目的:为皮肤科医生治疗雄激素性脱发提供更多的临床经验,我们评估了联合微针疗法治疗雄激素性脱发的疗效和安全性。
方法:我们在PubMed中全面搜索了联合微针治疗脱发的研究,摘录医学数据库,和Cochrane图书馆数据库。文献检索时间为2012年至2022年。制定了纳入和排除标准,并根据该标准对文献进行筛选。使用Cochrane偏差风险工具评估研究质量。研究者从数据中提取信息后,应用Revman5.3和Stata15.1软件对数据进行分析。
结果:最后,纳入了涉及696例AGA患者的13项RCTs,以比较MN联合治疗与单一MN治疗或单一药物治疗AGA的临床有效性和不良事件。Meta分析结果显示:(1)毛发密度和直径的变化:联合MN组明显优于任何单一治疗组,差异有统计学意义(MD=13.36,95%CI=[8.55,18.16],Z=5.45,p<0.00001;MD=18.11,95%CI=[13.70,22.52],Z=8.04,p<0.00001;MD=13.36,95%CI=[8.55,18.16],Z=5.45,p<0.00001;MD=2.50,95%CI=[0.99,4.02],Z=3.23,p=0.001);(2)疗效满意度评价:联合MN组的医生满意度评分明显高于任何单一治疗组,具有统计学差异(RR=2.03,95%CI=[1.62,2.53],Z=6.24,p<0.00001)。两组患者满意度差异无统计学意义(RR=3.44,95%CI=[0.67,17.59],Z=1.49,p=0.14)。(3)安全性:联合治疗和单药治疗的不良反应发生率无统计学差异(RR=0.83,95%CI=[0.62,1.12],Z=1.22,p=0.22)。
结论:联合MN组在毛发密度和直径方面有统计学意义的改善,与单药治疗相比,安全性好。
OBJECTIVE: To provide dermatologists with more clinical experience in treating androgenetic alopecia, we evaluated the effect and safety of combined microneedling therapy for androgenetic alopecia.
METHODS: Studies on combined microneedling for hair loss were comprehensively searched by us in PubMed, Excerpta Medica Database, and the Cochrane Library Database. The literature search spanned the period from 2012 to 2022. Inclusion and exclusion criteria were developed, and the literature was screened according to this criteria. The Cochrane Risk of Bias Tool was used to assess the quality of the studies. The researcher applied Revman 5.3 and Stata 15.1 software to analyze the data after extracting information from the data.
RESULTS: Finally, 13 RCTs involving 696 AGA patients were included to compare the clinical effectiveness and adverse events of combined MN therapy with single MN therapy or single drug therapy for AGA. The results of meta-analysis showed as follows: (1) Hair density and diameter changes: The combined MN group was significantly better than any single treatment group, and the differences were statistically significant (MD = 13.36, 95% CI = [8.55, 18.16], Z = 5.45, p < 0.00001; MD = 18.11, 95% CI = [13.70, 22.52], Z = 8.04, p < 0.00001; MD = 13.36, 95% CI = [8.55, 18.16], Z = 5.45, p < 0.00001; MD = 2.50, 95% CI = [0.99, 4.02], Z = 3.23, p = 0.001); (2) the evaluation of satisfaction for efficacy: The doctor satisfaction rating of the combined MN group was significantly higher than that of any single treatment group, with statistical difference (RR = 2.03, 95% CI = [1.62, 2.53], Z = 6.24, p < 0.00001). The difference between the two groups regarding patients satisfaction was not significant (RR = 3.44, 95% CI = [0.67, 17.59], Z = 1.49, p = 0.14). (3) Safety: There was no statistical difference in the incidence of adverse reactions between combination therapy and monotherapy (RR = 0.83, 95% CI = [0.62, 1.12], Z = 1.22, p = 0.22).
CONCLUSIONS: The combined MN group showed statistically significant improvement in hair density and diameter, and good safety compared with monotherapy.