中药治疗寻常型银屑病的Meta分析

目的利用Meta分析探讨中药治疗银屑病的临床疗效。方法计算机检索Cochrane图书馆临床对照试验库、MEDLINE、ELSEIVER数据库、Pubmed数据库、中国学术期刊全文数据库(CNKI)、万方数据库、维普期刊数据库、中国生物医学文献数据库(CBM),检索相关会议论文及所获文献的参考文献,收集中药治疗银屑病的临床RCT文献。由2名独立的研究者分别检索文献、提取资料,并按照Cochrane系统评价的方法严格评价纳入研究的质量并提取有效数据,然后应用Cochrane协作网提供的Rev Man5.3软件进行Meta分析。结果共纳入16个临床RCT。Meta分析结果显示:中药组总有效率、银屑病面积和严重程度指数(PASI)评分优于西药组,进一步分析,中药组优于阿维A胶囊组、迪银片组。结论中药治疗银屑病疗效优于阿维A胶囊、迪银片,但由于纳入文献的方法学质量较低,仍需要进行严格的多中心、大样本的随机双盲对照试验,提供高质量的临床证据。     

液氮冷冻与阿维A口服联合治疗多发性跖疣疗效观察

目的观察液氮冷冻与阿维A口服联合治疗多发性跖疣对患者疼痛程度及远期疗效的影响。方法选择2016年1月至2019年12月期间在某医院门诊部就诊的95例多发性跖疣患者为观察对象,随机分为两组。对照组47例进行单纯液氮冷冻治疗,观察组48例实施阿维A胶丸联合液氮冷冻治疗。比较两组的皮损评分、疼痛评分、临床疗效、不良反应发生情况、复发情况。结果观察组患者治疗后的皮损评分、疼痛评分均低于对照组,差异具有统计学意义(P 0.05);观察组患者治疗后的临床总有效率高于对照组,复发率低于对照组,差异具有统计学意义(P 0.05)。两组患者的皮肤瘙痒、皮肤干燥、红斑、口干四项不良反应发生率进行比较,差异无统计学意义(P 0.05)。结论对多发性跖疣患者采用液氮冷冻联合阿维A治疗安全有效,可减轻疼痛程度,降低复发率。     

来氟米特治疗狼疮性肾炎的Meta分析

目的评价来氟米特治疗狼疮性肾炎(lupus nephritis,LN)的疗效和安全性。方法检索Cochrane图书馆,PubMed,EMBASE,中国生物医学文献光盘数据库、中国期刊全文数据库和中国维普数据库等中关于来氟米特治疗LN疗效和安全性的随机对照试验(randomized controlled trial,RCT)文献。检索时间均从建库至2010年5月30日,由3名系统评价员进行文献资料提取和质量评价。疗效判断分为完全缓解(CR)、部分缓解(PR)和治疗无效(NR)。采用RevMan4.2软件进行Meta分析。结果共检索到62篇文献,符合纳入标准的3篇RCT文献(n=117)进入Meta分析。Meta分析结果显示:OR=0.36(95%CI,0.14～0.90)>0,菱形完全位于垂直线的左侧。结论来氟米特与环磷酰胺相比,在保证疗效的同时有更好的耐受性和安全性。     

皮损内注射5-氟尿嘧啶联合口服匹多莫德治疗泛发性跖疣83例临床观察

目的观察皮损内注射5-氟尿嘧啶注射液联合口服匹多莫德治疗泛发性跖疣的疗效。方法将83例泛发型趾疣患者作为治疗组,采用皮损内注射5-氟尿嘧啶注射液联合口服匹多莫德治疗;75例泛发型趾疣患者作为对照组,予传统CO2激光治疗,1个月后比较两组治疗效果。结果治疗组有效率(83.13%)明显高于对照组(70.67%)(P<0.05),两组差异有统计学意义。结论皮损内注射5-氟尿嘧啶注射液联合口服匹多莫德治疗泛发性跖疣,有效率优于传统的二氧化碳激光治疗,且在治疗过程中患者易于接受,没有明显的不良反应。     

