肠道牛皮的管理:一个系统的审查
Ted Zhou1, John Koussiouris1, Lauren Kim1
1Department of Medicine, McMaster University, Hamilton, ON, Canada.
Journal of cutaneous medicine and surgery
|July 31, 2024
概括
检查了肠道牛皮 (GP) 治疗疗效,发现局部皮质类固醇,calcipotriol和窄带UVB光疗是最有效的. 为了制定标准化建议,还需要进一步的随机对照试验.
科学领域:
- 皮肤病学 皮肤病学
- 系统审查是系统的审查.
- 基于证据的医学基于证据的医学.
背景情况:
- 肠道牛皮 (GP) 是一种常见的牛皮变体,有可能发展为慢性斑块牛皮.
- 有限的文献存在于各种状牛皮治疗方式的疗效.
- 本综述综合了当前关于全科医生治疗有效性的证据.
研究的目的:
- 系统地审查和综合现有数据,以确定不同治疗方式的有效性.
- 识别证据缺陷,并根据当前的发现提出治疗算法.
主要方法:
- 在主要数据库 (Medline,Embase,Web of Science,CINAHL) 进行了全面的文献搜索,没有日期限制.
- 分析了75项研究,包括病例报告,系列,回顾性研究和5项随机对照试验 (RCT).
- 关于局部治疗,全身疗法 (免疫抑制剂,抗生素,视网类药物,生物制剂) 和光疗的数据被提取和评估.
主要成果:
- 局部皮质类固醇和calcipotriol已经证明对GP的有效性. 对抗生素治疗对GP缓解的直接影响的证据很少.
- 光疗,特别是窄带紫外线B (UVB),显示出最强有力的有效性证据.
- 系统性疗法,如甲基和环素被确定为二线选择,与严重的,耐火病例的生物药物.
结论:
- 一个拟议的治疗算法建议使用局部皮质类固醇和皮醇奶油与光疗相结合的第一线治疗.
- 可以考虑支持性抗生素治疗. 建议使用甲甲酸或环素作为二线治疗.
- 高质量的RCT对于制定标准化,基于证据的治疗准则至关重要.
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