Efficacy And Safety Of External Treatment Of Traditional Chinese Medicine For Chloasma:A Network Meta-analysis

ObjectiVeat present,there are many literatures about the curative effect of external treatment of traditional Chinese medicine for chloasma.This paper studies the curative effect and safety of external treatment of traditional Chinese medicine for Chloasma by using the method of network meta-analysis,and sorts the probability of different intervention measures to screen out the best treatment scheme,so as to provide reference and basis for the selection of clinical treatment scheme and provide reference for the clinical application of external treatment of traditional Chinese medicine evidence for scientific standardization.Methodsaccording to the research objectives,the retrieval strategies were made.The Chinese knowledge network database(CNKI),Wan Fang DATA,VIP,sinomed,Pubmed,Embase and Cochrane library were established in December 2020 literature on the treatment of chloasma.The standards of inclusion and exclusion of documents were formulated.Two evaluators independently and strictly selected the documents according to the standards of inclusion and exclusion,and the extracted data were imported into excel software for sorting,and the documents included were evaluated by revman15.3.Finally,the network meta analysis was carried out by stata16.0 statistical software.Resultsa total of 38 RCTs were included,including 3804 subjects,involving 17 interventions,with clinical efficiency and incidence of adverse reactions as primary and secondary outcome indicators,and odds ratio(or)and 95% confidence interval(CI)as effect indicators.In terms of clinical efficiency,38 studies involved 17 interventions,and the results of direct and indirect comparison between most interventions were comparable,among which: 1.micro acupuncture + TXA / HQ;acupuncture + Vc / Ve / GSH;acupoint catgut embedding + Q1064;acupoint injection + Q1064;acupoint catgut embedding + acupuncture + TXA / HQ;acupuncture + TXA / HQ;acupoint injection + TXA / HQ;micro acupuncture + Q1064 were better than those of TXA or HQ treatment.2.Microneedles +TXA/HQ;facial scraping +Vc/Ve/GSH;acupuncture +Vc/Ve/GSH;acupoint catgut embedding + Q1064;Chinese herbal mask + Q1064;acupoint injection+ Q1064;acupuncture +TXA/HQ;acupoint injection +TXA/HQ;microacupuncture + Q1064;acupoint injection + Chinese medicine mask +Vc/Ve/GSH is superior to the treatment based on Vc/Ve/GSH.3.acupuncture +Vc/Ve/GSH;acupoint catgut embedding plus Q1064;Chinese herbal mask + Q1064;acupoint injection + Q1064 are better than Q1064 laser treatment.4.Microneedle +TXA/HQ;acupuncture+Vc/Ve/GSH;acupoint catgut embedding + Q1064;acupoint injection+ Q1064;acupoint injection +TXA/HQ is superior to Chinese mask+TXA/HQ.5.Microneedle +TXA/HQ;acupuncture +Vc/Ve/GSH;acupoint catgut embedding + Q1064;Chinese herbal mask + Q1064;acupoint injection + Q1064;acupuncture +TXA/HQ;acupoint injection of+TXA/HQ;microacupuncture + Q1064;acupoint injection + facial mask+Vc/Ve/GSH are superior to Chinese herbal mask.6.Acupoint injection + Q1064 and acupoint injection + Chinese herbal mask+Vc/Ve/GSH are superior to Chinese herbal mask +Vc/Ve/GSH.7.There was no significant difference in other intervention measures.In general,combination therapy is better than conventional therapy or single mask therapy.The probability rank is: acupoint injection + Q1064 > acupoint catgut embedding + Q1064 > acupuncture + Vc/Ve/GSH > acupoint injection + TXA/HQ > microneedle + Q1064> acupuncture + TXA/HQ >point injection + Chinese herbal mask + Vc/Ve/GSH > microneedle +TXA/HQ > facial scraping + Vc/Ve/GSH > Chinese herbal mask+Q1064 > regulating acupuncture point catgut embedding +acupuncture +TXA/HQ > Chinese herbal mask + Vc/Ve/GSH > Q1064 >Chinese medicine mask + TXA/HQ > TXA/HQ > Vc/Ve/GSH > Chinese medicine mask.Acupoint injection + Q1064 nm laser is the best treatment scheme.The local inconsistency is not significant,and the stability of the results is acceptable.In terms of incidence of adverse reactions,18 studies involved13 interventions: microneedles+ TXA/HQ,TXA/HQ,Vc/Ve/GSH,acupoint catgut embedding+ Q1064,Q1064,Chinese herbal mask +Q1064,acupoint injection + Q1064,Chinese medicine mask +TXA/HQ,acupoint injection +TXA/HQ,microneedle + Q1064,Chinese herbal mask,Chinese herbal mask + Vc/Ve/GSH,acupoint injection + Chinese herbal mask+ +Vc/Ve/GSH.There was no significant difference in the incidence of adverse reactions among the 13 interventions.ConCIusion1.Compared with the conventional treatment of western medicine alone,external treatment of traditional Chinese medicine combined with conventional treatment can enhance the curative effect,and the safety can be improved.2.Acupoint injection combined with Q1064 is probably the best treatment.Due to the small number of high-quality studies included in this study,more high-quality studies are needed in the future.