平阳霉素皮损内注射与超脉冲CO_2激光治疗跖疣的疗效对比

目的:比较平阳霉素皮损内注射与超脉冲CO2激光治疗跖疣的疗效。方法:将160例跖疣患者随机分为治疗组和对照组,治疗组使用平阳霉素皮损内注射,对照组用超脉冲CO2激光治疗,1月后比较两组患者的疗效;6月后随访,比较两组患者的复发率。结果:1月后治疗组痊愈率为77.5%,对照组为60%;治疗组总有效率为91.25%,对照组为78.75%;6月后治疗组复发率为3.23%,对照组为20.8%,差异均有统计学意义。结论:平阳霉素皮损内注射较超脉冲CO2激光治疗跖疣的疗效好,不良反应少,复发率低。     

平阳霉素皮损内注射与超脉冲CO2激光治疗跖疣的疗效对比

目的:比较平阳霉素皮损内注射与超脉冲CO2激光治疗跖疣的疗效.方法:将160例跖疣患者随机分为治疗组和对照组,治疗组使用平阳霉素皮损内注射,对照组用超脉冲CO2激光治疗,1月后比较两组患者的疗效;6月后随访,比较两组患者的复发率.结果:1月后治疗组痊愈率为77.5%,对照组为60%;治疗组总有效率为91.25%,对照组为78.75%;6月后治疗组复发率为3.23%,对照组为20.8%,差异均有统计学意义.结论:平阳霉素皮损内注射较超脉冲CO2激光治疗跖疣的疗效好,不良反应少,复发率低.     

第一跖趾关节融合术与第一跖趾关节置换术治疗进展性[足母]僵硬的Meta分析

目的采用Meta分析的方法比较第一跖趾关节融合术与第一跖趾关节置换术治疗僵硬的有效性和安全性。方法系统检索PubMed、Embase、Cochrane library及CNKI数据库,检索时间为2000年1月—2020年1月。制作森林图对比术前和随访末期两种术式的AOFAS评分、VAS评分、患者满意率、返修率及并发症发生情况。结果共纳入6篇RCT,结果显示关节融合组临床疗效评分(AOFAS、VAS)及随访末期患者满意率优于跖趾关节置换组,术后返修率及并发症发生率低于跖趾关节置换组。结论第一跖趾关节融合术治疗进展性僵硬比第一跖趾关节置换术更有优势。     

点阵激光联合氟尿嘧啶注射液局部注射治疗难治性跖疣临床对照研究

目的观察点阵激光联合氟尿嘧啶注射液局部注射治疗难治性跖疣的临床疗效与安全性。方法选取多发性跖疣其他方法治疗无效的患者随机分为两组,试验组(35例)CO_2点阵激光联合氟尿嘧啶局部注射(每一处皮损注射0.5 ml氟尿嘧啶),对照组(32例)仅用CO_2点阵激光(功率5～20 W、点阵模式、反复至点状出血),每周1次,连用3次,随访观察6个月。结果经过治疗3次后,试验组有效率(85.7%)高于对照组(68.6%),P 0.05,试验组皮损清除率(79.5%)显著高于对照组(59.0%), P 0.05,试验组的复发率(12%)显著低于对照组(24%),P 0.05。两组不良反应发生率低,无统计学差异。结论 CO_2点阵激光联合氟尿嘧啶注射液局部注射治疗跖疣的临床疗效显著优于单独应用一种治疗方法,有效率及清除率高,复发率及不良反应低。     

Brodalumab治疗中、重度斑块状银屑病随机对照试验的Meta分析

目的 :系统评价Brodalumab治疗中、重度斑块状银屑病的疗效和安全性。方法 :计算机检索2000—2017年中国期刊全文数据库(CNKI)、万方数据库、中国生物医学文献数据库、Pub Med、Medline及Embase,纳入Brodalumab治疗中、重度斑块状银屑病的随机对照试验(RCT)。由2名研究者单独使用Jadad评分量表对文献进行质量评价,采用Rev Man 5.3软件进行系统分析。结果:共纳入5篇RCT,包括4 076例中、重度斑块状银屑病患者。Meta分析示治疗12周时,Brodalumab组疗效和不良反应与安慰剂组比较,差异均有统计学意义(P0.05)。Brodalumab组皮下注射140 mg或210 mg连续治疗12周后,银屑病患者银屑病皮损面积和严重程度指数(PASI)积分下降达75%(PASI 75)、PASI 90、PASI 100和疾病严重度静态测量级别达s PGA 0或1的例数均显著高于安慰剂组,差异有统计学意义(P0.05)。Brodalumab组治疗后发生的主要不良反应为鼻咽炎。结论 :皮下注射Brodalumab 140 mg(2周1次)或210 mg(2周1次)连续12周治疗中、重度斑块状银屑病有效,但需注意不良反应的发生,仍需要更多RCT证实剂量与疗效及安全性的关系。     

