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

Table 2

Outcome measures and description of efficacy across studies.

Study	Outcome measures (measurement points)	Efficacy (PT + RT vs RT)
Chen et al. 2016	Melasma area and color score, physician assessment, and serum levels of α-MSH and E2 (12th week)	% of patients with “cure” or “improvement”: clinical response: 85.4% vs. 39.6% (); % improvement in melasma area score: 71.7% vs. 33.6% (); % improvement in melasma color score: 81.9% vs. 36.2% (); % improvement in serum levels of α-MSH: 38.2% vs. 2.4% () and E2: 31.6% vs. 19.4% ()
Ji et al. 2013	Physician assessment (12th week)	% of patients with “cure” or “improvement”: clinical response: 84% vs. 58% ()
Jiang et al. 2019	Physician assessment, recurrence rate (8th and 12th weeks, 3-month follow-up)	At 8th week, % of patients with “cure” or “improvement”: clinical response: 42.2% vs. 37.8% (). At 12th week, % of patients with “cure” or “improvement”: clinical response: 66.7% vs. 55.6% (), recurrence rate: 8.9% vs. 20% ()
Lu et al. 2017	Physician assessment (12th week)	% of patients with “cure” or “improvement”: clinical response: 85.4% vs. 61.0% ()
Luo et al. 2019	Physician assessment, MASI score, and serum levels of sex hormones (12th week)	% of patients with ‘‘cure’’ or ‘‘improvement’’: clinical response: 60.0% vs. 26.9% (); % improvement in MASI score: 77.1% vs. 41.2% (); % improvement in serum levels of E2: 71.6% vs. 48.4% (), testosterone: 133.8% vs. 52.3% (), progesterone: 1.4% vs. 1.4% (), FSH: 62.0% vs. 36.7% (), and LH: 53.0% vs. 30.8% ()
Wang et al. 2018	Physician assessment, MASI score, DLQI, serum levels of SOD, and MDA (12th week and 3-month follow-up)	At 12th week % of patients with “cure” or “improvement”: clinical response: 50.0% vs. 30.0% (); % improvement in MASI score: 76.3% vs. 48.5% (); % improvement in DLQI: 67.6% vs. 51.4% (); % improvement in serum levels of SOD: 86.3% vs. 48.8% () and MDA: 55.2% vs. 36.5% (); 3-month follow-up % improvement in MASI score: 76.1% vs. 42.1% (); % improvement in DLQI: 66.1% vs. 24.0% ()
Wang et al. 2019	Physician assessment and serum levels of E2, LH, and FSH (12th week)	% of patients with “cure” or “improvement”: clinical response: 81.0% vs. 52.4% (); improvement in serum levels of E2, LH and FSH ()
Xie et al. 2016	Physician assessment, skin lesion score, DLQI, and serum levels of E2, progestogen, SOD, MDA, and LPO (12th week)	% of patients with “cure” or “improvement”: clinical response: 68.3% vs. 52.4% (); % improvement in skin lesion score: 75.5% vs. 64.3% (); % improvement in DLQI: 79.5% vs. 64.4% (); % improvement in serum levels of E2: 19.1% vs. 8.0% (), progestogen: 27.9% vs. 13.0% (), SOD: 36.7% vs. 16.1% (), MDA: 26.3% vs. 21.5% (), and LPO: 41.9% vs. 25.9% ()
Xu et al. 2019	Physician assessment and skin lesion score (12th week)	% of patients with “cure” or “improvement”: clinical response: 80.8% vs. 62.0% (); % improvement in skin lesion score: 55.1% vs. 46.4% ()
Zhu et al. 2016	Physician assessment, skin lesion score, and serum levels of SOD and MDA (12th week)	% of patients with “cure” or “improvement”: clinical response: 67.4% vs. 50.0% (); % improvement in skin lesion score: 45.4% vs. 31.9% (); % improvement in serum levels of SOD: 34.0% vs. 7.0% () and MDA: 41.1% vs. 27.5% ()

PT + RT: phytotherapy plus routine therapy, RT: routine therapy, E2: estradiol, MSH: melanocyte-stimulating hormone, FSH: follicle-stimulating hormone, LH: luteinizing hormone, DLQI: dermatology life quality index, and LPO: lipid hydroperoxide.