目的 系统评价复方甘草酸苷联合米诺地尔治疗斑秃的有效性及安全性。方法 计算机检索PubMed、Cochrane library、Embase、万方数据库、中国期刊全文数据库(CNKI)、维普信息资源系统中关于复方甘草酸苷联合米诺地尔组治疗斑秃临床疗效观察的随机对照试验(randomized controlled trial,RCT),并与单纯米诺地尔组比较,检索时间为1979-01至2018-05,分析文献、提取纳入文献的资料并评价纳入研究的文献质量。采用统计软件RevMan 5.3对数据进行Meta分析。结果 共纳入11篇中文RCT文献,合计1102例患者。Meta分析结果 显示,两组有效率比较,差异有统计学意义[OR=3.86,95%CI(2.83,5.25),P＜0.01];两组痊愈率比较,差异有统计学意义[OR=3.05, 95%CI(2.33,3.99),P＜0.01];两组不良反应发生率比较,差异无统计学意义[OR=0.91,95%CI(0.52,1.58),P=0.73],但两组发生局部刺激性皮炎比较,差异有统计学意义[OR=0.50,95%CI(0.26,0.96),P=0.04]。结论 与单纯米诺地尔治疗相比,复方甘草酸苷联合米诺地尔治疗斑秃的有效率及痊愈率更高,不良反应较轻。
Abstract
Objective To systematically evaluate the efficacy and safety of compound glycyrrhizin combined with minoxidil in the treatment of alopecia areata.Methods Randomized controled trials were retrieved from PubMed, Cochrane library, EmBase, Wanfang database, Chinese journal full text database (CNKI) and the VP information resource system was used to observe the clinical efficacy of compound glycyrrhizin combined with minoxidil in the treatment of alopecia areata (randomized controlled trial, RCT). The retrieval covered the period between January 1979 and May 2018.The related literature was analyzed and evaluated. Statistical software RevMan 5.3 was used for the meta-analysis of the data.Results A total of 11 Chinese RCT articles were included, involving 1102 patients. The meta-analysis Results showed that there was statistically significant difference between the two groups in the effective rate [OR=3.86, 95% CI (2.83, 5.25, P<0.01)]and in the cure rate[OR=3.05, 95%CI (2.33, 3.99), P<0.01]. There was no significant difference in the incidence of adverse reactions between the two groups [OR=0.91, 95%CI(0.52, 1.58), P=0.73], but the difference in the incidence of irritant dermatitis was statistically significant between the two groups[OR=0.50, 95% CI (0.26, 0.96), P=0.04].Conclusions Compared with minoxidil treatment, compound glycyrrhizin combined with minoxidil has a better effect and a higher recovery rate in the treatment of alopecia areata, and the side effect is relatively light.
关键词
复方甘草酸苷 /
米诺地尔 /
斑秃 /
随机对照试验
Key words
compound glycyrrhizin /
minoxidil /
alopecia areata /
randomized controlled trial
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] 赵 辨. 中国临床皮肤病学[M]. 南京:江苏科学技术出版社, 2009:1029-1031.
[2] Strazzulla L C, Wang E H C, Avila L, et al. Alopecia areata : Disease characteristics, clinical evaluation, and new perspectives on pathogenesis [J]. J Am Acad Dermatol, 2018, 78(1): 1-12.
[3] 崔 玲, 刘 艳, 罗 红. 武警某部官兵皮肤病4348例发病情况调查与分析 [J]. 武警医学, 2015, 26(6): 632-633.
[4] Spano F, Donovan J C. Alopecia areata: Part 2: treatment [J]. Can Fam Physician, 2015, 61(9): 757-761.
[5] 刘维峰, 曹华胜. 自拟阿是穴药物注射治疗斑秃149例 [J]. 武警医学, 2001, 12(1): 59.
[6] Iorizzo M, Oranje A P. Current and future treatments of alopecia areata and trichotillomania in children [J]. Expert Opin Pharmacother, 2016, 17(13): 1767-1773.
[7] Hordinsky M, Donati A. Alopecia areata: an evidence-based treatment update [J]. Am J Clin Dermatol, 2014, 15(3): 231-246.
