Chinese Herbal Bath for Eczema: A Systematic Review and Meta-analysis of 39 Randomised Controlled Trials

Abstract

Introduction

Chinese herbal bath (CHB) shows promise in treating eczema, but high-grade clinical evidence is lacking. This review aims to systematically evaluate the efficacy and safety of CHB in the treatment of eczema.

Methods

PubMed, Embase, Cochrane Library, China Network Knowledge Infrastructure, VIP Chinese Journal Service Platform, and Wan Fang Database were searched for Randomised controlled trials comparing CHB with non-CHB interventions for eczema. RevMan5.4 software was used to calculate the 95% confidence interval (CI) risk ratio (RR) and perform meta-analysis.

Results

Our meta-analysis incorporated data from 39 randomised controlled trials, demonstrating CHB's enhanced efficacy over conventional therapy (RR, 1.15; 95% CI, 1.11–1.20; P < 0.00001) and improved outcomes when used in conjunction with conventional therapy (RR, 1.14; 95% CI, 1.09–1.19; P < 0.00001). Significant improvements were observed in Eczema Area Severity Index scores (mean difference [MD], −1.04; 95% CI, −1.50 to −0.59; P < 0.00001), visual analogue scale scores (MD, −0.61; 95% CI, −0.64 to −0.58; P < 0.00001), and Dermatology Life Quality Index scores (MD, −1.15; 95% CI, −1.68 to −0.61; P < 0.00001), alongside a lower recurrence rate (RR, 0.24; 95% CI, 0.14–0.41; P < 0.00001) without an increased risk of adverse events. Additionally, immunological marker analysis revealed significant modulatory effects on the immune response.

Conclusions

Chinese herbal bath represents a safe and effective alternative for eczema treatment, offering significant clinical improvements and potential immunological benefits. Future research should focus on larger, high-quality randomised controlled trials and detailed biochemical analyses of CHB formulations to further validate these findings and explore the mechanisms of action.