Centre for Research in Evidence-Based Practice, Bond University, Robina, Queensland, Australia
Centre for Research in Evidence-Based Practice, Bond University, Robina, Queensland, Australia.
Ann Fam Med. 2019 Nov;17(6):545-553. doi: 10.1370/afm.2445.
Antibiotic use in acne treatment raises concerns about increased resistance, necessitating alternatives. We assessed the effectiveness of blue-light therapy for acne.
We analyzed randomized controlled trials comparing blue light with nonlight interventions. Studies included people of any age, sex, and acne severity, in any setting, and reported on investigator-assessed change in acne severity, patients' assessment of improvement, change in inflammatory or noninflammatory lesions, and adverse events. Where data were sufficient, mean differences were calculated.
Eighteen references (14 trials) including 698 participants were included. Most of the trials were small and short (<12 weeks) and had high risk of bias. Investigator-assessed improvement was quantitatively reported in 5 trials, of which 3 reported significantly greater improvement in blue light than comparator, and 2 reported improvement. Patients' assessments of improvement were quantitatively reported by 2 trials, favoring blue light. Mean difference in the mean number of noninflammatory lesions was nonsignificant between groups at weeks 4, 8, and 10-12 and overall (mean difference [MD] = 3.47; 95% CI, -0.76 to 7.71; = 0.11). Mean difference in the mean number of inflammatory lesions was likewise nonsignificant between groups at any of the time points and overall (MD = 0.16; 95% CI, -0.99 to 1.31; = 0.78). Adverse events were generally mild and favored blue light or did not significantly differ between groups.
Methodological and reporting limitations of existing evidence limit conclusions about the effectiveness of blue light for acne. Clinicians and patients should therefore consider the balance between its benefits and adverse events, as well as costs.
痤疮治疗中抗生素的使用引发了人们对耐药性增加的担忧,因此需要寻找替代疗法。本研究评估了蓝光疗法治疗痤疮的疗效。
我们分析了比较蓝光与非光照干预措施的随机对照试验。研究纳入了任何年龄、性别和痤疮严重程度的人群,无论其所处环境如何,并报告了研究者评估的痤疮严重程度变化、患者对改善情况的评估、炎症性或非炎症性病变的变化以及不良事件。若数据充分,则计算均数差值。
纳入了 18 篇参考文献(14 项试验),共 698 名参与者。大多数试验规模较小且持续时间较短(<12 周),存在较高的偏倚风险。5 项试验定量报告了研究者评估的改善情况,其中 3 项试验报道蓝光组的改善明显优于对照组,2 项试验报道了改善情况。2 项试验定量报告了患者对改善情况的评估,均倾向于蓝光治疗。在第 4、8、10-12 周及总体上,两组间非炎症性病变的平均数量的均数差值无统计学意义(差值=3.47;95%置信区间,-0.76 至 7.71; = 0.11)。在任何时间点和总体上,两组间炎症性病变的平均数量的均数差值也无统计学意义(差值=0.16;95%置信区间,-0.99 至 1.31; = 0.78)。不良事件通常为轻度,且倾向于蓝光治疗或两组间无显著差异。
现有证据的方法学和报告局限性限制了我们对蓝光治疗痤疮有效性的结论。因此,临床医生和患者应权衡其获益与不良事件以及成本之间的关系。