Table 1 Characteristics of the Included studies

Chronic gastritis

Chen [15]

RCT

60

30

Paraffin therapy combined with external application of herbal paste

Routine care (including general care, observation of illness, diet, emotional care)

Treatment site: the stomach and epigastric region

Traditional Chinese medicine: Flos Caryophylli, Rhizoma Cyperi, Radix Angelicae Dahuricae, Semen Raphani, Rhizoma Corydalis, Cattail Pollen, Fructus Schisandrae Chinensis, Radix Puerariae Lobatae, Ramulus Cinnamomi

Duration of treatment: Chinese herbal paste retained more than 6 h, paraffin retained 30 min

Treatment frequency: 1 time/day, 7 days a course of treatment

96.7% vs. 86.7% (P<0.05)

Outcome measure: total effective rate

Keritherapy combined with external application of Chinese medicine in the adjuvant treatment of chronic gastritis has significant clinical nursing effect

Wang [16]

RCT

60

30

Paraffin therapy combined with Chinese herbal iontophroesis

Gastric mu- cosa protectant and gastric dynamic agent were prescribed for routine oral administration(mosapride citrate and thiosemicarbazone)

Treatment site: acupoints of paraffin therapy: Zhongwan (CV12), Shenque (CV8), Guanyuan (CV4); acupoints of Chinese herbal iontophroesis: Weishu (BL21), Changshu (BL25)

Traditional Chinese medicine: Radix Astragali, Radix Angelicae Sinensis, Rhizoma Chuanxiong, Semen Persicae, Flos Carthami, Borneolum Syntheticum

Duration of treatment: 30 min

Treatment frequency: 1 time/day, 15 days a course of treatment

93.3% vs. 86.7% (P<0.05)

Outcome measure: clinical symptom score

In the treatment group, all of the clinical symptoms were apparently relieved or disappeared after treatment, indicating the significant difference as compared with those before treatment (P<0.05). In the control group, a part of clinical symptoms were apparently relieved. The significant difference presented in the improvement on eipgastric pain and distention as compared with those before treatment (P<0.05)

Epigastric pain

Huang [17]

RCT

64

32

Paraffin therapy combined with external application of herbal paste

Conventional therapy (acid suppression and gastric protection therapy, H. pylori eradication in H. pylori positive cases)

Treatment site: the stomach and epigastric region

Traditional Chinese medicine: Pericarpium Zanthoxyli, Radix Astragali, Rhizoma Alpiniae Officinarum, Ramulus Cinnamomi, Radix Paeoniae Alba, etc

Duration of treatment: 30 min

Treatment frequency: 1 time/day, 14 days a course of treatment

90.6% vs. 81.3% (P<0.05)

Outcome measure: Clinical symptom score

After treatment, the scores of stomach pain, gastric distension and acid vomiting in both groups were lower than those before treatment (P<0.05, P<0.01), and the scores of each symptom in the wax therapy group were significantly lower than those in the control group (P<0.05, P<0.01)

You [18]

RCT

60

30

Paraffin therapy combined with external application of herbal paste

Conventional treatment (acid suppressio, gastric protection, protection of gastric mucosa, etc.)

Treatment site: the stomach and epigastric region

Traditional Chinese medicine: Radix Astragali, Pericarpium Zanthoxyli, Fructus Foeniculi, Ramulus Cinnamomi, Rhizoma Zingiberis

Not mentioned

96.67% vs. 76.67% (P<0.05)

Outcome measure: The TCM syndrome integral

The TCM syndrome integral was decreased in both 2 groups after intervention, and was lower in the observation group than that in the control group (P<0.05)

High muscular tension of limb in children with spastic cerebral palsy

Zhang [19]

RCT

96

48

Chinese herbal paraffin cake therapy

Rehabilitation training and the treatment of Bobath

Treatment site: muscle spasm sites

Traditional Chinese medicine: Radix Angelicae Sinensis, Radix Paeoniae Alba, Herba Taxilli, Pheretima

Duration of treatment: 40 min

Treatment frequency: 1 time/day, 6 times/week with 1 d break. 6 weeks continuous treatment

