| Evidence based medicine(EBM)enables us to select and apply the current best evidence(knowledge)to patients’ clinical problems in clinical medical practice,make scientific diagnosis and treatment decisions,and put them into clinical practice,so as to obtain good effect,improve the level of clinical medicine and achieve our own progress.Through systematic reviews(SR),evidence-based medicine(EBM)combined data from randomized controlled trials that met established inclusion and exclusion criteria for meta-analysis to increase the sample size,improve the efficacy of testing,and reduce bias.Acne can occur in all age groups.With the improvement of living standards,the incidence of acne is increasing year by year.With a certain loss of tolerance,to the patient’s physical and psychological impact,can produce depression,social isolation and suicidal ideation.With the development of traditional Chinese medicine,traditional Chinese medicine has a certain effect in the treatment of acne,may be a way to treat acne.In this study,the effectiveness and safety of tanshinone capsules in the treatment of acne were systematically evaluated and meta-analyzed,providing new evidence for the clinical treatment of acne.Objective:The efficacy and safety of tanshinone capsules in the treatment of acne were systematically reviewed.Methods:Retrieval databases:China National Knowledge Infrastructure(CNKI)、wanfang database、weipu database、Chinese biomedical literature service system(CBM)、 Pub Med 、 Cochrane library 、 EMBASE.Literature screening included patients diagnosed with acne,the intervention measures were tanshinone capsules or tanshinone capsules on the basis of the control group,the control group was placebo,no treatment or conventional western medicine;The outcome indexes were recovery rate,total effective rate,recurrence rate,serum sex hormone level(T,FSH,LH,E2)and adverse reactions.Sebum secretion rate.The types of studies included were randomized controlled trials.Data from included literatures were extracted,meta-analysis was conducted with Rev Man5.3 software,forest maps were drawn,heterogeneity test and sensitivity analysis were conducted,and funnel plots were drawn to detect publication bias when the number of literatures was greater than 9.Subgroup analysis should be carried out when the heterogeneity is too large,and descriptive analysis should be applied when the included literature is insufficient or meta-analysis is not available.Results:A total of 1684 papers were retrieved in this study,and 26 papers were finally included,all of which were published in Chinese.In the case of tanshinone capsules combined with western medicine and western medicine comparison,there were 1062 cases in the treatment group and 1005 cases in the control group.In the case of tanshinone capsules combined with western medicine comparison alone,there were 840 cases in the study group and 814 cases in the control group,all of which met the diagnostic criteria for acne.According to the inclusion and exclusion criteria,a total of 26 literatures were included.Through the observation of the included literatures,the clinical efficacy of tanshinone capsule in the treatment of acne was mainly based on the following two criteria:Obvious effect: skin loss resolution rate: 60% ～ 89%;Effective: skin loss resolution rate of 20% ～ 59%;Invalid: the decay rate of lesions is no more than 19% or the damage increases.(2)curative effect standard ii: cure: rash resolution ≥ 90%,no new rash;Obvious effect: the rash resolution rate is 70% ～ 90%,but there are less than 5 new rashes.Progress: the rash resolution rate is 40% ～ 69%,with less than 10 new rashes.Ineffective: rash resolution is below 40%,or new rash appears continuously with no control of inflammation.Therefore,this study conducted meta-analysis according to different criteria to reduce the heterogeneous sources of literature.1 recovery rateEfficacy criteria oneThe recovery rate of tanshinone capsule combined with western medicine for acne was higher than that of western medicine group [RR=1.88,95%CI(1.58,2.22),Z=7.24,p<0.00001].The recovery rate of tanshinone capsules in treating acne was not significantly different from that of the western medicine group [RR=1.17,95%CI(0.97,1.42),Z=1.62,p=0.10].Efficacy criteria twoThe recovery rate of tanshinone capsule combined with western medicine for acne was higher than that of western medicine group [RR=1.65,95%CI(1.07,2.53),Z=2.28,p=0.02].The