Graduate school, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
Department of Geriatric, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China.
J Dermatolog Treat. 2024 Dec;35(1):2381766. doi: 10.1080/09546634.2024.2381766. Epub 2024 Sep 4.
Alopecia areata (AA) is a common autoimmune skin disease. Our study aimed to systematically evaluate the efficacy and safety of compound glycyrrhizin (CG) combined with topical minoxidil therapy in treating AA.
We searched the PubMed, EMBASE, Cochrane Library, Web of Science, CNKI, Wanfang, and VIP databases. Randomized controlled trials (RCTs) on CG combined with topical minoxidil therapy compared with topical minoxidil therapy alone for AA were included. The Cochrane Collaborative Network Tool was used to assess the risk of bias. Statistical analysis was completed using RevMan5.3 software and Stata 15.0 software. The GRADE system was used to evaluate the quality of evidence for outcomes.
11 RCTs and 1189 patients were included. Compared with topical minoxidil therapy alone, CG combined with topical minoxidil therapy was more effective at improving the clinical efficacy (RR = 1.36, 95% CI [1.27, 1.45], < 0.00001). The SALT score (MD = -10.09, 95% CI [-12.89, -7.30], < 0.00001), serum TNF-α levels (MD = -0.99, 95% CI [-1.19, -0.39], < 0.00001), serum IL-12 levels (MD = -8.84, 95% CI [-11.20, -6.47], < 0.00001) and serum IFN-γ levels (MD = -7.44, 95% CI [-11.51, -3.37], = 0.0003) were reduced, and the serum TGF-β1 levels (MD = 2.40, 95% CI [1.24, 3.57], < 0.0001) were increased. There were no significant differences in reported adverse events, including irritant contact dermatitis (RR = 0.51, 95% CI [0.25, 1.01], = 0.05),' gastrointestinal reactions (RR = 2.47, 95% CI [0.49, 12.55], = 0.28), lower limb edema (RR = 2.60, 95% CI [0.61, 11.06], = 0.20), facial edema (RR = 2.33, 95% CI [0.61, 8.93], = 0.22), or localized itching (RR = 0.56, 95% CI [0.18, 1.75], = 0.32), between the two groups.
The current evidence indicates that CG combined with topical minoxidil therapy is effective and safe for AA. However, owing to the suboptimal quality of the included studies, more high-quality and large-scale RCTs are needed for comprehensive analysis and further validation.
斑秃（AA）是一种常见的自身免疫性皮肤疾病。本研究旨在系统评价复方甘草酸苷（CG）联合米诺地尔治疗 AA 的疗效和安全性。
我们检索了 PubMed、EMBASE、Cochrane 图书馆、Web of Science、CNKI、万方和 VIP 数据库。纳入 CG 联合米诺地尔治疗与单独使用米诺地尔治疗 AA 的随机对照试验（RCT）。使用 Cochrane 协作网络工具评估偏倚风险。使用 RevMan5.3 软件和 Stata 15.0 软件完成统计分析。使用 GRADE 系统评估结局的证据质量。
共纳入 11 项 RCT 和 1189 例患者。与单独使用米诺地尔治疗相比，CG 联合米诺地尔治疗在提高临床疗效方面更有效（RR=1.36，95%CI[1.27，1.45]， < 0.00001）。SALT 评分（MD=-10.09，95%CI[-12.89，-7.30]， < 0.00001）、血清 TNF-α 水平（MD=-0.99，95%CI[-1.19，-0.39]， < 0.00001）、血清 IL-12 水平（MD=-8.84，95%CI[-11.20，-6.47]， < 0.00001）和血清 IFN-γ 水平（MD=-7.44，95%CI[-11.51，-3.37]， = 0.0003）降低，血清 TGF-β1 水平（MD=2.40，95%CI[1.24，3.57]， < 0.0001）升高。报告的不良反应，包括刺激性接触性皮炎（RR=0.51，95%CI[0.25，1.01]， = 0.05）、胃肠道反应（RR=2.47，95%CI[0.49，12.55]， = 0.28）、下肢水肿（RR=2.60，95%CI[0.61，11.06]， = 0.20）、面部水肿（RR=2.33，95%CI[0.61，8.93]， = 0.22）或局部瘙痒（RR=0.56，95%CI[0.18，1.75]， = 0.32），在两组之间无显著差异。
目前的证据表明，CG 联合米诺地尔治疗 AA 是有效且安全的。然而，由于纳入研究的质量欠佳，需要更多高质量和大规模的 RCT 进行全面分析和进一步验证。
