CO₂点阵激光联合糖皮质激素治疗斑秃的有效性和安全性的Meta分析

Meta-Analysis on the Efficacy and Safety of Fractional CO₂ Laser Combined with Corticosteroids in the Treatment of Alopecia Areata

摘要: 目的：本研究旨在判断CO₂点阵激光联合糖皮质激素治疗斑秃的有效性和安全性。方法：采用Cochrane的方法进行Meta分析，检索时间范围从建库至2024年7月，检索数据库包括PubMed、Web of Science、EMbase、The Cochrane Library、中国知网数据库、万方数据库、维普数据库，使用固定或随机效应模型进行风险比(RR)分析，效应量以95%可信区间(CI)表示。结果：共纳入8篇文献，其中6篇文献进行Meta分析，与单独使用药物相比，FrCO₂联合糖皮质激素治疗方案的疗效更高(RR, 1.52 [1.19~1.94])，试验组与对照组的差异有统计学意义(p < 0.05)；与单独使用药物相比，FrCO₂联合糖皮质激素治疗方案不存在副作用更高的风险(RR, 0.82 [0.33~2.02])，试验组与对照组的差异无统计学意义(p > 0.05)。结论：FRCO₂联合糖皮质激素能够有效治疗斑秃，治疗的效果要优于单独使用糖皮质激素，并且无显著的副作用，安全性较高。

Abstract: Objective: The purpose of this study is to evaluate the effectiveness and safety of fractional CO₂ laser combined with corticosteroids for treating alopecia areata. Methods: A Meta-analysis was performed following the Cochrane methodology, covering a search range from database establishment to July 2024. The databases searched included PubMed, Web of Science, EMbase, The Cochrane Library, CNKI, Wanfang Database, and VIP Database. The risk ratio (RR) was analyzed using fixed or random effects models, with effect sizes expressed as 95% confidence intervals (CI). Results: A total of 8 studies were included, with 6 studies analyzed in the Meta-analysis. The FrCO₂ combined with corticosteroid treatment was more effective than corticosteroids alone (RR, 1.52 [1.19~1.94]), showing a statistically significant difference between the treatment and control groups (p < 0.05). Additionally, there was no higher risk of adverse effects with the FrCO₂ and corticosteroids combination compared to corticosteroids alone (RR, 0.82 [0.33~2.02]), with no statistically significant difference between the treatment and control groups (p > 0.05). Conclusion: FrCO₂ combined with corticosteroids is an effective treatment for alopecia areata, showing superior results compared to corticosteroids alone, with no significant adverse effects and a high safety profile.