion articles and contributions relating to health services and policy, health economics and psychology.
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