Effectiveness and Safety of Chinese Angelica Decoction for Chronic Urticaria: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

SHI Chunrui ¹ , SHI Chunbo ² , KUANG Qianhua ¹ ,  LI Youping ³ , YAN Xiang ¹ , REN Wanming ¹ , YANG Kehu ⁴ , LI Lun ⁴

1. The First Hospital of Lanzhou University, Lanzhou 730000, China;2. Anning Branch of Lanzhou General Hospital, Lanzhou Command CPLA, Lanzhou 730070, China; 3. Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, China; 4. Evidence-Based Medicine Center, Lanzhou University, Lanzhou 730000, China;

Corresponding author：

LI Youping, Email: rwm@public.lz.gs.cn

Keywords：

Chronic urticaria; Traditional Chinese medicine; Chinese angelica decoction; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.20120196

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective 　To evaluate the effectiveness and safety of Chinese angelica decoction (CAD) versus conventional treatment (CT) for chronic urticaria (CU).
Methods 　Systematic searches were conducted in PubMed, The Cochrane Library, SCI, EMbase, VIP, CNKI and CBM to collect randomized controlled trials (RCTs) on CAD treating CU from inception to July 2011. Two reviewers independently screened articles according to the inclusion and exclusion criteria, extracted data and evaluated the quality of the included studies. Then meta-analysis was performed using RevMan 5.0.2.
Results 　A total of 11 RCTs involving 1081 patients were included. The results of meta-analysis demonstrated that compared with the CT group (antihistamine therapy), CAD seemed higher in the cure rate (OR=2.36, 95%CI 1.80 to 3.10, I2=22%, P lt;0.000 01), improvement rate (OR=4.56, 95%CI 2.65 to 7.87, I2=0%, P lt;0.000 01), and lower in the relapse rate at the third month after the treatment (OR=0.43, 95%CI 0.22 to 0.82, I2=0%, P=0.01). No study reported the quality of life and severe adverse reactions after CAD treatment.
Conclusion 　Current evidence shows CAD may be superior to CT in treating CU patients. However, due to lack of enough high-quality studies, CAD has to be further studied by conducting more strictly-designed, multicenter, large-scale and double-blind RCTs.

Citation： SHI Chunrui,SHI Chunbo,KUANG Qianhua,LI Youping,YAN Xiang,REN Wanming,YANG Kehu,LI Lun. Effectiveness and Safety of Chinese Angelica Decoction for Chronic Urticaria: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2012, 12(10): 1261-1269. doi: 10.7507/1672-2531.20120196 Copy

