Efficacy and Safety of Qingpeng Ointment for Subacute and Chronic Eczema: A Systematic Review and Meta-Analysis

Abstract

Objective. To evaluate the efficacy and safety of Qingpeng ointment for the treatment of subacute and chronic eczema. Method. Randomized controlled trials (RCTs) on Qingpeng ointment for subacute and chronic eczema were searched on PubMed, the Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang Database, Chinese Biomedical Literature Database, and Chinese Science and Technology Periodical Journal from their inception to 30 November 2020. Quality assessment and data analysis were performed by Review Manager 5.3. Results. A total of 26 RCTs were included. Qingpeng ointment could significantly improve the total efficacy rate (TER) ( $\text{RR}=2.60$ , 95% CI: 2.11 to 3.21, $P<0.00001$ ), reduce the total symptom score (TSS) ( $\text{SMD}=-2.35$ , 95% CI: -3.74 to -0.97, $P=0.0009$ ), and decrease visual analogue scale (VAS) for pruritus ( $\text{MD}=-3.86$ , 95% CI: -4.41 to -3.31, $P<0.00001$ ) compared with the placebo. The TER of Qingpeng ointment was similar to that of topical corticosteroid (TCS) ( $\text{RR}=0.96$ , 95% CI: 0.88 to 1.03, $P=0.25$ ), and the TSSs between Qingpeng ointment and medium or low potency TCS were not significantly different ( $\text{SMD}=-0.05$ , 95% CI: -0.22 to 0.12, $P=0.54$ ). However, Qingpeng ointment was not superior to TCS in reducing VAS score ( $\text{SMD}=0.48$ , 95% CI: 0.00 to 0.96, $P=0.05$ ). In addition, Qingpeng ointment combined with TCS performed better than TCS alone in all three outcomes. For safety, nothing but skin irritative reactions occurred in the Qingpeng ointment group, and its incidence of skin irritative reactions was similar to those of the placebo ( $\text{RR}=1.47$ , 95% CI: 0.61 to 3.55, $P=0.40$ ) and TCS ( $\text{RR}=1.82$ , 95% CI: 0.79 to 4.22, $P=0.16$ ). The combined therapy did not increase the risk of skin irritative reactions ( $\text{RR}=0.69$ , 95% CI: 0.27 to 1.78, $P=0.44$ ). Conclusion. Qingpeng ointment is an effective and safe treatment for subacute and chronic eczema. It is also an add-on treatment to TCS for eczema. However, due to the suboptimal quality of the included studies, more large-sample and high-quality RCTs are needed to improve the evidence quality.