Evidence and potential mechanisms of traditional Chinese medicine for the treatment of psoriasis vulgaris: a systematic review and meta-analysis

Figures & data

Table 1. Summary of the included studies.

Study	Subjects (T/C)	Duration	Intervention	TCM outcome (PASI)	Control	Control outcome (PASI)
Huang and Lin (2019)	50/50	12w	Self-made Decoction + basic treatment	4.56 ± 1.39	Basic treatment	7.84 ± 1.52
Li et al. (2016)	38/40	12w	Huoxue Jiedu Dcoction(HXJDD)	6.73 ± 4.41	Placebo	10.94 ± 9.26
Long et al. (2018)	30/30	12w	Self-made Liangxue Xiaobi Decoction + basic treatment	4.15 ± 1.67	Basic treatment	8.29 ± 3.54
She (2017)	81/40	12w	Calm-the-Mind-and-Relieve-Itching Fomula	11.34 ± 6.58	Placebo	26.68 ± 7.12
Wang (2012)	30/30	12w	Silver Soup combined with Seedlings Medicine Away Tinea Pill	3.36 ± 0.06	Basic treatment	7.36 ± 0.46
Yang et al. (2017)	45/45	12w	Qingre Liangxue Xiaoyin Decoction + basic treatment	5.78 ± 1.46	Basic treatment	8.74 ± 1.53
Yao et al. (2013)	42/40	12w	Spleen-strengthening and Detoxification Decoction + basic treatment	5.40 ± 4.73	Basic treatment	9.73 ± 4.94
Cui (2019)	150/150	8w	Liangxue Tuiyin Decoction + basic treatment	3.86 ± 0.75	Basic treatment	4.61 ± 0.92
Ding (2017)	40/40	8w	Ziyin Huoxue Runzao Decoction + basic treatment	2.22 ± 0.78	Basic treatment	5.84 ± 1.81
Wu and Li (2015)	80/80	8w	Jianpi Jiedu Decoction + basic treatment	3.5 ± 1.6	Basic treatment	7.3 ± 3.2
Wu (2019)	34/32	8w	Peiyuan purging prescription	0.69 ± 0.662	Nonintervention	1.53 ± 0.785
Yuan (2019)	30/30	8w	Qingre Huoxue Jiedu prescription	4.33 ± 1.07	Nonintervention	6.38 ± 1.47
Zhang (2013)	40/40	8w	Oxymatrine capsule + basic treatment	1.98 ± 0.46	Basic treatment	2.78 ± 1.12
Zhang (2017)	32/30	8w	Tripterygium hypoglaucum (levl.) hutch mixture	5.64 ± 3.58	Basic treatment	6.60 ± 4.67
Zhou (2011)	235/115	8w	Liangxue Jiedu Decoction/ Yangxue Jiedu Decoction/Huoxue Jiedu Decoction	6.69 ± 6.53	Placebo	7.06 ± 7.57
Zhou (2012)	35/27	8w	Liangxuehuoxue Complex Prescription	3.8 ± 2.87	Placebo	6.9 ± 1.64
Zhu (2014)	30/30	8w	Yu Shi Xiao Bi Yin Decoction (YSXBI)+ basic treatment	1.52 ± 1.36	Basic treatment	3.02 ± 2.51

Figure 1. PASI score comparison.

Table 2. Therapeutic effects of TCM.

Research	Formula	Herbs	Main components	Beneficial effects
Huang and Lin (2019)	Self-made Decoction	Cortex Moutan Radicis, Fructus Gardeniae, Radix Rehmanniae Recens, Cacumen Platycladi, Rhizoma Smilacis Glabrae, Radix Paeoniae Alba, Radix Isatidis, Flos Sophorae, Radix Arnebiae, Herba Taraxaci, Radix Angelicae Sinensis, Radix Angelicae Dahuricae, Radix Salviae Miltiorrhizae, Radix Glycyrrhizae.	Paeonol, Gardenin A, Catalpol, Myricitrin, Astilbin, Total glycosides of peony, Tryptamine, Sophora japonica flower polysaccharides, Shikonin, Polysaccharide from T.mongolicum, Angelica sinensis polysaccharide, Coumadin, Tanshinone IIA, Glycyrrhizin.	Suppressing the maturation and activation of DCs; antihyperlipidemic; antioxidation; cell cycle arrest and apoptosis in KCs; alleviating mitochondrial dysfunction; inhibiting TNF-α、IL-17、IL-1、IL-6; inhibiting mast cell proliferation; suppressing VEGF; inhibiting platelet aggregation; inhibiting ICAM-1.
