外用米诺地尔治疗女性雄激素性脱发的系统评价

Topical minoxidil for androgenetic alopecia in women:a systematic review

目的评价外用米诺地尔治疗女性雄激素性脱发的疗效和安全性。方法计算机检索Medline(1966～2010)、Embase(1984～2010)和中国生物医学文献数据库(1978～2010),手工检索发表与未发表的中文文献,收集所有关于米诺地尔治疗女性雄激素性脱发的随机对照试验,根据纳入和排除标准筛选文献,提取资料和进行质量评价,采用Rev-Man5.1软件对数据进行Meta分析。结果共纳入8篇RCT,包括1252例患者,均为高质量研究。对治疗效果的Meta分析显示:1cm2评估区域非毳毛计数:2%米诺地尔与安慰剂比较,WMD合并=11.68,[95%CI(7.94,15.43),P<0.00001];2%米诺地尔与安慰剂比较(患者的自我评判)RR合并=1.27,[95%CI(1.11,1.47),P=0.0007];2%米诺地尔与安慰剂比较(研究者的评判)RR合并=1.54,[95%CI(1.29,1.84),P<0.00001]。所有研究均未发现严重不良反应。结论外用2%米诺地尔治疗女性雄激素性脱发比安慰剂有效,但5%、1%米诺地尔与安慰剂的比较以及2%米诺地尔与alfatradiol的比较,由于纳入的研究太少尚不能得出肯定的结论。

Objective To evaluate the efficacy and safety of topical minoxidil for androgenetic alopecia in women.Methods Electronic database MEDLINE（1966-2010）,EMbase（1984～2010） and CBM（1978～2010） were sarched to collect Randomised Controlled Trails（RCTs）.Still,published and unpublished journals in Chinese were manually searched.Collecting RCT,screening,retrieving of studies and evaluating the quality of the studies were based on the criteria of predefined inclusion and exclusion.Meta-analyse were conducted by using RevMan 5.1.Results 8 high methodological RCTs which involving 1252 patients were included.Meta-analysis indicates that the 1cm2 non-vellus hair count： WMD combination=11.68 [95%CI（7.94,15.43）,P0.00001]between 2% minoxidil group and placebo;RR combination=1.27[95%CI（1.11,1.47）,P=0.0007] between 2% minoxidil group and placebo（patient self evaluation）;RR combination=1.54 [95%CI（1.29,1.84）,P〈0.00001] between 2% minoxidil and placebo（evaluation of researcher）.No severe side effect was identified.Conclusion Topical 2% minoxidil is more effective for treating androgenetic alopecia in women compared to placebo.There is no affirmative conclusion can be drawn based on the comparison of minoxidil（both 1% and 5%） with placebo due to the limited study number.Also,there is no conclusive finding can be identified based on the comparison of topical 2% minoxidil and alfatrodio due to the same reason.