目的:评价口服多西环素抗生素与大环内酯类药物治疗睑板腺功能障碍(MGD)的疗效和安全性。
方法:系统评价和荟萃分析。
方法:我们对包括口服抗生素MGD治疗临床结果在内的所有同行评审的已发表研究进行了系统的电子数据库检索。在加权汇总分析中提取并评估了各个研究数据,包括总体征和症状评分,睑板腺分泌评分,泪液破裂时间(TBUT),荧光素染色评分及并发症发生率。
结果:发现了两千九百三十三项研究,其中54人有资格进行系统审查,六项前瞻性研究最终被纳入分析,报告了来自三个国家的563例病例。受影响患者的年龄在12至90岁之间。总的来说,两种治疗方法均可改善MGD体征和症状。在汇总分析中,大环内酯类药物的总体征评分(合并标准化平均差(SMD)-0.51,95%置信区间(CI):-0.99至-0.03)睑板腺分泌评分(合并SMD-0.25,95CI:[-0.48,-0.03]),TBUT(SMD-0.31,95CI:[-0.50,-0.13])和荧光素染色评分(SMD-1.01,95CI:[-1.72,-0.29])。此外,虽然两种治疗方法均未出现严重并发症,大环内酯组的不良事件显著减少(合并比值比0.24,95%CI为0.16~0.34).
结论:大环内酯类和四环素类都是MGD的有效治疗方法。在这项研究中,与四环素类药物相比,大环内酯类药物具有更好的疗效和安全性.
OBJECTIVE: To
review the efficacy and safety of oral doxycycline antibiotics versus macrolides in the treatment of meibomian gland dysfunction (MGD).
METHODS: Systematic
review and meta-analysis.
METHODS: We performed a systematic search of electronic databases for all peer-reviewed published studies which included clinical outcomes of oral antibiotic MGD treatment. Individual study data were extracted and evaluated in a weighted pooled analysis, including total sign and symptom scores, meibomian gland secretion score, tear break-up time (TBUT), fluorescein staining score and rate of complications.
RESULTS: Two thousand nine hundred and thirty-three studies were found, of which 54 were eligible for the systematic
review, and six prospective studies were ultimately included for analysis, reporting on 563 cases from three countries. Age of affected patients ranged between 12 and 90 years. Overall, both treatment methods induced improvement in MGD signs and symptoms. In pooled analysis, macrolides were significantly superior in the total signs score (pooled standardized mean difference (SMD) -0.51, 95% confidence interval (CI): -0.99 to -0.03), meibomian gland secretion score (pooled SMD -0.25, 95%CI: [-0.48, -0.03]), TBUT (SMD -0.31, 95%CI: [-0.50, -0.13]) and fluorescein staining score (SMD -1.01, 95%CI: [-1.72, -0.29]). Moreover, while no severe complications were reported for both treatments, the macrolide group exhibited significantly less adverse events (pooled odds ratio 0.24 with a 95% CI of 0.16 to 0.34).
CONCLUSIONS: Both macrolides and tetracyclines are effective treatments for MGD. In this study, macrolides exhibited better efficacy and safety profile compared to tetracyclines.