Li et al. (2016)	Huoxue Jiedu Dcoction(HXJDD)	Herba Hedyotis, Caulis Spatholobi, Euonymus alatus, Rhizoma Curcumae, Flos Carthami, Semen Persicae, Radix Scrophulariae, Pericarpium Cirri Reticulatae, Polyporus, Radix Salviae Miltiorrhizae.	Polysaccharide from Hedyotis diffusa, Total flavonoids of Caulis Spatholobi, Total flavonoids in Euonymus alatus, Curcumol, Safflower yellow, Amygdalin, Iridoid glycosides of scrophularia ningpoensis, Hesperidin, Polyporus polysaccharide, Tanshinone IIA.	Inhibiting Bcl-2, MMP-2; anti-inflammation, inhibiting VEGF-A; reducing lipid peroxidation; inhibiting angiogenic properties; interfering T-lymphocyte trafficking; reducing IL-1, IL-6, COX-2; bacteriostasis; antioxidation; cell cycle arrest and apoptosis in KCs.
Long et al. (2018)	Self-made Liangxue Xiaobi Decoction	Cortex Moutan Radicis, Fructus Gardeniae, Radix Rehmanniae Recens, Cacumen Platycladi, Rhizoma Smilacis Glabrae, Radix Paeoniae Alba, Radix Isatidis, Flos Sophorae, Radix Arnebiae, Herba Taraxaci, Radix Angelicae Sinensis, Radix Angelicae Dahuricae, Radix Salviae Miltiorrhizae, Radix Glycyrrhizae.	Myricitrin, Astilbin, Total glycosides of peony, Tryptamine, Sophora japonica flower polysaccharides, Shikonin, Polysaccharide from T.mongolicum, Angelica sinensis polysaccharide, Coumadin, Tanshinone IIA, Glycyrrhizin, Paeonol, Gardenin A, Catalpol.	Suppressing the maturation and activation of DCs; antihyperlipidemic; antioxidation; cell cycle arrest and apoptosis in KCs; alleviating mitochondrial dysfunction; inhibiting TNF-α、IL-17、IL-1、IL-6; inhibiting mast cell proliferation; suppressing VEGF; inhibiting platelet aggregation; inhibiting ICAM-1.
She (2017-1)	NO.1 Recipel	Os Draconis, Concha Ostreae, Magnetitum, Concha Margaritifera, Petiolus Trachycarpi Carbonisatus, Radix Sanguisorbae, Radix Angelicae Sinensis, Radix Rehmanniae Preparata.	Calcarea carbonica, Magnetite, Ziyuglycoside, Angelica sinensis polysaccharide, Catalpol.	Inducing apoptosis; anti-inflammation; down-regulating the expression of Bcl-2, up-regulating the expression of Bax; inhibiting platelet aggregation, enhancing the activity of SOD.
She (2017-2)	NO.2 Recipel	Os Draconis, Concha Ostreae, Magnetitum, Concha Margaritifera, Petiolus Trachycarpi Carbonisatus, Radix Sanguisorbae, Rhizoma Sparganii, Rhizoma Curcumae.	Calcarea carbonica, Magnetite, Ziyuglycoside, Sparstolonin B, Curcumol.	Inducing apoptosis; anti-inflammation; down-regulating the expression of Bcl-2, up-regulating the expression of Bax; inhibiting toll-like receptor (TLR)-2, TLR-4, antiangiogenesis; regulating HIF-1α.
