Table2_Combination of traditional Chinese medicine and standard biomedical treatment for rosacea: a systematic review and a meta-analysis.XLSX

BackgroundA combination of standard biomedical treatment and traditional Chinese medicine (TCM) has been suggested as a therapeutic approach for rosacea that may significantly lower the recurrence rate and clinical symptom scores. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the impact of this combination treatment on clinical symptom and TCM syndrome scores, as well as on the scores of the Dermatology Life Quality Index (DLQI), erythema index (EI), and interleukin 37 (IL-37) levels in patients with rosacea.
MethodsThe PROSPERO registration number for the study is CRD42023472737. We systematically searched the PubMed, Embase, Web of Science, China National Knowledge Infrastructure Wanfang Database, China Biomedical Medicine database (CBM), and the VIP information resource integration service platform (cqvip) databases for RCTs (published from the beginning to September 2023, regardless of the language used) that compared the traditional Chinese medicine and standard biomedical treatment combination treatment to conventional anti-rosacea treatments. Our primary outcomes comprised the clinical symptom and TCM syndrome scores, and the scores of Dermatology Life Quality Index, erythema index, and IL-37 levels. We used a random-effects model to evaluate the pooled data.
ResultsWe identified 260 studies. Of these, 13 eligible studies were employed for analysis (N = 1,348 participants). Compared with other anti-rosacea treatments, the TCM and standard biomedical treatment combination treatment yielded an improved mean reduction in the clinical symptom score −2.24% [95% CI (–3.02 to −1.46), p < 0.00001], TCM syndrome score −4.42 [95% CI (–5.33 to −3.50), p < 0.00001], and the score of DLQI of −2.55 [95% CI (–3.73 to −1.36), p < 0.00001], EI of −151.97 [95% CI (–276.59 to −27.36), p < 0.00001], and IL-37 level −4.23 [95% CI (–4.95 to −3.51), p = 0.854], as well as in the overall effective rate risk ratio (RR) = 1.25 [95%CI (1.18, 1.32), p = 0.994] and the recurrence rate = 0.27 [95%CI (0.15, 0.46), p = 0.297].
ConclusionThe TCM and standard biomedical treatment combination treatment can provide a better outcome, including a reduction in the TCM syndrome and clinical symptom scores, and in the scores of DLQI, EI, and IL-37. Hence, this combination is a viable and more effective therapeutic approach for rosacea. However, these results should be considered cautiously because of uncertain evidence and the low quality of the study reports considered in this meta-analysis.
Systematic Review Registration:website, identifier CRD42023472737.

背景
有研究提出将标准西医治疗与中医药（Traditional Chinese Medicine, TCM）联合应用作为玫瑰痤疮的治疗方案，该方案或可显著降低复发率并改善临床症状评分。本研究针对随机对照试验（randomized controlled trial, RCT）开展系统评价与Meta分析，旨在评估此种联合治疗对玫瑰痤疮患者临床症状评分、中医证候评分、皮肤病生活质量指数（Dermatology Life Quality Index, DLQI）评分、红斑指数（erythema index, EI）以及白细胞介素37（interleukin 37, IL-37）水平的影响。

方法
本研究的PROSPERO注册编号为CRD42023472737。我们系统检索了PubMed、Embase、Web of Science、中国知网、万方数据知识服务平台、中国生物医学文献数据库（CBM）以及维普资讯整合服务平台（cqvip）自建库至2023年9月发表的、对比中医药联合标准西医治疗与常规玫瑰痤疮治疗方案的RCT研究，不限发表语言。本研究的主要结局指标包括临床症状评分、中医证候评分、皮肤病生活质量指数评分、红斑指数以及白细胞介素37水平。我们采用随机效应模型对合并数据进行分析。

结果
本研究共检索到260项研究，其中13项符合纳入标准的研究被纳入分析，共纳入1348名受试者。与其他玫瑰痤疮治疗方案相比，中医药联合标准西医治疗可显著提升各项指标的平均改善幅度：临床症状评分平均降低2.24% [95%置信区间（CI）：-3.02 ~ -1.46，p < 0.00001]，中医证候评分平均降低4.42 [95%CI：-5.33 ~ -3.50，p < 0.00001]，皮肤病生活质量指数评分平均降低2.55 [95%CI：-3.73 ~ -1.36，p < 0.00001]，红斑指数平均降低151.97 [95%CI：-276.59 ~ -27.36，p < 0.00001]，白细胞介素37水平平均降低4.23 [95%CI：-4.95 ~ -3.51，p = 0.854]；同时可提升总体有效率[风险比（RR）=1.25，95%CI：1.18 ~ 1.32，p = 0.994]，并降低复发率[风险比（RR）=0.27，95%CI：0.15 ~ 0.46，p = 0.297]。

结论
中医药联合标准西医治疗可显著改善玫瑰痤疮患者的各项临床结局指标，包括降低中医证候评分与临床症状评分，以及皮肤病生活质量指数、红斑指数与白细胞介素37水平，因此该联合治疗方案是一种可行且更为有效的玫瑰痤疮治疗手段。但鉴于本Meta分析纳入的研究证据尚不充分且报告质量偏低，故对本研究结果需审慎解读。

系统评价注册信息：网站，标识符CRD42023472737。