光动力疗法治疗中、重度痤疮的系统评价  

Efficacy of Photodynamic Therapy in the Treatment of Moderate to Severe Acne: A Systemic Review

作　　者：易文娟[1] 梁虹[1] 蔡桂容[1] 郭毅[2] 谢婷[1] 

机构地区：[1]武汉大学人民医院皮肤科,湖北武汉430060 [2]武汉大学公共卫生学院流行病学教研室,湖北武汉430071

出　　处：《中国皮肤性病学杂志》2013年第7期677-680,691,共5页The Chinese Journal of Dermatovenereology

摘　　要：目的系统性评价光动力疗法治疗中、重度痤疮的临床疗效。方法检索相关数据库,搜索随机对照试验(RCT),试验组采用光动力疗法,对照组采用单纯光疗法(不予光敏剂处理)。由3名研究者应用Rev-Man5.0.25和GRADEprofiler3.2.2统计学软件分别对符合质量标准的RCT进行Meta分析和严格的质量评价及资料提取。结果共纳入10个RCT。与单纯光疗法相比,光动力疗法可以提高痤疮治疗4周和大于8周时的有效率,降低痤疮复发率,差异均有统计学意义(P均<0.01),OR(95%CI)分别为5.95(3.26～10.86),21.54(9.87～47.01)及<0.001(0.00～0.03);12周时痤疮炎性皮损计数减少率差异也有统计学意义(P<0.01),WMD=16.92,95%CI(10.62～23.22)。GRADE系统推荐分级均为低等级。结论光动力疗法治疗中、重度痤疮疗效明显、复发率低、疗效持续时间长,但也存在光敏剂带来的不良反应。Objective To evaluate the clinical efficacy of photodynamic therapy in the treatment of moderate to severe acne. Methods Relevant databases were searched for the randomized controlled trials （RCTs）. Experimental group received photodynamic therapy, and control group received light therapy alone （not include photosensitizer）. Three independent researchers evaluated and analyzed the included studies using RevMan 5.0.25 and GRADEprofiler 3.2.2 software. Results A total 10 trials were discovered, Meta-analyses showed 4 important outcomes. Compared with light therapy alone, photodynamic therapy increased the efficacy in 4 weeks and more than 8 weeks post final treatment, and decreased the acne recurrence rate, there were statistically differences （P 〈0.01）, OR（95% CI） were 5.95（3.26 - 10.86）, 21.54（9.87 -47.01 ）and 〈0. 001 （0.00 0.03）, respectively. To the mean reduction of inflammatory acne in 12 weeks, there was also statistically difference between photodynamic therapy and light therapy alone （P 〈 0. 01 ）, WMD = 16.92,95% CI（ 10.62 - 23.22）. The 4 outcomes were all of low quality in the GRADE system. Conclusion The current evidence shows, photodynamic therapy could improve moderate to severe acne obviously, reduce recurrence, and its efficacy remained for a longer time. But there are also adverse actions due to the photosensitizer.

关 键 词：光动力疗法 痤疮 随机对照试验 系统性评价 Meta分析 

分 类 号：R758.733[医药卫生—皮肤病学与性病学]