表皮生长因子、成纤维细胞生长因子和粒细胞-巨噬细胞集落刺激因子作为急性皮肤伤口愈合治疗药物的临床有效性和安全性：一项系统评价和荟萃分析。

The clinical effectiveness and safety of using epidermal growth factor, fibroblast growth factor and granulocyte-macrophage colony stimulating factor as therapeutics in acute skin wound healing: a systematic review and meta-analysis.

作者信息

Wei Yating, Li Jiangfeng, Huang Yao, Lei Xun, Zhang Lijun, Yin Meifang, Deng Jiawen, Wang Xiaoyan, Fu Xiaobing, Wu Jun

机构信息

Department of Burn and Plastic Surgery, Department of Wound Repair, Shenzhen Institute of Translational Medicine, the First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China.

Shenzhen University, Shenzhen, China.

出版信息

Burns Trauma. 2022 Mar 7;10:tkac002. doi: 10.1093/burnst/tkac002. eCollection 2022.

DOI:10.1093/burnst/tkac002

PMID:35265723

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8900703/

Abstract

BACKGROUND

Promoting wound healing is crucial to restore the vital barrier function of injured skin. Growth factor products including epidermal growth factor (EGF), fibroblast growth factor (FGF) and granulocyte-macrophage colony stimulating factor (GM-CSF) have been used for decades although no systematic evaluation exists regarding their effectiveness and safety issues in treating acute skin wounds. This has resulted in a lack of guidelines and standards for proper application regimes. Therefore, this systematic review and meta-analysis was performed to critically evaluate the effectiveness and safety of these growth factors on skin acute wounds and provide guidelines for application regimes.

METHODS

We searched PubMed/Medline (1980-2020), Cochrane Library (1980-2020), Cochrane CENTRAL (from establishment to 2020), ClinicalTrials.gov (from establishment to 2020), Chinese Journal Full-text Database (CNKI, 1994-2020), China Biology Medicine disc (CBM, 1978-2019), Chinese Scientific Journal Database (VIP, 1989-2020) and Wanfang Database (WFDATA, 1980-2019). Randomized controlled trials (RCTs), quasi-RCTs and controlled clinical trials treating patients with acute skin wounds from various causes and with those available growth factors were included.

RESULTS

A total of 7573 papers were identified through database searching; 229 papers including 281 studies were kept after final screening. Administering growth factors significantly shortened the healing time of acute skin wounds, including superficial burn injuries [mean difference (MD) = -3.02; 95% confidence interval (CI):-3.31 ~ -2.74; 0.00001], deep burn injuries (MD = -5.63; 95% CI:-7.10 ~ -4.17; < 0.00001), traumata and surgical wounds (MD = -4.50; 95% CI:-5.55 ~ -3.44; < 0.00001). Growth factors increased the healing rate of acute skin wounds and decreased scar scores. The incidence of adverse reactions was lower in the growth factor treatment group than in the non-growth factor group.

CONCLUSIONS

The studied growth factors not only are effective and safe for managing acute skin wounds, but also accelerate their healing with no severe adverse reactions.

摘要

背景

促进伤口愈合对于恢复受损皮肤的重要屏障功能至关重要。包括表皮生长因子（EGF）、成纤维细胞生长因子（FGF）和粒细胞-巨噬细胞集落刺激因子（GM-CSF）在内的生长因子产品已使用数十年，但对于它们在治疗急性皮肤伤口方面的有效性和安全性问题尚无系统评估。这导致缺乏关于正确应用方案的指南和标准。因此，进行了这项系统评价和荟萃分析，以严格评估这些生长因子对皮肤急性伤口的有效性和安全性，并提供应用方案指南。

方法

我们检索了PubMed/Medline（1980 - 2020年）、Cochrane图书馆（1980 - 2020年）、Cochrane CENTRAL（从创刊到2020年）、ClinicalTrials.gov（从创刊到2020年）、中国期刊全文数据库（CNKI，1994 - 2020年）、中国生物医学文献数据库（CBM，1978 - 2019年）、中文科技期刊数据库（VIP，1989 - 2020年）和万方数据库（WFDATA，1980 - 2019年）。纳入了治疗各种原因引起的急性皮肤伤口患者并使用现有生长因子的随机对照试验（RCT）、半随机对照试验和对照临床试验。

结果

通过数据库检索共识别出7573篇论文；最终筛选后保留了229篇论文，包括281项研究。给予生长因子显著缩短了急性皮肤伤口的愈合时间，包括浅度烧伤（平均差值（MD）=-3.02；95%置信区间（CI）：-3.31至-2.74；P = 0.00001）、深度烧伤（MD=-5.63；95%CI：-7.10至-4.17；P < 0.00001）、创伤和手术伤口（MD=-4.50；95%CI：-5.55至-3.44；P < 0.00001）。生长因子提高了急性皮肤伤口的愈合率并降低了瘢痕评分。生长因子治疗组的不良反应发生率低于非生长因子组。