阿维A联合紫外线治疗银屑病疗效的Meta分析  

Acitretin Combined with NB-UVB for Psoriasis: A Meta-analysis of Randomized Controlled Trials

作　　者：张家华[1] 刘毅[2] 李征[1] 王道英[1] 李秀霞[1] 杨克虎[1] 王宝玺[3] 

机构地区：[1]兰州大学循证医学中心,甘肃兰州730000 [2]兰州大学基础医学院,甘肃兰州730000 [3]中国医学科学院皮肤病研究所,江苏南京210042

出　　处：《中国皮肤性病学杂志》2014年第12期1211-1215,共5页The Chinese Journal of Dermatovenereology

基　　金：常见与危重皮肤病的诊治规范研究(201002016)

摘　　要：目的系统评价阿维A联合窄谱中波紫外线（NB—UVB）治疗银屑病的临床疗效。方法计算机检索Cochrane Library，PubMed，EMBASE和中国生物医学文献数据库、中国期刊全文数据库、中文科技期刊数据库和数字化期刊全文数据库，收集所有关于阿维A联合NB—UVB治疗寻常性银屑病的随机对照试验，采用Cochrane系统评价员手册推荐的质量评价标准评价纳入研究质量，并用RevMan5．3进行Meta分析。结果纳入23篇随机对照试验。Meta分析结果显示：阿维A联合NB—UVB治疗组痊愈率和总有效率的疗效均优于单用阿维A（OR=2．44，95％CI1．86－3．19；OR=3．90，95％C12．72－5．60）或窄谱中波紫外线的痊愈率和总有效率（OR=2．56，95％CI2．04－3．22；OR=4．44，95％CI3．24—6．08）。结论阿维A联合NB—UVB治疗银屑病疗效优于单用阿维A或窄谱中波紫外线。但由于纳入试验的方法学质量较低，仍需要进行严格的多中心、大样本的随机双盲对照试验，提供高质量临床证据。Objective To assess the efficacy of acitretin combined with NB-UVB for psoriasis. Methods We in- eluded randomized controlled trial on acitretin combined with NB-UVB for psoriasis reported by PubMed, EMBASE, Cochrane Library, CNKI, VIP,Wanfang database and other sources. Two reviewers independent- ly evaluated the quality of the included studies and extracted the data. Meta analyses were performed using RevMan 5.5 software. Results Meta analyses for 23 RCTs showed that acitretin combined with NB-UVB were more efficient than acitretin （ OR = 2.44,95 % CI 1.86 - 3.19 ; OR = 3.90,95 % CI 2.72 - 5.60 ） or NB-UVB （ OR = 2.56,95 % CI 2.04 - 3.22 ; OR = 4.44,95 % CI 3.24 - 6.08 ）, respectively. Conclusion The combination of aeitretin with NB-UVB improved the efficacy of each treatment alone. Regarding the poor quality of the methods for the included studies, multi-center, large scale, randomized, double-blind controlled trials are needed to improve the quality of evidences.

关 键 词：银屑病 阿维A 窄谱中波紫外线 随机对照试验 META分析 

分 类 号：R758.63[医药卫生—皮肤病学与性病学]