ORIGINAL RESEARCH article
Front. Pharmacol.
Sec. Ethnopharmacology
Effectiveness and safety of Chinese traditional medicine Ulcer Ointment for skin ulcers: a systematic review and meta-analysis of randomized controlled trials
Bingrui Zhang 1
Wenying Wang 1
Shengxian Wu 1
Lei Chen 1
Fengtong Liu 1
Xiaoran Li 2
Dongyang Lin 1
Mingyue Liu 1
Xi Li 1
1. Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
2. Capital Medical University Affiliated Beijing Friendship Hospital, Beijing, China
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Abstract
Introduction: 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. Methods: We systematically searched eight databases for randomized controlled trials (RCTs) focusing on UO for skin ulcers. Pooled mean differences (MD) and relative risks (RR) with 95% confidence intervals (CI) were calculated. Results: 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 to 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 to 2.34, 8 RCTs, n = 462), percentage reduction in ulcer area (RR 17.82%, 95% CI 12.63 to 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 to 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. Conclusion: 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.
Summary
Keywords
Diabetic foot ulcers, Meta-analysis, Skin ulcers, Systematic review, Traditional Chinese Medicine, Venous leg ulcers
Received
10 December 2025
Accepted
18 February 2026
Copyright
© 2026 Zhang, Wang, Wu, Chen, Liu, Li, Lin, Liu and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Xi Li
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