Herpes zoster (HZ) is a common infection in individuals with immunocompromised immune systems, such as Acquired Immune Deficiency Syndrome (AIDS) patients. Traditional Chinese Medicine (TCM) has been used widely in clinical practice for HZ, which remains not supportive from evidence. This systematic review aimed to evaluate the effectiveness and safety of TCM in treating HIV-associated HZ.
Eight electronic databases, including CNKI, Wanfang, VIP, SinoMed, WHO ICTRP, CENTRAL, PubMed, and clinicaltrials.gov, were searched for randomized controlled trials (RCTs) testing TCM in treating HIV-associated HZ. Data were extracted on citations, study design, interventions, and outcomes. Cochrane risk of bias tool 2.0 were used for quality evaluation. We performed meta-analyses by Revman 5.3 software. Effect estimates were presented as risk ratio (RR) for dichotomous data and mean difference (MD) for continuous data with their 95% confidence interval (CI).
Twelve RCTs (644 patients) were included, majority of them had high or unclear risk of bias in terms. The result of meta-analysis showed that, pain intensity (VAS 0-5) in Chinese herbal medicine (CHM) group was lower than it in drugs group (MD=-0.87, 95%CI [-1.69, -0.04], 2 trials, n=93). Duration of herpes related pain (days) of patients in combination group was shorter than those in drugs group (MD=-9.19, 95%CI [-16.73, -1.65], n=144). The incidence of postherpetic neuralgia (PHN) in combination group was lower than it in drugs group (RR = 0.49, 95% CI [0.25, 0.99], n=202). As for cure rate (defined as complete absence of pain and herpes), 2 trials showed that CHM was better than drugs (RR = 1.58 , 95% CI [1.13, 2.22], n=93), 5 trials showed combination treatment was better than drugs (RR = 1.40, 95% CI = [1.08, 1.82], n=224). Cure rate in acupuncture group was more improved than that in drugs group (RR=1.99, 95%CI=[1.18, 3.36], n=120). Four trials reported adverse effects which found no serious adverse events occurred.
Chinese herbal medicine and acupuncture demonstrate more benefits than drugs in relieving pain, improving cure rate and reducing incidence of PHN for HIV-associated HZ. However, given to the limited data and various TCM therapies, the conclusions need to be verified in future trials.
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