1例瘢痕性类天疱疮的循证治疗

Evidence-based treatment programs for 1 case of cicatricial pemphigoid patient

目的:借助循证医学的方法为1例确诊为瘢痕性类天疱疮患者制定循证治疗方案。方法:在充分评估患者情况后,提出临床问题,从Cochrane图书馆(2010年第3期)、Medline(PubMed网站1990年1月～2010年12月)、和http://sumsearch.uthsca.edu/searchf orm4.htm进行检索。检索词为cicatrical pemphigus;meta analysis,randomizedcontrolled trial,clinicalcontrolled trial,(瘢痕性类天疱疮,系统评价,Meta分析,随机对照试验和临床对照试验),并手工检索《中华皮肤科杂志》等相关的4种中国科技论文统计源期刊(创刊～2010年)。结果:未检索到系统评价文献,检索到随机对照试验论著6篇,运用了循证医学方法的高质量综述2篇,以及英国皮肤病医师协会拟订的治疗指南。通过对检索结果进行分析,为患者制定合理的治疗方案。皮质类固醇激素是治疗类天疱疮的首选药物,治疗口腔瘢痕性类天疱疮时建议选用中等剂量激素,经6个月的治疗随访,证实该方案适合此患者。结论:循证治疗口腔瘢痕性类天疱疮患者有助于提高临床疗效。

Objective：Use the method of Evidence-based medicine to develop evidence-based treatment programs for 1 case of cicatricial pemphigoid patient newly diagnosed.Method：After a full assessment to the situation of the patient,clinical questions are raised,From the Cochrane Library（Issue 3,2010）、Medline（PubMed website January 1990-December 2010）、and http：//sumsearch.Uthsca.Edu/searchf orm4.Htm on the search.Search terms as cicatricial pemphigus;meta analysis,randomized controlled trial,clinical controlled trial,Cicatricial pemphigoid,the system review Meta-analysis,Randomized controlled trials and controlled clinical trials,and hand searching,＂Journal of Dermatology＂ and other related four kinds of Chinese scientific papers such as Source Journal（founded 2010）.Result：There are not systematic reviews of the results,retrieve 6 pieces of randomized controlled trials,two pieces of high-quality review which has been made of evidence-based medicine methods,and the treatment guidelines that made by British Association of Dermatology Physician develop.Through the analysis of the results,has been developed a reasonable treatment for the patient.Corticosteroid is the first choice to pemphigoid,Suggested to choose moderate doses of hormone to treat oral cicatricial pemphigoid,the program is confirmed suitable for the patient after 6 months of treatment follow-up.Conclusion：Evidence-based treatment of oral cicatricial pemphigoid patients can effectively improve the curative effect.