背景:博来霉素,最初是一种抗肿瘤药物,在1990年代中期被探索为病理性疤痕治疗。然而,其疗效和安全性因个体而异。
目的:本研究旨在评估局部博来霉素治疗增生性瘢痕和瘢痕疙瘩的疗效和安全性。
方法:我们回顾了以英文发表的随机对照试验(RCT)和对照临床试验(CCT),比较病灶内博莱霉素与安慰剂或常见病灶内瘢痕治疗。主要结果包括瘢痕改善的百分比变化,色素沉着,复发,萎缩,疼痛,毛细血管扩张症,溃疡,患者自我评估,和观察者评估(>50%)。
结果:六项试验符合标准。与曲安奈德相比,博来霉素显著改善瘢痕减少(p<0.05)。与其他治疗相比,色素沉着(p=0.05)和复发(p=0.21)没有显着差异。在安全方面,博来霉素引起的皮肤萎缩(p<0.01)和毛细血管扩张(p<0.01)较少,但疼痛更多(p=0.03)。
结论:博来霉素比TAC更有效,5-FU,或TAC联合5-FU治疗瘢痕疙瘩和肥厚性瘢痕,降低皮肤萎缩和毛细血管扩张的风险。然而,它可能比5-FU或TAC引起更多的疼痛。进一步的全面研究,包括RCT,是客观分析所必需的。
BACKGROUND: Bleomycin, originally an antitumor drug, was explored as a pathological scar treatment in the mid-1990s. However, its efficacy and safety profile varies among individuals.
OBJECTIVE: This study aimed to assess topical bleomycin\'s efficacy and safety in treating hypertrophic scars and keloids.
METHODS: We reviewed randomized controlled trials (RCTs) and controlled clinical trials (CCTs) published in English, comparing intralesional bleomycin to placebos or common intralesional scar treatments. Primary outcomes included percentage change in scar improvement, pigmentation, recurrence, atrophy, pain,
telangiectasia, ulceration, patient self-assessment, and observer assessment (>50%).
RESULTS: Six trials met the criteria. Bleomycin significantly improved scar reduction compared to triamcinolone (p < 0.05). There was no significant difference in pigmentation (p = 0.05) and recurrence (p = 0.21) compared to other treatments. In terms of safety, bleomycin caused less skin atrophy (p < 0.01) and
telangiectasia (p < 0.01) but more pain (p = 0.03) than other treatments.
CONCLUSIONS: Bleomycin was more effective than TAC, 5-FU, or TAC combined with 5-FU for treating keloids and hypertrophic scars with lower skin atrophy and
telangiectasia risks. However, it may cause more pain than 5-FU or TAC. Further comprehensive studies, including RCTs, are required for objective analysis.