Department of Plastic Surgery, The Third Xiangya Hospital, Central South University, Tongzipo Road 138, Yuelu District, Changsha, 410013, China.
Department of Urology, The Third Xiangya Hospital, Central South University, Changsha, 410013, China.
Aesthetic Plast Surg. 2020 Jun;44(3):947-952. doi: 10.1007/s00266-020-01637-x. Epub 2020 Feb 13.
A safe and effective treatment for melasma, an acquired refractory pigmented skin disease, remains a problem, although numerous clinical trials have explored the possibility of combined therapy involving intense pulsed light. To date, little is known regarding the efficacy of this treatment. The current study, therefore, sought to explore the effectiveness of intense pulsed light.
We used published studies from literature databases, based on established inclusion criteria, to calculate standardized mean differences (SMDs) and risk ratio (RRs), and evaluated the effectiveness of combined therapy with intense pulsed light in melasma patients. We performed data analysis using the Review Manager 5.3 software at 95% confidence interval.
We obtained a total of 8 studies, involving 215 patients, from the databases and found a significant effect on efficacy following combined therapy with intense pulsed light. Specifically, the melasma area and severity index (MASI) score was significantly low (SMD = 0.61, CI [0.42, 0.80] P < 0.0001 for a fixed-effects model), while a four-point scoring scale self-assessment by patients was significantly high (RR = 1.44, CI [1.17, 1.76] P = 0.0004 for a fixed-effects model).
Our meta-analysis showed that IPL-based combination therapy for melasma can effectively reduce the MASI score and result in higher satisfaction among patients, indicating an effective method for treatment of the condition.
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
尽管已经进行了大量临床试验来探索强脉冲光（IPL）联合治疗的可能性，但对于获得性难治性色素性皮肤病——黄褐斑，仍然缺乏安全有效的治疗方法。到目前为止，对于这种治疗方法的疗效知之甚少。因此，本研究旨在探讨 IPL 的疗效。
我们根据既定的纳入标准，使用文献数据库中的已发表研究来计算标准化均数差（SMD）和风险比（RR），评估 IPL 联合治疗黄褐斑患者的有效性。我们使用 Review Manager 5.3 软件在 95%置信区间进行数据分析。
我们从数据库中总共获得了 8 项研究，涉及 215 名患者，发现 IPL 联合治疗在疗效方面有显著效果。具体来说，黄褐斑面积和严重程度指数（MASI）评分明显降低（SMD=0.61，CI[0.42，0.80]，固定效应模型 P<0.0001），而患者的四点自评评分明显升高（RR=1.44，CI[1.17，1.76]，固定效应模型 P=0.0004）。
我们的荟萃分析表明，基于 IPL 的联合治疗方案可有效降低 MASI 评分，并提高患者的满意度，是治疗该病的有效方法。
证据水平 III：本杂志要求作者为每篇文章分配一个证据水平。有关这些循证医学评级的完整描述，请参考目录或在线作者指南 www.springer.com/00266。
