联合微针疗法治疗雄激素性脱发的疗效和安全性：随机临床试验的系统评价和荟萃分析。
Efficacy and safety of combined microneedling therapy for androgenic alopecia: A systematic review and meta-analysis of randomized clinical trials.
机构信息
Department of Dermatology, The First Hospital of Hebei Medical University, Shijiazhuang, China.
Candidate Branch of National Clinical Research Center for Skin Diseases, Shijiazhuang, China.
出版信息
J Cosmet Dermatol. 2024 May;23(5):1560-1572. doi: 10.1111/jocd.16186. Epub 2024 Jan 18.
OBJECTIVE
To provide dermatologists with more clinical experience in treating androgenetic alopecia, we evaluated the effect and safety of combined microneedling therapy for androgenetic alopecia.
METHODS
Studies on combined microneedling for hair loss were comprehensively searched by us in PubMed, Excerpta Medica Database, and the Cochrane Library Database. The literature search spanned the period from 2012 to 2022. Inclusion and exclusion criteria were developed, and the literature was screened according to this criteria. The Cochrane Risk of Bias Tool was used to assess the quality of the studies. The researcher applied Revman 5.3 and Stata 15.1 software to analyze the data after extracting information from the data.
RESULTS
Finally, 13 RCTs involving 696 AGA patients were included to compare the clinical effectiveness and adverse events of combined MN therapy with single MN therapy or single drug therapy for AGA. The results of meta-analysis showed as follows: (1) Hair density and diameter changes: The combined MN group was significantly better than any single treatment group, and the differences were statistically significant (MD = 13.36, 95% CI = [8.55, 18.16], Z = 5.45, p < 0.00001; MD = 18.11, 95% CI = [13.70, 22.52], Z = 8.04, p < 0.00001; MD = 13.36, 95% CI = [8.55, 18.16], Z = 5.45, p < 0.00001; MD = 2.50, 95% CI = [0.99, 4.02], Z = 3.23, p = 0.001); (2) the evaluation of satisfaction for efficacy: The doctor satisfaction rating of the combined MN group was significantly higher than that of any single treatment group, with statistical difference (RR = 2.03, 95% CI = [1.62, 2.53], Z = 6.24, p < 0.00001). The difference between the two groups regarding patients satisfaction was not significant (RR = 3.44, 95% CI = [0.67, 17.59], Z = 1.49, p = 0.14). (3) Safety: There was no statistical difference in the incidence of adverse reactions between combination therapy and monotherapy (RR = 0.83, 95% CI = [0.62, 1.12], Z = 1.22, p = 0.22).
CONCLUSION
The combined MN group showed statistically significant improvement in hair density and diameter, and good safety compared with monotherapy.
目的
为了给皮肤科医生提供更多雄激素性脱发治疗的临床经验，我们评估了微针联合治疗雄激素性脱发的疗效和安全性。
方法
我们在 PubMed、Embase 和 Cochrane 图书馆数据库中全面检索了关于毛发微针治疗脱发的研究。文献检索时间跨度为 2012 年至 2022 年。制定了纳入和排除标准，并根据这些标准筛选文献。使用 Cochrane 偏倚风险工具评估研究质量。研究人员在提取数据后，应用 Revman 5.3 和 Stata 15.1 软件对数据进行分析。
结果
最终纳入了 13 项随机对照试验，涉及 696 例 AGA 患者，比较了联合 MN 治疗与单一 MN 治疗或单一药物治疗 AGA 的临床疗效和不良反应。荟萃分析结果显示：（1）毛发密度和直径变化：联合 MN 组明显优于任何单一治疗组，差异具有统计学意义（MD=13.36，95%CI=[8.55, 18.16]，Z=5.45，p<0.00001；MD=18.11，95%CI=[13.70, 22.52]，Z=8.04，p<0.00001；MD=13.36，95%CI=[8.55, 18.16]，Z=5.45，p<0.00001；MD=2.50，95%CI=[0.99, 4.02]，Z=3.23，p=0.001）；（2）疗效评估满意度：联合 MN 组医生满意度评分明显高于任何单一治疗组，差异具有统计学意义（RR=2.03，95%CI=[1.62, 2.53]，Z=6.24，p<0.00001）。两组患者满意度差异无统计学意义（RR=3.44，95%CI=[0.67, 17.59]，Z=1.49，p=0.14）；（3）安全性：联合治疗与单一治疗的不良反应发生率无统计学差异（RR=0.83，95%CI=[0.62, 1.12]，Z=1.22，p=0.22）。
结论
与单一疗法相比，联合 MN 组在毛发密度和直径方面有显著改善，且安全性良好。
Zotero 插件