recovery rate of tanshinone capsule in treating acne was higher than that of western medicine group [RR=1.45,95%CI(1.03,2.03),Z=2.14,p=0.03].2 total efficiencyEfficacy criteria oneThe total effective rate of tanshinone capsules combined with western medicine in the treatment of acne was higher than that of the western medicine group [RR=1.10,95% CI(1.07,1.13),Z=6.17,p<0.00001].The total effective rate of tanshinone capsules in treating acne was not significantly different from that of the western medicine group [RR=1.03,95%CI(0.98,1.09),Z=1.17,p=0.24].The total effective rate of tanshinone capsules in treating acne was not significantly different from that of western medicine group(oral)[RR=1.04,95%CI(0.98,1.12),Z=1.25,p=0.21].The total effective rate of tanshinone capsules in treating acne was not significantly different from that of western medicine group(external use)[RR=1.00,95%CI(0.91,1.10),Z=0.00,p=1.00].Efficacy criteria twoThe total effective rate of tanshinone capsules combined with western medicine was higher than that of western medicine group [RR=1.05,95% CI(1.01,1.10),Z=2.20,p=0.03].The total effective rate of tanshinone capsules in treating acne was not significantly different from that of the western medicine group [RR=1.07,95% CI(0.98,1.17),Z=1.58,p=0.11].3 the recurrence rateThe recurrence rate of Tanshinone capsule combined with western medicine in the treatment of acne was not statistically significant compared with the western medicine group [RR=0.44,95%CI(0.16,1.26),Z=1.53,P=0.13].4 Incidence of adverse skin reactionsThe incidence of skin adverse reactions of tanshinone capsules combined with western medicine in the treatment of acne was not significantly different from that of the western medicine group [RR=0.96,95%CI(0.66,1.40),Z=0.20,P=0.84].There was no significant difference in the incidence of skin adverse reactions between tanshinone capsules and the western medicine group [RR=0.82,95%CI(0.49,1.36),Z=0.79,P=0.43].5 Serum sex hormone levels 5.1 Testosterone level(T)Tanshinone capsules combined with western medicine reduced testosterone levels better than the western medicine group alone [RR=-14.88,95% CI(-18.05,-11.72),Z=9.21,P<0.00001].5.2 serum luteinizing hormone(LH)There was no statistically significant difference in serum lutein levels between tanshinone capsule and western medicine group in the treatment of acne [RR=0.06,95% CI(-1.69,-1.81),Z=0.07,P=0.94].5.3 follicle-stimulating hormone(FSH)There was no significant difference in follicle-stimulating hormone levels between shenone capsule and western medicine group in the treatment of acne [RR=0.49,95% CI(-0.39,1.38),Z=1.09,P=0.28].5.4 estradiol(E2)The level of estradiol in tanshinone capsules combined with western medicine was not significantly different from that in the western medicine group [RR=1.07,95% CI(-7.73,9.86),Z=0.24,P=0.81].6.According to the inclusion and exclusion criteria,only one document was finally included,so descriptive analysis was conducted.The results showed that tanshinone capsule combined with western medicine was superior to western medicine alone in reducing sebum secretion rate in acne patients.conclusion1.The curative effect of Tanshinone capsule combined with western medicine on acne is better than that of western medicine alone.The combination of drugs can improve the curative effect without increasing the recurrence rate and the incidence of skin adverse reactions2.The efficacy of tanshinone capsule alone in the treatment of acne was better than that of western medicine,while the incidence of adverse skin reactions was lower than that of western medicine.More randomized controlled trials are needed to confirm this conclusion.3.The testosterone level of tanshinone capsule combined with western medicine in the treatment of acne was better than that of western medicine alone.In terms of serum luteinizing hormone level,estradiol level and follicle-stimulating hormone level,tanshinone capsule combined with western medicine in the treatment of acne had no statistical significance compared with the western medicine group alone.4.In terms of sebum secretion rate,only one article was included according to inclusion and exclusion criteria,so descriptive analysis was conducted.The results showed that tanshinone capsule combined with western medicine was superior to western medicine alone in reducing sebum secretion rate in acne patients. |
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