Table_1_Tanshinone Capsules Combined With Prednisone for Facial Seborrheic Dermatitis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.docx

BackgroundFacial seborrheic dermatitis (FSD), also called facial seborrheic eczema, is a common disease affecting both male and female patients worldwide. Tanshinone is the main bioactive component extracted from the Traditional Chinese Medicine Salvia miltiorrhiza Bunge, which is widely used in treating skin inflammatory diseases. It is necessary to evaluate the clinical evidence for tanshinone capsule treatment of FSD. This study aimed to evaluate the safety and effectiveness of tanshinone capsules combined with prednisone in the treatment of facial seborrheic dermatitis and to provide evidence for clinical practice.MethodsStudies were searched in PubMed, the Cochrane Library, the Chinese Biomedical Literature Database, the China National Knowledge Infrastructure, the Chinese Scientific Journal Database, and WanFang Database before October 2021. We also searched for randomized controlled clinical trials (RCT) of tanshinone capsules combined with prednisone on facial seborrheic dermatitis. The meta-analysis was conducted according to the guidelines of the Cochrane Handbook. Two reviewers regulated the research selection, data extraction, and risk of bias assessment, respectively, and a third reviewer was used for consulting when necessary. Review Manager Software 5.3 was used for meta-analysis.ResultsA total of 10 RCTs with 916 participants were included. Nine studies reported total effectiveness, five studies reported symptom score, seven studies reported adverse events, and four studies reported recurrence rate. The duration of treatment was 4 to 8 weeks. Combination therapy showed better clinical effects compared to the prednisone (OR: 5.82; 95% CI: 3.53, 9.59; p < 0.00001). Combination therapy could repair skin lesions (MD: −0.40; 95% CI: −0.51, −0.30; p < 0.00001), reduce skin erythema (MD: −0.58, 95% CI: −0.67, −0.49; p < 0.00001), relieve skin itch (MD: −0.70; 95% CI −0.77, −0.63; p < 0.00001), and desquamation score (MD: −0.64; 95% CI: −0.71, −0.56; p < 0.00001). Furthermore, combination therapy could reduce adverse events (OR: 0.46; 95% CI: 0.26, 0.84; p = 0.01) and control recurrence rate (OR: 0.22; 95% CI: 0.13, 0.36; p < 0.00001).ConclusionsCompared with prednisone, tanshinone capsules combined with prednisone may be effective in the treatment of facial seborrheic dermatitis. However, due to the high risk and ambiguity of bias in the included trials, the conclusion of this study must be interpreted carefully.

背景：面部脂溢性皮炎（FSD），亦称面部脂溢性湿疹，是全球范围内男女患者均易罹患的常见病症。丹参酮是从传统中药丹参（Salvia miltiorrhiza Bunge）中提取的主要生物活性成分，广泛用于治疗皮肤炎症性疾病。评估丹参酮胶囊治疗FSD的临床证据是必要的。本研究旨在评估丹参酮胶囊联合泼尼松治疗面部脂溢性皮炎的安全性和有效性，并为临床实践提供证据。方法：在2021年10月之前，我们对PubMed、Cochrane图书馆、中国生物医学文献数据库、中国知网、中国科学期刊数据库和万方数据库进行了研究搜索。我们还搜索了丹参酮胶囊联合泼尼松治疗面部脂溢性皮炎的随机对照临床试验（RCT）。根据Cochrane手册的指南进行了荟萃分析。两名审稿人分别负责研究选择、数据提取和偏倚风险评估，必要时第三名审稿人进行咨询。使用Review Manager Software 5.3软件进行荟萃分析。结果：共纳入10项RCT，涉及916名参与者。9项研究报告了总有效率，5项研究报告了症状评分，7项研究报告了不良事件，4项研究报告了复发率。治疗持续时间为4至8周。联合疗法与泼尼松相比，具有更好的临床效果（OR：5.82；95% CI：3.53，9.59；p < 0.00001）。联合疗法可修复皮肤病变（MD：−0.40；95% CI：−0.51，−0.30；p < 0.00001），减少皮肤红斑（MD：−0.58，95% CI：−0.67，−0.49；p < 0.00001），缓解皮肤瘙痒（MD：−0.70；95% CI：−0.77，−0.63；p < 0.00001）和脱屑评分（MD：−0.64；95% CI：−0.71，−0.56；p < 0.00001）。此外，联合疗法可减少不良事件（OR：0.46；95% CI：0.26，0.84；p = 0.01）和控制复发率（OR：0.22；95% CI：0.13，0.36；p < 0.00001）。结论：与泼尼松相比，丹参酮胶囊联合泼尼松可能在治疗面部脂溢性皮炎方面有效。然而，由于纳入试验的高风险和偏倚的不确定性，本研究结论的解读必须谨慎。