低能量激光治疗促进毛发生长改善女性型脱发

Low-Level Laser Treatment Promotes Hair Growth to Improve Female Pattern Hair Loss

目的:系统性归纳不同干预措施治疗女性型脱发的有效性和安全性,确定两者兼顾的治疗方案及机制。方法:计算机检索PubMed、The Cochrane Library、Web of Science、EMbase、CNKI、WanFang Data、CBM、VIP数据库,搜集不同干预措施治疗女性型脱发的随机对照试验,语种限定为中文和英文,检索时限均为2000年1月1日至2022年07月20日,包括单一和联合治疗,除外中药治疗和动植物组织提取物等相关治疗。由2位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用StataMP 17中的network及mvmeta软件包进行数据处理。结局指标为头发数量相对于基线的平均变化,因其为连续型变量,故采用均数差及95%可信区间(confidence interval, CI)作为统计分析的效应量,当P < 0.05时认为差异有统计学意义。结果:经严格文献筛选后共纳入14个研究,涉及外用不同浓度的米诺地尔、口服米诺地尔、低能量激光、口服避孕药及多组联合疗法共计11种干预措施。Meta分析结果显示,低能量激光治疗增加头发计数的效果优于其余10种干预措施(P = 0.05);在不良反应方面,外用1%米诺地尔的耐受性最好,其余干预措施因不良反应退出实验的可能性没有差别(P = 0.05)。结论:低能量激光是改善女性型脱发患者毛发数量最好的干预措施,且耐受性较好,不良反应少。综合而言,低能量激光可能是治疗女性型较为脱发最理想的干预措施。受纳入研究数量和质量限制,上述结论尚需开展更多高质量研究予以验证。

AIM: To systematically summarize the effectiveness and safety of different interventions in the treatment of female pattern alopecia, and determine the optimal treatment plan and mechanism. METHODS: A computer search of PubMed, The Cochrane Library, Web of Science, EMbase, CNKI, WanFang Data, CBM, and VIP databases was conducted to collect randomized controlled trials of different interventions for the treatment of female pattern alopecia in Chinese and English. The search period was from January 1, 2000 to July 20, 2022, and included both single and combination treatments, except for herbal treatments and plant and animal tissue extracts. Data were processed using the network and mvmeta packages in StataMP 17 after independent screening of the litera-ture by 2 evaluators, extraction of information, and evaluation of the risk of bias of the included studies. The ending indicator was the mean change in hair count relative to baseline, which is a con-tinuous variable, so the mean difference and 95% confidence interval (CI) were used as effect sizes for statistical analysis, and differences were considered statistically significant when P < 0.05. RESULTS: A total of 14 studies involving different concentrations of topical minoxidil, oral minoxidil, Low-Level Laser Therapy, oral contraceptives and combinations of therapies between them were in-cluded after rigorous literature screening. meta-analysis showed that Low-Level Laser Therapy in-creased hair count better than the remaining 10 interventions (P = 0.05);in terms of adverse ef-fects, topical minoxidil 1% Minoxidil was the best tolerated, and the remaining interventions did not differ in the likelihood of withdrawal from the trial due to adverse effects (P = 0.05). CONCLUSION: The available evidence suggests that Low-Level Laser Therapy is the best intervention for increasing hair count in female pattern baldness and is well tolerated. Taken together, Low-Level Laser Therapy may be the ideal intervention for the treatment of more female-pattern alopecia. Due to the number and quality of included studies, the above findings need to be validated by additional high-quality studies.