复方甘草酸苷治疗斑秃的系统评价

A Meta-analysis of Compound Glycyrrhizin for Alopecia Areata

目的评估复方甘草酸苷治疗斑秃的临床疗效及安全性。方法检索相关数据库,搜集随机对照试验(RCT),实验组单用复方甘草酸苷或联合中药、西药、物理及光化学疗法;对照组为单用中药、西药、物理及光化学治疗,也可加用胱氨酸及中药等。两名评价员独立评价纳入RCT的方法学质量并提取数据;采用Revman5.1软件做Meta分析。结果纳入40篇中文RCT文献,研究质量均为C级。Meta分析结果显示:与对照组相比,复方甘草酸苷组可以显著提高近期有效率(RR=1.41;95%CI为1.35～1.49;P<0.00001)和痊愈率(RR=1.69;95%CI为1.56～1.83;P<0.00001)。根据治疗方法或对照方法不同采用亚组分析,得到相似结果。复方甘草酸苷组面部或下肢轻度水肿的发生率明显增高。结论复方甘草酸苷联合应用可明显提高治疗斑秃的有效率和痊愈率,但具有引起面部或下肢轻度水肿发生率增高的倾向。

Objective To assess the efficacy and safety of compound glycyrrhizin for alopecia areata. Methods We retrieved relevant database to collect randomized controlled trials （RCTs）. Experimental group received compound glycyrrhizin alone, or combined with other chinese or western medicine, modality or photochemical therapy ; Control group received the same treatments other than compound glycyrrhizin, or additional cystine, vitamins, etc. Two review authors assessed the quality of the included studies and extracted data independently. Data was analyzed by RevMan 5.1 software. Results Forty RCTs were included, the quality was poor. Meta analysis resuhs suggested that compound glycyrrhizin had a statistically significant benefit in improving effective rate （RR = 1.41 ;95% CI： 1.35 - 1.49 ;P 〈 0. 000 01 ） and recovery rate （RR = 1.69 ;95% CI： 1.56-1.83;P 〈0.000 O1 ）. Subgroup analses saggested that the results were stable. However, compound glycyrrhizin may associate with more mild facial or lower extremities edema. Conclusion Compound glycyr rhizin can improve recovery rate and effective rate in alopecia areata. But it tends to increase mild facial or lower extremities edema.