非那雄胺治疗中国男性雄激素性秃发疗效和安全性的临床观察

通过双盲、随机、安慰剂对照单中心研究，评价非那雄胺治疗中国男性雄激素性秃发的疗效和安全性，结果显示非那雄胺口服1mg/d治疗男性雄激素性秃发的有效率为70．8％，而安慰剂为25．5％，两组比较有显著性差异（P＜0．001），两组中与,奶可能或肯定有关的不良事件发生率无显著性差异，治疗组为0．9％，对照组为1．8％。     

非那雄胺与米诺地尔治疗男性雄激素性秃发疗效比较

目的:比较1 mg非那雄胺、5%米诺地尔及两者联合治疗男性雄激素性秃发(AGA)的疗效.方法:观察206例Hamilton-Norwood分级为Ⅲv、Ⅳ和Ⅴ级的男性AGA患者,分别给予1 mg非那雄胺(68例)、5%米诺地尔(74例)、1 mg非那雄胺和5%米诺地尔联合治疗(64例),疗程6个月.结果:治疗3个月时,联合治疗组有效率优于非那雄胺组.6个月时非那雄胺组、米诺地尔组及联合治疗组有效率分别为67.65%、62.16%和81.25%,联合治疗组优于米诺地尔组.脱发程度和病程不同者有效率差异均具有统计学意义(P < 0.05).结论:非那雄胺和米诺地尔联合治疗男性AGA起效较早,病程较短、脱发程度较轻、疗程较长者治疗效果较好.     

非那雄胺和米诺地尔治疗雄激素性秃发的临床研究

目的:观察非那雄胺、5%米诺地尔及两者联合治疗男性雄激素性秃发(AGA)的疗效.方法:男性AGA患者共248例,分为3组,分别外用5%米诺地尔、口服非那雄胺,及米诺地尔与非那雄胺联合治疗,随访12个月,每次随访时拍照并进行分级和评分,同时观察和记录不良反应.结果:用药6个月、12个月时,联合用药组疗效优于口服组及外用组.口服组、联合用药组的疗效与疗程呈正相关,各组患者的疗效与脱发严重程度相关,与发病年龄和家族史无相关性.结论:联合治疗与单独口服非那雄胺、单独外用米诺地尔相比,起效快,疗效好;且疗程长达1年,联合用药的疗效优于单独用药.     

低剂量非那雄胺控制男性型秃发临床观察

目的通过随机双盲对照试验评估每日口服非那雄胺1mg治疗2年有效并满意后,减量为5mg/周及1mg隔1日口服治疗中国男性型秃发的疗效。方法选择非那雄胺治疗2年或2年以上的男性型秃发患者175例,随机分为非那雄胺减量治疗组88例和安慰剂对照组87例,分别口服非那雄胺(1~24周5mg/周,24~48周1mg隔日1次口服)或安慰剂48周。并由皮肤科医师在24~48周时对治疗前、后的头发进行显微照像并评价,同期患者也进行自我评价。结果治疗前、后头发显微照像分析认为,治疗24周时非那雄胺减量治疗组脱发率为48.86%,而安慰剂对照组为98.85%,差异有统计学意义(P<0.05)。治疗48周后非那雄胺减量治疗组的脱发率为73.86%,安慰剂对照组为100%,差异有统计学意义。患者在24周和48周时的自我评价的结果也与之相似。结论低剂量口服非那雄胺维持治疗对中国男性型秃发患者脱发有一定作用。     

非那雄胺对不同年龄组雄激素性脱发患者的疗效观察

目的评价非那雄胺1mg/d治疗不同年龄组雄激素性脱发(AGA)男性患者的疗效及安全性。方法选取117名符合Norwood/Hamilton分级Ⅲ～Ⅴ级及Ludwing分级Ⅰ～Ⅱ级的AGA患者,按年龄分为两组:I组(≤26岁)、II组(26岁),均每日口服非那雄胺1mg,连续12个月。结果Ⅰ组在治疗第3,6,9,12个月的有效率分别是为42.31%,65.38%,88.46%,96.15%;Ⅱ组分别为28.33%,46.67%,73.33%,80.00%。在治疗6个月、9个月和12个月时Ⅰ组和Ⅱ组的有效率差异均有统计学意义(P均0.05)。结论每日口服1mg非那雄胺能安全有效的治疗AGA,且疗效与年龄相关,≤26岁的患者疗效更佳。     

