5-氨基酮戊酸光动力疗法联合CO_2激光治疗尖锐湿疣疗效的系统评价

Efficacy of 5-aminolevulinie acid-photodynamic therapy combined with CO_2 laser for condyloma acuminatum:A systematic review

目的:系统评价5-氨基酮戊酸光动力疗法(ALA-PDT)联合CO2激光与CO2激光单用比较治疗尖锐湿疣的疗效和安全性。方法:计算机检索CNKI、VIP、Google学术收索引擎和万方数据知识服务平台(2001至2011.11),按照拟定的纳入及排除标准选择文献、提取资料和进行质量评价,采用RevMan 5.0软件对纳入文献进行Meta分析。结果:共纳入10个随机对照实验,合计841例患者。Meta分析结果表明,5-氨基酮戊酸光动力疗法联合CO2激光治疗复发率低于CO2激光治疗〔OR=0.15,95%CI(0.10,0.22),P<0.00001〕;治疗组治愈率高于对照组〔OR=6.93,95%C1(4.18,11.49),P<0.00001〕两种治疗方案产生的不良反应相当,差异无统计学意义〔OR=1.22,95%C1(0.42,3.59),P=0.71〕。结论:5-氨基酮戊酸光动力疗法联合CO2激光治疗尖锐湿疣能有效降低复发率,提高临床治愈率。但由于纳入研究质量普遍较低,期待更多合理设计的随机对照实验提供高质量的证据。

Objective：To assess the clinical effectiveness and safety of 5-aminolevulinie acid-photodynamic therapy（ALA-PDT） combined with CO2 laser versus an CO2 laser alone for patients with condyloma acuminatum（CA）.Methods：Such databases as CNKI,VIP,Google Academic and Wanfang data（2001 to November 2011）were searched to collect the randomized controlled trials（RCTs）according to inclusive and exclusive criteria,the data were extracted,the quality was assessed,and meta-analysis was conducted by using Revman 5.0 software.Result：Ten RCTs involving 841 patients with CA were included.The meta-analysis showed that ALA-PDT combined with CO2 laser group was fewer than the CO2 laser alone group in the recurrence rate（OR=0.15,95 % CI（0.10,0.22）,P0.00001）;the cure rate in the treatment group were superior to the control group（OR=6.93,95%CI（4.18,11.49）,P0.00001）;but the adverse events between the two group was similar without significant difference（OR=1.22,95%CI（0.42,3.59）,P=0.71）.Results：The ALA-PDT combined with CO2 laser can effectively reduce the recurrence rate and improve the clinical cure rate.Because of the low quality of the included studies,more high-quality trails are required to provide high quality evidence.