背景：外用米诺地尔是男性和女性型脱发的推荐一线药物治疗方法。然而,小剂量口服米诺地尔已被超说明书使用，具有良好的临床疗效和安全性。
目的：比较外用米诺地尔作为雄激素性脱发首选治疗与每日口服1毫克米诺地尔的有效性和安全性。
方法：65例AGA患者随机分配接受5％外用溶液或1mg/天口服米诺地尔治疗6个月。通过测量头发直径来评估治疗效果，摄影评估,和患者自我评估问卷。通过病史记录和体格检查检查治疗的安全性。
结果：治疗6个月后，局部和口服米诺地尔组的头发直径均有明显改善（p<0.001）。然而,两组间差异无统计学意义。摄影评估表明，局部米诺地尔组在位于12厘米处的所有标记点上的头发密度显着改善（p=0.025），16厘米（p=0.034），和24厘米（p=0.014）距离glabella，但不是在口服米诺地尔组。然而，两组间差异无显著性。在每一组中,超过60%的患者对他们的治疗表示满意，两组间差异无统计学意义。
结论：尽管外用米诺地尔比口服1毫克米诺地尔有更好的整体治疗效果，两组间差异无显著性。因此,在女性和男性型脱发中，1毫克口服米诺地尔可能与标准外用米诺地尔一样有效和安全。
BACKGROUND: Topical minoxidil is the recommended first-line pharmacologic treatment for male and female pattern hair loss. However, low-dose oral minoxidil has been used off-label with good clinical efficacy and safety.
OBJECTIVE: To compare the effectiveness and safety of topical minoxidil as a first-choice treatment of androgenetic alopecia versus 1 mg daily oral minoxidil.
METHODS: Sixty-five AGA patients were randomly allocated to receive either 5% topical solution or 1 mg/day oral minoxidil for 6 months. Treatment efficacy was evaluated by measuring hair diameter, photographic assessment, and patient self-assessment questionnaires. The safety of treatment was checked through history taking and physical examination.
RESULTS: Both topical and oral minoxidil groups showed significant improvement in hair diameter after 6 months of treatment (p < 0.001). However, there was no significant difference between the two groups. The photographic assessment demonstrated a significant improvement in hair density in the topical minoxidil group in all marked points located at 12 cm (p = 0.025), 16 cm (p = 0.034), and 24 cm (p = 0.014) distance from the glabella but not in the oral minoxidil group. Nevertheless, the difference between the two groups was not significant. In each group, over 60% of patients expressed satisfaction with their treatments, and no significant difference was detected between the two groups.
CONCLUSIONS: Although topical minoxidil has a better overall therapeutic effect than 1 mg oral minoxidil, the difference between the two groups was not significant. Therefore, 1 mg oral minoxidil may be as effective and safe as standard topical minoxidil in female and male pattern hair loss.
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