他克莫司软膏治疗儿童特应性皮炎疗效和安全性的meta分析

Efficacy and safety of topical tacrolimus for childhood atopic dermatitis:a meta-analysis

目的 :系统评价他克莫司软膏治疗儿童特应性皮炎的有效性及安全性。方法 :搜索电子数据库MEDLINE and PubMed、the Cochrane Central Register of Controlled(CENTRAL)、EMbase、中国知网、万方数据库以及维普数据库,检索时间从建库到2016年9月。检索他克莫司软膏治疗儿童特应性皮炎的随机对照试验(RCT)并根据Cochrane系统评价方法评价纳入文献质量,提取相关数据并用Stata/SE11.0软件进行meta分析。结果:最终纳入18个RCT共计2821例中到重度儿童特应性皮炎儿童患者。结果显示:(1)0.03%和0.1%他克莫司软膏可以有效治疗儿童特应性皮炎且无明显不良反应;(2)他克莫司软膏疗效优于氢化可的松软膏,但与甲泼尼龙和氟轻松相比差异无统计学意义;(3)0.1%与0.03%他克莫司软膏疗效及不良反应发生率差异无统计学意义。结论:外用他克莫司软膏可有效治疗儿童特应性皮炎,且具有较低的不良反应发生率。

Objective： To evaluate the efficacy and safety of tacrolimus ointment in the treatment of childhood atopic der- matitis. Methods： Randomized controlled trials（RCTs） of tacrolimus ointment for childhood atopic dermatitis were searched in databases of MEDLINE and PubMed, the Cochrane Central Register of Controlled （CENTRAL）, EMbase, China Knowledge Network, Wanfang Database and Vip Database from their establishment to September 2016. The quality of articles was evalu- ated according to the Cochrane systematic review. Meta-analysis was performed using Stata/SEll.0 software. Results： The analysis was performed in a total of 18 studies, including 2821 patients with moderate to severe atopic dermatitis in children. The results showed： ①0.03% and 0.1% tacrolimus ointment could effectively treat childhood atopic dermatitis with no obvious adverse effects; ② 0.03% and 0.1% tacrolimus ointment exhibited comparable therapeutic efficacy and induced similar rates of adverse events; ③The efficacy of tacrolimus ointment was superior to that of hydrocortisone acetate, but did not differ from that of methyl prednisone and fluocinolone. Conclusion： Topical tacrolimus ointment is effective for childhood atopic dermatitis, but with a lower incidence of side effects.