Wang (2012)	Silver Soup combined with Seedlings Medicine Away Tinea Pill	Cornu Bubali, Radix Rehmanniae Recens, Cortex Moutan Radicis, Cortex Dictamni, Radix Gentianae, Flos Lonicerae, Fructus Forsythiae, Cortex Pseudolaricis, Cortex Lycii, Radix Glycyrrhizae, Radix Paeoniae Rubra, Radix Arnebiae, Radix Isatidis, Radix Sophorae Tonkinensis, Rhizoma Imperatae, Smilax china L., Euphorbia Helioscopia.	Catalpol, Paeonol, Dictamnus dasycarpus polysaccharide, Dictamnus dasycarpus polysaccharide, Gentiopicroside, Lonicerin, Phillyrin, Pseudolaric acid B, Total flavonoids from Lycii Cortex, Glycyrrhizin, Total glycosides of peony, Shikonin, Tryptamine, Oxymatrine, Rhizoma Imperatae polysaccharide, Smilaxin.	Antioxidation; suppressing the maturation and activation of DCs; attenuating the expression of COX-2, iNOS, IL-1β; anti-inflammation; inhibiting the activity of hemolytic streptococci; suppressing PPARγ-mediated NF-κB activation; inhibiting ICAM-1 expression;  inhibiting Th17 cell differentiation and KCs proliferation;  inducing KCs apoptosis; inhibiting mast cell proliferation.
Yang et al. (2017)	Qingre Liangxue Xiaoyin Decoction	Cornu Bubali, Cortex Moutan Radicis, Radix Scutellariae, Radix Paeoniae Alba, Flos Sophorae, Radix Rehmanniae Recens, Radix Trichosanthis, Folium Isatidis, Radix Arnebiae, Radix Sophorae Tonkinensis, Radix Sophorae Flavescentis, Radix Isatidis, Fructus Gardeniae, Radix Glycyrrhizae, Herba Hedyotis.	Paeonol, Baicalin, Total glycosides of peony, Sophora japonica flower polysaccharides, Catalpol, Trichosanthin, Indigo, Shikonin, Oxymatrine, Matrine, Tryptamine, Gardenin A, Polysaccharide from Hedyotis diffusa.	Suppressing the maturation and activation of DCs; inhibiting cell proliferation; inhibiting the generation of TNF-α、IL-17、IL-1、IL-6; antioxidation; down-regulation of VEGF and MMPs expression;  inducing apoptosis and suppressing growth in KCs, controlling the differentiation of Treg; inhibiting mast cell proliferation; antihyperlipidemic; inhibiting ICAM-1 expression.
Yao et al. (2013)	Spleen-strengthening and Detoxification Decoction	Rhizoma Smilacis Glabrae, Rhizoma Dioscoreae Septemlobae, Fructus Forsythiae, Herba Hedyotis, Radix Sophorae Flavescentis, Semen Coicis, Poria, Rhizoma Atractylodis Macrocephalae, Radix Codonopsis, Radix Angelicae Sinensis, Radix Salviae Miltiorrhizae, etc.	Astilbin, Total saponins of Fructus thunbergii, Phillyrin, Polysaccharide from Hedyotis diffusa, Matrine, Coixenolide, Pachyman, Atractylodes macrocephala lactones, Codonopsis pilosula polysaccharide, Angelica sinensis polysaccharide, Tanshinone IIA.	Suppressing IL-6 , IL-22; decreasing the expression of TNF-α, IL-1β, IL-8; inhibiting the inflammation via the PPARγ pathway, antioxidation; inhibiting Bcl-2, MMP-2; up-regulating Treg and Bax; enhancing the phagocytic ability of macrophages; inducing apoptosis via JAK2 / STAT3 pathway; maintaining the balance of Th1/Th2 and Th17/Treg; inhibiting platelet aggregation, enhancing the activity of SOD; cell cycle arrest and apoptosis in KCs.
