中华皮肤科杂志 ›› 2008, Vol. 41 ›› Issue (6): 419-421.

• • 上一篇    下一篇

外用吡美莫司治疗特应性皮炎的系统评价

孙晓东 闫志华 施辛   

  1. 苏州大学附属第二医院皮肤科 苏州大学附属第二医院皮肤科 苏州大学附属第二医院
  • 收稿日期:2007-09-11 修回日期:2007-09-27 发布日期:2008-06-15
  • 通讯作者: 施辛 E-mail:shx9@163.com

Topical pimecrolimus for Aatopic dermatitis: a systematic review

  

  • Received:2007-09-11 Revised:2007-09-27 Published:2008-06-15

PDF

161

摘要： 【摘要】目的 评价外用吡美莫司治疗特应性皮炎的疗效和安全性。方法 计算机检索Cochrane图书馆（2007年第2期），Medline（1966～2007），Embase（1974～ 2007）和中国生物医学文献数据库（CBM, 1978～2007），收集所有外用吡美莫司与赋形剂或外用糖皮质激素制剂或外用他克莫司制剂的随机对照试验（RCT），由两名评价人员独立提取资料与评价质量，用RevMan软件统计分析。结果 共纳入16篇RCT，包括4241例患者，均为高质量研究。对IGA治疗成功率的Meta分析结果显示：0. 1%吡美莫司与赋形剂比较，OR合并=2.87 [95% CI(2.21，3.73), P <0.001]。0. 1%吡美莫司与0.1%戊酸倍他米松比较， OR=0.15 [95% CI(0.05，0.47), P <0.001 ]。0. 1%吡美莫司与0. 03%他克莫司比较， OR合并=0.74 [ 95% CI(0.39，1.37) ,P=0.33 ]。所有研究均未发现严重的不良反应。结论 外用吡美莫司治特应性皮炎比赋形剂有效，而不如外用强效糖皮质激素有效。0. 1%吡美莫司与0. 03%他克莫司疗效相同。吡美莫司对湿疹面积和严重程度指数评分、瘙痒程度评分、生活质量相关评分均有明显改善。

关键词: 吡美莫司, 特应性皮炎, 随机对照试验, 系统评价, Meta分析

Abstract: Objective To evaluate efficacy and safety of topical pimecrolimus (SDZ ASM 981) for atopic dermatitis. Methods Randomized controlled trials (RCT) were identified from the Cochrane Library(issue 2, 2007)，Medline(1966～2007)，Embase(1974～2007) and CBM(1978～2007). RCT comparing pimecrolimus with vehicle or corticosteroids or tacrolimus were included. Two reviewers independently assessed trials quality and extracted date.The RevMan software was used for statistical analysis. Results Seventeen randomized controlled trials involving 4290 patients were included, with all trials of high methodological quality. Meta-analysis indicated that 0. 1% pimecrolimus was more effective than vehicle with odds ratio of 2.87 [95% CI(2.21，3.73), P <0.001].0.1% pimecrolimus was less effective than 0.1% betamethasone valerate with odds ratio of 0.15 [95% CI(0.05，0.47), P <0.001 ].0.1% pimecrolimus and 0.03% tacrolimus had the same curative effect with odds ratio of 0.74 [ 95% CI(0.39，1.37) ,P=0.33 ] .No serious adverse effects were identified. Conclusions Topical pimecrolimus for atopic dermatitis is more effective than vehicle but less effective than topical potent corticosteroids. 0.1% pimecrolimus and 0.03% tacrolimus had the same curative effect. Pimecrolimus tends to improve EASI scores, pruritus scores as well as quality of life scores.