1.	Maurer M, Weller K, Bindslev-Jensen C, et al. Unmet clinical needs in chronic spontaneous urticaria. A GA (2) LEN task force report (1). Allergy, 2011, 66(3): 317-330.
2.	Zuberbier T, Asero R, Bindslev-Jensen C, et al. EAACI/GA(2)LEN/EDF/WAO guideline: definition, classification and diagnosis of urticaria. Allergy, 2009, 64(10): 1417-1426.
3.	O’donnell BF, Lawlor F, Simpson J, et al. The impact of chronic urticaria on the quality of life. Br J Dermatol, 1997, 136(2): 197-201.
4.	Maurer M, Ortonne JP, Zuberbier T. Chronic urticaria: an internet survey of health behaviours, symptom patterns and treatment needs in European adult patients. Br J Dermatol, 2009, 160(3): 633-641.
5.	Baiardini I, Giardini A, Pasquali M, et al. Quality of life and patients’ satisfaction in chronic urticaria and respiratory allergy. Allergy, 2003, 58(7): 621-623.
6.	Delong LK, Culler SD, Saini SS, et al. Annual direct and indirect health care costs of chronic idiopathic urticaria: a cost analysis of 50 nonimmunosuppressed patients. Arch Dermatol, 2008, 144(1): 35-39.
7.	Zuberbier T, Asero R, Bindslev-Jensen C, et al. EAACI/GA(2)LEN/EDF/WAO guideline: management of urticaria. Allergy, 2009, 64(10): 1427-1443.
8.	Morgan M, Khan DA. Therapeutic alternatives for chronic urticaria: an evidence-based review, part 1. Ann Allergy Asthma Immunol, 2008, 100(5): 403-411.
9.	刘文静, 黄永菁. 荨麻疹中医治疗进展. 四川中医, 2007, 25(10): 40-43.
10.	李广瑞. 慢性荨麻疹的中医治疗对策. 中国中西医结合皮肤性病学杂志, 2009, 8(5): 325-326.
11.	Frew AJ. 25 Immunotherapy of allergic disease. J Allergy Clin Immunol, 2003, 111(2 Suppl): S712-719.
12.	侯秀俊. 中西医结合治疗慢性荨麻疹48例. 山西中医, 2000, 16(2): 31.
13.	杜芙萍. 当归饮子治疗慢性荨麻疹32例. 山东中医杂志, 2000, 19(8): 466.
14.	肖红丽, 陈汉章. 当归饮子治疗慢性荨麻疹的临床观察. 四川中医, 2002, 20(1): 62-63.
15.	冯霞. 中药当归饮子治疗慢性荨麻疹疗效分析. 中国皮肤性病学杂志, 2004, 18(1): 52-53.
16.	王朋军. 当归饮子治疗慢性荨麻疹79例. 光明中医, 2006, 21(3): 31.
17.	张刚, 张建华. 当归饮子治疗荨麻疹的临床观察. 辽宁中医杂志, 2007, 34(3): 333.
18.	孙元亮. 养血祛风法治疗慢性荨麻疹疗效观察. 湖南中医学院学报, 2007, 22(4): 70.
19.	吕明富. 中西医结合治疗慢性荨麻疹40例临床观察. 中医药导报, 2007, 13(6): 62-63.
20.	陈煜华. 当归饮子治疗慢性荨麻疹42例临床观察. 中医药导报, 2008, 14(9): 55, 66.
21.	肖红丽, 眭道顺, 朱其杰, 等. 当归饮子治疗慢性荨麻疹的疗效及对患者血清白三烯B4的抑制作用研究. 辽宁中医杂志, 2008, 35(4): 545-547.
22.	陈训军. 当归饮子加味治疗慢性荨麻疹的疗效观察. 湖北中医学院学报, 2009, 11(3): 49.
23.	Altrichter S, Boodstein N, Maurer M. Matrix metalloproteinase-9: a novel biomarker for monitoring disease activity in patients with chronic urticaria patients? Allergy, 2009, 64(4): 652-656.
24.	Kaplan AP, Greaves M. Pathogenesis of chronic urticaria. Clinical and Experimental Allergy, 2009, 39(6): 777-787.
25.	代淑芳, 刘爱民. 慢性荨麻疹中医病因证型研究进展. 中国中西医结合皮肤性病学杂志, 2009, 8(3): 197-199.
26.	Qi C. Relationship between T cell subsets and traditional Chinese medicine type in patients with ovarian tumor. Chinese Journal of Dermatovenerology of Integrated Traditional and Western Medicine, 1994, 14(6): 334-336.
27.	Yang TH, Lu BH, Jia M, et al. Angelica polysaccharides on mice immune function. Chinese Pharmacological Bulletin, 2003, 19(4): 448-451.
28.	Lin AH, Li YR. Astragalus on mice immune function. J Fourth Mil Med Univ, 2003, 24(17): 201.

