丹参治疗病理性瘢痕的临床疗效: 系统评价与Meta分析

doi:10.5246/jcps.2024.09.063

摘要/Abstract

摘要：

本研究旨在系统评价丹参治疗病理性瘢痕的临床治疗效果, 并为瘢痕药物治疗提供参考依据。通过计算机检索英文及中文数据库建库至2022年12月的文献, 检索词为Salvia miltiorrhiza、cryptotanshinone、tanshinone、tanshinone IIA、sodium-tanshinol、compound Salvia miltiorrhiza dripping pills、cicatrix、cicatrices、scar。筛选所有丹参治疗病理性瘢痕的临床随机对照研究, 与是否采用盲法或分配隐藏无关, 不限患者国籍、种族或年龄。纳入的文献通过软件(RevMan 5.4)进行数据分析, 其中, 数值变量使用标准均数差或加权均数差; 二分类变量使用比值比, 所有合并统计分析的数据均计算95%可信区间(95% CI), P < 0.05表示具有统计学意义。最终纳入6篇符合标准的相关文献, 共计778例患者。治疗显效率的结果为: OR = 3.83, 其95% CI = 2.65～5.54, 表明丹参治疗组的治疗显效率显著高于对照组。治疗总有效率的结果为: OR = 6.94, 其95% CI = 2.53～19.06, 表明丹参治疗组的治疗总有效率显著高于对照组。治疗3个月后瘢痕积分的结果为: MD = –0.96, 其95% CI = –2.29～0.36, 表明丹参治疗组治疗3个月后的瘢痕积分较对照组未显著改善。治疗6个月后瘢痕积分的结果为: MD = –1.37, 其95% CI = –2.44～–0.30, 表明丹参治疗组治疗6个月后的瘢痕积分较对照组显著改善。研究证实, 丹参治疗可显著改善临床瘢痕患者的治疗显效率及治疗总有效率, 对瘢痕患者具有良好的临床治疗效果。

关键词: 丹参, 病理性瘢痕, Meta分析, 转化生长因子-β

Abstract:

To systematically assess the clinical efficacy of Salvia miltiorrhiza (SM) in treating pathological scars and provide a reference basis for scar pharmacotherapy, we conducted a comprehensive literature search in both English and Chinese databases from database inception to December 2022. Key search terms included Salvia miltiorhiza, cryptotanshinone, tanshinone IIA, sodium-tanshinol, compound Salvia miltiorrhiza dripping pills, cicatrix, cicatrices, and scar. The inclusion criteria encompassed all clinical randomized controlled studies on the treatment of pathological scars with SM, without regard to blinding or allocation concealment, as well as irrespective of patient nationality, race, or age. Data from the selected literature were subjected to analysis using RevMan 5.4 software, employing the standard mean difference or weighted mean difference for numerical variables and odds ratios (ORs) for dichotomous variables. Statistical significance was set at P < 0.05. Six eligible studies involving a total of 778 patients met the inclusion criteria. The analysis revealed a significant therapeutic efficacy with an OR of 3.83 (95% CI: 2.65–5.54), indicating a substantially higher therapeutic efficacy rate in SM group compared to the control group. Furthermore, the total effective rate of treatment exhibited an OR of 6.94 (95% CI: 2.53–19.06), signifying a significantly superior treatment outcome in SM group. Regarding scar scores, no significant improvement was observed in SM group compared to the control group after 3 months of treatment (mean difference [MD] = –0.96, 95% CI: –2.29–0.36). However, after 6 months of treatment, the scar score demonstrated a noteworthy improvement in SM group (MD = –1.37, 95% CI: –2.44 to –0.30) compared to the control group. In summary, this study affirmed that SM treatment markedly enhanced the therapeutic efficacy and overall treatment efficiency for clinical scar patients, underscoring its positive clinical therapeutic impact on scar patients.

Key words: SM, Pathological scar, Meta-analysis, TGF-β

Supporting:

宋志红, 杨金姬, 张洪壮, 范文霞, 朱安琪, 李少杰, 付浩. 丹参治疗病理性瘢痕的临床疗效: 系统评价与Meta分析[J]. 中国药学(英文版), 2024, 33(9): 846-856.

Zhihong Song, Jinji Yang, Hongzhuang Zhang, Wenxia Fan, Anqi Zhu, Shaojie Li, Hao Fu. Clinical efficacy of Salvia miltiorrhiza in pathological scar treatment: A systematic review and meta-analysis[J]. Journal of Chinese Pharmaceutical Sciences, 2024, 33(9): 846-856.

图/表 6

Figure 1. Screening and inclusion process of evaluation literatures.

Table 1. General information of included literatures.

Figure 2. Forest plot of Meta-analysis of the significant efficacy rate of the SM and control groups.

Figure 3. Forest plot of Meta-analysis of the total efficacy rate of the SM and control groups.

Figure 4. Forest plot of Meta-analysis of scar scores after 3 months of treatment in SM and control groups.

Figure 5. Forest plot of Meta-analysis of scar scores after 6 months of treatment in SM and control groups.

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