芦荟治疗急慢性创伤疗效的系统评价

目的系统评价芦荟及芦荟产品（如外用敷料及凝胶等）对急性创伤（如撕裂伤、手术切口及烧伤等）和慢性创伤（如感染性伤口及动静脉溃疡等）的疗效。方法计算机检索TheCochraneLibrary、PubMed、EMbase、CBM、CNKI和VIP，检索时限均为从建库至2012年4月，收集芦荟或其派生产品治疗急慢性创伤的随机对照试验（RCT）。由2名研究者独立进行文献筛选、数据提取及偏倚风险评估后，采用RevMan5．0软件进行Meta分析。结果最终纳入15个RCT，共计773例患者，纳入研究的质量均较低。8个RCT评价芦荟用于治疗急性创伤（烧伤、痔切除术及皮肤活检），所有文献均未涉及是否有感染发生这一指标。Meta分析结果显示：与磺胺嘧啶银乳膏相比，芦荟产品能提高烧伤患者的伤口愈合数[RR=I．28，95％CI（1．03，1．60），P=0．03]；与抗生素霜相比，芦荟产品能缩短烧伤患者的平均伤口愈合时间[MD=-12．90，95％CI（-13．29，-12．51），P〈0．00001）]；与传统治疗相比，芦荟凝胶增加了皮肤急性外科创伤伤口愈合患者数[RR=16．33，95％CI（3．46，77．15），P=0．0004]，能提高压疮患者伤口愈合数[RR=1．73，95％CI（1．21，2．49），P=0．003]。结论应用芦荟外用制剂或敷料对急慢性创伤均有积极意义，但此结论至今仍缺少高质量研究证据予以支持。

Effectiveness of Aloe Vera for Acute and Chronic Wounds: A Systematic Review

Objective To systematically evaluate the effectiveness of aloe vera and its products （e.g. dressing for external use, and gel） for both acute （e.g. laceration, surgical incision, and burn） and chronic （e.g. infectious wound, and artery and venous ulceration） wounds. Methods With ＂aloe＂ and ＂wound＂ as the index words, such databases as Cochrane Library, PubMed, EMbase, CBM, CNKI and VIP were searched from the inception to April, 2012 to collect the randomized controlled trials （RCTs） about aloe vera or its products for treating acute and chronic wounds. Two authors independently screened literature, extracted data and assessed the risks of bias. Then meta-analysis was conducted using RevMan 5.0 software. Results A total of 15 RCTs involving 773 participants were included, and all studies were of low quality. There were 8 RCTs which evaluated aloe vera for treating acute wounds （burn, haemorrhoidectomy, and skin biopsy）, and no RCT reported the incidence of infection. Compared with silver sulfadiazine, aloe vera products could increase the proportion of healing wounds for patients with burn （RR= 1.28, 95%CI 1.03 to 1.60, P=0.03 ）; compared with antibiotic cream, aloe vera products could reduce the average healing time for patients with burn （MD= -12.90, 95%CI -13.29 to -12.51, P〈0.000 01）; compared with conventional therapy, aloe vera gel could increase the proportion of healed patients with acute surgical wounds （RR--16.33, 95%CI 3.46 to 77.15, P=0.000 4）, and could increase the proportion of healed patients with pressure sores （RR=1.73, 95%CI 1.21 to 2.49, P=0.003）. Conclusion The application of aloe vera topical agents and dressings is positively significant to both acute and chronic wounds. But this conclusion still needs to be supported by high quality trials.