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.     

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。     

非那雄胺1mg/d治疗杭州地区184例男性雄激素性秃发患者的疗效观察

目的:评价杭州地区男性雄激素性秃发(androgenetic alopecia,AGA)患者服用1 mg/d非那雄胺的疗效和安全性。方法:收集2010年1月—2011年12月在该院脱发专科就诊且服用1 mg/d非那雄胺的184例男性AGA患者的临床资料和临床照片:临床疗效评估采用患者自我评估与医生照片评估相结合,以标准化的7级量表评定疗效,并进行临床疗效和临床性征相关性分析。结果:1 mg/d非那雄胺治疗杭州地区男性AGA患者的总有效率为75.00%,其中轻度改善、中度改善和明显改善分别为38.04%、23.37%和13.59%。临床疗效与脱发部位、脱发等级和治疗时间有关,而与发病年龄和发病病程无明显相关。治疗患者中仅4例出现一过性轻度不良反应。结论:口服1 mg/d非那雄胺可有效治疗男性AGA,且耐受性好。     

雄激素性秃发患者治疗前后头发中微量元素的变化检测

<正>非那雄胺(商品名:保法止)1998年被美国食品药品管理局(FDA)批准用于治疗雄激素性秃发(androgenic alopecia,AGA),它是Ⅱ型5α还原酶的特异性抑制剂,能不可逆地结合Ⅱ型5α还原酶,从而抑制睾酮转化为二氢睾酮(dihydrotestosterone,DHT),使血清及组织中DHT的浓度显著下降。国外有研究表明,每天1 mg非那雄胺能显著降低DHT水平,且DHT的下降与临床疗效相关,对于DHT偏高的26岁以下患者,在治疗12个月时血清DHT水平可下降50%~([1])。此外,有研究对290例口服非那雄胺的患者随访5年,发现     

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.     

口服普萘洛尔联合外用马来酸噻吗洛尔滴眼液治疗婴幼儿血管瘤的近期疗效和安全性评价

目的观察口服普萘洛尔联合外用马来酸噻吗洛尔治疗血管瘤的疗效。方法选取我院确诊为血管瘤患儿110例,随机分为普萘洛尔联合马来酸噻吗洛尔组(A组:55例)和普萘洛尔组(B组:55例),A组患者每8小时给药1次,初始剂量为0.15mg/kg,检测生命体征及血糖,若平稳可逐渐增加至1mg/kg。同时将马来酸噻吗洛尔滴眼液直接均匀地滴在瘤体表面,3次/d。B组患者口服普萘洛尔方法与A组完全相同,观察血管瘤的体表面积,彩色B超,血糖,血常规,心电图等变化。结果治疗4周后按Achauer分级标准进行疗效评价:A组Ⅳ级8例,Ⅲ级32例,Ⅱ级13例,Ⅰ级2例。B组Ⅳ级3例,Ⅲ级25例,Ⅱ级21例,Ⅰ级8例。A组总有效率为72.7%(40∕55);B组总有效率为50.9%(28∕55),两组比较差异显著(P0.05)。治疗8周后疗效评价:A组Ⅳ级18例,Ⅲ级34例,Ⅱ级3例,Ⅰ级0例。B组Ⅳ级12例,Ⅲ级33例,Ⅱ级9例,Ⅰ级1例。A组总有效率为94.5%(52∕55),B组总有效率为81.8%(45∕55),两组间的差异有统计学意义(P0.05)。结论口服普萘洛尔联合外用马来酸噻吗洛尔治疗婴幼儿血管瘤的疗效比单独服用普萘洛尔更加明显和快速,患儿瘢痕形成也较少,值得临床推广应用。     

盐酸非索非那定片长疗程递减治疗慢性荨麻疹31例疗效观察

目的评价盐酸非索非那定片长疗程递减和每日疗法治疗慢性荨麻疹的疗效。方法将61例入选患者采用随机数字表法随机分2组,治疗组予非索非那定片口服,第1个月时口服60mg,2～3次/d;第2个月时口服30mg,2次/d;第3个月时口服30mg,1次/d,疗程3个月。对照组予非索非那定片60mg口服,2～3次/d,疗程1个月。两组患者在治疗期间每2周复诊1次,观察疗效和不良反应,且随访1个月。结果治疗组有效率为87.10%,复发率为29.03%,明显优于对照组的63.33%和56.67%,差异均有显著性意义(P均<0.05)。结论盐酸非索非那定片长疗程递减治疗慢性荨麻疹的疗效优于每日疗法治疗组,且复发率低。     

