光动力治疗中重度痤疮疗效的meta分析

发布时间：2018-05-18 12:30

本文选题：寻常痤疮 + 光动力疗法　；参考：《重庆医科大学》2017年硕士论文

【摘要】：背景:痤疮是皮肤科常见病之一,是累及毛囊皮脂腺的慢性炎症性疾病[1]。中重度痤疮通常发生于青少年,部分病人皮损常持续到成年时期,若治疗不当往往会留色素沉着、瘢痕等[2]。当发生于颜面部时严重影响外观,使患者产生消极、负面情绪,部分病人甚至有抑郁、自杀倾向。由于人们对常规传统疗法的抵制及耐药,使其治疗效果不佳,且容易反复发作。近年来,已有较多实践表明光动力疗法(photodynamic therepy,PDT)治疗中重度痤疮效果较好,但缺乏较明确的循证医学证据。目的:综合分析、评价PDT治疗中重度痤疮疗效与安全性,为PDT治疗中重度痤疮提供循证医学依据。方法:电子检索数据库:Pubmed、EMbase、the Cochrane Library、中国知网(CNKI)、维普数据库(VIP)、万方数据库等,按照纳入标准纳入有关PDT治疗中重度痤疮的随机对照试验(randomized controlled trial,RCT),检索日期为各数据库建库日期-2017年2月。依据Cochrane偏倚评价工具推荐的质量评价标准,对纳入试验进行评价,并采用RevMan 5.3软件进行统计学分析、处理。由两名研究者独自筛选、提取资料、质量评价,如果有争议,则双方共同讨论,必要时交由第三方仲裁。结果:根据纳入、排除标准,共纳入23篇RCT,病人总数为1515人。meta分析结果显示:PDT在治疗中重度痤疮中有效率及痊愈率均优于单用红光组、红蓝光组及强脉冲光(Intense Pulsed Light,IPL)组;与口服异维A酸组疗效相当,但较其更安全,无明显系统性反应,且复发率较低。PDT常见不良反应有灼热、刺痛、红斑等,患者多能耐受,经对症处理后均可缓解。结论:PDT治疗中重度痤疮起效快,有效率及痊愈率高,复发率低,无严重不良反应。但受纳入研究质量限制,本结论尚需要更多大样本、多中心、高质量的RCT进行验证。
[Abstract]:Background: acne is one of the common diseases in dermatology. It is a chronic inflammatory disease involving hair follicle sebaceous gland. Moderate and severe acne usually occurs in adolescents, and some of the patients' skin lesions continue into adulthood. Pigmentation, scar and so on are often left if treated improperly [2]. When it occurs in the face, it seriously affects the appearance of the patients, causing negative and negative emotions, and some patients even have depression and suicidal tendency. Because of resistance and resistance to conventional traditional therapy, it has poor therapeutic effect and is prone to relapse. In recent years, many practices have shown that photodynamic therapy (PDT) is effective in the treatment of moderate and severe acne, but there is no clear evidence of evidence-based medicine. Objective: to evaluate the efficacy and safety of PDT in the treatment of moderate and severe acne and to provide evidence-based medical evidence for the treatment of moderate and severe acne by PDT. Methods: the electronic retrieval database: Pubmedus Embase was Cochrane Library, CNKI, Weip, Wanfang, et al. According to the inclusion criteria, the randomized controlled trial of PDT in the treatment of moderate and severe acne was conducted. The date of retrieval was the date of the establishment of each database from February 2017 to February 2017.Methods: a randomized controlled trial on the treatment of moderate and severe acne with PDT was carried out according to the inclusion criteria. The date of retrieval was the date of establishment of each database from February 2017 to February 2017. According to the quality evaluation standard recommended by Cochrane bias evaluation tool, the inclusion test was evaluated and analyzed statistically with RevMan 5.3 software. The two researchers independently sift the data, extract the data, evaluate the quality, and, if there is a dispute, discuss it together and submit it to a third party for arbitration if necessary. Results: according to the inclusion and exclusion criteria, 23 RCTs were included. The total number of patients was 1515. The results of meta analysis showed that the effective rate and cure rate of the treatment of moderate and severe acne were better than those of the red light group, the red blue light group and the strong pulse Pulsed light group. The curative effect was similar to that of oral isotinic acid group, but it was safer than that of oral isoretinoic acid group, and had no obvious systemic reaction, and the recurrence rate of PDT was lower. The common adverse reactions of PDT were burning, prickly pain, erythema and so on. The patients were tolerant and could be alleviated after symptomatic treatment. Conclusion: the treatment of moderate and severe acne with 1% PDT has rapid onset, high effective rate and cure rate, low recurrence rate and no serious adverse reactions. However, due to the limited quality of the study, more large samples, multicenter and high quality RCT are needed to verify this conclusion.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R758.733

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