中文译文：局部注射维拉帕米与曲安奈德治疗瘢痕疙瘩和增生性瘢痕的安全性和疗效：系统评价和荟萃分析。
The Safety and Efficacy of Intralesional Verapamil Versus Intralesional Triamcinolone Acetonide for Keloids and Hypertrophic Scars: A Systematic Review and Meta-analysis.
机构信息
At the Wound Repair Center, First Affiliated Hospital of Nanchang University, China, Zheng-Ying Jiang, MD; Xin-Cheng Liao, MD; Ming-Zhuo Liu, PhD, MD; and Zhong-Hua Fu, MD; and Ding-Hong Min, MD, are burn surgeons and wound repair consultants; and Guang-Hua Guo, PhD, MD, is Director. The authors have disclosed no financial relationships related to this article. Submitted March 15, 2019; accepted in revised form July 9, 2019.
出版信息
Adv Skin Wound Care. 2020 Apr;33(4):1-7. doi: 10.1097/01.ASW.0000655476.10403.d6.
BACKGROUND
Keloids and hypertrophic scars often result after skin trauma. Currently, intralesional triamcinolone acetonide (TAC) is the criterion standard in nonsurgical management of keloids and hypertrophic scars. Intralesional verapamil may be an effective alternative modality, but it has been insufficiently studied. Accordingly, the study authors conducted a systematic review and meta-analysis of randomized controlled trials to compare the efficacy and safety of the two drugs.
METHODS
The study authors systematically searched the MEDLINE, EMBASE, Cochrane Library, and China National Knowledge Infrastructure databases for relevant trials published in any language through September 2018.
RESULTS
According to the four studies included in this review, TAC improved scar pliability and vascularity more than verapamil after 3 weeks (P < .05). For scar height and scar pigmentation, no statistical difference was observed between the treatments (P > .05). The difference in effects on symptoms was not statistically significant (P = .89). For pain and telangiectasia, no statistical difference was observed (P > .05). Verapamil resulted in fewer cases of skin atrophy (P < .05).
CONCLUSIONS
It appears that TAC is more effective than verapamil for improving scar pliability and vascularity in keloids and hypertrophic scars after 3 weeks of treatment. However, verapamil has fewer adverse drug reactions than TAC, which allows for a longer treatment period and the possibility that it might be effective for patients who cannot receive TAC.
背景
瘢痕疙瘩和增生性瘢痕通常是在皮肤创伤后产生的。目前，皮损内曲安奈德（TAC）是瘢痕疙瘩和增生性瘢痕非手术治疗的标准。皮损内维拉帕米可能是一种有效的替代方式，但研究不足。因此，研究作者对随机对照试验进行了系统评价和荟萃分析，以比较这两种药物的疗效和安全性。
方法
研究作者系统地检索了 MEDLINE、EMBASE、Cochrane 图书馆和中国国家知识基础设施数据库中 2018 年 9 月以前以任何语言发表的相关试验。
结果
根据本综述纳入的四项研究，TAC 在 3 周后改善瘢痕柔韧性和血管生成的效果优于维拉帕米（P<.05）。对于瘢痕高度和瘢痕色素沉着，两种治疗方法之间无统计学差异（P>.05）。治疗效果的差异无统计学意义（P=.89）。对于疼痛和毛细血管扩张，无统计学差异（P>.05）。维拉帕米导致皮肤萎缩的病例较少（P<.05）。
结论
TAC 似乎比维拉帕米更有效，可在 3 周的治疗后改善瘢痕疙瘩和增生性瘢痕的柔韧性和血管生成。然而，维拉帕米的不良反应比 TAC 少，这允许更长的治疗期，并且有可能对不能接受 TAC 的患者有效。
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