短期应用雷公藤联合甲硝唑治疗痤疮

1997年 1月至 1998年 10月,我们采用雷公藤多甙片加甲硝唑片联合短期口服疗法治疗中重度痤疮,临床疗效较为满意,现报道如下。 一、临床资料 所有病例均为本院门诊患者,治疗组 32例,男 18例,女 14例,年龄 24～ 36岁;病程 1～ 15年。对照组 28例,其中男 16例,女 12例,年龄 20～ 32岁,病程 7个月至 12年。皮损分为Ⅱ度至Ⅲ度,所有患者 1个月内未接受任何治疗,未生育者不入选治疗组, 治疗组患者疗前肝功能、血、尿常 二、治疗方法 治疗组口服雷公藤多甙片 (泰州制药厂 )20 mg每日 3次,甲硝唑片 0.2 g每日 3次;对照组口服甲…     

非那雄胺治疗男性型秃发疗程与疗效的相关性分析

目的:初步探讨非那雄胺在治疗男性型秃发中的疗程与疗效的相关性。方法:选取177例患男性型秃发的患者,口服非那雄胺1 mg,每天1片,连服24个月以上,并对患者在服药前和服药后6个月、12个月、18个月及24个月拍摄头部脱发区,比较4个时段的疗效。结果:6个月、12个月18个月及24个月的显效率和总有效率分别为:15.85%、52.54%;50.84%;92.90%;53.67%、93.78%;58.75%、94.91%。4个时段相比较,6个月分别与12个月、18个月及24个月的疗效比较差异有统计学意义,而12个月分别与18个月及24个月的疗效相比差异则无统计学意义。结论:口服非那雄胺治疗男性型秃发在12个月内疗程越长其显效率及总有效率越高,疗程与疗效呈正相关,连服12个月时疗效最显著。     

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。     

Finasteride, 1 mg daily administration on male androgenetic alopecia in different age groups: 10-year follow-up

Finasteride 1 mg is indicated for the treatment of men with androgenetic alopecia (AGA). However, more than 5 years efficacy and safety has not been previously reported. To assess the efficacy over 10 years in different age groups of men with AGA. 118 men, between 20 and 61 years, with AGA receiving finasteride (1 mg/day), were enrolled in this uncontrolled study. Efficacy evaluation was assessed with standardized global photographs at T0,T1,T2,T5,T10. Statistical analysis was made using frequency tables and evaluating the chi-square index with its p-value. Better improvements are observed in patients older than 30 years (42.8% aged between 20 and 30 years did not improve also after 10 years) or with higher AGA grades (58.9% for AGA grade IV and 45.4% for AGA grade V had the first improvement just after 1 year). In 21% of cases, the treatment continuation beyond 5 years provided better results. Side effects were referred by 6% of the patients; nevertheless, some of them went on with treatment because of the great results. In our opinion, the result after the first year can help in predicting the effectiveness of the treatment. Its efficacy was not reduced as time goes on; in fact, a big proportion of subjects unchanged after 1 year, improved later on, maintaining a positive trend.     

Use of finasteride in the treatment of men with androgenetic alopecia (male pattern hair loss)

Finasteride, a type 2-selective 5alpha-reductase inhibitor, was approved in 1997 as the first oral pharmacologic therapy for the treatment of men with androgenetic alopecia (AGA; male pattern hair loss). Originally developed for the treatment of men with benign prostatic hyperplasia (BPH) at a dose of 5 mg/day, finasteride has a well-established, excellent safety profile. Subsequent studies demonstrated that finasteride was an effective treatment for men with AGA at an optimal dose of 1 mg/day. This report summarizes the published peer-reviewed literature on the use of finasteride in the treatment of men with AGA, including the data on long-term (5 years) use of finasteride in a placebo-controlled clinical trial environment.     

