# Effectiveness and safety of Chinese traditional medicine Ulcer Ointment for skin ulcers: a systematic review and meta-analysis of randomized controlled trials

## TL;DR

This study reviews evidence that Ulcer Ointment, a traditional Chinese medicine, may help heal skin ulcers and reduce pain, but more high-quality research is needed.

## Contribution

A systematic review and meta-analysis of RCTs evaluating the effectiveness and safety of Ulcer Ointment for skin ulcers.

## Key findings

- Ulcer Ointment showed higher healing rates and reduced ulcer area compared to no intervention.
- It was more effective than standard topical drugs in healing and pain reduction.
- No severe adverse events were reported, but study quality was low.

## Abstract

Ulcer Ointment (UO), a topical agent derived from traditional Chinese medicine, has been widely used for skin ulcers. This review evaluates its effectiveness and safety.

We systematically searched eight databases for randomized controlled trials (RCTs) focusing on UO for skin ulcers. Pooled mean difference (MD) and relative risks (RR) with 95% confidence intervals (CI) were calculated.

Fourteen RCTs involving 978 participants with diabetic foot ulcers, venous leg ulcers, acutely infected ulcers, and pressure ulcers were included. Overall study quality was low. Compared with no intervention, UO was associated with a higher healing rate (RR = 2.24, 95% CI: 1.42–3.52, 2 RCTs, n = 140), reduced ulcer area, shorter healing time, lower pain scores, and elevated vascular endothelial growth factor (VEGF) levels. UO were more efficacious than standard topical drugs in healing rate (RR = 1.87, 95% CI: 1.49–2.34, 8 RCTs, n = 462), percentage reduction in ulcer area (RR = 17.82%, 95% CI: 12.63–23.00, 3 RCTs, n = 179), ulcer area (RR = −1.66 cm2, 95% CI: −1.98 to −1.35, 3 RCTs, n = 157), healing time, clinical effective rate (RR = 1.21, 95% CI: 1.10–1.32, 9 RCTs, n = 491), TCM symptom complex scores, pain scores, and VEGF levels. Although these differences are statistically significant, the clinical reliability of these benefits remain uncertain. No severe adverse events were reported in the UO group.

Based on the currently available low-quality evidence, UO has shown preliminary indications of potential benefits in ulcer healing, improvement of TCM symptoms, pain alleviation, and elevation of VEGF levels. However, the exact efficacy of UO for skin ulcers requires further validation through high-quality double-blind RCTs.