Systematic Evaluation On The Effectiveness Of Treating Herpes Zoster With Longdan Xiegan Decoction. Appendix: Clinical Observation Upon 36 Cases Of Liver Damp Heat Type Herpes Zoster.

Purpose Longdan Xiegan decoction is a common prescription for the treatment of liver damp heat type herpes zoster with a satisfactory clinical effect, which agreed well in the previous reports from theoretical studies in the literature. Due to the lack of a practical evidence in evaluating the effectiveness and safety of Longdan Xiegan decoction, more evidence-based medicine are needed to prove it. This paper is intended to make a systematic evaluation and quality rating of the clinical effectiveness upon the RCT literature of treating herpes zoster with Longdan Xiegan decoction in the past 20 years, which is based on the worldwide-known syndrome- oriented medical method, in order to provide supplementary evidence for Traditional Chinese Medicine clinical decision-making. At the same time, 36 cases of small sample cases were collected for randomized controlled clinical observation.Method 1. Systematic evaluation section: According to the recommended System evaluation method in the international Cochrane collaboration Handbook 5.1.0 to evaluate the quality of all the random or semi-random controlled trials about treating herpes zoster with Longdan Xiegan Tang,which is published or unpublished all over the world. Using the computer to retrieval the databases from 1995 to 2015,such as National Library of Medicine(Pub Med), UK Cochrane Library randomized controlled trials database, EMBASE, and Chinese biomedical literature database(CBM), VIP Chinese science and technology periodical database(VIP), Chinese knowledge infrastructure(CNKI)andWanfang Chinese academic meeting dissertation ful-text database related literature and search all the library books and documents of Yunnan university of traditional Chinese medicine by hands. Literature quality assessment and data extraction were included in the study, and the data were analyzed by using Rev Man 5.0 statistical software provided by Cochrane collaboration network. 2. Clinical observation section The 72 patients of liver damp heat type herpes zoster, who have met the inclusion criteria were randomly divided into experimental group and control group with 36 cases in each group. The experimental group was treated with Longdan Xiegan decoction, and Aciclovir ointment for external use,the control group was given the conventional treatmen with 10 days as a course of treatment. The two group of patients were recorded the VAS score and symptom classification quantitative score in newly diagnosed and treated for 10 days. At the end of treatment use the SPSS20.0 statistical software for statistical analysis and evaluation of the overall efficacyResult 1. Systematic evaluation section In this study, a total of 241 articles were consulted, and 11 articles, with a total of 1100 patients were finally involved according to the literature quality evaluatio n and Jadad score standard, which were all low quality studies. Meta analysis showed that the total effective rate of the experimental group is quite different from the control group in comparison, the over effect RR=5.06, with its 95% confidence interval ranging from 2.84 to 9.02, and its P value equals 0.000. With regard to the three main clinical evaluation indicators of the pain time, blister and scabby time, traditional Chinese medicine group was obviously shotter than routine western medicine treatment. However, due to the low quality of literature and the publication bias, a higher quality of clinical research for confirmation will still be needed in the future. 2. Clinical observation section In accordance with the inclusion criteria of 72 patients, shedding 5 cases, of which the treatment group accounted for 2 cases,the control group accounted for 3 cases. After observation, statistics and analysis, the total effective rate of the two group was 85.29 percent and 75.76 percent, its P value equals 0.017. There was significant difference between the treatment group and control group(P < 0.05),with regard to the lesional skin symptoms score, visual simulation score and a time to pain, blister, and crusting.Conclusion 1. Systematic evaluation section 1. Longdan Xiegan Decoction in treating herpes zoster is effective, can shorten the pain, blister stopping and scabbying time and improving the clinical efficacy by comparing with conventional treatment of routine western medicine. 2.Due to the small amount samples of the included studies, the uniformed efficacy of the criteria, and the low method of quality evaluation, the interpretation of the results of this evaluation should be taken seriously. 3. In order to confirm the efficacy of Longdan Xiegan Tang in the treatment of herpes zoster, the further more high-quality trials are still necessary,and the tests should be evaluated by large samples,multi-center and more rigorously designed. 2. Clinical observation section Relatively favorable effectiveness can be seen in both groups of treating liver damp heat type of herpes zoster patients.But in improving the visual analogue score, symptoms scores and shortting the timing, the treatment group is significantly better than simple oral medicine group. As showing the high compliance of patients, no apparent adverse reactions, the method of Chinese material medica is rewarded to be promoted and applicated in clinical.