背景:炎症后色素沉着过度(PIH)是激光手术后常见的并发症。最近的研究将表皮生长因子(EGF)应用于激光手术后的激光区域,以降低PIH的发生率,但结果存在争议。因此,我们对随机对照试验(RCTs)进行了全面的文献综述,以调查该问题.
方法:两位审稿人独立检索了文献,提取,并分析了数据。共纳入7项RCT,涉及169例患者,以评估EGF对激光手术后恢复和预防PIH的疗效。
结果:结果表明,EGF组的PIH发生率相对低于对照组,虽然差异无统计学意义(OR0.64,95%CI0.33~1.25,p=0.19)。然而,与对照组相比,在激光手术后第1个月,EGF组的黑色素指数(MI)评分显著下降(SMD-1.57,95%CI-2.83~-0.31,p=0.01).此外,EGF侧患者的满意评分明显较高(SMD0.49,95%CI0.22〜0.76,p=0.0004)。在第2周和第2个月,MI的变化没有显着差异,红斑指数(EI),激光治疗后第3天和第7天经表皮失水(TEWL),分别。
结论:目前的荟萃分析发现,含EGF的局部产品对PIH的暂时抑制作用有限,对减少激光后红斑或促进表皮屏障修复没有显著作用。由于样本量小和明显的组间异质性,未来需要更多的研究。
BACKGROUND: Post-inflammatory hyperpigmentation (PIH) is a common complication after laser surgeries. Recent studies applied epidermal growth factor (EGF) on the lasered area after laser surgery to decrease the incidence of PIH with controversial results. Therefore, a comprehensive literature
review of randomized controlled trials (RCTs) was conducted to investigate the issue.
METHODS: Two reviewers independently searched the literatures, extracted, and analyzed the data. A total of seven RCTs involving 169 patients were included to evaluate the efficacy of EGF on recovery and PIH prevention after laser surgery.
RESULTS: The results show that the incidence of PIH in the EGF group was relatively lower than that in the control group, although the difference was not statistically significant (OR 0.64, 95% CI 0.33 ~ 1.25, p = 0.19). However, the EGF groups had a significant decrease in melanin index (MI) scores at the 1st month after the laser surgery when compared to the control groups (SMD -1.57, 95% CI -2.83 ~ -0.31, p = 0.01). In addition, the patients on the EGF side rated significantly higher satisfactory scores (SMD 0.49, 95% CI 0.22 ~ 0.76, p = 0.0004). There was no significant difference as regard to changes in MI at the 2nd week and 2nd month, erythema index (EI), and trans-epidermal water loss (TEWL) at days 3 and 7 after laser therapy, respectively.
CONCLUSIONS: The current meta-analysis found a limited temporary inhibitory effect of EGF-containing topical products on PIH with no significant effect on reducing post-laser erythema or promoting epidermal barrier repair. More studies are needed in the future due to the small sample size and marked intergroup heterogeneities.