Chiu Yu-Jen, Perng Cherng-Kang, Ma Hsu
Division of Plastic and Reconstructive Surgery, Department of Surgery, Taipei Veterans General Hospital, 19/F, No. 201, Sec. 2, Shipai Rd., Beitou Dist, Taipei, 11217, Taiwan.
Department of Surgery, School of Medicine, National Yang Ming University, Taipei, Taiwan.
Lasers Med Sci. 2018 Sep;33(7):1549-1556. doi: 10.1007/s10103-018-2516-7. Epub 2018 Apr 26.
The treatment of stable non-segmental vitiligo is often challenging, which new therapies are being searched. Multiple clinical trials have proposed the benefits and safety of using fractional carbon dioxide (CO) laser as an adjunct therapy to conventional treatments. This study aimed to evaluate the safety and efficacy of fractional carbon dioxide laser as a combination therapy to conventional treatments in patients with stable non-segmental vitiligo. A literature search using PubMed, EMBASE, and the Cochrane Library was performed for comparative studies among vitiligo patients treated with additional fractional CO laser. Clinical outcomes in the selected studies were compared, and a meta-analysis was performed via Review Manager version 5.3, according to the PRISMA guidelines. Six studies with a total of 184 patches/patients were included in the present meta-analysis. The combination therapy group had significantly superior results than that of the control group (≥ 75% re-pigmentation, risk ratio [RR] 2.80, 95% confidence interval [CI] 1.29-6.07; ≥ 50% re-pigmentation, RR 2.26, 95% CI 1.23-5.9; < 25% re-pigmentation, RR 0.57, 95% CI 0.43-0.75). Limitations of the study included the small number of studies and sample size, inadequate blinding of participants, and variation between therapy protocols. Meta-analysis revealed that using fractional CO laser in combination with conventional treatments is efficient and safe, and may be considered as an adjunct therapeutic option for patients with refractive non-segmental vitiligo.
稳定型非节段性白癜风的治疗往往具有挑战性，因此人们一直在探索新的治疗方法。多项临床试验提出了使用分次二氧化碳（CO）激光作为传统治疗辅助疗法的益处和安全性。本研究旨在评估分次二氧化碳激光作为传统治疗联合疗法对稳定型非节段性白癜风患者的安全性和有效性。通过PubMed、EMBASE和Cochrane图书馆进行文献检索，以查找接受额外分次CO激光治疗的白癜风患者的比较研究。比较所选研究中的临床结果，并根据PRISMA指南通过Review Manager 5.3版进行荟萃分析。本荟萃分析纳入了六项研究，共184个皮损/患者。联合治疗组的结果明显优于对照组（色素重新沉着≥75%，风险比[RR] 2.80，95%置信区间[CI] 1.29 - 6.07；色素重新沉着≥50%，RR 2.26，95% CI 1.23 - 5.9；色素重新沉着<25%，RR 0.57，95% CI 0.43 - 0.75）。该研究的局限性包括研究和样本量较少、参与者未充分设盲以及治疗方案之间存在差异。荟萃分析表明，联合使用分次CO激光和传统治疗方法是有效且安全的，对于难治性非节段性白癜风患者可考虑作为一种辅助治疗选择。
