口服氨甲环酸片辅助治疗黄褐斑的Meta分析

Oral tranexamic acid tablet for assisted treatment of melasma:a Meta analysis

目的评价止血药氨甲环酸片治疗黄褐斑的疗效和安全性。方法计算机检索英文数据库PubMed,EBSCO,ISI Web of science,ovid,Science Direct,the Cochrane Library(2015年第12期)、CENTRAL,以及维普、中国知网(CNKI)、万方检索;时间从建库至2016年1月7日,查找关于氨甲环酸治疗黄褐斑的随机对照试验(RCT)研究,2位评价员独立筛选文献,提取资料和评价纳入研究的质量,使用Stata12.0软件进行Meta分析。结果共纳入RCT研究16篇,两组同时涉及有效率13篇,疗效评分5篇,报道不良反应情况14篇,复发情况4篇:(1)两组对比的疗效差异有统计学意义[OR=2.49,95%CI(1.39,4.46),P=0.002];(2)总有效率[r5=0.75,95%CI(0.69,0.82,P=0.000];总有效率[r6=0.93,95%CI(0.91,0.95,P=0.005];(3)疗程为8周时,氨甲环酸组的疗效评分低于对照组,差异有统计学意义[SMD=-1.23,95%CI(-1.38,-1.08),P=0.000];(4)4篇报道了不良反应情况,不良反应类型主要为胃肠道反应及月经量减少,3篇报道了复发的例数,1篇报道了复发的比率。结论氨甲环酸组治疗黄褐斑的疗效优于对照组;口服氨甲环酸片治疗黄褐斑安全性较为可靠,但存在复发情况。

Objective To evaluate the efficacy and safety of hemostatic tranexamic acid tablet in the treatment of chloasma. Methods Such databases as PubMed, EBSCO, ISI Web of Science, Cochrane Library （Issue 12,2015） CENTRAL, VIP, CNKI Wanfang Database were electronically retrieved from their establishment to January 7,2016 for seeking the randomized controlled trials （RCTs） on tranexamic acid tablet in treating melasma. Two valuators independently screened the literatures,extracted the data and evaluated the quality of included RCTs. The meta analysis was performed by using Stata 12, 0 software. Results Sixteen RCTs were included, simultaneously involving the efficiency in the two groups（n= 13） the severity＇score （n= 5）, adverse reactions （n= 14） and the recurrence situation （n=4）. （1）The difference of curative effect between the two groups was statistically significant [OR=2.49,95%CI（1.3.9,4.46） ,P=0. 002];（2） the total effective rate [r5=0.75,95%CI（0.69,0.82）,P=0. 000];the total ef- fective ratel[r6=0.93,95%CI（0.91,0.95,P=0. 005];（3） when the course of treatment was 8 weeks,the curative effect score in the tranexamic acid group, was lower than that in the control group [SMD= -1.23,95 %CI（- 1.38,-1.08）, P= 0. 000], and the difference was statistically significant; （4） 4 articles reported the adverse reactions. The main adverse reaction types were gastroin- testinal reactions and menstruation volume decrease. 3 articles reported the number of recurrent cases, and 1 article reported the rate of recurrence. Conclusion The curative effect in the tranexamic acid treatment group in treating chloasma is better than that in the control group;oral tranexamic acid tablet has the reliable safety in the treatment of chloasma,but there is recurrence situation.