Khandpur Sujay, Suman Mansi, Reddy Belum Sivanagi
Department of Dermatology and S.T.D., Maulana Azad Meical College and Associated Lok Nayak Hospital, New Delhi, India.
J Dermatol. 2002 Aug;29(8):489-98. doi: 10.1111/j.1346-8138.2002.tb00314.x.
Our understanding of the aetiology of androgenetic alopecia (AGA) has substantially increased in recent years. As a result, several treatment modalities have been tried with promising results especially in early stages of AGA. However, as far as has been ascertained, there is no comprehensive study comparing the efficacy of these agents alone and in combination with each other. One hundered male patients with AGA of Hamilton grades II to IV were enrolled in an open, randomized, parallel-group study, designed to evaluate and compare the efficacy of oral finasteride (1 mg per day), topical 2% minoxidil solution and topical 2% ketoconazole shampoo alone and in combination. They were randomized into four groups. Group I (30 patients) was administered oral finasteride, Group II (36 patients) was given a combination of finasteride and topical minoxidil, Group III (24 patients) applied minoxidil alone and Group IV (10 patients) was administered finasteride with topical ketoconazole. Treatment efficacy was assessed on the basis of patient and physician assessment scores and global photographic review during the study period of one year. At the end of one year, hair growth was observed in all the groups with best results recorded with a combination of finasteride and minoxidil (Group II) followed by groups IV, I and III. Subjects receiving finasteride alone or in combination with minoxidil or ketoconazole showed statistically significant improvement (p<0.05) over minoxidil only recipients. No signifcant side-effects related to the drugs were observed. In conclusion, it is inferred that the therapeutic efficacy is enhanced by combining the two drugs acting on different aetiological aspects of AGA.
近年来，我们对雄激素性脱发（AGA）病因的理解有了显著提高。因此，人们尝试了多种治疗方法，尤其是在AGA的早期阶段，取得了令人鼓舞的成果。然而，据已确定的情况，尚无全面研究比较这些药物单独使用及相互联合使用的疗效。一百名汉密尔顿分级为II至IV级的AGA男性患者被纳入一项开放、随机、平行组研究，旨在评估和比较口服非那雄胺（每日1毫克）、外用2%米诺地尔溶液和外用2%酮康唑洗发水单独使用及联合使用的疗效。他们被随机分为四组。第一组（30名患者）服用口服非那雄胺，第二组（36名患者）接受非那雄胺与外用米诺地尔的联合治疗，第三组（24名患者）仅使用米诺地尔，第四组（10名患者）服用非那雄胺并外用酮康唑。在为期一年的研究期间，根据患者和医生的评估评分以及整体照片评估来评估治疗效果。一年结束时，所有组均观察到头发生长，非那雄胺与米诺地尔联合使用组（第二组）效果最佳，其次是第四组、第一组和第三组。单独接受非那雄胺治疗或与米诺地尔或酮康唑联合治疗的受试者与仅使用米诺地尔的受试者相比，在统计学上有显著改善（p<0.05）。未观察到与药物相关的明显副作用。总之，可以推断，联合使用作用于AGA不同病因方面的两种药物可提高治疗效果。
