随机对照试验系统评价和荟萃分析微针对雄激素性脱发患者头发再生的影响

Effect of Microneedle on Hair Regrowth in Patients with Androgenetic Alopecia:A Systematic Review and Meta-Analysis of Randomized Controlled Trials

目的:通过比较微针结合5%米诺地尔局部治疗或单独使用微针与5%米诺地尔局部治疗雄激素性脱发,以评估微针的有效性和安全性。方法:检索Embase、PubMeD、Cochrane图书馆、维普、万方和中国知网等数据库相关文献,对照组接受5%米诺地尔溶液局部治疗,治疗组患者接受单独微针或微针联合5%米诺地尔局部治疗。评估头发再生的主要标准是头发计数和头发直径的增加。使用Stata15软件对数据进行汇总。结果:共纳入472名参与者进行8项研究。与5%米诺地尔局部治疗相比,微针结合5%米诺地尔治疗显示出头发计数显著增加(SMD:15.82,95%CI:12.34,19.31,P<0.05),但头发直径未增加(SMD:-0.21,95%CI:-2.94,2.52,P=0.879>0.05)。亚组分析结果表明,无论微针深度小于1mm(SMD:1.16,95%CI:0.86,1.42,P<0.05)还是大于1mm(SMD:0.52,95%CI:0.23,0.82,P<0.05),微针结合5%米诺地尔治疗均显示出头发计数显著增加;无论是在12周(SMD:1.08,95%CI:0.76,1.39,P<0.05)还是21~24周(SMD:0.64,95%CI:0.35,0.92,P<0.05),微针结合5%米诺地尔治疗增加的头发计数和头发直径的效果显著优于单独使用5%米诺地尔局部治疗。结论:据本研究发现,微针单独治疗雄激素性脱发的效果可能有限。然而,微针结合5%米诺地尔局部治疗在头发计数方面有更好的头发再生效果,可以作为雄激素性脱发的额外治疗选择。结合亚组分析结果,建议采用12周期,微针穿透深度小于1mm的治疗方式。

Objective Our objective was to assess the effectiveness and safety of microneedle by comparing microneedle plus 5%topical minoxidil treatment and microneedle alone to 5%topical minoxidil.Methods We searched databases such as Embase,PubMed,Cochrane library,VIP Database for Chinese Technical Periodicals,Wanfang,and China National Knowledge Infrastructure in relation to literature.The control group received 5%topical minoxidil solution,whereas the treatment group received either microneedle coupled with minoxidil or microneedle alone.The increase in hair count and hair diameter was the main evaluation criterion for assessing hair regrowth.Data were pooled with Stata 15 software.Results Eight studies with 472 participants were included.Compared with 5%topical minoxidil therapy,microneedle plus minoxidil treatment showed a significant increase in hair count(standard mean difference[SMD]:15.82,95%confidence interval[CI]:12.34,19.31,p<0.05),but no increase in hair diameter(SMD:0.21,95%CI:2.94,2.52,p=0.879>0.05).The results of subgroup analysis suggested that microneedle plus minoxidil treatment showed a significant increase in hair count whether the depth of microneedle was less than 1 mm(SMD:1.16,95%CI:0.86,1.42,p<0.05)or more than 1 mm(SMD:0.52,95%CI:0.23,0.82,p<0.05).In terms of treatment period subgroup,microneedle combined with minoxidil therapy significantly increased hair count and hair diameter than single 5%topical minoxidil,whether in 12-week period(SMD:1.08,95%CI:0.76,1.39,p<0.05)or 21 to 24 weeks period(SMD:0.64:95%,CI:0.35,0.92,p<0.05).Conclusion According to this study,the effect of microneedle treatment alone on androgenetic alopecia(AGA)may be limited.However,microneedle plus 5%topical minoxidil treatment had better hair regrowth in hair count and can be considered as an additional therapy option for AGA.Combined with subgroup analysis results,12-week period and less than 1 mm depth of microneedle penetration were recommended.