中华皮肤科杂志 ›› 2011, Vol. 44 ›› Issue (10): 750-753.

• 荟萃分析 • 上一篇    下一篇

外用吡美莫司治疗18岁以下特应性皮炎患者的Meta分析

孙晓东1,2,陈玲玲3,4,施辛3,闫志华3,5,蔡永莲3,黎平6,张静3   

  1. 1. 苏州大学附属第二医院皮肤科
    2. 唐山市丰南区妇幼医院
    3. 苏州大学附属第二医院
    4. 苏州市立医院本部
    5.
    6. 四川省903医院
  • 收稿日期:2010-11-09 修回日期:2011-07-02 出版日期:2011-10-15 发布日期:2011-09-30
  • 通讯作者: 施辛 E-mail:shx9@163.com

Topical pimecrolimus for the treatment of atopic dermatitis in patients younger than 18 years: a meta-analysis

  • Received:2010-11-09 Revised:2011-07-02 Online:2011-10-15 Published:2011-09-30

PDF

44

赞

摘要：

目的 评价外用吡美莫司治疗儿童-婴儿特应性皮炎的疗效和安全性。方法 计算机检索Cochrane图书馆（2010年第2期）、Medline（1966～2010）、Embase（1974～2010）和CBM（1978～2010.6）、CNKI（1980～2010.6）等数据库，纳入所有外用吡美莫司与安慰剂或外用糖皮质激素或外用他克莫司的随机对照试验，由2组研究者（每组3人）独立提取资料与评价质量，用RevMan5.0软件统计分析。结果 共纳入16个研究，5076例儿科患者，均为高质量研究。Meta分析治疗有效率，结果显示：1%吡美莫司无论短期疗程和长期疗程均优于安慰剂（P值均小于0.01），1%吡美莫司与0.03%他克莫司比较疗效无差别（P值均大于0.05），但不如0.1%他克莫司有效（P=0.01）。所有研究均未发现严重的不良反应。最常见的不良反应是皮肤刺激和烧灼感。结论 外用吡美莫司治疗儿童-婴儿特应性皮炎有效安全，能改善IGA评分、瘙痒评分及PIQoL-AD评分。尚不清楚与TCs的疗效相比有无优势，故需进行更多的RCT。

关键词: Meta分析

Abstract:

Objective To evaluate efficacy and safety of topical pimecrolimus for atopic dermatitis in children and infants. Methods Randomized controlled trials (RCT) were identified from the Cochrane Library(issue 2, 2010) , Medline(1966～2010) , Embase(1974～2010), CBM(1978～2010.6) , CNKI(1978～2010.6). RCT reporting efficacy outcomes and tolerability, in comparison to topical corticosteroids (TCs) or vehicle or tacrolimus, were included. Two group reviewers independently assessed trials quality and extracted date. The RevMan 5.0 software was used for statistical analysis. Results Sixteen studies involving 5076 pediatric patients were included, with all trials of high methodological quality. Meta-analysis indicated that 1% pimecrolimus was more effective than vehicle (all P < 0.01).1% pimecrolimus was as effective as 0.03% tacrolimus (all P > 0.05).1% pimecrolimus was less effective than 0.1% tacrolimus (P=0.01). No serious adverse effects were identified except irritating and burning sensation of skin. Conclusions Topical pimecrolimus for atopic dermatitis in children and infants is efficacy and safety, with tended to improve IGA scores, pruritus scores as well as PIQoL-AD scores. Comparing with TCs, it is not yet known, whether topical pimecrolimus is more effective to treat atopic dermatitis. In addition, the more RCTs should be undertaken.

Key words: Meta-analysis