Traditional Chinese medicine for pressure ulcer: a meta-analysis

To assess the effect of Traditional Chinese Medicine (TCM) [Chinese herbal medicine ointment (CHMO), acupuncture and moxibustion] on pressure ulcer. In this study, we searched MEDLINE, EMBASE, CENTER, CBM, CNKI, WAN FANG and VIP for articles published from database inception up to 4 April 2011. We included randomised controlled trials (RCTs), which compared the effects of TCM with other interventions. We assessed the methodological quality of these trials using Cochrane risk of bias criteria. Ten of 565 potentially relevant trails that enrolled a total of 893 patients met our inclusion criteria. All the included RCTs only used CHMO intervention, because acupuncture and moxibustion trials failed to meet the inclusive criteria. A meta-analysis showed beneficial effects of CHMO for pressure ulcer compared with other treatments on the total effective rate [risk ratio (RR): 1 center dot 28; 95% confidence interval (CI): 1 center dot 201 center dot 36; P = 0 center dot 53; I2 = 0%), curative ratio (RR: 2 center dot 02; 95% CI: 1 center dot 732 center dot 35; P = 0 center dot 11; I2 = 37%) and inefficiency rate (RR: 0 center dot 16; 95% CI: 0 center dot 020 center dot 80; P = 0 center dot 84; I2 = 0%). However, the funnel plot indicated that there was publication bias in this study. The evidence that CHMO is effective for pressure ulcer is encouraging, but due to several caveats, not conclusive. Therefore, more rigorous studies seem warranted.