5％咪喹莫特乳膏治疗尖锐湿疣Meta分析

A meta-analysis of the effectiveness of 5% imiquimod cream in the treatment of condyloma acuminatum

目的以循证医学的方法对5％咪喹莫特乳膏治疗尖锐湿疣的疗效与安全性进行系统评价,方法检索PubMed、Ovid、Web of Science、UMI、Elsevier以及Cochrane图书馆、中文科技期刊数据库(CNKI)、中国生物医学文献数据库(CBMDisc),纳入比较5％咪喹莫特乳膏与安慰剂或氟尿嘧啶乳膏的随机对照试验,由两名评价者独立提取资料并进行方法学质量评估。试验数据的统计分析采用Cochrane协作网提供的RevMan 4．2．8软件进行。结果最终纳入8个临床随机对照试验,对5％咪喹莫特乳膏治疗尖锐湿疣进行了Meta分析,与安慰剂组相比,差异具有统计学意义;与氟尿嘧啶乳膏组相比,疗效差异无统计学意义,没有报道与5％咪喹莫特乳膏临床应用相关的严重系统性不良反应。结论现有临床证据表明,5％咪喹莫特乳膏治疗尖锐湿疣有确切的疗效与较好的安全性。

Objective To evaluate the efficacy and safety of 5% imiquimod cream in the treatment of condyloma acuminatum. Methods The PubMed, Ovid, Web of Science, UMI, Elsevier, Cochrane Library, CNKI and CBMDisc were searched. The randomized controlled trials （RCT） comparing 5% imiquimod cream versus placebo or fluorouracil cream were included, and two authors independently reviewed the data and assessed the quality. The data were inputted and analyzed by RevMan 4.2.8 software supplied by the Cochrane Collaboration. Results Eight trials ranked high quality were included. Meta-analysis of the treatment of condyloma acuminatum with 5% imiquimod cream showed the clinical effective rates were significantly different between 5% imiquimod cream and placebo, while were not between 5% imiquimod and flurouracil cream. No serious systematical adverse reaction was recorded. Conclusion Topical 5% imiquimod cream is an effective and safe regimen for the treatment of condyloma acuminatum.