苦参素穴位注射联合液氮冷冻治疗多发性跖疣63例临床观察

目的研究苦参素穴位注射联合液氮冷冻对多发性跖疣的临床疗效。方法将117例多发性跖疣患者随机分为治疗组和对照组,治疗组以苦参素穴位注射联合液氮冷冻进行治疗,对照组单纯用液氮冷冻。结果治疗组和对照组的愈显率分别为88.89%和72.22%,治疗组显著高于对照组(P0.05);复发率分别为6.35%和31.48%,治疗组显著低于对照组。结论苦参素穴位注射联合液氮冷冻可提高多发性跖疣的临床疗效,减少复发。     

Comparative study between fractional carbon dioxide laser vs intralesional steroid injection in treatment of alopecia areata

Few studies have reported Fractional Carbon Dioxide (FCO2) laser use in treating alopecia areata (AA), yet, effectiveness of this therapy has not been comparatively analyzed. To assess efficacy and safety of FCO2 laser in comparison to traditional intralesional corticosteroids injection (ILCs) in treatment of AA. This study included 20 patients with at least two patches of AA. Patients were subjected to history taking, general, dermatological and folliscopic examination. One patch was treated by FCO2 laser every 2 weeks for 3 to 6 sessions, while the other treated with intradermal injection of Triamcinolone Acetonide monthly for three sessions maximally. Evaluation of treatment response was done by physician clinical assessment using Mean Improvement Score (MISP), patient satisfaction and folliscopic examination measuring hair density (hair/cm²) before each session, 1 month and 3 months after end of sessions. The obtained data were tabulated and statistically analyzed. There was a highly significant improvement with FCO2 laser rather than ILCs 3 months after last session according to MISP, patient satisfaction and hair density without serious side effects or relapse. FCO2 laser could be a better therapeutic alternative for treating AA in comparison to traditional ILCs.     

得宝松局封联合咪喹莫特乳膏治疗瘢痕疙瘩疗效评价

目的:评价复方倍他米松注射液皮损内注射联合5%咪喹莫特乳膏外涂治疗瘢痕疙瘩的疗效。方法:将患者随机分为两组,治疗组给予复方倍他米松注射液皮损内注射,每3周1次,共3次。同时给予隔日外涂5%咪喹莫特乳膏,连续3个月;对照组单纯给予复方倍他米松注射液皮损内注射。两组患者均于疗程结束后6个月评价疗效和复发。结果:治疗组有效率93.55%,对照组有效率70.37%,复发率治疗组低于对照组,差异有显著性意义,不良反应轻微。结论:复方倍他米松注射液皮损内注射联合5%咪喹莫特乳膏外涂治疗瘢痕疙瘩安全、有效。     

Efficacy and safety of superficial cryotherapy for alopecia areata: A retrospective,comprehensive review of 353 cases over 22 years

Alopecia areata (AA) affects anagen hair follicles, resulting in non‐scarring hair loss. Since introduced by Huang et al., superficial cryotherapy has been accepted as a considerable primary therapeutic modality for AA. The aim of this study was to objectively clarify the therapeutic efficacy and safety of superficial hypothermic cryotherapy for treatment of AA. Medical records of 353 patients from 1993 to 2014 were retrospectively analyzed. According to the response to the superficial cryotherapy, patients were categorized into four groups: “marked”, “partial”, “poor” and “no recovery”. The marked and partial recovery groups were considered as responders. The proportions of the responders among patient subgroups which were defined by various patients, disease, and treatment factors were compared. Of the patients, 60.9% were classified as responders after 3 months of superficial hypothermic cryotherapy. The proportion of the responders were higher when the treatment interval was 2 weeks or less and in the incipient disease stage, with statistical significance. No severe side‐effects other than mild pain and pruritus were reported. In conclusion, superficial cryotherapy is an effective and safe therapeutic modality for AA. Especially when the treatment interval is 2 weeks or less and in the first occurrence of the disease, the therapeutic outcome is superior.     

