在整形外科中使用COX抑制剂 纤维增殖性疾病:系统性审查
Yu Ting Tay1, Elisha Purcell2, Ishith Seth2,3
1Department of Plastic and Reconstructive Surgery, Eastern Health, Melbourne, VIC 3128, Australia.
循环氧化原酶 (COX) 抑制剂在整形外科手术中治疗纤维扩散性疾病方面表现有前途,副作用最小. 需要进一步进行高质量的研究来确认它们的有效性并指导临床使用.
科学领域:
- 整形外科 整形外科 整形外科
- 皮肤病学 皮肤病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 纤维增殖性疾病 (FPD) 涉及过度的纤维细胞活动和原沉积,在塑性和重建性外科手术中提出了挑战.
- 诸如杜普伊特伦契约症和状痕等疾病是常见的FPD,需要有效的治疗策略.
- 循环氧化原酶 (COX) 抑制剂正在作为调节纤维化通路的辅助疗法进行探索.
研究的目的:
- 系统地审查COX抑制剂对与整形手术相关的FPD的疗效和安全性.
- 探索以表型为导向和特定路径的COX抑制剂在精密医学中的使用.
- 综合当前关于COX抑制剂在治疗纤维状况方面的证据.
主要方法:
- 在MEDLINE,Embase和Cochrane图书馆进行了全面的文献搜索.
- 来自符合条件的研究的数据使用表格摘要和叙事分析进行了综合分析.
- 使用GRADE指南评估证据的确定性.
主要成果:
- 涉及491名患者的13项研究 (1984-2024) 满足了纳入标准,重点关注过度缩性痕,杜普伊特伦合并和瘤.
- 九项研究报告了临床改善,4项显示统计学意义,3项显示没有差异.
- 通过口服和局部COX抑制剂观察到轻微的副作用;整体证据确定性被评为"低".
结论:
- COX 抑制剂显示出有希望的疗效和有利的安全概况,用于管理与整形手术相关的FPDs.
- 它们的可访问性和抗纤维素潜力需要进一步研究.
- 高质量,大规模的研究是必要的,以建立最终的临床建议.
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