A型肉毒毒素防治增生性瘢痕的Meta分析
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摘要
目的评价A型肉毒毒素(BTX-A)防治增生性瘢痕的疗效。方法计算机检索pubmed文献数据库、中国知网中文数据库、万方数据库。收集所有使用A型肉毒毒素注射治疗增生性瘢痕的相关文献,进行Meta分析,以进行系统评价。结果共纳入8个随机对照试验518例患者。目前Meta分析结果显示:1 BTX-A组与对照组的温哥华瘢痕量表评分无统计学差异(Z=0.57,P>0.05)。2 BTX-A组患者满意率高于对照组(Z=4.59,P<0.01)。3BTX-A组视觉模拟量表得分高于对照组(Z=9.40,P<0.01)。4BTX-A组的瘢痕宽度小于对照组(Z=4.91,P<0.01)。结论 A型肉毒毒素注射治疗增生性瘢痕有一定的疗效,无明显的副作用,但其治疗效果的确切性和稳定性仍需更多高质量的研究验证。
Objective To systematically evaluate the curative effect of botulinum toxin type A curing the hypertrophic scar.Methods Used computer to search Pub Med literature database, China hownet database in Chinese and wanfang database,to collect all the relevant clinical reports of using BTX-A improve the hypertrophic scar,then using the Meta analysis to evaluate the system. Results Participants included eight randomized controlled trial of 518 patients.(1)the vancouver scar scale score have no significant difference between BTX-A group and the control group(Z=0.57,P >0.05).(2) patients satisfaction rate of BTX-A group is higher than the control group( Z=4.59,P <0.01).(3) the visual analogue scale score of BTX- A group is higher than the control group(Z=9.40,P <0.01).(4) the scar width of BTX-A group is less than the control group(Z=4.91,P <0.01).Conclusion The injection treatment of BTX-A for hyperplastic scar has certain curative effect,without obvious side effects, but the authenticity and stability of therapeutic effect has to be verified by more high quality research.
Objective To systematically evaluate the curative effect of botulinum toxin type A curing the hypertrophic scar.Methods Used computer to search Pub Med literature database, China hownet database in Chinese and wanfang database,to collect all the relevant clinical reports of using BTX-A improve the hypertrophic scar,then using the Meta analysis to evaluate the system. Results Participants included eight randomized controlled trial of 518 patients.(1)the vancouver scar scale score have no significant difference between BTX-A group and the control group(Z=0.57,P >0.05).(2) patients satisfaction rate of BTX-A group is higher than the control group( Z=4.59,P <0.01).(3) the visual analogue scale score of BTX- A group is higher than the control group(Z=9.40,P <0.01).(4) the scar width of BTX-A group is less than the control group(Z=4.91,P <0.01).Conclusion The injection treatment of BTX-A for hyperplastic scar has certain curative effect,without obvious side effects, but the authenticity and stability of therapeutic effect has to be verified by more high quality research.
引文
[1]Frank B,Paul H M,Joost S.On the nature of hypertrophytic scars and keloids:A review[J].Plast Reconstr Surg,1999,10(4):1435-1440.
[2]Urioste SS,Am dt KA,Dover JS.Keloids and hypertrophytic scars,review and treatm ent strategies[J].Sem in Gutan Med Sury,1999,10(8):159-165.
[3]Clark HD,Wells GA,Hu?t C.Assessing the quality of randomized trials:reliability of the Jadadscale[J].Control Clin Trials,1999,20(5):448-52.
[4]Chun-Shin Chang,Christopher Glenn Wallace,Yen-Chang Hsiao.Botulinum Toxin to Improve Results in Cleft Lip Repair:A DoubleBlinded,Randomized,Vehicle-Controlled Clinical Trial[J].PLos One,2014,9(12):1-12.
[5]Youn Sung Kim,Hyun Joo Lee,Sang Hyun Cho.Early postoperative treatment of thyroidectomy scars using botulinum toxin:A split-scar,double-blind randomized controlled trial[J].Wound Repair and Regeneration,2014,22:605-612.
[6]Makram Ziade,Sophie Domergue,Dominique Batifol.Use of botulinum toxin type A to improve treatment of facial wounds:A prospective randomised study[J].Plastic Reconstructive and Aesthetic Surgery,2013,12(6),209-214.
[7]Chun-Shin Chang,Christopher Glenn Wallace,Yen-Chang Hsiao.Botulinum Toxin to Improve Results in Cleft Lip Repair[J].Plastic and Reconstructive Surgery,2014,13(4):34-55.
[8]王长惠,魏翠娥,刘长海,等.局部注射A型肉毒毒素在防止面部整形美容切口瘢痕增生中的应用[J].大家健康,2011,5(9):3-5.