Not mentioned

Outcome measure: Gross Motor Function Measure(GMFM), Fine Motor Function, Measure(FMFM), Modified Ashworth Scale (MAS), Clinic Spastcity Index (CSI)

After treatment, scores of three functional areas of A, B, C of GMFM scale and the total score in observation group were higher than which in control group (P < 0. 05). And the scores of functional areas of B, C, D, E of FMFM scale and the total score were also higher than those in control group (P < 0. 05). Otherwise, classifications of MAS and CSI in observation group were less than those in control group (Z = − 2.337, P < 0.05 and Z = − 3.021, P < 0. 05)

Diabetes peripheral neuropathy

Wang [20]

RCT

180

90

Paraffin therapy combined with external application of herbal paste

Traditional treatment (such as Chinese herbal tonics, oral hypoglycemic drugs or insulin treatment, diet control, exercise, intravenous lipoic acid 300–600 mg, etc.)

Treatment site: Yongquan (KI1)

Traditional Chinese medicine: Cortex Cinnamomi

Duration of treatment: 60 min

Treatment frequency: 1–2 times / day

92.2% vs.78.8% (P<0.05)

Outcome measure: total effective rate

paraffin therapy combined with herbal acupoint application of cassia paste

Supraspinatus tendinitis

Wang [21]

RCT

53

26

Paraffin therapy combined with Chinese herbal package

Lidocaine hydrochloride

Treatment site: shoulder joint

Traditional Chinese medicine: Ramulus Mori, Olibanum, Myrrha, Ramulus Cinnamomi, Natrii Sulfas, Radix Achyranthis Bidentatae, Flos Carthami, Herba Lycopodii, Herba Vaccinii Urophylli, Cortex Erythrinae, Rhizoma Corydalis, Radix Angelicae Dahuricae, Radix Saposhnikoviae, Radix et Rhizoma Clematidis

Duration of treatment: 20 min

Treatment frequency: 1 time/day, 4 weeks a course of treatment

NRS:92.3% vs.74.1% (P<0.05) CS:84.6% vs.70.4% (P<0.05)

Outcome measure: Numerical Rating Scalle (NRS), Activities of Daily Living (ADL), Constant-Murley Score (CS)

The score of ADL were reduced, and the effect of the treatment group was better than that of the control group (P < 0.05)

Scapulohumeral periarthritis

Li [22]

RCT

60

30

Chinese herbal paraffin cake therapy and acupuncture

Shoulder joint functional exercise and oral diclofenac sodium enteric capsules

Treatment site: pain site

Traditional Chinese medicine: Ramulus Cinnamomi, Ramulus Mori, Rhizoma Curcumae Longae, Radix Aconiti, Radix Aconiti Kusnezoffii, Semen Sinapis, Radix et Rhizoma Asari

Duration of treatment: 20 min

Treatment frequency: 1 time/day, 10 days a course of treatment

90% vs. 80% (P<0.05)

Outcome measure: Visual Analogue Scale (VAS), Hospita for Special Surgery (HSS), Melle Score

The score of HSS, score of Melle, and VAS score were all reduced, and the effect of the treatment group was better than that of the control group (P < 0.05)

Liu [23]

RCT

96

45

Paraffin therapy combined with external application of herbal paste and massage

Acupuncture combined with massage

Treatment site: pain site

Traditional Chinese medicine: Radix Aconiti, Radix Aconiti Kusnezoffii, Semen Sinapis, Olibanum, Myrrha, Radix Angelicae Pubescentis, Ramulus Cinnamomi, Radix Angelicae Dahuricae, Rhizoma Arisaematis, Agkistrodon

Duration of treatment: 40 min

Treatment frequency: 1 time/day, 10 days a course of treatment, two courses of treatment in total

97.7% vs.84.3% (P<0.0025)

Outcome measure: Effective rate

The effective rate in the treatment group was better than that in the control group (P < 0.025)

Zhu [24]