Treatment of localized non-segmental vitiligo with intradermal 5-flurouracil injection combined with narrow-band ultraviolet B: A preliminary study

Abstract Background: Several treatment modalities had been used for the treatment of vitiligo but the optimal treatment has not yet been identified. Aim: To evaluate the efficacy and safety of intradermal injection of 5-flurouracil (5-FU) combined with narrow-band ultraviolet B (NB-UVB) as a treatment option for vitiligo. Patients and methods: The study included 60 vitiligo patients with overall symmetrical lesions affecting less than 30% of body surface area. For each patient, one side of the body was treated with NB-UVB alone (control side) while the other side was treated with NB-UVB therapy in addition to intradermal injection of 5-FU (50 mg/ml), 0.01-0.02 ml per injection with 1 cm apart in skin of vitiligo, every 2 weeks for 4 months. Results: The overall repigmentation was significantly higher in the 5-FU side compared with control side in all body parts (p < 0.001) except for the acral lesions where the difference was not significant (p = 0.561). No systemic side effects of 5-FU were detected, and the majority of the patients reported pain during injections. Conclusions: Intradermal 5-FU injection in combination with NB-UVB could be considered as a simple, safe, tolerable and cheap technique for treatment of vitiligo. It shortens the duration of NB-UVB therapy and improves the outcome, repigmentation. Longer follow-up is needed.     

富血小板血浆局部注射治疗雄激素性脱发的疗效及安全性系统评价

目的：对富血小板血浆局部注射治疗雄激素脱发的有效性及安全性进行评价。方法：计算机检索截至2020年5月的Pubmed、Embase、the Cochrane library、Web of science、中国知网（CNKI）、中国生物医学文献服务系统、万方数据库、维普中文科技期刊全文数据库中关于富血小板血浆治疗雄激素脱发的随机对照试验，经2名医生筛选纳入文献并进行文献评价，最后对纳入文献进行分析，采用Revman 5.3软件进行meta分析。结果：纳入10个文献，212例患者。meta分析显示：①富血小板血浆注射可增加毛发密度，与安慰剂组比较差异有显著性（WMD=29.39，95% CI=1.89～56.89，P=0.04）。②局部暂时疼痛是主要的不良事件，其它少见的不良事件包括：出血、瘀斑、水肿等，无严重不良反应发生。结论：富血小板血浆局部注射有利于改善毛发密度，未发现严重不良反应。     

The efficacy of intradermal injection of type A botulinum toxin for facial rejuvenation

The aim of this study is to evaluate the efficacy for effectiveness of type A botulinum toxin intradermal injection for facial rejuvenation. Forty female subjects were randomly divided into two groups: BoNTA group and control group. In BoNTA group, each subject's facial skin was treated with intradermal injection of BoNTA, and subjects of the control group were treated with intradermal saline solution injection. Subjects receiving one session of treatment and evaluations were conducted at baseline, four weeks, and twelve weeks after treatment. The outcome assessments included subjective satisfaction scale; blinded clinical assessment; and the biophysical parameters of roughness, elasticity, skin hydration, transepidermal water loss (TEWL), erythema, and melanin index. BoNTA group showed higher physician's global assessment score, subject satisfaction score, roughness, skin hydration, skin elasticity, and lower TEWL compared to that of control group at 12 weeks post‐treatment. No significant difference was found among erythema and melanin index at baseline, four, and twelve weeks after treatment among the two major groups. In conclusion, intradermal BoNTA injection can be considered as an effective method for facial rejuvenation.     