[9]王育红,涂惠芳,杜芳,等.A型肉毒素抑制内眦赘皮术后瘢痕的观察[J].国际眼科杂志,2015,15(6):1103-1106.
[10]陈海华,程含,李金晟,等.A型肉毒毒素预防毛发移植术中瘢痕增生的前瞻随机对照研究[J].中国医疗美容,2015,11(2):35-37
[11]栾迎春.A型肉毒毒素防止面部美容切口瘢痕增生的效果观察[J].中国医疗美容,2015,11(2):44-45.
[12]刘海兵,唐丹,曹海燕,等.温哥华瘢痕量表的信度研究[J].中国康复医学杂志,2006,21(3):240-242.
[13]Tyack Z,Simons M,Spinks A,et al.A systematic review of the quality of burn scar rating scales for clinical and research use[J].Burns,2012,38(1):6-18.
[14]Oliveira GV,Chinkes D,Mitchell C,et al.Objective assessment of burn scar vascularity,erythema,pliability,thickness,and Dermatologic surgery,2005,31(1):48-58.
[15]Nedelec B,Correa JA,Rachelska G,et al.Quantitative Measurement of Hypertrophic Scar:Interrater Reliability and Concurrent Validity.[J].Burn Care Res,2008,29(3):501-511.
[16]Fearmonti R,Bond J,Erdmann D,et al.A Review of Scar Scales and Scar Measuring Devices[J].Eplasty,2010,10(2):354-363.
[17]Ramirez-Castaneda J,Jankovic J.Long-term efficacy,safety,and side effect profile of botulinum toxin in dystonia:a 20-year followup[J].Toxicon,2014,90(12):344-348.
[18]Streker M,Luebberding S,Krueger N.Patientreported outcomes after incobotulinumtoxin A treatment for upper facial wrinkles[J].Dermatol Surg,2015,11(2):29-38.
[19]Chen M,Yan T,Ma K,et al.Botulinum toxin type A inhibitsα-smooth muscle actin and myosin II expression in fibroblasts derived from scar contracture[J].Ann Plast Surg,2014,20(8):655-658.
[20]Haubner F,Leyh M,Ohmann E,et al.Effects of botulinum toxin A on patient-specific keloid fibroblasts in vitro[J].Laryngoscope,2014,124(6):1344-1351.
[21]Lucioni A,Bales GT,Lotan TL,et al.Botulinum toxin type A inhibits sensory neuropeptide release in rat bladder models of acute injury and chronic inflammation[J].BUJ Int,2008,101(3):366-370.
[22]Wen WD,Yuan F,Wang JL,et al.Botulinum toxin therapy in the ovalbumin-sensitized rat[J].Neur oimmunomodulation,2007,14(2):78-83.
[23]Maderal AD,Tang JC,Vivas AC,et al.Hypertrophic scars and keloids,part 2:newer and investigational therapies[J].Cosmet Dermatol,2012,25(1):373-379.
[24]Filipovic B,Bach-Rojecky L,Lackovic Z.Lasting reduction of postsurgical hyperalgesia after single injection of botulinum toxin type A in rat[J].Fundam Clin Pharmacol,2010,24(1):43-45.
[25]Fagien S,Brandt FS.Primary and adjunctive use of botulinum toxin type A(Botox)in facial aesthetic surgery:beyond the blabella[J].Clin Plast Surg,2001,28:127-148.
[26]Soo C,Show WW,Zhang X,et al.Differential expression of matrix metalloproteinase and their tissue-derived inhibitors in cutaneous wound repair[J].Plast Reconst Surg,2000,10(5):637-638.
[27]Lucioni A,Bales GT,Lotan TL,et al.Botulinum toxin type A inhibits sensory neuropeptide release in rat bladder models of acute injury and chronic inflammation[J].BUJ Int,2008,101(3):366-370.
[2]Urioste SS,Am dt KA,Dover JS.Keloids and hypertrophytic scars,review and treatm ent strategies[J].Sem in Gutan Med Sury,1999,10(8):159-165.
[3]Clark HD,Wells GA,Hu?t C.Assessing the quality of randomized trials:reliability of the Jadadscale[J].Control Clin Trials,1999,20(5):448-52.
[4]Chun-Shin Chang,Christopher Glenn Wallace,Yen-Chang Hsiao.Botulinum Toxin to Improve Results in Cleft Lip Repair:A DoubleBlinded,Randomized,Vehicle-Controlled Clinical Trial[J].PLos One,2014,9(12):1-12.
