Kangfuxin (Periplaneta americana) Lotion for adjunctive treatment of ulcerative colitis: A systematic review and meta-analysis of randomized controlled trials

Abstract

Objective: The objective of the study is to investigate the effect of Kangfuxin lotion as adjunctive therapy for treating ulcerative colitis (UC) through a systematic review and meta-analysis of randomized controlled trials (RCTs). Materials and Methods: RCTs comparing Kangfuxin lotion with no treatment, placebo, western medications or combination therapy for treatment of UC were included in this study. Two English and three Chinese electronic databases were searched. All searches ended in December 2017. Data and quality assessment carried out respectively. RevMan 5.2 software (Copenhagen, The Nordic Cochrane Centre, The Cochrane Collaboration, 2014) was used to analyze with effect estimate presented as mean difference (MD), risk ratio (RR) and 95% confidence interval (CI). Results: Fifteen trials with 1050 participants were included in this review. Overall, 13 trials were eligible for meta-analysis. Kangfuxin lotion combined with Mesalazine was better than Mesalazine on clinical cure rate (RR 1.45, 95% CI 1.24–1.70, 7 trials), recurrence rate of UC (RR 0.22, 95% CI 0.07–0.72, 2 trials), or endoscopic mucosal recovery (RR 8.05, 95% CI 2.64–24.57, 2 trials). And Kangfuxin lotion combined with triple live bacteria tablets (Bifidobacterium-Lactobacillus- Streptococcus thermophilus)was superior with regard to symptoms remission rate (RR 5.36, 95% CI 1.73–16.60, 3 trials), endoscopic disease activity score (MD − 2.30, 95% CI − 2.64–−1.96, 1 trial). There were no reports on the serious adverse events of Kangfuxin lotion. Conclusion: Kangfuxin lotion as adjunctive treatment appears more effective than medications alone on clinical cure rate, recurrence rate, endoscopic mucosal recovery and improvement rate of related symptoms.