复方多黏菌素B软膏联合糖皮质激素治疗湿疹有效性和安全性的meta分析

Efficacy and safety of compound polymyxin B ointment combined with glucocorticoids in treatment of eczema:meta-analysis

目的:系统评价复方多黏菌素B软膏联合糖皮质激素治疗湿疹的有效性和安全性。方法:计算机检索Cochrane library、 Embase、 Pubmed、 CNKI、 CBM、 VIP和Wanfang data数据库,搜集复方多黏菌素B软膏联合糖皮质激素治疗湿疹的随机对照试验,检索时限均为建库至2018年3月。由2位研究者独立筛选文献、提取资料和评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行meta分析。结果:共纳入11个研究,累计纳入患者1397例。Meta分析结果显示:有效性方面,联合复方多黏菌素B软膏和糖皮质激素治疗湿疹可提高有效率(RR=1.21, 95%CI:1.15～1.27, P<0.001),且可减少复发率(RR=0.23, 95%CI:0.12～0.46, P<0.001)。安全性方面,复方多黏菌素B软膏联合糖皮质激素并不会增加不良反应发生率(RR=0. 85, 95%CI:0.47～1.57, P=0.61)。结论:外用糖皮质激素基础上联用复方多黏菌素B软膏可以提高湿疹治疗有效率,降低疾病复发率,同时不增加不良反应的发生风险。

ObjectiveTo systematically review the efficacy and safety of compound polymyxin B ointment combined with glucocorticoids in the treatment of eczema.MethodsThe data about randomized controlled trials of compound polymyxin B ointment combined with glucocorticoids for the treatment of eczema were searched from Cochrane library, Embase, Pubmed, CNKI, CBM, VIP and Wanfang, from the establishment of the database to March 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed using RevMan 5.3 software.ResultsA total of 11 studies involving 1397 patients were included. The results of meta-analysis showed that in terms of efficacy, combined compound polymyxin B ointment with glucocorticoids could improve treatment efficiency rate （RR=1.21, 95% CI： 1.15-1.27, P〈0.001） and reduce the recurrence rate （RR=0.23, 95% CI： 0.12-0.46, P〈0.001） compared to the control group; in terms of safety, combined compound polymyxin B ointment with glucocorticoids couldn′t increase the incidence of adverse reactions rate （RR=0.85,95% CI： 0.47-1.57,P=0.61）. ConclusionIn the treatment of eczema, compound polymyxin B ointment combined with glucocorticoids can improve treatment efficiency rate and reduce the recurrence rate, and it doesn′t increase the risk of adverse reactions.