[5]Youn Sung Kim,Hyun Joo Lee,Sang Hyun Cho.Early postoperative treatment of thyroidectomy scars using botulinum toxin:A split-scar,double-blind randomized controlled trial[J].Wound Repair and Regeneration,2014,22:605-612.
[6]Makram Ziade,Sophie Domergue,Dominique Batifol.Use of botulinum toxin type A to improve treatment of facial wounds:A prospective randomised study[J].Plastic Reconstructive and Aesthetic Surgery,2013,12(6),209-214.
[7]Chun-Shin Chang,Christopher Glenn Wallace,Yen-Chang Hsiao.Botulinum Toxin to Improve Results in Cleft Lip Repair[J].Plastic and Reconstructive Surgery,2014,13(4):34-55.
[8]王长惠,魏翠娥,刘长海,等.局部注射A型肉毒毒素在防止面部整形美容切口瘢痕增生中的应用[J].大家健康,2011,5(9):3-5.
[9]王育红,涂惠芳,杜芳,等.A型肉毒素抑制内眦赘皮术后瘢痕的观察[J].国际眼科杂志,2015,15(6):1103-1106.
[10]陈海华,程含,李金晟,等.A型肉毒毒素预防毛发移植术中瘢痕增生的前瞻随机对照研究[J].中国医疗美容,2015,11(2):35-37
[11]栾迎春.A型肉毒毒素防止面部美容切口瘢痕增生的效果观察[J].中国医疗美容,2015,11(2):44-45.
[12]刘海兵,唐丹,曹海燕,等.温哥华瘢痕量表的信度研究[J].中国康复医学杂志,2006,21(3):240-242.
[13]Tyack Z,Simons M,Spinks A,et al.A systematic review of the quality of burn scar rating scales for clinical and research use[J].Burns,2012,38(1):6-18.
[14]Oliveira GV,Chinkes D,Mitchell C,et al.Objective assessment of burn scar vascularity,erythema,pliability,thickness,and Dermatologic surgery,2005,31(1):48-58.
[15]Nedelec B,Correa JA,Rachelska G,et al.Quantitative Measurement of Hypertrophic Scar:Interrater Reliability and Concurrent Validity.[J].Burn Care Res,2008,29(3):501-511.
[16]Fearmonti R,Bond J,Erdmann D,et al.A Review of Scar Scales and Scar Measuring Devices[J].Eplasty,2010,10(2):354-363.
[17]Ramirez-Castaneda J,Jankovic J.Long-term efficacy,safety,and side effect profile of botulinum toxin in dystonia:a 20-year followup[J].Toxicon,2014,90(12):344-348.
[18]Streker M,Luebberding S,Krueger N.Patientreported outcomes after incobotulinumtoxin A treatment for upper facial wrinkles[J].Dermatol Surg,2015,11(2):29-38.
[19]Chen M,Yan T,Ma K,et al.Botulinum toxin type A inhibitsα-smooth muscle actin and myosin II expression in fibroblasts derived from scar contracture[J].Ann Plast Surg,2014,20(8):655-658.
[20]Haubner F,Leyh M,Ohmann E,et al.Effects of botulinum toxin A on patient-specific keloid fibroblasts in vitro[J].Laryngoscope,2014,124(6):1344-1351.
[21]Lucioni A,Bales GT,Lotan TL,et al.Botulinum toxin type A inhibits sensory neuropeptide release in rat bladder models of acute injury and chronic inflammation[J].BUJ Int,2008,101(3):366-370.
[22]Wen WD,Yuan F,Wang JL,et al.Botulinum toxin therapy in the ovalbumin-sensitized rat[J].Neur oimmunomodulation,2007,14(2):78-83.
[23]Maderal AD,Tang JC,Vivas AC,et al.Hypertrophic scars and keloids,part 2:newer and investigational therapies[J].Cosmet Dermatol,2012,25(1):373-379.
[24]Filipovic B,Bach-Rojecky L,Lackovic Z.Lasting reduction of postsurgical hyperalgesia after single injection of botulinum toxin type A in rat[J].Fundam Clin Pharmacol,2010,24(1):43-45.
[25]Fagien S,Brandt FS.Primary and adjunctive use of botulinum toxin type A(Botox)in facial aesthetic surgery:beyond the blabella[J].Clin Plast Surg,2001,28:127-148.
[26]Soo C,Show WW,Zhang X,et al.Differential expression of matrix metalloproteinase and their tissue-derived inhibitors in cutaneous wound repair[J].Plast Reconst Surg,2000,10(5):637-638.
[27]Lucioni A,Bales GT,Lotan TL,et al.Botulinum toxin type A inhibits sensory neuropeptide release in rat bladder models of acute injury and chronic inflammation[J].BUJ Int,2008,101(3):366-370.