阿奇霉素与多西环素治疗生殖道沙眼衣原体感染疗效的Meta分析

目的 系统评价阿奇霉素与多西环素治疗生殖道沙眼衣原体感染的疗效。方法 计算机检索Cochrane图书馆、PubMed、EMBASE、CBMdisc、CNKI和万方数据库,搜索关于阿奇霉素与多西环素治疗生殖道沙眼衣原体感染的临床随机对照试验（RCT）,以微生物学转阴作为判愈标准。治疗组采用阿奇霉素治疗,对照组采用多西环素治疗。检索时间为1980年1月1日至2017年10月。由两名研究者共同独立提取资料并评估纳入研究质量。采用 Stata?12.0软件对试验数据进行统计分析。结果 共纳入24篇文章,包括24个RCT、2 369例患者,阿奇霉素治疗组1 302例,多西环素治疗组1 067例。Meta分析结果显示,阿奇霉素与多西环素治疗生殖道沙眼衣原体感染的微生物学有效率差异有统计学意义。采用固定效应模型对数据合并分析后显示,多西环素有效率优于阿奇霉素,有效率差异为2.8%（95% CI,0.9% ~ 4.6%）。结论 阿奇霉素治疗生殖道沙眼衣原体感染后的微生物学有效率低于多西环素,但临床应用的确切疗效尚需更多的RCT证实。     

光动力疗法联合果酸治疗面部中重度痤疮临床疗效观察

目的观察5-氨基酮戊酸光动力疗法(ALA-PDT)联合果酸治疗面部中重度痤疮的有效性及安全性。方法 52例面部中重度痤疮患者随机分为两组,试验组25例,先给予ALA-PDT治疗,每周1次,共2次,2周后行果酸治疗,每2周1次,共2次。对照组27例,仅给予ALA-PDT治疗,每周1次,共2次。在治疗结束后2、4、8周进行疗效判断及不良反应记录。结果治疗后2、4周试验组与对照组疗效相比,差异无统计学意义(P0.05);治疗后8周试验组疗效明显优于对照组(P0.05)。结论 ALA-PDT联合果酸治疗面部中重度痤疮是一种安全、有效的治疗方法。     

Efficacy of botulinum toxin A in the treatment of axillary and palmar hyperhidrosis: 10 cases

Axilliary and palmar hyperhidrosis can become a considerable social and psychological handicap. Local treatments are not always effective and endoscopic thoracic sympathectomy is not without side effects. The efficacy of botulinum toxin has recently been demonstrated in axillary and palmar hyperhidrosis. Between June 2001 and June 2002, we treated all the patients presenting with axillary and palmar hyperhidrosis, resistant to classical treatments, with intradermal injections of botulinum toxin A (Dysport). The aim was to assess the interest of this technique at moderate doses, in a prospective, open, controlled study. PATIENTS AND METHODS: The hyperhidrotic areas, revealed by Minor's test, were treated with intradermal injections of 100 U of Dysport in the axilliary form and 250 U in the palmar form. Patients were seen after 1 month and 6 months and underwent a Minor's test, photographic control and they filled-in a questionnaire to measure their satisfaction. RESULTS: Ten patients: 9 women and 1 man aged 19 to 63, were included. Three of them consulted for palmar hyperhidrosis and 7 for auxiliary hyperhidrosis. Within 2 to 7 days, treatment was successful in all patients. The follow-up was of 3 to 12 months. The satisfaction index was comprised between 7/10 and 9/10. The relapse-free interval was of 2 to 9 months. Three patients were given a second injection, which doubled the relapse-free period. Side effects included pain with the palmar injections and moderate headaches.DISCUSSION: This French study confirms the efficacy of botulinum toxin A in the treatment of axillary and palmar hyperhidrosis with relatively low doses (100 U of Dysport per armpit and 250 U per palm). This is an easily reproducible, well tolerated, method without major side effects.     

养阴活血除湿法治疗慢性湿疹的临床观察

目的观察养阴活血除湿法治疗慢性湿疹的临床疗效和安全性。方法 70例慢性湿疹患者,随机分为试验组和对照组,试验组给予养阴活血除湿方和氯雷他定口服,醋酸曲安奈德尿素软膏外用,对照组给予氯雷他定口服,醋酸曲安奈德尿素软膏外用,4周后对2组患者临床疗效进行评估。结果试验组有效率89.47%,对照组有效率69.75%,2组有效率比较差异有统计学意义(P0.05)。试验组有4例患者出现轻微胃肠道不适,对照组有3例患者出现轻度嗜睡及心悸。结论养阴活血除湿法治疗慢性湿疹临床有辅助疗效,不良反应小。