The Selection Rule And Meta-analysis Of Herb Medicine In External Treatment Of Eczema

ObjectiveExternal therapy of traditional Chinese medicine has a long history. It is effective in the therapy of eczema. In addition, it is convenient and long-term use and less adverse reaction. In recent years, The reports of Chinese medicine external treatment of eczema is increasing year by year. Chinese medicine external treatment can effectively improve the skin rash, itching and other symptoms. In order to evaluate the efficacy of the external therapy of traditional Chinese medicine and sum up the selection rule of medicine in treating eczema, we systematically review the external therapy of traditional Chinese medicine in eczema. The result will provide evidence-based basis for traditional Chinese medicine external treatment of eczema and guide the clinical therapy.Using the keyword "eczema" or "eczema"to search the database. The searching database include The Cochrane Central Register of controlled trials, PubMed(1966-), The Chinese biomedical literature database (1979-), China hownet (1979-), VIP database (1989-) and Chinese clinical trial Register (ChiCTR).The retrieval time is from2003to2013. To evaluate the efficacy of the external therapy of traditional Chinese medicine in treating eczema, use the RevMan5.2.0to Meta analysis the randomized controlled trials of the external therapy of traditional Chinese medicine in treating eczema. Analyze the heterogeneity of the literature in clinical heterogeneity and method. If the literature research with homogeneity (P>0.05, I2<50%), use the fixed effects model to analyze, otherwise use the random effects model. Use OR as count data and the interval estimation use95%CI. Summarize the rules of the prescription with TCM inheritance system Results1.Meta analysis:Of which13articles,1paper is from PubMed data base,1paper is thesis and11papers are from journals. The maximum sample size is224, the minimum sample size of is42.13RCTs were adopted, including1372cases. The results are①heterogeneity analysis:Because of the fixed effect model with effect size heterogeneity is small (P=0.18>0.05, I2=26%<50%), so we adopt the fixed effect model to merge.②efficacy analysis:the combined OR is0.44and95%confidence interval is [0.33,0.60]. The OR is statistically significant, indicating that the efficacy of traditional Chinese medicine external treatment of eczema is more effective than the control group.③safety Analysis:Only two RCTs reported adverse reactions, seven cases in control group and2cases in TCM group.④sensitivity analysis:there was small different in OR when we use the fixed effects model and the random effects model.⑤assessment of publication bias:the distribution of funnel plot is asymmetric.2. The selection rule of herb medicine in external treatment of eczema: Detoxification and Insecticidal herbs are widely used in the treatment of eczema. Result of literature summary are①The chinese herb medicine commonly used in external treatment of eczema are including Sophorae Flavescentis, phellodendron, Fructus Cnidii, Dictamni, Kochia scoparia etc.②The common Combinations are Sophorae Flavescentis with Kochia scoparia, Fructus Cnidii with Kochia scoparia, Kochia scoparia with phellodendron.GonclusionThe external therapy of traditional chinese medicine is an effective method in treating eczema without serious adverse reaction. The literature of this Systematically review are low quality, most of the literature without random grouping method explicitly or not enough scientific method, all the experiments are not using randomization concealment and blinding, and only a small part of the literature describes the withdrawal and exit number and reason. The credibility of the conclusion was reduced, because of the publication bias and the low quality literature.