文献简介

出版社:British Journal of Dermatology

作  者:E.J. van Zuuren, S.F. Kramer, B.R. Carter

编  号:10.1111/j.1365-2133.2011.10473.x

关键字:management strategies | a Cochrane systematic review | summary

年  份:2011   点击量:722

文献摘要

Rosacea is a common chronic skin disease affecting the face. There are numerous treatment options, but it is unclear which are the most effective. The aim of this review was to assess the evidence for the efficacy and safety of treatments for rosacea. Searches included the Cochrane Skin Group Specialised Register, the Cochrane Central Register of Controlled Trials in The Cochrane Library, MEDLINE, EMBASE, Science Citation Index, and Ongoing Trials Registers (updated February 2011). Randomized controlled trials in people with moderate to severe rosacea were included. Fifty-eight trials, including 27 from the original review, comprising 6633 participants were included in this updated review. Interventions included topical metronidazole, oral antibiotics, topical azelaic cream or gel, topical benzoyl peroxide and ⁄or combined with topical antibiotics, sulphacetamide⁄sulphur, and others. There was some evidence that topical metronidazole and azelaic acid were more effective than placebo. Two trials indicated that doxycycline 40 mg was more effective than placebo. There was no statistically significant difference in effectiveness between doxycycline 40 mg and 100 mg but there were fewer adverse effects. One study reported that ciclosporin ophthalmic emulsion was significantly more effective than artificial tears for treating ocular rosacea. Although the majority of included studies were assessed as being at high or unclear risk of bias, there was some evidence to support the effectiveness of topical metronidazole, azelaic acid and doxycycline (40 mg) in the treatment of moderate to severe rosacea, and ciclosporin 0.05% ophthalmic emulsion for ocular rosacea. Further well-designed, adequately powered randomized controlled trials are required.

酒渣鼻是影响面部的一种常见的慢性皮肤病。酒渣鼻有多种治疗方法,但至于哪种方法最有效,目前还不清楚。这篇综述的目的是评估酒渣鼻安全和有效治疗方法的证据。搜索包括Cochrane皮肤组专业记录、Cochrane图书馆中Cochrane中心记录的对照试验、MEDLINE数据库、EMBASE数据库、科学引文索引,以及正在进行的试验记录 (20112月更新)。在参与本项研究的轻度至重度酒渣鼻患者中开展随机对照试验。58个实验中,其中27个来自原始综述,6633个参与者被纳入这项最新的综述中。干预措施包括外用甲硝唑、口服抗生素、外用壬二酸乳膏或凝胶、局部用过氧化苯甲酰和/或联合外用抗生素、磺胺醋酰钠/硫磺等等。一些证据显示外用甲硝唑和壬二酸比安慰剂更有效。两次试验也表明40mg多西环素比安慰剂更有效。在统计学上40mg100mg的多西环素的有效性无显著差异,但副作用较少。一项研究报告指出在治疗眼酒渣鼻时,环孢素眼用乳剂比人工泪液更有效。尽管大多数研究评估认为存在偏高或未知的风险,但一些证据支持在治疗中度至重度酒渣鼻时,外用甲硝唑、壬二酸和多西环素(40mg)的有效性,以及在治疗眼酒渣鼻时0.05%环孢素眼用乳剂的有效性。因此,仍需要进一步的精心设计、充分的随机对照试验加以验证。