Cui (2019)	Liangxue Tuiyin Decoction	Rhizoma Smilacis Glabrae, Herba Hedyotis, Radix Rehmanniae Recens, Folium Isatidis, Radix Sophorae Flavescentis, Radix Scrophulariae, Semen Coicis, Phellodendron chinense Schneid, Herba Artemisiae Annuae, Radix Scutellariae.	Astilbin, Polysaccharide from Hedyotis diffusa, Catalpol, Indigo, Matrine, Iridoid glycosides of scrophularia ningpoensis, Coixenolide, Berberine, Artemisinin, Baicalin.	Suppressing IL-6 and IL-22, decreasing proliferation and improving differentiation in HaCaT cells, inhibiting Th17 cell differentiation; enhancing the antitumor activities; antioxidation; cell cycle arrest and autophagy induction; bacteriostasis, anti-inflammation; up-regulating Treg and Bax, down-regulating Bcl-2; reducing psoriatic inflammatory cytokines; reducing VEGF, MMP-2 and MMP-9 in skin lesions.
Ding (2017)	Ziyin Huoxue Runzao Decoction	Carapax et Plastrum Testudinis, Concha Ostreae, Radix Rehmanniae Recens, Radix Scrophulariae, Asparagus cochinchinensis (Lour.) Merr, Radix Polygoni Multiflori, Caulis Spatholobi, Radix Paeoniae Rubra, Spica Prunellae, Herba Hedyotis, Rhizoma Curcumae, Radix Trichosanthis, Fructus Forsythiae, Radix Glycyrrhizae, etc.	Collagen, Calcarea carbonica, Catalpol, Iridoid glycosides of scrophularia ningpoensis, Asparagus polysaccharide, 2, 3, 5, 4′-Tetrahydroxy-stilbene-2-O-β-D-glucoside, Total flavonoids of Caulis Spatholobi, Total glycosides of peony, Total glycosides of peony, Spica prundllae polysaccharide, Polysaccharide from Hedyotis diffusa, Urcumol, Trichosanthin, Phillyrin, Glycyrrhizin.	Inducing apoptosis; antioxidation; anti-inflammation, bacteriostasis; decreasing the expression of VEGF; down-regulation of IL-6, TNF-α, VCAM-1 and MCP-1 expression; promoting caspase-3 secretion; inhibiting Th17 cell differentiation and KCs proliferation; antitumor, immunoregulation; inhibiting Bcl-2, MMP-2; inhibiting angiogenic properties through regulating HIF-1α; inhibiting ICAM-1 expression in KCs.
Wu and Li (2015)	Jianpi Jiedu Decoction	Rhizoma Smilacis Glabrae, Fructus Forsythiae, Piper longum L., Semen Coicis, Herba Hedyotis, Poria, Radix Sophorae Flavescentis, Radix Codonopsis, Radix Angelicae Sinensis, Rhizoma Atractylodis Macrocephalae, Radix Salviae Miltiorrhizae.	Astilbin, Phillyrin, Piperlonguminine, Coixenolide, Polysaccharide from Hedyotis diffusa, Pachyman, Matrine, Codonopsis pilosula polysaccharide, Angelica sinensis polysaccharide, Atractylodes macrocephala lactones, Tanshinone IIA.	Suppressing IL-6 and IL-22, decreasing proliferation and improving differentiation in HaCaT cells, inhibiting Th17 cell differentiation; anti-inflammation via the PPARγ signaling pathway, antioxidation; Inducing apoptosis, lipid-lowering; up-regulating Treg and Bax, down-regulating Bcl-2; enhancing the antitumor activities; enhancing the phagocytic ability of macrophages; cell cycle arrest and autophagy induction; maintaining the balance of Th1/Th2 and Th17/Treg; inhibiting platelet aggregation.