RCT

560

280

Paraffin therapy combined with external application of herbal paste

Acupuncture combined with massage

Treatment site: pain site

Traditional Chinese medicine: Olibanum, Radix Angelicae Pubescentis, Radix Angelicae Dahuricae, Ramulus Cinnamomi, Radix Paeoniae Rubra, Radix Aconiti, Fructus Psoraleae, Herba Vaccinii Urophylli, Herba Lycopodii, Agkistrodon

Duration of treatment: 40 min

Treatment frequency: 1 time/day

99.29% vs. 92.84% (P<0.05)

Outcome measure: Effective rate

The therapy of kerotherapy for relieving pain on frozen shoulder shows a good effect, and is worthy of promotion

Knee osteoarthritis

Han [25]

RCT

99

33

Paraffin therapy combined with Chinese herbal iontophroesis

Paraffin therapy or Chinese herbal iontophroesis

Treatment site: knee joint

Traditional Chinese medicine: Radix Stephaniae Tetrandrae, Radix Saposhnikoviae, Radix Angelicae Sinensis, Cortex Erythrinae, Rhizoma Dioscoreae Nipponicae, Rhizoma et Radix Notopterygii, Radix et Rhizoma Clematidis, Rhizoma Chuanxiong, Olibanum, Poria, Radix Gentianae Macrophyllae, Flos Carthami, Radix Aconiti, Myrrha, Herba Vaccinii Urophylli

Duration of treatment: Chinese herbal iontophroesis retained 20 min, paraffin retained 30 min

Treatment frequency: 1 time/day, 14 days a course of treatment

96.67% vs.83.33% vs.76.67%

(P<0.05)

Outcome measure: The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), McGill pain Questionnaire(MPQ)

After the intervention, there was a difference between the WOMAC arthritis index and the McGill pain scale score in the test group 3 and the test group 1 and the test group 2 (P < 0.05)

Mu [26]

RCT

64

32

Bushen Huoxue decoction and

paraffin therapy combined with Chinese herbal package

Celecoxib Capsules

Treatment site: knee joint

Traditional Chinese medicine: Cortex Erythrinae, Herba Vaccinii Urophylli, Olibanum, Myrrha, Radix Angelicae Sinensis, Pericarpium Zanthoxyli, Rhizoma Chuanxiong, Flos Carthami, Radix et Rhizoma Clematidis, Radix Angelicae Dahuricae, Radix et Rhizoma Glycyrrhizae,Radix Saposhnikoviae

Duration of treatment: 30 min

Treatment frequency: 1 time/day, 15 days a course of treatment, 2 courses of treatment in total

97.5% vs. 78.1% (P<0.05)

Outcome measure: WOMAC

The values of WOMAC after treatment of 15 d and 30 d were significantly lower than those before treatment, and the experimental group’s WOMAC was more decreased than that of the control group

Fan [27]

RCT

78

45

Chinese herbal paraffin cake therapy and Chinese herbal fumigation

Oral administration of glucosamine potassium sulfate capsules and intra- articular injection of sodium hyaluronate

Treatment site: knee joint

Traditional Chinese medicine: Radix et Rhizoma Clematidis, Semen Strychni, Rhizoma et Radix Notopterygii, Radix Arnebiae, Flos Carthami, Rhizoma Chuanxiong, Radix Angelicae Dahuricae, Radix Aconiti Brachypodi

Duration of treatment: 30 min

Treatment frequency: 1 time/day, 4 weeks a course of treatment

95.56% vs. 75.76% (P<0.05)

Outcome measure: clinical symptom score, hospital for special, effective rate surgery (HSS), NRS, Matrix metallo proteinase-3 (MMP-3) assay

The clinical symptom scores, NRS scores, and levels of MMP-3 were decreased, and scores of HSS were increased after treatment in the 2 groups. The effects of the treatment group was better than those of the control group (P < 0.05)

Li [28]

RCT

60

32

Paraffin therapy combined with external application of herbal paste with “midnight noon ebb flow” theory

Paraffin therapy combined with external application of herbal paste

Comparator: Mingmen (GV4, 17:00–19:00), Shenshu (BL23,17:00–19:00); “midnight noon ebb flow” theory: Yingggu (KI10,17:00–19:00), Taixi (KI3,17:00–19:00), Fuliu (KI7,19:00–21:00)