[8] 任强强. 复方甘草酸苷、米诺地尔酊联合液氮冷冻治疗儿童斑秃33例临床观察 [J]. 中国皮肤性病学杂志, 2016,30 (2): 219-220.
[9] Kicinski M, Springate D A, Kontopantelis E. Publication bias in meta-analyses from the Cochrane Database of Systematic Reviews [J]. Stat Med, 2015, 34(20): 2781-2793.
[10] 俞 莺, 袁 波. 复方甘草酸苷片联合米诺地尔溶液治疗斑秃疗效观察 [J]. 中国美容医学, 2012, 21(13): 1784-1785.
[11] 吴国根. 复方甘草酸苷联合5%米诺地尔液治疗斑秃50例疗效观察 [J]. 江西医药, 2011, 46(10): 936-937.
[12] 岳 振, 江从军. 复方甘草酸苷联合2%米诺地尔液治疗学龄期儿童斑秃疗效观察 [J]. 齐齐哈尔医学院学报, 2015, 36(27): 4104-4105.
[13] 张凤娇, 马红卫. 复方甘草酸苷片联合米诺地尔治疗斑秃43例疗效观察 [J]. 中国医药指南, 2013, (18): 196-197.
[14] 曹海育. 复方甘草酸苷联合米诺地尔酊治疗斑秃的疗效观察 [J]. 中国医药指南, 2012, 10(10): 484-485.
[15] 朱国良. 复方甘草酸苷片联合米诺地尔擦剂治疗斑秃疗效观察 [J]. 现代诊断与治疗, 2016, 27(7): 1246-1247.
[16] 朱希聪, 余忠义, 张 为. 复方甘草酸苷片联合米诺地尔溶液治疗斑秃的疗效观察 [J]. 现代实用医学, 2015,27(9):1221-1222.
[17] 李春花. 美能片联合外用2%米诺地尔酊剂治疗斑秃120例疗效观察[J]. 医学理论与实践, 2011, 24(5): 551-551.
[18] 杨雅方. 复方甘草酸苷联合5%米诺地尔液治疗斑秃的临床疗效 [J]. 中国医药指南, 2016, 14(30): 4-6.
[19] 王丽莉. 5%米诺地尔液联合复方甘草酸苷治疗斑秃临床疗效观察 [J]. 中国现代药物应用, 2016, (4): 174-175.
[20] 黄文晖. 复方甘草甜素片联合米诺地尔治疗斑秃38例疗效观察 [J]. 中国中西医结合皮肤性病学杂志, 2009, 8(1): 41-41.
[21] Kassira S, Korta D Z, Chapman L W, et al. Review of treatment for alopecia totalis and alopecia universalis [J]. Int J Dermatol, 2017, 56(8):801-810.
[22] 王 博, 杨淑霞. 自身免疫在斑秃发病机制中的作用 [J]. 临床皮肤科杂志, 2010, 39(10): 670-672.
[23] Yang D, Zheng J, Zhang Y, et al. Total Glucosides of Paeony Capsule Plus Compound Glycyrrhizin Tablets for the Treatment of Severe Alopecia Areata in Children: A Randomized Controlled Trial[J]. Evid Based Complement Med, 2013(5): 1-5.
[24] Gold R, Buttgereit F,Toyka K V. Mechanism of action of glucocorticosteroid hormones: possible implications for therapy of neuroimmunological disorders [J]. J Neuroimmunol, 2001, 117(1-2): 1-8.
[25] Fujisawa Y, Sakamoto M, Matsushita M, et al. Glycyrrhizin inhibits the lytic pathway of complement — Possible mechanism of its anti-inflammatory effect on liver cells in viral hepatitis &mdash [J]. Microbiol Immunol, 2013, 44(9): 799-804.
[26] 张明发, 沈雅琴. 甘草酸及其衍生物的抗炎和抗变态反应研究进展 [J]. 现代药物与临床, 2011, 26(5): 359-364.
[27] Han J H, Kwon O S, Chung J H, et al. Effect of minoxidil on proliferation and apoptosis in dermal papilla cells of human hair follicle [J]. J Dermatol Sci, 2004, 34(2): 91-98.
基金
天津市科技计划项目(14JCYBJC29200/180246)
PDF(1227 KB)