Wu (2019)	Peiyuan purging prescription	Astragaloside; Angelica sinensis polysaccharide; Ephedrine; Tanshinone IIA; Catalpol; Alizarin; Shikonin; Polysaccharides from Saposhnikovia divaricata; Chitin.	Astilbin, Total saponins of Fructus thunbergii, Phillyrin, Polysaccharide from Hedyotis diffusa, Matrine, Coixenolide, Pachyman, Atractylodes macrocephala lactones, Codonopsis pilosula polysaccharide, Angelica sinensis polysaccharide, Tanshinone IIA.	Upregulating SIRT1 expression, anti-inflammatory; inhibiting platelet aggregation; suppressing TNF-α-induced proliferation of HaCaT, inhibiting the CCL20 secretion of IL-17-induced HaCaT cells; leading to cell cycle arrest and apoptosis in vitro in keratinocytes; antioxidation; antitumor; suppressing the growth in KCs via CEBP-δ upregulation; suppressing IL-17-induced VEGF expression; bacteriostasis, lipid-lowering, regulating immune.
Yuan (2019)	Qingre Huoxue Jiedu prescription	Rhizoma Smilacis Glabrae, Asiatic moonseed rhizome, Radix Arnebiae, Herba Hedyotis, Radix Rehmanniae Recens, Cortex Moutan Radicis, Radix Salviae Miltiorrhizae, Radix Angelicae Sinensis, Radix Glycyrrhizae, etc.	Astilbin, Dauricine, Shikonin, Polysaccharide from Hedyotis diffusa, Catalpol, Paeonol, Tanshinone IIA, Angelica sinensis polysaccharide, Glycyrrhizin, etc.	Suppressing IL-6 and IL-22,decreasing proliferation and improving differentiation in HaCaT cells, inhibiting Th17 cell differentiation; antioxidation, negatively regulating inflammatory via NF-κB inactivation;  inducing apoptosis and suppressing growth in KCs; suppressing IL-17-induced VEGF expression; suppressing the maturation and activation of DCs; leading to cell cycle arrest and apoptosis in vitro in keratinocytes; inhibiting platelet aggregation; inhibiting ICAM-1 expression.
Zhang (2017)	Tripterygium hypoglaucum (levl.) hutch mixture	Tripterygium hypoglaucum(Levl.)Hutch, Radix Rehmanniae Recens, Cortex Moutan Radicis, Radix Paeoniae Rubra, Radix Astragali seu Hedysari, Rhizoma Atractylodis Macrocephalae, Poria, Cortex Dictamni, Radix Paeoniae Rubra.	Celastrol, Catalpol, Paeonol, Total glycosides of peony, Astragaloside, Atractylodes macrocephala lactones, Pachyman, Dictamnus dasycarpus polysaccharide, Glycyrrhizin.	Immunosuppression, inducing apoptosis in human HaCaT cells, antioxidation; suppressing the maturation and activation of DCs;  inhibiting Th17 cell differentiation and KCs proliferation; upregulating SIRT1 expression, anti-inflammatory; inhibiting the generation of TNF-α, IL-6; enhancing the phagocytic ability of macrophages; attenuating the expression of COX-2, iNOS, IL-1β; inhibiting ICAM-1 expression.
Zhou (2011-1)	Liangxue Jiedu Decoction	Rhizoma Smilacis Glabrae, Flos Sophorae, Radix Arnebiae, Rhizoma pardis, Radix Rehmanniae Recens, Cortex Dictamni, Radix Paeoniae Rubra, etc.	Astilbin, Sophora japonica flower polysaccharides, Shikonin, Polyphyllin, Catalpol, Dictamnus dasycarpus polysaccharide, Total glycosides of peony, etc.	Suppressing IL-6 and IL-22, decreasing proliferation and improving differentiation in HaCaT cells, inhibiting Th17 cell differentiation; inducing apoptosis and suppressing growth in KCs; antitumor; antioxidation; decreasing the expression of HIF-1α、VEGF; attenuating the expression of COX-2, iNOS, IL-1β; inhibiting Th17 cell differentiation and KCs proliferation.
