308 nm准分子激光联合复方卡力孜然酊治疗白癜风临床疗效的Meta分析

Systematic review and Meta-analysis of the clinical efficacy and safety of 308 nm excimer laser combined with compound Kaliziran tincture in the treatment of vitiligo

目的探究308 nm准分子激光联合复方卡力孜然酊治疗白癜风疗效是否会优于其单一的治疗。方法检索中国知网、维普、万方、中国生物医学文献、PubMed、EMBASE、Cochrane等数据库自建库起至2023年8月15日止,有关308 nm准分子激光联合复方卡力孜然酊治疗白癜风疗效的随机对照实验研究文献。由2名研究员单独提取资料并交叉核对结果,然后评价纳入文献的偏倚风险,采用RevMan5.4软件行统计学分析。结果7个临床随机对照试验被纳入,合计681例白癜风患者。Meta分析结果显示:308 nm准分子激光联合复方卡力孜然酊总有效率[RR=1.43,95%CI(1.08,1.89)]及治愈率[RR=1.55,95%CI(1.13,2.14)]均优于单一的光疗,联合用药在总有效率[RR=1.49,95%CI(1.19,1.88)]及治愈率[RR=2.28,95%CI(1.59,3.26)]较单独外用复方卡力孜然酊也更有效,亚组分析中单用308 nm准分子激光或单用复方卡力孜然酊为对照组的研究在每日外涂复方卡力孜然酊2次和3次及以上之间疗效差异无统计学意义(P>0.05)。结论准分子激光光疗联合复方卡力孜然酊较单独使用光疗或复方卡力孜然酊效果更好。因本次采纳文献数量少且质量较低,仍需更高质量的多中心研究加以验证。

Objective To investigate whether the efficacy of 308 nm excimer laser combined with Kaliziran tincture in the treatment of vitiligo is superior to its single treatment Method.Methods Randomized controlled trials on the efficacy of 308 nm excimer laser combined with kalizin tincture in the treatment of vitiligo were searched from CNKI,VIP database,Wanfang database,China Biomedical Literature Database,PubMed,EMBASE,Cochrane library up to August 2023.Data were extracted separately by two researchers and the results were cross-checked,and then the risk of bias in the included literature was evaluated.Revman 5.4 software was used for statistical analysis.Results Seven clinical randomized controlled trials were enrolled,involving a total of 681 patients with vitiligo.The meta-analysis results showed that the overall effective rate[RR=1.43,95%CI(1.08,1.89)]and cure rate[RR=1.55,95%CI(1.13,2.14)]of 308 nm excimer laser combined with compound kaliziran tincture were superior to single phototherapy.The combined treatment was also more effective in the total effective rate[RR=1.49,95%CI(1.19,1.88)]and cure rate[RR=2.28,95%CI(1.59,3.26)]compared to topical compound kaliziran tincture alone.And there was no significant difference in the efficacy between patients applying topical tincture of compound kaliziran two and three times a day or more in the subgroup analysis(P>0.05),using 308 nm excimer laser alone or compound kaliziran tincture alone as the control group.Conclusion 308 nm excimer laser combined with compound kalizin tincture has better effect than 308 nm excimer laser or compound kalizin tincture alone.However,due to the small number and low quality of the literature adopted in this study,higher quality multicenter studies are needed to verify this.