干扰素治疗蕈样霉菌病的系统评价

Interferon Therapy for Mycosis Fungoides: A Systematic Review

目的采用系统评价方法,评估干扰素（IFN）治疗蕈样霉菌病（MF）的疗效及安全性。方法计算机检索截止2010年5月的Cochrane协作网系统评价方法,纳入所有比较IFN与其他方法治疗MF的随机对照试验及临床对照试验进行质量评价,采用RevMan 5.0.24软件进行Meta分析。结果共纳入6篇符合标准的已发表文献,包括142例受试者。Meta分析结果显示：IFNα-单独使用对MF的疗效优于安慰剂组[OR=69.36,95%CI（3.71~1 296.64）]及地精丹方剂[OR=35.53,95%CI（1.78~710.56）];而IFNα-与胸腺肽[OR=15.11,95%CI（0.71~322.61）]及IFNα-＋阿维A酯[OR=3.10,95%CI（0.79~12.12）]的临床疗效差异无统计学意义;IFN-γ联合窄谱中波紫外线（NB-UVB）治疗与单用NB-UVB的临床疗效差异无统计学意义[OR=15.00,95%CI（0.46~485.32）]。90%的患者出现轻度＂流感样症状＂的不良反应,多可缓解及消退。结论 IFN是目前治疗MF的一线用药,疗效确切且大部分患者耐受性较好。

Objective To evaluate the clinical efficacy and side effects of interferon（IFN） in the treatment of mycosis fungoides（MF） with the method of systematic review.Methods According to the Cochrane reviewer＇s handbook,all the clinical controlled trials involving mycosis fungoides being treated with interferon were retrieved.The Cochrane Collaboration＇s software RevMan 5.0.24 was used for meta-analysis.Results Only six papers including 142 patients met the inclusion criteria.Meta-analyses indicated the results as follows： IFN-α monotherapy was more effective than placebo [OR=69.36,95% CI（3.71-1 296.64）] and a traditional Chinese medicine（Di-jing-dan） [OR=35.53,95% CI（1.78-710.56）],but no significant difference was found between INF-α and thymic peptide [OR=15.11,95% CI（0.71-322.61）],and between IFN-α monotherapy and IFN-α combined with etretinate therapy [OR=3.10,95% CI（0.79-12.12）];and there was no significant difference between the efficacy of IFN-γ combined narrowband ultraviolet B（NB-UVB） therapy and that of single NB-UVB therapy [OR=15.00,95% CI（0.46-485.32）];Influenza-like side effects occurred to 90% of all the patients,which were usually slight and easy to release.Conclusion Although there are some mild side effects,interferon is safe to treat MF.