Zhou (2011-2)	Yangxue Jiedu Decoction	Radix Salviae Miltiorrhizae, Radix Angelicae Sinensis, Radix Rehmanniae Recens, Ophiopogonis Radix, Radix Scrophulariae, Caulis Spatholobi, Rhizoma Smilacis Glabrae, etc.	Tanshinone IIA, Angelica sinensis polysaccharide, Catalpol, Ophiopogonin D, Iridoid glycosides of scrophularia ningpoensis, Total flavonoids of Caulis Spatholobi, Astilbin, etc.	Leading to cell cycle arrest and apoptosis in vitro in KCs; inhibiting platelet aggregation; antioxidation; attenuating pro-inflammatory cytokine mRNA expressions in TNF-α-inflamed HaCaT cells; anti-inflammation, bacteriostasis, immunoenhancement; inhibiting VEGF-A secretion; suppressing IL-6 and IL-22, decreasing proliferation and improving differentiation in HaCaT cells, inhibiting Th17 cell differentiation.
Zhou (2011-3)	Huoxue Jiedu Decoction	Herba Hedyotis, Rhizoma Curcumae, Euonymus alatus, Flos Carthami, Caulis Spatholobi, Caulis Spatholobi, Semen Persicae, Radix Salviae Miltiorrhizae, etc.	Polysaccharide from Hedyotis diffusa, Curcumol, Total flavonoids in Euonymus alatus, Safflower yellow, Total flavonoids of Caulis Spatholobi, Amygdalin, Tanshinone IIA, etc.	Enhancing the antitumor activities; inhibiting angiogenic properties through regulating HIF-1α; inhibiting Bcl-2, MMP-2; inhibiting the AMPK/NF-κB and reducing expression of IL-1, IL-6, TNF-, and COX-2; inhibiting VEGF-A secretion, anti-inflammation; interfering T-lymphocyte trafficking; leading to cell cycle arrest and apoptosis in vitro in KCs.
Zhou (2012)	Liangxuehuoxue Complex Prescription	Folium Isatidis, Radix Rehmanniae Recens, Radix Scutellariae, Radix Arnebiae, Radix Salviae Miltiorrhizae, Radix Paeoniae Rubra, Cortex Moutan Radicis, Radix Angelicae Sinensis, Rhizoma Smilacis Glabrae, etc.	Indigo, Catalpol, Baicalin, Shikonin, Tanshinone IIA, Total glycosides of peony, Paeonol, Angelica sinensis polysaccharide, Astilbin, etc.	Inhibiting the IL-17 production of Th17 cells; antioxidation; down-regulating the PI3K/AKT/mTOR pathway to inhibit cell proliferation, inhibiting the expression of TNF-α、IL-1β、IL-6 and IL-8;  inducing apoptosis and suppressing growth in KCs; suppressing the IL-17-induced VEGF expression; inhibiting platelet aggregation; inhibiting Th17 cell differentiation.
Zhu (2014)	Yu Shi Xiao Bi Yin Decoction (YSXBI)	Notopterygium Incisum, Angelicae Pubescentis Radix, Radix Cyathulae officinalis Kuan, Radix Scrophulariae, Radix Paeoniae Rubra, Radix Paeoniae Alba, Rhizoma Smilacis Glabrae, Radix Salviae Miltiorrhizae, Radix Angelicae Sinensis, Cortex Dictamni, Caulis Spatholobi, Caulis Polygoni Multiflori, Zaocys Dhumnades, Pheretima posthuma, Rhizoma Sparganii, Rhizoma Curcumae, Radix Glycyrrhizae, etc.	Notopterol, Osthole,  Polysaccharide from Radix Cyathulae officinalis Kuan, Iridoid glycosides of scrophularia ningpoensis, Total glycosides of peony, Astilbin, Tanshinone IIA, Angelica sinensis polysaccharide, Dictamnus dasycarpus polysaccharide, Total flavonoids of Caulis Spatholobi, Quercetin, Zaocys typeIIcollagen, Lumbricus Polypeptide, Sparstolonin B, Curcumo, Glycyrrhizin, etc.	Decreasing the expression of TNF- and IL-6, down-regulating TSLP production from KCs; antioxidation; anti-inflammation, bacteriostasis, immunoenhancement;  inhibiting Th17 cell differentiation and KCs proliferation; inhibiting the generation of IL-17、IL-1; leading to cell cycle arrest and apoptosis in vitro in KCs; inhibiting platelet aggregation; inhibiting VEGF-A secretion; lipid-lowering; inhibiting angiogenic properties through regulating HIF-1α; inhibiting ICAM-1 expression.
