背景:太阳扁豆的治疗包括局部和物理治疗,包括化学剥离,激光,强烈的脉冲光,还有冷冻疗法.缺乏对治疗方法及其疗效的直接比较。
目的:比较不同治疗方式对扁桃体的治疗效果和不良事件。
方法:Cochrane,MEDLINE,和Embase数据库在2021年8月25日进行了搜索。如果研究符合我们预定的人群,干预,比较器,结果,研究设计框架。结果以叙事形式呈现。
结果:48篇文章符合纳入标准,代表总共1,763名患者。总的来说,联合治疗显示出完全缓解的病例频率最高(65%,n=299/458),其次是激光治疗(43%,n=395/910),外用类维生素A(21%,n=12/57),冷冻疗法(15%,n=25/169),和果皮(6%,n=8/125)。使用局部类维生素A时最常见的不良事件(82%,n=23/28),其次是基于组合的治疗(39%,n=184/466),冷冻疗法(33%,n=47/144),基于激光的治疗(23%,n=173/738),和果皮(19%,n=21/110)。
结论:尽管纳入的研究设计存在异质性,患者群体,治疗方案,和结果衡量标准,我们的结果表明,基于组合的治疗和基于激光的治疗是最有效的治疗方式.尽管冷冻疗法以前被认为是一线疗法,我们的结果显示,与其他治疗方式相比,它的合并缓解率显著较低.
Treatments for solar lentigines include topical and physical therapies, including chemical peels, lasers, intense pulsed light, and cryotherapy. A direct comparison of treatment methods and their efficacy is lacking.
To compare treatment efficacy and adverse events for different treatment modalities for lentigines.
Cochrane, MEDLINE, and Embase databases were searched on August 25, 2021. Studies were included if they met our predetermined population, intervention, comparator, outcomes, study design framework. Results are presented in narrative form.
Forty-eight articles met the inclusion criteria, representing a total of 1,763 patients. Overall, combination-based treatments showed the greatest frequency of cases with complete response (65%, n = 299/458), followed by laser-based treatments (43%, n = 395/910), topical retinoids (21%, n = 12/57), cryotherapy (15%, n = 25/169), and peels (6%, n = 8/125). Adverse events occurred most commonly while using topical retinoids (82%, n = 23/28), followed by combination-based treatments (39%, n = 184/466), cryotherapy (33%, n = 47/144), laser-based treatments (23%, n = 173/738), and peels (19%, n = 21/110).
Despite heterogeneity of included study designs, patient populations, treatment regimens, and outcome measures, our results suggest that combination-based treatments and laser-based treatments were the most efficacious treatment modalities. Although cryotherapy was previously considered first-line, our results show that it has substantially lower pooled response rates compared with other treatment modalities.