背景:白癜风是一种常见的脱色素性皮肤病。这项工作是为了系统地评估火针联合308nm准分子激光治疗白癜风的疗效和安全性。
方法:我们搜索了PubMed,EMBASE,科克伦图书馆,WebofScience,CNKI,万方,VIP数据库。包括火针联合308nm准分子激光治疗与308nm准分子激光治疗白癜风的随机对照试验(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。
结果:在这项研究中,纳入10例RCTs和1333例患者。结果表明,与单用308nm准分子激光治疗相比,火针结合308nm准分子激光治疗更有效提高临床有效率(RR=1.36,95%CI[1.24,1.50],p<0.00001),血清CD4+水平(MD=3.12,95%CI[2.50,3.74],p<0.00001),CD4+/CD8+比值(MD=0.24,95%CI[0.09,0.39],p=0.001),和通过皮肤科生活质量指数(DLQI)测量的生活质量(MD=3.76,95%CI[3.33,4.19],p<0.00001),并降低白癜风面积评分指数(VASI)(MD=-5.47,95%CI[-6.56,-4.37],p<0.00001)。报告的不良事件,包括发红,肿胀,疼痛,水泡,和瘙痒,是可控的,所有这些事件都很好地耐受。
结论:目前的证据表明,火针联合308nm准分子激光治疗白癜风是安全有效的。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.
BACKGROUND: Vitiligo is a common depigmenting skin disorder. This work is performed to systematically evaluate the efficacy and safety of fire needles combined with 308 nm excimer laser therapy in treating vitiligo.
METHODS: We searched the PubMed, EMBASE, Cochrane Library, Web of Science, CNKI, Wanfang, and VIP databases. Randomized controlled trials (RCTs) on fire needles combined with 308 nm excimer laser therapy with 308 nm excimer laser therapy alone for vitiligo 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.
RESULTS: In this study, 10 RCTs and 1333 patients were included. The results showed that compared with 308 nm excimer laser therapy alone, fire needle combined with 308 nm excimer laser therapy is more effective in improving clinical effective rate (RR = 1.36, 95% CI [1.24, 1.50], p < 0.00001), serum CD4+ level (MD = 3.12, 95% CI [2.50, 3.74], p < 0.00001), CD4+/CD8+ ratio (MD = 0.24, 95% CI [0.09, 0.39], p = 0.001), and quality of life measured by the Dermatology Life Quality Index (DLQI) (MD = 3.76, 95% CI [3.33, 4.19], p < 0.00001), and reducing the Vitiligo Area Score Index (VASI) (MD = -5.47, 95% CI [-6.56, -4.37], p < 0.00001). The reported adverse events, including redness, swelling, pain, blisters, and itching, were controllable, and all these events were well tolerated.
CONCLUSIONS: The current evidence indicates that fire needle combined with 308 nm excimer laser therapy is effective and safe for vitiligo. 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.