A systematic review and meta-analysis of randomized controlled trials: Skin-patch of Chinese herbal medicine for patients with acute gouty arthritis.

AIMS: To evaluate the evidence of the effectiveness and safety of Chinese herbal medicine skin-patches for patients with acute gouty arthritis. BACKGROUND: Acute gouty arthritis is a problem that can limit the level of activity and impair the quality of life. In China, many clinical studies have demonstrated that skin-patches of Chinese herbal medicines benefit patients with acute gouty arthritis. However, the reported clinical effects vary. DESIGN: A systematic review and meta-analysis of randomized controlled trials. DATA SOURCES: Three English databases including CENTRAL (1993 to February 2017), PubMed (1966 to February 2017) and EMBASE (1974 to February 2017) and four Chinese databases including Chinese National Knowledge Infrastructure, Chinese VIP Information, SinoMed and Wanfang (all, 1949 - February 2017) were searched. Randomized controlled trials that compared skin-patches of Chinese herbal medicine with or without conventional treatments to conventional treatments, no treatment or a placebo treatment for patients with acute gouty arthritis were included. REVIEW METHODS: We conducted a systematic review and meta-analysis following the Cochrane process. Two authors selected the studies, extracted the data and evaluated the risk of bias of the included trials. RESULTS: Nineteen studies met our inclusion criteria. After synthesizing the data, the results showed that skin-patches of CHM combined with Western medicine seemed to be more effective than Western medicine alone for pain relief in patients with acute gouty arthritis and had fewer adverse events. CONCLUSION: Due to the quality of the data, larger and more rigorously designed clinical trials with proper outcome measures are necessary.