Traditional Chinese medicine: Cortex Cinnamomi, Radix Aconiti Lateralis Praeparata, Herba Epimedii

Duration of treatment: 30 min

Treatment frequency: 1 time/day, 7 days a course of treatment, four courses of treatment in total

83.87% vs.72.73% (P<0.05)

Outcome measure: VAS, WOMAC

After 4 weeks of intervention, the VAS scores and WOMAC scores of the two groups were lower than those before treatment (P < 0.05). The effects of the treatment group were better than those of the control group (P < 0.05)

Rheumatoid arthritis

Li [29]

RCT

80

40

Paraffin therapy combined with external application of herbal paste

Routine drug treatment (methotrexate or leflunomide) and nursing

Treatment site: painful joints

Traditional Chinese medicine: Rhizoma Chuanxiong, Flos Carthami, Cortex Acanthopanacis, Rhizoma Sparganii, Borneolum Syntheticum, Lignum Sappan, Rhizoma Curcumae, Radix Aconiti Kusnezoffii, Radix Aconiti, Ramulus Cinnamomi

Duration of treatment:20- 30 min

Treatment frequency: 1 time/day, 2 weeks a course of treatment

92.5% vs.85.0% (P<0.05)

Outcome measure: VAS, tenderness index, swelling index, functional classification, time of morning stiffness

After treatment, the VAS score, tenderness index, swelling index, functional classification, time of morning stiffness in the 2 groups were improved than those before treatment (P < 0.05); and the treatment group was better than the control group (P < 0.05 or P < 0.01)

Wang [30]

RCT

100

50

Traditional Chinese and Western medicine treatment (methotrexate + duhuo jisheng decoction) and paraffin therapy combined with external application of herbal paste

Traditional Chinese and Western medicine treatment (methotrexate + duhuo jisheng decoction)

Treatment site: pain sites

Composition of duhuo jisheng decoction: Radix Angelicae Pubescentis, Herba Taxilli, Radix Gentianae Macrophyllae, Radix Saposhnikoviae, adix et Rhizoma Asari, Rhizoma Chuanxiong, Radix Angelicae Sinensis, Radix Rehmanniae,Radix Paeoniae Alba, Cortex Cinnamomi, Poria, Cortex Eucommiae, Radix Achyranthis Bidentatae, Radix et Rhizoma Ginseng, Radix et Rhizoma Glycyrrhizae

Not mentioned

80% vs.52% (P<0.05)

Outcome measure: MMP-3, RANKL, the baseline serum biochemical indexes

After treatment, the baseline serum biochemical indexes, the levels of serum MMP-3 and RANKL both groups were significantly lower than those before treatment (P < 0.05), and the content of OPG in serum was significant- ly higher than that before treatment (P < 0.05). The changes in the observation group were more obvious than those in the control group (P < 0.05)

Jia [31]

RCT

213

71

Paraffin therapy combined with external application of herbal paste

Conventional medications and Chinese medicine pasting therapy or conventional medications and wax therapy

Treatment site: pain sites

Traditional Chinese medicine: Rhizoma et Radix Notopterygii, Radix Angelicae Pubescentis, Radix et Rhizoma Clematidis, Radix et Rhizoma Asari, Radix Aconiti, Radix Aconiti Kusnezoffii, Rhizoma Chuanxiong, Olibanum, Myrrha, Ramulus Cinnamomi, Radix Saposhnikoviae, Radix Stephaniae Tetrandrae, Radix Paeoniae Rubra, Pericarpium Zanthoxyli, Lignum Pini Nodi, Rhizoma Kaempferiae, Fructus Psoraleae, Herba Epimedii, Herba Vaccinii Urophylli, Herba Lycopodii

Duration of treatment: Chinese herbal paste retained 6–8 h, paraffin retained 20 min

Treatment frequency: 1 time/week, 1 week a course of treatment

90.14% vs.73.24% vs.83.10% (P<0.05)

Outcome measure: NRS

After treatment, the NRS score and morning stiffness time of the three groups were improved (P < 0.05), and the treatment group was superior to control group 1 and the control group 2 (P < 0.05)