Long-term treatment with finasteride 1 mg decreases the likelihood of developing further visible hair loss in men with androgenetic alopecia (male pattern hair loss)

There are no reports on the effects of pharmacologic treatment on the likelihood of developing further visible hair loss in men with androgenetic alopecia (AGA). Our objectives were to examine whether finasteride 1 mg treatment decreases the likelihood of developing further visible hair loss in men with AGA. We conducted an analysis of global photographic assessment data from two Phase III trials in which 1553 men with AGA received finasteride 1 mg/day or placebo for up to 5 years. Finasteride 1 mg treatment led to a 93% decrease relative to placebo in the 5-year likelihood of developing further visible hair loss (95% CI: 89-97%; p < 0.001). We conclude that, in men with AGA, treatment with finasteride 1 mg/day over 5 years led to a marked and sustained decrease in the likelihood of developing further visible hair loss.     

Evaluation of efficacy and safety of finasteride 1 mg in 3177 Japanese men with androgenetic alopecia

Before now, there has been no study of finasteride use exceeding 1 year in Japanese men with androgenetic alopecia (AGA) except the study subsequently conducted from the development phase. Since the launch of finasteride, no study in a larger population had been reported. Ethnic variation of the onset age, progressive nature and degree of hair loss of androgenetic alopecia are known. The therapeutic effect of oral finasteride (Propecia) was examined on androgenetic alopecia of Japanese men. The efficacy and safety of finasteride (1 mg tablet) was evaluated in Japanese men with AGA in the long term. The study enrolled 3177 men given finasteride 1 mg/day from January 2006 to June 2009 at our clinic. Efficacy was evaluated in 2561 men by the modified global photographic assessment; the photographs were assessed using the standardized 7-point rating scale. Safety data were assessed by interviews and laboratory tests in all men enrolled in the study. The overall effect of hair growth was seen in 2230 of 2561 men (87.1%), in whom hair greatly (11.1%), moderately (36.5%) and slightly (39.5%) increased. The response rate improved with increasing duration of treatment. Adverse reactions occurred in 0.7% (23/3177) of men; seven men discontinued treatment based on risk-benefit considerations. No specific safety problems associated with long-term use were observed. This study represents data collected at a single institution. Many patients did not receive follow-up examination. In Japanese men with AGA, oral finasteride used in the long-term study maintained progressive hair regrowth without recognized side-effect.     

An open, randomized, comparative study of oral finasteride and 5% topical minoxidil in male androgenetic alopecia

BACKGROUND AND AIM: Androgenetic alopecia (AGA) is undoubtedly the most common form of hair loss in males. It is a condition which may cause cosmetic and psychosocial problems in androgen-dependent cases. In this open, randomized and comparative study we evaluated the efficacy of oral finasteride and 5% topical minoxidil treatment for 12 months in 65 male patients with mild to severe AGA. METHODS: We randomly assigned 40 (61.53%) patients to receive 1 mg/day oral finasteride for 12 months, and 25 (38.47%) patients applied 5% topical minoxidil solution twice daily for 12 months. RESULTS: There were no significant differences between the 2 groups considering age, age of onset of hair loss, family history and type of hair loss (p > 0.05). In the clinical evaluation at the endpoint of treatment, the clinical cure rates (i.e. increased intensity of hair) were 80% (32/40) for the oral finasteride group and 52% (13/25) for the 5% topical minoxidil group. Encountered side effects were all mild, and there was no need to stop the treatment. In the group given oral finasteride, side effects were noted in 7 patients: 6 patients suffered from loss of libido, and 1 patient had an increase in other body hairs; irritation of the scalp was seen in 1 patient in the group administered 5% minoxidil. These adverse events disappeared as soon as the treatment was stopped. The laboratory data on both drug groups did not show any statistically or clinically significant intragroup changes from baseline values to the endpoint (p > 0.05), except the level of serum total testosterone which was increased, and free testosterone and serum prostate-specific antigen in the finasteride group which were statistically decreased from baseline values to the endpoint (p < 0.05). CONCLUSION: In this comparative study of systemic finasteride and topical minoxidil, it was concluded that both drugs were effective and safe in the treatment of mild to severe AGA, although oral finasteride treatment was more effective (p < 0.05). Adverse events were not considered important either, and these side effects disappeared as soon as the treatment was stopped.     

