维拉帕米与曲安奈德对病理性瘢痕疗效及安全性的Meta分析  

Meta-Analysis of the Efficacy and Safety of Verapamil and Triamcinolone Acetonide in the Treatment of Pathological Scar

作　　者：刘唱 金春花[1] 罗银利 王芬芬 庄金磊 金升元 金哲虎[2] LIU Chang;JIN Chunhua;LUO Yinli;WANG Fenfen;ZHUANG Jinlei;JIN Shengyuan;JIN Zhehu(Department of Burn and Plastic Surgery,the Affiliated Hospital of Yanbian University,Yanji 133000,China;Department of Dermatology,the Affiliated Hospital of Yanbian University,Yanji 133000,China)

机构地区：[1]延边大学附属医院整形烧伤科,吉林延吉133000 [2]延边大学附属医院皮肤科,吉林延吉133000

出　　处：《中国皮肤性病学杂志》2024年第1期50-58,共9页The Chinese Journal of Dermatovenereology

基　　金：国家自然科学基金项目(81960561)。

摘　　要：目的 利用Meta分析评价维拉帕米与曲安奈德治疗病理性瘢痕的临床有效性及安全性。方法 检索PubMed、Embase、Web of Science、Cochrane Library、CNKI(China national knowledge infrastructure)、维普、万方医学数据库,纳入维拉帕米和曲安奈德(triamcinolone acetonide, TAC)治疗病理性瘢痕的随机对照试验(randomized controlled trial, RCT),并进行方法学质量评价。纳入使用温哥华瘢痕量表(Vancouver scar scale, VSS)评估治疗效果和报告不良反应的随机对照试验。连续数据和二分类变量分别以平均差(mean difference, MD)和相对风险(risk ratio,RR)进行分析,使用RevMan5.4和Stata 16.0软件进行数据处理。结果 13篇RCT文献纳入本项研究,累计病例730例。Meta分析结果显示:与维拉帕米组相比,曲安奈德组对瘢痕厚度、柔韧性以及第3周、第9周后的血管密度的改善效果更好。维拉帕米组总的不良反应发生率、皮肤萎缩、毛细血管扩张和色素脱失的发生率均显著低于曲安奈德组,烧灼感的发生率显著高于曲安奈德组,对于色素沉着的改善以及疼痛的不良反应发生率两组差异无统计学意义。结论 对于病理性瘢痕的治疗,曲安奈德组的治疗效果更好,见效更快,维拉帕米组的不良反应发生率更低。维拉帕米可以作为一种低成本、不良反应发生率低、疗效较好的非激素药物治疗方式。Objective To evaluate the clinical efficacy and safety of verapamil and triamcinolone acetonide in the treatment of pathological scars using Meta-analysis.Methods The medical databases of PubMed, Embase, Web of Science, Cochrane Library, China national knowledge infrastructure(CNKI), VIP and Wanfang were searched and included in the randomized controlled trials(RCT)of verapamil and triamcinolone acetonide(TAC)in the treatment of pathological scars, and the methodological quality was evaluated.The RCT using the Vancouver scar scale(VSS)was included to evaluate the efficacy of treatment and report adverse reactions.Continuous data and binary variables were analyzed by mean difference(MD)and risk ratio(RR), respectively, and the data were processed by RevMan5.4 software and Stata 16.0 software.Results Thirteen RCT literatures were included in this study, with a total of 730 cases.The results of Meta-analysis showed that compared with verapamil group, the improvement effect of scar thickness, flexibility and vascular density at week 3 and 9 in TAC group was better than those in verapamil group.The total incidence of adverse reactions, skin atrophy, telangiectasia and depigmentation in verapamil group were significantly lower than those in TAC group, while the incidence of burning sensation in verapamil group was significantly higher than that in TAC group.There were no significant difference in pigmentation improvement and the incidence of adverse reactions to pain between the two groups.Conclusion For the treatment of pathological scar, the therapeutic effect of TAC group is better, the effect is faster, and the incidence of adverse reaction of verapamil group is lower.Verapamil can be used as a non-hormonal drug therapy with low cost, low incidence of adverse reactions and good curative effect.

关 键 词：维拉帕米 曲安奈德 病理性瘢痕 随机对照试验 META分析 

分 类 号：R739.5[医药卫生—肿瘤]