中药内服联合非那雄胺治疗男性雄激素性秃发临床观察及依从性分析

目的观察中药内服联合1 mg非那雄胺治疗男性雄激素性秃发(AGA)的疗效。方法青年男性AGA患者共70例,随机分为2组,分别予口服1 mg非那雄胺联合中药、单纯口服中药治疗,观察2组治疗3、6个月时头皮局部症状(油腻、瘙痒、头屑)、毛发生长改善情况。结果中药内服联合1 mg非那雄胺治疗湿热青年男性型脱发28例(剔除脱落7例),止脱率为89.3%,有效率为82.2%;对照组收录27例(剔除脱落8例),止脱率为85.2%,有效率为55.6%,治疗组止脱率较对照组差异无统计学意义(P0.05),治疗组的有效率要高于对照组,差异有统计学意义(P0.05);经6个月治疗后,治疗组与对照组组内头皮油腻、瘙痒、头屑情况较治疗前均有明显好转,差异有统计学意义(P0.05),2组间头发油腻、头屑、头皮瘙痒情况治疗后差异无统计学意义(P0.05);治疗组脱落率为20.0%,对照组脱落率为22.86%,低于单纯口服非那雄胺脱落率;秃发的疗效同秃发的严重程度呈负相关性。结论单纯中药内服可显著改善头皮局部症状(油腻、头屑及瘙痒),毛发生长改善较慢;中药内服联合1 mg非那雄胺治疗AGA可较快的控制秃发情况,缓解头皮症状,提高患者依从性,降低脱落率,提高疗效。     

雄激素性秃发治疗进展

雄激素性秃发是最常见的一种脱发,在基因易感的女性也同样常见。该文总结了针对男性和女性雄激素性秃发的内服药物（如非那雄胺、异维A酸、氟他胺、激素疗法等）、外用药物（如米诺地尔、非那雄胺凝胶等）、毛发移植和物理治疗（高压氧及激光）等治疗方法的原理、用法、不良反应等最新进展。     

雄激素性秃发治疗的最新研究进展

雄激素性秃发是临床常见病,对患者的外在形象、心理健康、生活及工作等诸多方面都有极大的影响。临床上关于雄激素性脱发的治疗比较局限,且存在一定的不良反应。本文主要着眼于雄激素性秃发的治疗手段,结合最新研究进展,除了临床常规使用的药物外,还归纳总结了若干辅助疗法,如低能量激光和富血小板血浆等。同时,关于国内、外植物有效成分的研究也进行了阐述。对于那些新发现的,对治疗雄激素性秃发有潜在治疗作用的药物也进行了讨论,旨在扩展治疗方法,扩宽治疗思路,为临床应用提供更多的选择。     

早发性雄激素性秃发1例

患儿男,12岁.因脱发半年就诊.患儿半年前无明显诱因开始脱发,伴夜间多梦.4岁时曾患"斑秃",后治愈.其父患雄激素性秃发.体格检查:发育正常,营养良好,系统检查无异常.皮肤科检查:头顶部弥漫性毛发稀疏,发质细软,头皮及头发油腻感(图 1).颞部、枕部头发正常.拉发试验阴性.面部及胸背部无痤疮.     

Evaluation of sexual function in subjects taking finasteride for the treatment of androgenetic alopecia

BACKGROUND: Our practical experience indicates that sexual side-effects in subjects taking finasteride 1 mg (Propecia) for androgenetic alopecia are much less common than reported in the literature. OBJECTIVE: To evaluate the sexual function in subjects taking finasteride (1 mg) compared with age-matched controls using the International Index of Erectile Function (IIEF). METHODS: The IIEF, a brief, reliable questionnaire, was self-administered to 236 patients taking Propecia and 236 age-matched males attending the Department of Dermatology of the University of Bologna. RESULTS: Statistical analysis showed no differences between scores obtained with the IIEF in subjects taking finasteride and controls. CONCLUSIONS: The sexual and erectile function of subjects taking finasteride does not significantly differ from that of age-matched controls. This is consistent with the experience of many dermatologists who do not see sexual or erectile dysfunction in patients taking Propecia.     

