Review Article

Efficacy and Safety of Oral Herbal Drugs Used as Adjunctive Therapy for Melasma: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

Table 1

Characteristics of included studies.

Interventions
StudyStudy designSample sizeAge (years)Duration (years)Experiment group (E)Control group (C)Adverse eventsDropout (reason)

Chen et al. 2016Randomized, controlled trial96 (48E, 48C)19–43 E: 32.6 ± 6.4; C: 31.8 ± 6.9E: 2.6 ± 1.4; C: 2.8 ± 1.5Danggui Shaoyao powder, twice-daily + ultrasonic therapy with L-vitamin C, once-weekly for 12 weeksUltrasonic therapy with L-vitamin C, once-weekly for 12 weeksNR0

Ji et al. 2013Randomized, controlled trial100 (50E, 50C)28–50 40.33 ± 6.352–22 13.2 ± 2.1Honghua Xiaoyao tablet, three times daily + vitamin C, three times daily, and hydroquinone cream, twice-daily for 12 weeksVitamin C, three times daily, and hydroquinone cream, twice-daily for 12 weeksE: 9 × gastrointestinal reaction, 6 × burning and erythema; C: 9 × burning and erythema0

Jiang et al. 2019Randomized, controlled trial90 (45E, 45C)29–51 E: 45.52 ± 4.39; C: 45.63 ± 4.42NRBa Zhen capsule, twice-daily + hydroquinone cream, twice-daily for 12 weeksTopical hydroquinone cream, twice-daily for 12 weeksE: 1 × gastrointestinal reaction; C: 1 × pruritus and 2 × erythema0

Lu et al. 2017Randomized, controlled trial82 (41E, 41C)29–55 E: 42.4 ± 6.5; C: 41.1 ± 7.7E: 8.9 ± 2.8; C: 10.0 ± 2.3Honghua Xiaoyao granule, three times daily + tranexamic acid tablet, twice-daily for 12 weeksTranexamic acid tablet, twice-daily for 12 weeksE: 7 × gastrointestinal reaction and 3 × menoxenia; C: 8 × gastrointestinal reaction and 7 × menoxenia0

Luo et al. 2019Randomized, controlled trial156 (78E, 78C)21–45 E: 34.6 ± 2.5; C: 33.7 ± 2.4E: 4.2 ± 1.9; C: 5.3 ± 1.7Danggui Shaoyao powder, twice-daily + glutathione, three times daily, and vitamin C, three times daily, and vitamin E, once-daily for 12 weeksGlutathione tablets three times daily, and vitamin C tablets, three times daily, and vitamin E capsules, once-daily for 12 weeks00

Wang et al. 2018Randomized evaluator-blinded clinical trial94 (47E, 47C)24–49 E: 36.36 ± 7.43; C: 35.61 ± 6.69E: 3.46 ± 2.62; C: 3.52 ± 2.25Tiaogan Jianpi Quban powder, twice-daily + vitamin C tablet, three times daily, and vitamin E cream, once-daily for 12 weeksVitamin C tablets, three times daily and vitamin E cream, once-daily for 12 weeks0E: 5 (unknown reasons); C: 6 (unknown reasons)

Xie et al. 2016Randomized, controlled trial126 (63E, 63C)30–48 E: 37.3 ± 9.1; C: 38.1 ± 8.6E: 1.6 ± 0.9; C: 1.7 ± 1.0Tiaochong Xiaoban decoction, twice-daily + glutathione, and vitamin C and vitamin E tablets, three times daily, and hydroquinone cream, twice-daily for 12 weeksGlutathione, vitamin C, and vitamin E tablets, three times daily, and hydroquinone cream, twice-daily for 12 weeksNR0

Xu et al. 2019Randomized, controlled trial102 (52E, 50C)29–53E: 1–20; C: 1–19Honghua Xiaoyao tablets, three times daily + tranexamic acid, twice-daily, and hydroquinone cream, twice-daily 12 weeksTranexamic acid, twice-daily, and hydroquinone cream, twice-daily 12 weeksE: 2 × gastrointestinal reaction and 1 × erythema; C: 1 × gastrointestinal reaction, 2 × menoxenia, and 1 × facial tingling0

Zhu et al. 2016Randomized, controlled trial85 (43E, 42C)20–50 E: 34.67 ± 4.28; C: 34.81 ± 1.15E: 4.2 ± 1.9; C: 5.3 ± 1.8Danggui Shaoyao decoction, twice-daily + glutathione tablet, once-daily for 12 weeksGlutathione tablet, once-daily for 12 weeksE: 2 × gastrointestinal reaction and 1 × pricking; C: 2 × pricking and 1 × peeling0

Wang et al. 2019Randomized, controlled trial84 (42E, 42C)23–47 E: 31.54 ± 3.11; C: 30.86 ± 3.25E: 4.61 ± 1.19; C: 4.58 ± 1.23Jingtian Quban capsule, twice-daily + glutathione tablet, three times daily for 12 weeksGlutathione tablet, three times daily for 12 weeksNR0

NR: not reported.