■斑秃(AA)是一种常见的自身免疫性皮肤病。本研究旨在系统评价复方甘草酸苷(CG)联合米诺地尔外用治疗AA的疗效和安全性。
■我们搜索了PubMed,EMBASE,科克伦图书馆,WebofScience,CNKI,万方,VIP数据库。纳入了CG联合局部米诺地尔治疗与单纯局部米诺地尔治疗AA的随机对照试验(RCT)。Cochrane协作网络工具用于评估偏倚风险。使用RevMan5.3软件和Stata15.0软件完成统计学分析。GRADE系统用于评估结果的证据质量。
■11项RCT和1189例患者被纳入。与单用局部米诺地尔治疗相比,CG联合局部米诺地尔治疗在提高临床疗效方面更有效(RR=1.36,95%CI[1.27,1.45],p<0.00001)。盐评分(MD=-10.09,95%CI[-12.89,-7.30],p<0.00001),血清TNF-α水平(MD=-0.99,95%CI[-1.19,-0.39],p<0.00001),血清IL-12水平(MD=-8.84,95%CI[-11.20,-6.47],p<0.00001)和血清IFN-γ水平(MD=-7.44,95%CI[-11.51,-3.37],p=0.0003)减少,和血清TGF-β1水平(MD=2.40,95%CI[1.24,3.57],p<0.0001)增加。报告的不良事件没有显着差异,包括刺激性接触性皮炎(RR=0.51,95%CI[0.25,1.01],p=0.05),胃肠道反应(RR=2.47,95%CI[0.49,12.55],p=0.28),下肢水肿(RR=2.60,95%CI[0.61,11.06],p=0.20),面部水肿(RR=2.33,95%CI[0.61,8.93],p=0.22),或局部瘙痒(RR=0.56,95%CI[0.18,1.75],p=0.32),两组之间。
■目前的证据表明,CG联合米诺地尔局部治疗对AA有效且安全。然而,由于纳入研究的质量欠佳,需要更多高质量和大规模的RCT进行综合分析和进一步验证.
UNASSIGNED: Alopecia areata (AA) is a common autoimmune skin disease. Our study aimed to systematically evaluate the efficacy and safety of compound glycyrrhizin (CG) combined with topical minoxidil therapy in treating AA.
UNASSIGNED: We searched the PubMed, EMBASE, Cochrane Library, Web of Science, CNKI, Wanfang, and VIP databases. Randomized controlled trials (RCTs) on CG combined with topical minoxidil therapy compared with topical minoxidil therapy alone for AA were included. The Cochrane Collaborative Network Tool was used to assess the risk of bias. Statistical analysis was completed using RevMan5.3 software and Stata 15.0 software. The GRADE system was used to evaluate the quality of evidence for outcomes.
UNASSIGNED: 11 RCTs and 1189 patients were included. Compared with topical minoxidil therapy alone, CG combined with topical minoxidil therapy was more effective at improving the clinical efficacy (RR = 1.36, 95% CI [1.27, 1.45], p < 0.00001). The SALT score (MD = -10.09, 95% CI [-12.89, -7.30], p < 0.00001), serum TNF-α levels (MD = -0.99, 95% CI [-1.19, -0.39], p < 0.00001), serum IL-12 levels (MD = -8.84, 95% CI [-11.20, -6.47], p < 0.00001) and serum IFN-γ levels (MD = -7.44, 95% CI [-11.51, -3.37], p = 0.0003) were reduced, and the serum TGF-β1 levels (MD = 2.40, 95% CI [1.24, 3.57], p < 0.0001) were increased. There were no significant differences in reported adverse events, including irritant contact dermatitis (RR = 0.51, 95% CI [0.25, 1.01], p = 0.05),\' gastrointestinal reactions (RR = 2.47, 95% CI [0.49, 12.55], p = 0.28), lower limb edema (RR = 2.60, 95% CI [0.61, 11.06], p = 0.20), facial edema (RR = 2.33, 95% CI [0.61, 8.93], p = 0.22), or localized itching (RR = 0.56, 95% CI [0.18, 1.75], p = 0.32), between the two groups.
UNASSIGNED: The current evidence indicates that CG combined with topical minoxidil therapy is effective and safe for AA. However, owing to the suboptimal quality of the included studies, more high-quality and large-scale RCTs are needed for comprehensive analysis and further validation.