长脉冲1064 nm Nd:YAG激光联合外用抗真菌药治疗甲真菌病疗效的Meta分析

Meta analysis: efficacy of long-pulsed 1064nm Nd:YAG laser combined with topical antifungal agents in the treatment of onychomycosis

目的:通过Meta分析方法评价长脉冲1064 nm Nd:YAG激光联合外用抗真菌药治疗甲真菌病的疗效。方法:搜集PubMed、Web of Science、Sinomed、FMRS、知网、中国生物医学文献数据库、维普和万方数据库自建库至2021年3月1日收纳的长脉冲1064 nm Nd:YAG激光联合外用抗真菌药治疗甲真菌病的随机对照试验,统计软件采用Rev Man5.3和Stata11.0。结果:共纳入6项随机对照试验,353个病例。与单一激光治疗相比,长脉冲1064 nmNd:YAG激光联合外用抗真菌药物具有更高的临床有效率(OR=1.49,95%CI 1.04~2.12,Z=2.20,P=0.03)和真菌学清除率(OR=1.85,95%CI 1.21~2.82,Z=2.86,P=0.004),且复发率低(OR=0.23,95%CI 0.08~0.70,Z=2.59,P=0.010)。结论:长脉冲1064 nm Nd:YAG激光联合外用抗真菌药是治疗甲真菌病的有效手段。

Objective:To evaluate the efficacy of long-pulsed 1064nm Nd:YAG laser combined with topical antifungal agents in the treatment of onychomycosis by meta-analysis.Methods:Randomized controlled trials of long-pulsed 1064nm Nd:YAG laser combined with topical antifungal agents in the treatment of onychomycosis were collected in PubMed,Web of Science,Sinomed,FMRS,CNKI,CBM,VIP and Wanfang Database from inception to March 1st,2021.Rev Man5.3 and Stata11.0 were used as statistical software.Results:Six randomized controlled trials with 353 patients were included in total.Compared with single laser treatment,long-pulse 1064 nmNd:YAG laser combined with topical antifungal agents had higher clinical response rates(OR=1.49,95%CI 1.04~2.12,Z=2.20,P=0.03)and mycological clearance rates(OR=1.85,95%CI 1.21~2.82,Z=2.86,P=0.004),and the recurrence rates were lower(OR=0.23,95%CI 0.08~0.70,Z=2.59,P=0.010).Conclusion:The treatment of long-pulsed 1064nm Nd:YAG laser combined with topical antifungal drugs is effective in the treatment of onychomycosis.