强脉冲光联合药物治疗玫瑰痤疮的Meta分析

Efficacy of intense pulsed light in treatment of rosacea: a Meta analysis

目的:评估强脉冲光联合药物对玫瑰痤疮的治疗效果。方法:2022年12月至2023年4月,陕西中医药大学附属医院皮肤科检索PubMed、Embase、Cochrane Library、中国知网、万方、维普、CBM等中、英文数据库,收集强脉冲光联合药物治疗玫瑰痤疮的随机对照研究,共纳入6个试验559例患者进行Meta分析。结果:强脉冲光联合药物治疗玫瑰痤疮疗效明显优于单纯药物治疗(Z=6.15,P<0.001)。进行亚组分析后,强脉冲光联合四环素类药物治疗玫瑰痤疮疗效优于单用四环素类药物(Z=3.17,P<0.05),强脉冲光联合米诺环素治疗玫瑰痤疮疗效优于单用米诺环素(Z=2.37,P<0.05)。临床评估改善红斑、丘疹脓疱、瘙痒及毛细血管扩张等方面的评分差异均有统计学意义(均P<0.05)。结论:强脉冲光治疗玫瑰痤疮疗效确切,与外用或口服药联用疗效优于单纯用药,但效果稳定性需要更多高质量的随机对照试验证实。

Objective To evaluate the therapeutic effect of intense pulsed light on rosacea.Methods From December 2022 to April 2023,the Dermatology Department of the Affiliated Hospital of Shaanxi University of Chinese Medicine searched PubMed,Embase,Cochrane Library,CNKI,Wanfang,VIP,CBM and other Chinese and English databases to collect clinical randomized controlled studies on intense pulsed light treatment of rosacea for ameta-analysis.Results A total of 559 patients were included in 6 randomized controlled trials.The efficacy of the combination of strong pulsed light and medication in the treatment of rosacea was significantly better than that of medication alone(Z=6.15,P<0.001).After subgroup analysis,the combination of strong pulsed light and tetracycline drugs was more effective in treating rosacea than using tetracycline drugs alone(Z=3.17,P<0.05).The efficacy of the combination of strong pulsed light and minocycline in the treatment of rosacea was better than that of minocycline alone(Z=2.37,P<0.05),and clinical evaluation showed the improvements of erythema,papules,and pustules.The differences in scores for itching and capillary dilation were statistically significant(P<0.05).Conclusions The efficacy of intense pulsed light therapy for rosacea is definite,and its combination with topical or oral medication is superior to that of medication alone.However,the stability of the effect needs to be confirmed by more high-quality randomized controlled trials.