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冷冻疗法与其他治疗方式相比在掌跖疣治疗中的疗效:一项系统评价和网状Meta分析

The efficacy of cryotherapy compared to other modalities in the management of palmoplantar warts: a systematic review and network meta-analysis.

作者信息

Alrashidi Anwar R, Shaheen Esraa, Abualola Amal, Alharkan Alanoud A, Aljuaid Abdulaziz, Alshareef Khalid M, Ghaddaf Abdullah A, Alamri Samer, Samarkandy Sahal J

机构信息

Department of Dermatology, King Fahad Medical City, Riyadh.

College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah; King Abdullah International Medical Research Center, Jeddah.

出版信息

Dermatol Reports. 2025 May 23;17(2). doi: 10.4081/dr.2024.10121. Epub 2024 Oct 25.


DOI:10.4081/dr.2024.10121
PMID:40586422
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12264738/
Abstract

Several treatment modalities for palmoplantar warts (PPW) have been introduced, but none have been proven to be significantly effective in all patients. The study aims to assess the efficacy and safety of cryotherapy compared to other modalities for PPW. Searches were conducted in Medline, Embase, Scopus, and CENTRAL databases, along with additional reference and citation tracking from included studies. Randomized controlled trials (RCTs) comparing various treatments for PPW were included. Two independent pairs extracted the data from the included studies. Outcomes assessed included cure rates, pain scores, recurrence rates, and adverse events. A network meta-analysis using Netmeta in R software was employed, with treatments ranked by p-scores. A total of 27 RCTs that enrolled 2539 participants were deemed eligible. As per p-scores, needling yielded the highest odds for the cure rate (p=1.00), followed by intralesional injection of the measles, mumps, and rubella (MMR) vaccine (p=0.90). For the pain score, 76% topical monochloroacetic acid (p=0.13) showed the lowest mean pain score, while cryotherapy yielded the highest score (p=0.90). Furthermore, cryotherapy showed the highest odds for recurrence rate (p=0.75), followed by intralesional injection of Candida antigen (p=0.61). Regarding adverse events, 0.05% intralesional bleomycin had the highest rate (p=0.93), followed by cryotherapy (p=0.61).

摘要

已经介绍了几种治疗掌跖疣(PPW)的方法,但没有一种被证明对所有患者都有显著疗效。本研究旨在评估冷冻疗法与其他治疗PPW的方法相比的疗效和安全性。在Medline、Embase、Scopus和CENTRAL数据库中进行了检索,并对纳入研究的参考文献和引用进行了额外追踪。纳入了比较PPW各种治疗方法的随机对照试验(RCT)。两组独立人员从纳入研究中提取数据。评估的结果包括治愈率、疼痛评分、复发率和不良事件。使用R软件中的Netmeta进行网络荟萃分析,根据p值对治疗方法进行排序。共有27项RCT纳入了2539名参与者,被认为符合条件。根据p值,针刺疗法治愈率的优势比最高(p=1.00),其次是病灶内注射麻疹、腮腺炎和风疹(MMR)疫苗(p=0.90)。对于疼痛评分,76%的局部使用单氯乙酸(p=0.13)显示平均疼痛评分最低,而冷冻疗法的评分最高(p=0.90)。此外,冷冻疗法复发率的优势比最高(p=0.75),其次是病灶内注射白色念珠菌抗原(p=0.61)。关于不良事件,0.05%的病灶内注射博来霉素发生率最高(p=0.93),其次是冷冻疗法(p=0.61)。

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本文引用的文献

[1]
Clinical guideline for the diagnosis and treatment of cutaneous warts (2022).

J Evid Based Med. 2022-9

[2]
Efficacy of cryotherapy for plantar warts: A systematic review and meta-analysis.

Dermatol Ther. 2022-6

[3]
The status of treatment for plantar warts in 2021: No definitive advancements in decades for a common dermatology disease.

Clin Dermatol. 2021

[4]
Diagnostic techniques in HPV infections and the need to implement them in plantar lesions: A systematic review.

Expert Rev Mol Diagn. 2021-12

[5]
Topical treatment for plantar warts: A systematic review.

Dermatol Ther. 2021-1

[6]
Long-pulsed neodymium-doped yttrium-aluminum-garnet laser versus cryotherapy for the treatment of cutaneous warts: A randomized controlled trial.

J Am Acad Dermatol. 2022-12

[7]
A review of intralesional wart therapy.

Dermatol Online J. 2020-3-15

[8]
Intralesional cryotherapy versus cryotherapy spray for the treatment of recalcitrant plantar warts: a prospective, randomized study.

J Dermatolog Treat. 2022-3

[9]
Comparison of 40% trichloroacetic acid and cryotherapy for the treatment of plantar warts: A single-blind, randomized clinical trial.

Dermatol Ther. 2020-7

[10]
Silver duct tape occlusion in treatment of plantar warts in adults: Is it effective?

Dermatol Ther. 2020-5

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