Comparative efficacy of various treatment regimens for androgenetic alopecia in men

Our understanding of the aetiology of androgenetic alopecia (AGA) has substantially increased in recent years. As a result, several treatment modalities have been tried with promising results especially in early stages of AGA. However, as far as has been ascertained, there is no comprehensive study comparing the efficacy of these agents alone and in combination with each other. One hundered male patients with AGA of Hamilton grades II to IV were enrolled in an open, randomized, parallel-group study, designed to evaluate and compare the efficacy of oral finasteride (1 mg per day), topical 2% minoxidil solution and topical 2% ketoconazole shampoo alone and in combination. They were randomized into four groups. Group I (30 patients) was administered oral finasteride, Group II (36 patients) was given a combination of finasteride and topical minoxidil, Group III (24 patients) applied minoxidil alone and Group IV (10 patients) was administered finasteride with topical ketoconazole. Treatment efficacy was assessed on the basis of patient and physician assessment scores and global photographic review during the study period of one year. At the end of one year, hair growth was observed in all the groups with best results recorded with a combination of finasteride and minoxidil (Group II) followed by groups IV, I and III. Subjects receiving finasteride alone or in combination with minoxidil or ketoconazole showed statistically significant improvement (p<0.05) over minoxidil only recipients. No signifcant side-effects related to the drugs were observed. In conclusion, it is inferred that the therapeutic efficacy is enhanced by combining the two drugs acting on different aetiological aspects of AGA.     

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％。     

Management of androgenetic alopecia.

BACKGROUND: Androgenetic alopecia (AGA) is the most frequent cause of hair loss affecting up to 50% of men and 40% of women by the age of 50. METHODS: This paper outlines the current status of diagnosis and offers guidelines for optimal management of AGA in both men and women. RESULTS: The diagnosis of AGA can usually be confirmed by medical history and physical examination alone. A trichogram can be useful to assess the progression of the hair loss. A scalp biospy is diagnostic but usually not required. In women with signs of hyperandrogenism, investigation for ovarian (polycystic ovarian disease) or adrenal (late-onset congenital adrenal hyperplasia) disorders is required. Mild to moderate AGA in men can be treated with oral finasteride or topical minoxidil. Oral finasteride at the dosage of 1 mg/day produced clinical improvement in up to 66% of patients treated for 2 years. The drug is effective for both frontal and vertex hair thinning. Medical treatment with finasteride or minoxidil should be continued indefinitely since interruption of therapy leads to hair loss with return to pretreatment status. Mild to moderate AGA in women can be treated with oral antiandrogens (cyproterone acetate, spironolactone) and/or topical minoxidil with good results in many cases. Hair systems and surgery may be considered for selected cases of severe AGA both in men and in women. CONCLUSIONS: Patients with AGA should be informed about the pathogenesis of the condition. If used correctly, available medical treatments arrest progression of the disease and reverse miniaturization in most patients with mild to moderate AGA.     

Evaluation of long‐term efficacy of finasteride in Korean men with androgenetic alopecia using the basic and specific classification system

Finasteride 1 mg is considered to be the standard treatment method for male androgenetic alopecia (AGA). However, there have only been a few studies investigating its long‐term efficacy. Moreover, its effect on various types of AGA remains unknown. In this study, the authors investigated the 5‐year efficacy of finasteride 1 mg in Korean men with AGA and analyzed the changes in hair growth according to the distribution of hair loss. The medical records of male AGA patients who were treated with oral finasteride for a period of at least 5 years at two university hospitals were retrospectively reviewed. Patients' photographs were evaluated using the basic and specific (BASP) classification and investigator's global assessment. Of the total 126 patients, 108 (85.7%) showed improvement after 5 years of treatment. According to the BASP classification, hair loss of the anterior hair line (basic type), vertex (V type), and frontal area (F type) was improved in 44.4%, 89.7% and 61.2% of patients, respectively. The V type showed a more rapid and steady improvement compared with the other types. Progression of alopecia after peak improvement was seen in 10.3% of cases of the V type, 16.2% of the F type and 0% of the basic type. In conclusion, finasteride 1 mg showed a sustainable effect for at least 5 years in Korean male AGA patients. The exact time points showing signs of first clinical improvement and sustainability were different depending on the type of alopecia.