1. Maurer M, Weller K, Bindslev-Jensen C, et al. Unmet clinical needs in chronic spontaneous urticaria. A GA (2) LEN task force report (1). Allergy, 2011, 66(3): 317-330.
2. Zuberbier T, Asero R, Bindslev-Jensen C, et al. EAACI/GA(2)LEN/EDF/WAO guideline: definition, classification and diagnosis of urticaria. Allergy, 2009, 64(10): 1417-1426.
3. O’donnell BF, Lawlor F, Simpson J, et al. The impact of chronic urticaria on the quality of life. Br J Dermatol, 1997, 136(2): 197-201.
4. Maurer M, Ortonne JP, Zuberbier T. Chronic urticaria: an internet survey of health behaviours, symptom patterns and treatment needs in European adult patients. Br J Dermatol, 2009, 160(3): 633-641.
5. Baiardini I, Giardini A, Pasquali M, et al. Quality of life and patients’ satisfaction in chronic urticaria and respiratory allergy. Allergy, 2003, 58(7): 621-623.
6. Delong LK, Culler SD, Saini SS, et al. Annual direct and indirect health care costs of chronic idiopathic urticaria: a cost analysis of 50 nonimmunosuppressed patients. Arch Dermatol, 2008, 144(1): 35-39.
7. Zuberbier T, Asero R, Bindslev-Jensen C, et al. EAACI/GA(2)LEN/EDF/WAO guideline: management of urticaria. Allergy, 2009, 64(10): 1427-1443.
8. Morgan M, Khan DA. Therapeutic alternatives for chronic urticaria: an evidence-based review, part 1. Ann Allergy Asthma Immunol, 2008, 100(5): 403-411.
9. 刘文静, 黄永菁. 荨麻疹中医治疗进展. 四川中医, 2007, 25(10): 40-43.
10. 李广瑞. 慢性荨麻疹的中医治疗对策. 中国中西医结合皮肤性病学杂志, 2009, 8(5): 325-326.
11. Frew AJ. 25 Immunotherapy of allergic disease. J Allergy Clin Immunol, 2003, 111(2 Suppl): S712-719.
12. 侯秀俊. 中西医结合治疗慢性荨麻疹48例. 山西中医, 2000, 16(2): 31.
13. 杜芙萍. 当归饮子治疗慢性荨麻疹32例. 山东中医杂志, 2000, 19(8): 466.
14. 肖红丽, 陈汉章. 当归饮子治疗慢性荨麻疹的临床观察. 四川中医, 2002, 20(1): 62-63.
15. 冯霞. 中药当归饮子治疗慢性荨麻疹疗效分析. 中国皮肤性病学杂志, 2004, 18(1): 52-53.
16. 王朋军. 当归饮子治疗慢性荨麻疹79例. 光明中医, 2006, 21(3): 31.
17. 张刚, 张建华. 当归饮子治疗荨麻疹的临床观察. 辽宁中医杂志, 2007, 34(3): 333.
18. 孙元亮. 养血祛风法治疗慢性荨麻疹疗效观察. 湖南中医学院学报, 2007, 22(4): 70.
19. 吕明富. 中西医结合治疗慢性荨麻疹40例临床观察. 中医药导报, 2007, 13(6): 62-63.
20. 陈煜华. 当归饮子治疗慢性荨麻疹42例临床观察. 中医药导报, 2008, 14(9): 55, 66.
21. 肖红丽, 眭道顺, 朱其杰, 等. 当归饮子治疗慢性荨麻疹的疗效及对患者血清白三烯B4的抑制作用研究. 辽宁中医杂志, 2008, 35(4): 545-547.
22. 陈训军. 当归饮子加味治疗慢性荨麻疹的疗效观察. 湖北中医学院学报, 2009, 11(3): 49.
23. Altrichter S, Boodstein N, Maurer M. Matrix metalloproteinase-9: a novel biomarker for monitoring disease activity in patients with chronic urticaria patients? Allergy, 2009, 64(4): 652-656.
24. Kaplan AP, Greaves M. Pathogenesis of chronic urticaria. Clinical and Experimental Allergy, 2009, 39(6): 777-787.
25. 代淑芳, 刘爱民. 慢性荨麻疹中医病因证型研究进展. 中国中西医结合皮肤性病学杂志, 2009, 8(3): 197-199.
26. Qi C. Relationship between T cell subsets and traditional Chinese medicine type in patients with ovarian tumor. Chinese Journal of Dermatovenerology of Integrated Traditional and Western Medicine, 1994, 14(6): 334-336.
27. Yang TH, Lu BH, Jia M, et al. Angelica polysaccharides on mice immune function. Chinese Pharmacological Bulletin, 2003, 19(4): 448-451.
28. Lin AH, Li YR. Astragalus on mice immune function. J Fourth Mil Med Univ, 2003, 24(17): 201.

Chinese Journal of Evidence-Based Medicine

Effectiveness and Safety of Chinese Angelica Decoction for Chronic Urticaria: A Systematic Review

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