308 nm准分子光/激光联合局部糖皮质激素治疗白癜风疗效与安全性的Meta分析

Efficacy and Safety of 308 nm Excimer Light/Laser Combined with Topical Glucocorticoid in the Treatment of Vitiligo:A Meta-Analysis

目的系统评价308 nm准分子光/激光联合局部糖皮质激素治疗白癜风的疗效与安全性。方法检索PubMed、EMBASE、CENTRAL、Web of Science、知网、维普、万方数据库中308 nm准分子光/激光联合局部糖皮质激素治疗白癜风的临床随机对照试验,检索时间为建库至2022年5月。两位研究员独立筛选文献并提取数据,采用RevMan5.3软件进行Meta分析,并按GRADE标准评价证据质量。结果共纳入9篇文献,样本量共889例。结果显示:联合治疗组和对照组在有效率[RR=1.31,95%CI(1.15,1.49),P<0.01)]、总不良反应发生率[RR=0.40,95%CI(0.26,0.62),P<0.01)]、瘙痒率[RR=0.44,95%CI(0.21,0.93),P<0.05)]方面差异均有统计学意义,在红斑、灼热、水疱、毛细血管扩张发生率方面差异无统计学意义。结论308 nm准分子光/激光联合局部糖皮质激素可提高白癜风治疗有效率,且不会增加不良反应发生率。

Objective To systematically evaluate the effectiveness and safety of 308 nm excimer light/laser combined with topical glucocorticoid in vitiligo.Methods Databases including PubMed,EMBASE,CENTRAL,Web of Science,CNKI,VIP and Wanfang Data were searched to collect randomized controlled trials(RCT)of 308 nm excimer light/laser combined with topical glucocorticoid in vitiligo from inception to May 2022.Two researchers independently screened the literature and extracted the data.The Meta-analysis was performed with RevMan5.3 software,and the quality of evidence was evaluated according to the GRADE standard.Results A total of 9 RCTs studies involving 889 cases of samples were included.The results showed that:There were statistically significant differences in the effective rate[RR=1.31,95%CI(1.15,1.49),P<0.01],total adverse reaction incidence[RR=0.40,95%CI(0.26,0.62),P<0.01],and itch rate[RR=0.44,95%CI(0.21,0.93),P<0.05)]between the combined treatment group and the control group.However,there was no significant difference in the incidence of erythema,scorching,blisters and telangiectasia.Conclusion The combination of 308 nm excimer light/laser with topical glucocorticoid can improve the effective rate of vitiligo without the increase of adverse reactions.