Evaluation of sexual function with an international index of erectile function in subjects taking finasteride for androgenetic alopecia

OBJECTIVE: To evaluate variations in sexual and erectile function in subjects taking 1 mg of finasteride for androgenetic alopecia by administering the abridged 5-item version of the International Index of Erectile Function (IIEF-5) questionnaire before and during treatment. DESIGN: In a multicenter study, 186 patients with androgenetic alopecia were asked to complete the IIEF-5 regarding the domain of erectile function before (at baseline) and 4 to 6 months after beginning finasteride treatment. The test was self-administered. SETTING: The study was conducted in 7 institutional dermatology departments in Italy (Bologna, Rome, Genoa, Cagliari, Milan, Florence, and Bari). PATIENTS: A total of 186 patients with androgenetic alopecia were evaluated before and 4 to 6 months after the initiation of finasteride therapy (1 mg). All patients (age range, 19-43 years; mean age, 28.3 years) were followed up as outpatients. RESULTS: The score on each of the 5 domains of the IIEF-5 did not show any significant change after 4 to 6 months of treatment. CONCLUSIONS: Our results support the clinical impression that sexual side effects are actually much less common than reported in clinical trials. The sexual function of all patients remained stable during treatment with 1 mg of finasteride.     

降压药对原发性Ⅰ级高血压男性性功能的影响

目的:考察5类降压药对原发性Ⅰ级高血压男性性功能的影响.方法:收集2010年2月至2012年10月在我院初次诊断为Ⅰ级高血压,未经药物治疗的患者163例,随机分为5个组别,分别为β-受体阻滞剂组33例、利尿剂组35例、钙通道阻滞剂组34例、血管紧张素转换酶抑制剂(Angiotensin Converting Enzyme Inhibitors,ACEI)组31例、血管紧张素受体拮抗剂(Angiotensin Receptor Blockers,ARB)组30例.结果:5个组别的Ⅰ型高血压用药前的收缩压、舒张压和性功能无显著差异(P＞0.05),经30 w的治疗,5个组别的舒张压和收缩压无显著差异(P＞0.05),但与治疗前比,5个组别均有明显的降低效果(P＜0.05).5个组别的性生活频率和性欲强度有显著差异(P＜0.05),勃起无显著差异,前3组的性生活频率、阴茎勃起例数和性欲显著降低(P＜0.05),后2组的性生活频率、阴茎勃起例数和性欲有降低趋势,但无统计学差异(P＞0.05).结论:与利尿剂、3-受体阻抗剂和钙离子拮抗剂比,ACEI和ABR对患者ED影响较小,但结果仍然缺乏确切的证据.     

Advances in the treatment of male androgenetic alopecia: a brief review of finasteride studies

Finasteride is a type 2 5a-reductase inhibitor and therefore mimics the biochemical profile of inherited type 2 5a-reductase deficiency in men. It was developed to grow hair in androgenetic alopecia and shrink benign prostatic hyperplasia. Various clinical trials of finasteride have confirmed its beneficial effects in androgenetic alopecia in males, but not in females. It can produce visible hair growth in up to 66% of men with mild to moderate alopecia, but importantly can stop hair loss in 91% of patients. In long-term finasteride studies, placebo patients were characterized by significant and progressive hair loss. It can be concluded that finasteride prevents further hair loss by actually continuing to grow enough hair to preserve scalp coverage. This is confirmed by the loss of hair following withdrawal of finasteride in such cases. The proven preservative effect of finasteride, in addition to its restorative effect, is a strong indication for prescribing it in early cases of androgenetic alopecia before much hair has been lost.     

雄激素性秃发的遗传机制研究现状

雄激素性秃发是脱发中最常见的类型,其发病机制尚不完全清楚.认为它是一种雄激素依赖性的、具有遗传特性的多基因遗传病.第一个发现的雄激素性秃发易感基闪一雄激素受体基因,位于X染色体上;另外,位于Y染色体上的性别决定基因、常染色体上的脱发基因等也与雄激素性秃发发病有关.最近,有学者通过对全基因扫描分析和精确定位,发现了雄激素性秃发新的易感位点-3q26和20p11,为研究雄激素性秃发的遗传机制提供了新的线索.     

丹参酮治疗雄激素源性脱发

目的:评价丹参酮治疗雄激素源性脱发的临床疗效和安全性.方法:将门诊患者随机分为丹参酮组39例(A组)和非那雄胺组37例(B组),两组除口服维生素B2、维生素B6和外用生发酊外,A组加口服丹参酮0.75 g,每日2次,B组加口服非那雄胺1 mg,每日1次.服药6个月和12个月时评价临床疗效和安全性.结果:两组疗效(A组:66.67%,B组:54.05%)与不良事件发生率(A组:5.13%,B组:8.11%)均无统计学差异(P＞0.05).结论:丹参酮是治疗雄激素源性脱发的有效和安全药物.     

雄激素性秃发的分类和分级方法

雄激素性秃发根据性别、种族、病情严重程度等可表现为不同的脱发模式,Hamilton-Norwood分类法通常用于男性型脱发,Ludwig法则适用于女性型脱发.BASP分类法涵盖种族、性别的差异,易于记忆和掌握.