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曲安奈德联合A型肉毒杆菌毒素治疗增生性瘢痕和瘢痕疙瘩的疗效:一项荟萃分析。

Efficacy of triamcinolone acetonide combined with botulinum toxin A in the treatment of hypertrophic scars and keloids: A meta-analysis.

作者信息

Shi Jianzhen, Zhang Siqi, Zhang Ziyue, Xu Jianru, Chen Yanmei, Sun Siyu

机构信息

School of Physics and Technology, Nantong University, Nantong, Jiangsu, China; Nantong University Xinglin College, Nantong, Jiangsu, China.

School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, Jiangsu,China.

出版信息

Burns. 2024 Dec;50(9):107250. doi: 10.1016/j.burns.2024.08.016. Epub 2024 Aug 24.

Abstract

BACKGROUND

This meta-analysis aims to evaluate the efficacy and safety of triamcinolone acetonide (TCA) combined with botulinum toxin type A (BTA) for treating hypertrophic scars and keloids.

METHODS

A comprehensive search of randomized controlled trials published before September 2023 was conducted across the Cochrane Library, Embase, PubMed, Web of Science, and CNKI databases. The analysis involved calculating pooled weighted mean difference (WMD), pooled risk ratios (RR), and 95 % confidence intervals (CI).

RESULTS

Inclusive of 11 studies with a total of 561 patients, the meta-analysis revealed a statistically significant difference in the effective rate between the BTA+ TCA and control groups (RR = 1.28, 95 % CI = 1.14-1.44). Moreover, BTA+ TCA demonstrated a significant improvement in Visual Analog Scale scores (WMD = -1.69, 95 % CI = -2.72 - -0.66) and Vancouver Scar Scale scores (WMD = -1.46, 95 % CI = -1.90 - -1.02) compared to the control group. However, no statistically significant difference in scar thickness was observed between the BTA+ TCA and control groups (WMD = -0.11, 95 % CI = -0.30 - 0.09).

CONCLUSION

This meta-analysis showed that the combined use of BTA and TCA demonstrates high effectiveness in scar treatment, but its influence on scar thickness is limited. Future research should further explore the sources of heterogeneity and validate the long-term effects and safety of this therapy.

摘要

背景

本荟萃分析旨在评估曲安奈德(TCA)联合A型肉毒杆菌毒素(BTA)治疗增生性瘢痕和瘢痕疙瘩的疗效和安全性。

方法

对2023年9月之前发表的随机对照试验进行全面检索,检索范围涵盖考克兰图书馆、Embase、PubMed、科学网和中国知网数据库。分析包括计算合并加权平均差(WMD)、合并风险比(RR)和95%置信区间(CI)。

结果

纳入11项研究,共561例患者,荟萃分析显示BTA+TCA组与对照组的有效率存在统计学显著差异(RR = 1.28,95%CI = 1.14 - 1.44)。此外,与对照组相比,BTA+TCA在视觉模拟量表评分(WMD = -1.69,95%CI = -2.72 - -0.66)和温哥华瘢痕量表评分(WMD = -1.46,95%CI = -1.90 - -1.02)方面有显著改善。然而,BTA+TCA组与对照组在瘢痕厚度方面未观察到统计学显著差异(WMD = -0.11,95%CI = -0.30 - 0.09)。

结论

本荟萃分析表明,BTA和TCA联合使用在瘢痕治疗中显示出高效性,但其对瘢痕厚度的影响有限。未来研究应进一步探索异质性来源,并验证该疗法的长期效果和安全性。

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