Oral Chinese herbal medicine in combination with phototherapy for vitiligo: A systematic review and meta-analysis of randomized controlled trials

Aims: The aim of this study was to assess the effects of oral Chinese herbal medicine (CHM) combined with phototherapy for vitiligo. Methods: We undertook a meta-analysis of relevant randomized controlled trials (RCTs) and searched eight bibliographic databases from inception to December 2015. Results: A total of 5 RCTs with 513 participants which assessed the efficacy of oral CHM in combination with narrow-band ultraviolet B (NB-UVB) in treating vitiligo were included. The meta-analysis revealed a superior effectiveness in those receiving oral CHM plus NB-UVB when compared to phototherapy alone (risk difference 0.22, 95% confidence interval 0.14 to 0.29, P < 0.00001). Only mild adverse events were reported without significant renal or liver function impairment. Conclusions: The current evidence demonstrates that oral CHM in combination with NB-UVB has a superior effectiveness in terms of repigmentation rate of vitiligo when compared to NB-UVB alone. Although the overall quality of included trials was low, oral CHM in combination with NB-UVB may be an alternative option of treatment for vitiligo. As to safety, there were only mild adverse events reported without significant renal or liver function impairment. However, there is limited available evidence of long-term follow-up and poor methodological quality of the available trials. Well-designed RCTs of adequate length and sample size that include life quality as an outcome are warranted.