Ankylosing spondylitis

Yu [32]

RCT

118

60

Conventional drug treatment and Chinese herbal paraffin cake therapy

Conventional drug treatment (sulfasalazine colon-soluble capsules or acetate-clofenac tablets)

Treatment site: painful joints

Traditional Chinese medicine: Cortex Cinnamomi, Rhizoma Zingiberis, Semen Coicis, Sanguis Draconis, Radix et Rhizoma Asari, Radix Aconiti, Radix Aconiti Kusnezoffii, Radix et Rhizoma Salviae Miltiorrhizae, Arisaema cum Bile, Radix Dipsaci, Rhizoma Cibotii

Duration of treatment: 20–30 min

Treatment frequency: 1 time/day, 6 months a course of treatment

91.67% vs 74.14% (P<0.05)

Outcome measure: bath Ankylosing Spondylitis Patient Global Score (BAS—G), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index(BASFI), VAS

The BAS—G, BASDAI, BASFI, VAS scores of nocturnal pain, rachialgia and general evaluation of doctor, ESR, CPR, the time of morning stiffness, the occiput—wall distance, the finger—floor distance, the mandible—stermum distance after treatment were obviously decreased in two groups as compared with those in before treatment, and the chest expansion and Schober's test were expanded, with statistical differences (P < 0. 05)

Cervical spondylopathy

Huang [33]

RCT

64

23

Western medicine and paraffin therapy combined with external application of herbal paste

Western medicine (vincristine Injection)

Treatment site: shoulder/neck

Traditional Chinese medicine: Rhizoma Chuanxiong, Semen Persicae, Flos Carthami, Radix Angelicae Sinensis, Olibanum, Myrrha, Herba Vaccinii Urophylli, Radix et Rhizoma Clematidis

Duration of treatment: 30 min

Treatment frequency: 1 time/day, 7 days a course of treatment, two courses of treatment in total

93.7% vs 81.2% (P<0.05)

Outcome measure: total effective rate

The average blood flow velocity of vertebral artery (VA) and basilar artery (BA) after treatment in two groups were better than those before treatment (P < 0.05 or P < 0.01), and the treatment group had more improvement than that of control group(P < 0.05)

Qiao [34]

RCT

128

64

Paraffin therapy combined with Chinese herbal collapse therapy and massage, acupuncture, intravenous infusion of anti-inflammatory and analgesic drugs, traction conventional therapy

Chinese medicine collapse and massage, acupuncture, intravenous infusion of anti-inflammatory and analgesic drugs, traction conventional therapy

Treatment site: shoulder/neck

Traditional Chinese medicine: Radix Angelicae Sinensis, Rhizoma Cibotii, Fructus Chaenomelis, Herba Lycopodii, Rhizoma Drynariae, Radix et Rhizoma Salviae Miltiorrhizae, Ramulus Cinnamomi, Herba Visci, Herba Vaccinii Urophylli, Cortex Periplocae, Flos Carthami, Rhizoma et Radix Notopterygii, Radix Angelicae Pubescentis, Radix et Rhizoma Clematidis, Herba Aristolochiae Mollissimae, Radix Aconiti, Radix Aconiti Kusnezoffii, Radix Gentianae Macrophyllae, Radix Saposhnikoviae, Rhizoma Homalomenae

Duration of treatment: Chinese herbal collapse therapy retained 20 min, paraffin retained 30 min

96.9% vs 85.9% (P = 0.03)

Outcome measure: Oswestry Disability Index(ODI)

After intervention, the scores of neck and shoulder pain, limitation of neck and shoulder movement, and limitation of upper limb movement were lower in both groups than before intervention, and the difference was statistically significant (P < 0.05)

Lumbar disc herniation

Huang [35]

RCT

100

50

Routine TCM care and treatment and paraffin therapy combined with Chinese herbal package

Routine TCM care and treatment (including dehydration and decompression, qi analgesic drugs, functional exercise, etc.)