Zhang (2013)	Oxymatrine capsule	Radix Sophorae Flavescentis	Matrine	Cell cycle arrest and autophagy induction by PI3K/Akt/mTOR pathway.

Table 3. Mechanism of Chinese herbs.

Herbs	Main components	Beneficial effects	Potential mechanisms	Experimental models	Reference Nos.
Radix Rehmanniae Recens	Catalpol	Antioxidation, promoting mitochondrial biogenesis, inducing apoptosis.	Up-regulating the levels of antioxidants such as Gpx, SOD and GSH; activation of AMPK-mediated mitochondrial biogenesis; up-regulated expressions of cleaved Caspase-3 and PARP.	cells; db/db mouse	(31–33)
Radix Salviae Miltiorrhizae	Tanshinone IIA	Inhibiting growth of KCs, antioxidation, improving depression.	Enhancing activation of cleaved caspase-3 and PARP; increaseing the activitiy of SOD, CAT, and GSH-Px; decreasing the activity of MDA and LDH; activating the ERK-CREB-BDNF Signaling Pathway.	cells; mouse	(34–36)
Radix Angelicae Sinensis	Angelica sinensis polysaccharide	Anti-inflammation, antitumor, suppressing oxidative stress.	Repression of NF-κB and JAK2/STAT3 pathways; regulating hepcidin expression and decreasing iron burden in liver.	cells; mouse	(24,37)
Rhizoma Smilacis Glabrae	Astilbin	Immunoregulation, decreasing proliferation and improving differentiation in HaCaT KCs, antioxidation; anti-angiogenesis.	Inhibiting Th17 cell differentiation; ameliorating elevations in inflammatory cytokines (IL-17A, TNF-α, IL-6, IFN-γ and IL-2); leading to S phase arrest of the cell cycle by induction of p53 and p21 and activated-AMPK; inducing KCs differentiation correlated with suppression of KRT5 and KRT14 and induction KRT1 and KRT10; reducing the ROS accumulation and VEGF expression via inducing Nrf2 nucleus translocation.	mouse; HaCaT cells	(25,26,38)
Herba Hedyotis	Polysaccharide from Hedyotis diffusa	Antitumor.	Enhancing the antitumor activity of CIK cells; releasing of cytochrome c from mitochondria into the cytosol prior to the activation of caspase-9 and −3.	cells	(40,41)
Radix Arnebiae	Shikonin	Inducing apoptosis and suppressing growth in KCs, anti-inflammation, anti-angiogenesis.	CEBP-δ upregulation; promoting the differentiation of iTreg cells by inhibiting the AKT/mTOR pathway; suppressing IL-17-induced VEGF expression.	mouse;HaCaT cells	(39,42,43)
Cortex Moutan Radicis	Paeonol	Anti-inflammation.	Inhibiting the maturation and activation of dendritic cells.	mouse	(44)
Radix Paeoniae Rubra	Total glycosides of peony	Attenuating inflammatory.	Inhibiting STAT1 and STAT3 phosphorylation.	mouse; guinea pig	(45)
Radix Glycyrrhizae	Glycyrrhizin	Anti-inflammation.	Inhibiting TNF-α-induced ICAM-1 expression via NF-κB/MAPK.	cells; mouse	(46)

Figure 2. Evaluation of adverse events.

Figure 3. Intervention duration comparison.

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Data availability statement

The data that support the findings of this study are stored in Guang’anmen Hospital (Beijing, China), and available from the corresponding author on reasonable request.