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含表皮生长因子的局部产品在激光手术后恢复和预防炎症后色素沉着过度中的作用:系统评价和荟萃分析。

The role of epidermal growth factor-containing topical products on recovery and post-inflammatory hyperpigmentation prevention after laser surgeries: A systematic review and meta-analysis.

机构信息

Department of Dermatology, Hangzhou Third People's Hospital, Affiliated Hangzhou Dermatology Hospital of Zhejiang University School of Medicine, Hangzhou, China.

出版信息

J Cosmet Dermatol. 2024 Feb;23(2):382-390. doi: 10.1111/jocd.16007. Epub 2023 Oct 18.

Abstract

BACKGROUND

Post-inflammatory hyperpigmentation (PIH) is a common complication after laser surgeries. Recent studies applied epidermal growth factor (EGF) on the lasered area after laser surgery to decrease the incidence of PIH with controversial results. Therefore, a comprehensive literature review of randomized controlled trials (RCTs) was conducted to investigate the issue.

METHODS

Two reviewers independently searched the literatures, extracted, and analyzed the data. A total of seven RCTs involving 169 patients were included to evaluate the efficacy of EGF on recovery and PIH prevention after laser surgery.

RESULTS

The results show that the incidence of PIH in the EGF group was relatively lower than that in the control group, although the difference was not statistically significant (OR 0.64, 95% CI 0.33 ~ 1.25, p = 0.19). However, the EGF groups had a significant decrease in melanin index (MI) scores at the 1st month after the laser surgery when compared to the control groups (SMD -1.57, 95% CI -2.83 ~ -0.31, p = 0.01). In addition, the patients on the EGF side rated significantly higher satisfactory scores (SMD 0.49, 95% CI 0.22 ~ 0.76, p = 0.0004). There was no significant difference as regard to changes in MI at the 2nd week and 2nd month, erythema index (EI), and trans-epidermal water loss (TEWL) at days 3 and 7 after laser therapy, respectively.

CONCLUSION

The current meta-analysis found a limited temporary inhibitory effect of EGF-containing topical products on PIH with no significant effect on reducing post-laser erythema or promoting epidermal barrier repair. More studies are needed in the future due to the small sample size and marked intergroup heterogeneities.

摘要

背景

激光手术后的炎症后色素沉着(PIH)是一种常见的并发症。最近的研究在激光手术后的激光区域应用表皮生长因子(EGF)以降低 PIH 的发生率,但结果存在争议。因此,进行了一项全面的文献综述,以调查随机对照试验(RCT)的问题。

方法

两名审查员独立搜索文献、提取和分析数据。共有 7 项 RCT 纳入了 169 名患者,以评估 EGF 在激光手术后恢复和预防 PIH 方面的疗效。

结果

结果显示,EGF 组的 PIH 发生率相对低于对照组,但差异无统计学意义(OR 0.64,95%CI 0.331.25,p=0.19)。然而,与对照组相比,EGF 组在激光手术后 1 个月时黑素指数(MI)评分显著降低(SMD -1.57,95%CI -2.83-0.31,p=0.01)。此外,EGF 组患者的满意度评分显著更高(SMD 0.49,95%CI 0.22~0.76,p=0.0004)。在激光治疗后第 3 天和第 7 天的 MI 变化、红斑指数(EI)和经表皮水分丢失(TEWL)方面,EGF 组与对照组之间没有显著差异。

结论

目前的荟萃分析发现 EGF 含有的局部产品对 PIH 有一定的暂时抑制作用,但对减少激光后红斑或促进表皮屏障修复没有显著效果。由于样本量小且组间异质性显著,未来需要进行更多的研究。

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