Treatment site: pain sites

Traditional Chinese medicine: Radix et Rhizoma Notoginseng, Sanguis Draconis, Cortex Eucommiae, etc

Duration of treatment: 30–60 min

Treatment frequency: 1 time/day, 7 days a course of treatment

96% vs 84% (P<0.05)

Outcome measure: NRS

The NRS scores of the two groups after treatment were lower than those before treatment (P < 0.01), and the experimental group was lower than the control group (P < 0.01)

Huang [36]

RCT

158

79

Routine TCM care and treatment

and paraffin therapy combined with Chinese herbal package

Routine TCM care and treatment (including medication, life coaching, rehabilitation training, psychological intervention)

Treatment site: pain sites

Traditional Chinese medicine: Radix et Rhizoma Notoginseng, Sanguis Draconis, Cortex Eucommiae, etc

Duration of treatment: 30–60 min

Treatment frequency: 1 time/day, 7 days a course of treatment

Not mentioned

Outcome measure: the Quality of Life, Health Survey Scores,Lumbar Disc Function

After treatment and care, the quality of life and health survey scores and lumbar disc function of the two groups were compared, and the experimental group was significantly increased, with statistically significant difference (P < 0.01). After treatment, the skin temperature and inflammatory reaction in the experimental group were significantly reduced, and the difference was statistically significant (P < 0.01)

Thoracolumbar compression fracture

Liu [37]

RCT

170

90

Routine treatment and paraffin therapy combined with external application of herbal paste

Routine treatment (including life coaching, rehabilitation training, TDP lamp irradiation)

Treatment site: pain sites

Traditional Chinese medicine: Cortex Phellodendri Chinensis, Radix Scutellariae, Semen Persicae, Flos Carthami, Olibanum, Myrrha, etc

Duration of treatment: Chinese herbal paste retained overnight, paraffin retained 20–30 min

Treatment frequency: 1–2 times/day(paraffin therapy),

4 weeks of treatment in total

92.2% vs 80.0% (P<0.05)

Outcome measure: total effective rate

The total effective rate of the observation group was significantly higher than that of the control group, and the difference was statistically significant (P < 0.05)

Distal radius fracture

Li [38]

RCT

80

40

Plaster external fixation with early opening combined with paraffin therapy combined with external application of herbal paste

Plaster external fixation, combined with PTCWEAOHP after removal of plaster

Treatment site: fracture site

Traditional Chinese medicine: Rhizoma Drynariae, Radix Dipsaci, Rhizoma Corydalis, Rhizoma Sparganii, Herba Lycopodii, Radix Angelicae Sinensis

Duration of treatment: 30 min

Treatment frequency: 1 time/day, 4 weeks of treatment in total

Not mentioned

Outcome measure: VAS, Cooney score

The difference in VAS scores between the 2 groups was statistically significant (P < 0.05) when functional exercise was performed immediately after removal of the cast, and the pain level in the treatment group was less than that in the control group. The difference between the two groups was statistically significant (P < 0.05), and the treatment group had better wrist function Cooney Score than the control group

Patellar fracture

Song [39]

RCT

150

50

Paraffin therapy combined with external application of herbal paste combined with shape memory alloy patella claw treatment

Chinese medicine hot washing combined with shape memory alloy patella claw treatment or Chinese medicine hot washing combined with patellar wire internal fixation treatment

Treatment site: pain sites

Traditional Chinese medicine: Sanguis Draconis, Olibanum, Myrrha, Radix et Rhizoma Notoginseng, Eupolyphaga seu Steleophaga, Aspongopus, Radix Dipsaci, Cortex Acanthopanacis, Rhizoma Zingiberis Recens, Herba Artemisiae Anomalae, Flos Carthami, Pyritum, Borax, Semen Strychni, Borneolum Syntheticum, cucumber seed, Whole chicken bone

Duration of treatment: 30 min

Treatment frequency: 1 time/day, 10 days a course of treatment, 2 courses of treatment in total

92.87% vs 89.71% vs 87.50% (P<0.05)

Outcome measure: knee mobility

The Knee Mobility of experimental group was better than control group 1 and control group 2, and the difference was statistically significant (P < 0.05)