Abstract
Objective Traditional Chinese medicine (TCM) therapies have been widely used for the treatment of androgenetic alopecia (AGA) for thousands of years. We conducted a meta-analysis to evaluate the curative efficacy and safety of TCM for treating AGA. Methods Randomized controlled trials (RCTs) of TCM for the treatment of AGA through March 2019 were systematically identified in 4 English databases, namely, PubMed, Cochrane Library, EMBASE, and Web of Science, and 4 Chinese databases, namely, Sino-Med, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), and WanFang. Quality assessment and data analysis were performed by Review Manager 5.3.5, and Stata 15.1 was used to cope with publication bias. Results 30 RCTs involving 2615 patients were randomly divided into a TCM group and a conventional medicine (CM) group. The results showed that the total efficacy rate (TER) of the TCM group was significantly higher than that of the control group (OR = 3.34, 95% CI = 2.75–4.05, P < 0.00001). The total symptom score (TSS) of the TCM group was markedly reduced when compared with the CM group (SMD = −0.86; 95% CI = −1.19, −0.53; P < 0.00001). The microelement levels (Fe2+, Zn2+, and Cu2+) in hair were significantly improved when complemented with TCM therapy. In addition, no significant differences were observed between the two groups in terms of adverse events (OR = 0.55, 95% CI = 0.29–1.05, P=0.07). Conclusions In view of the effectiveness and safety of TCM, the present meta-analysis suggests that TCM could be recommended as an effective and safe adjuvant therapy for the treatment of AGA by improving the TER, symptoms, serum testosterone levels, and microelement levels. However, long-term and higher-quality RCTs are needed to overcome the limitations of the selected studies and more precisely interrogate the efficacy and safety of TCM.
Highlights
Androgenetic alopecia, or male-pattern baldness, is one of the most common types of hair loss in both men and women, affecting approximately 0.2–2% of the world’s population [1, 2]
30 Randomized controlled trials (RCTs) involving 2615 patients were randomly divided into a Traditional Chinese medicine (TCM) group and a conventional medicine (CM) group. e results showed that the total efficacy rate (TER) of the TCM group was significantly higher than that of the control group. e total symptom score (TSS) of the TCM group was markedly reduced when compared with the CM group (SMD − 0.86; 95% CI − 1.19, − 0.53; P < 0.00001). e microelement levels (Fe2+, Zn2+, and Cu2+) in hair were significantly improved when complemented with TCM therapy
Because TCM is mainly used in China, we searched these aforementioned Chinese electronic databases to obtain as many clinical trials as possible. e search languages were restricted to Chinese and English
Summary
Androgenetic alopecia, or male-pattern baldness, is one of the most common types of hair loss in both men and women, affecting approximately 0.2–2% of the world’s population [1, 2]. Even if medically regarded as a relatively mild skin disease, alopecia leads to significant negative effects on the quality of life because of the importance of hair in people’s psyche [2]. Modern medical research suggests that AGA is characterized by an autosomal dominant polygenic inheritance of alopecia and is highly associated with androgen-. Finasteride, a specific inhibitor of 5α-reductase, shows high irreversible binding affinity to the enzyme and inhibits the conversion of testosterone into highly active dihydrotestosterone, which provides an effective target for AGA treatment. Three percent of patients experience sexual dysfunction [7]
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