| Background:Neurodermatitis (ND) also called lichen simplex chronicus, is a commonly seen chronic skin disease. This disease is associated with a dysfunctional nervous system, as well as an imbalance between the excitation and inhibition process of the cerebral cortex. This skin disorder is characterized by a self-perpetuating scratch-itch cycle, and constant scratching causes thick, leathery, brownish, lichenified skin. Nowadays, there is a rise in the usage of Traditional Chinese Medicine (TCM) in neurodermatitis treatment. TCM is effective in treating neurodermatitis, with minimal side effects.Objective:Evidence-based medicine (EBM) was used to evaluate the curative effect of Traditional Chinese Medicine in the treatment of neurodermatitis. The efficacy of Chinese medicine and Western Medicine for the treatment of neurodermatitis is being assessed objectively and fairly through the usage of Meta-analysis in this systematic review.Data and Method:Using search engines to retrieve articles in strict accordance with the inclusion and exclusion criteria from China National Knowledge Infrastructure database (CNKI), WANFANG database, VIP database, China Biology Medicine database (CBM), PubMed search until 31st December 2015. According to Cochrane Reviewer Handbook for each of included study, risk of bias assessment (assessments of methodological quality) and quality assessment are processed using 6 domain tools which include Random sequence generation; Allocation concealment; Blinding (object of study, Treatment plan, outcome measure, Assessments should be made for each main outcome or class of outcomes); Incomplete outcome data (Assessments should be made for each main outcome or class of outcomes);Selective reporting; Other sources of bias. Cochrane collaboration network is required to analysis of quality of evidence by using RevMan5.3 software, the ratio of Peto method (odds ratio),95% confidence interval are calculated. Based on the chi-squared (?2) statistic and the test for homogeneity. Meta-analysis using fixed effects model is assessed if there is good homogeneity (P>0.1), random effects model is used if there is low homogeneity (P< 0.1).Results:A total of 175 related literatures were retrieved. According to the standard therapeutic index stated in ?Guiding principle of clinical research on new drugs of Chinese Medicine? (The Ministry of Health of the People's Republic of China, 1997Edition), ?Guiding principle of clinical research on new drugs of Chinese Medicine? 1993edition,12 qualified randomized controlled study, containing a total of 1182 subjects were selected. Most of the data are grade B, parts of were grade C. After collecting data and systematic evaluation of Meta-analysis, the result for clinical efficacy of traditional Chinese medicine and Western Medicine OR 2.66; 95% CI[1.58,4.50],Z=3.66,P=0.0002, shows that the data is significantly difference, which means Traditional Chinese medicine is more effective than Western Medicine in treating Neurodermatitis; Clinical efficacy of traditional Chinese Medicine+ external bath and Western Medicine OR= 4.33; 95% CI[2.25, 8.35],Z=4.38,P<0.0001 shows that the data is significantly difference, which means Traditional Chinese Medicine+external bath is more effective than Western Medicine in treating Neurodermatitis; Clinical efficacy of traditional Chinese medicine+external use cream and Western Medicine OR=2.72; 95% CI [1.36,5.42]; Z=2.83,P=0.005<0.5 shows that the data is significantly difference, which means Traditional Chinese Medicine+external use cream is more effective than Western Medicine in treating Neurodermatitis; Clinical efficacy of traditional Chinese Medicine+Traditional Chinese Physiotherapy and Western Medicine OR=3.33; 95% CI[1.68,6.60],Z=3.45,P=0.0006 shows that the data is significantly difference, which means Traditional Chinese Medicine+Traditional Chinese Physiotherapy is more effective than Western Medicine in treating Neurodermatitis; The overall efficacy of traditional Chinese medicine treatment for neurodermatitis is better than Western Medicine.Conclusion:Evidence shows that traditional Chinese medicine treatment with is low recurrence rate is better than western medicine treatment for neurodermatitis. The literature quality on Traditional Chinese Medicine treatment of neurodermatitis is low. There are many methodological defects which affect the reliability and authenticity of research results. Higher quality of complete clinical trials is expected in future research to further confirm the result and consistency of this study so as to provide better clinical evidence. |
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