Effect of topical timolol and oral use propranolol for the treatment of superficial infantile hemangioma: A systematic review and Meta-analysis

doi:10.3969/j.issn.1005-4979.2021.02.005

Abstract

Abstract:

Objective: Through systematic reviews and Meta-analyses, the efficacy and side effects of topical timolol and oral use propranolol in the treatment of superficial infantile hemangioma were compared, and the therapeutic effect of topical timolol on this disease was further evaluated to guide the clinical rational administration of medication. Methods: A comparative study of timolol and propranolol in the treatment of infantile hemangioma was searched in both Chinese and English databases diversely. According to the results of heterogeneity test, fixed effect model was selected for Meta-analysis, and publication bias was assessed by funnel plot etc. Results: A total of 8 clinical studies were included for Meta-analysis. The results showed that, compared with oral use propranolol, topical timolol is significantly better in the treatment of infantile hemangiomas (RR=1.15, 95%CI [1.01, 1.30], P=0.04). However, its incidence of systemic adverse reactions was significantly lower than the oral use propranolol group, with an RR value of 0.26, 95%CI(0.17,0.40), P<0.000 01. All differences between these two kinds of therapeutic regimen were statistically significant. Funnel plot displayed that the articles included in this paper have no obvious publication bias. Conclusion: The overall effective rate of timolol group was significantly higher than that of propranolol group, and the incidence of systemic adverse reactions was significantly lower than that of propranolol group.

Key words: timolol, propranolol, infantile hemangiomas, Meta-analysis

摘要：

目的：通过系统综述及Meta分析比较局部外用噻吗洛尔与口服普萘洛尔治疗表浅型婴幼儿血管瘤的疗效及副作用的发生率，评估外用噻吗洛尔能否成为表浅型婴幼儿血管瘤的一线用药。方法：在多个中英文数据库中搜索关于局部外用噻吗洛尔及口服普萘洛尔治疗婴幼儿血管瘤的对比研究。根据研究目的选取效应量，先进行异质性检验，再进行Meta分析，应用漏斗图等评估发表偏倚。结果：共计纳入8篇临床研究进行Meta分析。结果显示，局部外用噻吗洛尔治疗婴幼儿血管瘤的疗效显著优于口服普萘洛尔[RR=1.15，95%CI（1.01，1.30），P=0.04]，而全身不良反应发生率相比口服普萘洛尔组明显降低[RR=0.26，95%CI（0.17，0.40），P<0.000 01]，差异均有统计学意义。漏斗图等显示本文所纳入的文献无明显发表偏倚。结论：局部外用噻吗洛尔治疗表浅型婴幼儿血管瘤，其总体有效率明显高于口服普萘洛尔组，且全身不良反应的发生率明显低于后者。

关键词: 噻吗洛尔, 普萘洛尔, 婴幼儿血管瘤, Meta分析

CLC Number:

R782

LI Xinghong, LI Chenxi, LING Bin, GONG Zhongcheng. Effect of topical timolol and oral use propranolol for the treatment of superficial infantile hemangioma: A systematic review and Meta-analysis[J]. 《Journal of Oral and Maxillofacial Surgery》, 2021, 31(2): 90-96.

李兴红, 李晨曦, 凌彬, 龚忠诚. 局部外用噻吗洛尔与口服普萘洛尔治疗表浅型婴幼儿血管瘤效果对比的Meta分析[J]. 《口腔颌面外科杂志》, 2021, 31(2): 90-96.

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URL: https://journal06.magtech.org.cn/Jweb_joms/EN/10.3969/j.issn.1005-4979.2021.02.005

https://journal06.magtech.org.cn/Jweb_joms/EN/Y2021/V31/I2/90

Figures/Tables 10

References 28

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作者	发表年份	研究类型	样本量	年龄/月	实验组	对照组	最长治疗时长/周
童国勇,等	2018	RCT	40	1.2~6.0	0.5%马来酸噻吗洛尔滴眼液，3次/d	口服普萘洛尔1 mg/kg，2次/d	24
Gong, et al	2015	RCT	39	2.0~9.0	0.5%马来酸噻吗洛尔滴眼液，2次/d	口服普萘洛尔1 mg/kg，1次/d	24
Diana B. et al	2019	CCT	559	4.0~2.0	0.5%马来酸噻吗洛尔滴眼液，2次/d	口服普萘洛尔1 mg/kg，1次/d	9
Wu, et al	2018	CCT	724	5.0~4.0	0.5%马来酸噻吗洛尔滴眼液，3次/d	口服普萘洛尔1 mg/kg，2次/d	29
郝媛媛,等	2020	CCT	200	2.0~18.0	0.5%马来酸噻吗洛尔滴眼液，2次/d	口服普萘洛尔1 mg/kg，2次/d	24
张凯驰,等	2017	CCT	50	2.0~18.0	0.5%马来酸噻吗洛尔滴眼液，2次/d	口服普萘洛尔1 mg/kg，2次/d	48
赵启飞,等	2013	RCT	141	2.0~13.0	0.5%马来酸噻吗洛尔滴眼液，1次/d	口服普萘洛尔1 mg/kg，1次/d	24
Zhao, et al	2016	CCT	107	2.0~12.0	0.5%马来酸噻吗洛尔滴眼液，3次/d	口服普萘洛尔1.5~2 mg/(kg·d)	24

作者	发表年份	研究类型	样本量	年龄/月	实验组	对照组	最长治疗时长/周
童国勇,等	2018	RCT	40	1.2~6.0	0.5%马来酸噻吗洛尔滴眼液，3次/d	口服普萘洛尔1 mg/kg，2次/d	24
Gong, et al	2015	RCT	39	2.0~9.0	0.5%马来酸噻吗洛尔滴眼液，2次/d	口服普萘洛尔1 mg/kg，1次/d	24
Diana B. et al	2019	CCT	559	4.0~2.0	0.5%马来酸噻吗洛尔滴眼液，2次/d	口服普萘洛尔1 mg/kg，1次/d	9
Wu, et al	2018	CCT	724	5.0~4.0	0.5%马来酸噻吗洛尔滴眼液，3次/d	口服普萘洛尔1 mg/kg，2次/d	29
郝媛媛,等	2020	CCT	200	2.0~18.0	0.5%马来酸噻吗洛尔滴眼液，2次/d	口服普萘洛尔1 mg/kg，2次/d	24
张凯驰,等	2017	CCT	50	2.0~18.0	0.5%马来酸噻吗洛尔滴眼液，2次/d	口服普萘洛尔1 mg/kg，2次/d	48
赵启飞,等	2013	RCT	141	2.0~13.0	0.5%马来酸噻吗洛尔滴眼液，1次/d	口服普萘洛尔1 mg/kg，1次/d	24
Zhao, et al	2016	CCT	107	2.0~12.0	0.5%马来酸噻吗洛尔滴眼液，3次/d	口服普萘洛尔1.5~2 mg/(kg·d)	24

作者	发表年份	随机化方法	隐藏	盲法	失访和退出	Jadad得分
童国勇,等	2018	恰当	不清楚	恰当	有	5
Gong, et al	2015	恰当	不清楚	恰当	有	5
赵启飞,等	2013	恰当	不清楚	恰当	无	6

作者	发表年份	随机化方法	隐藏	盲法	失访和退出	Jadad得分
童国勇,等	2018	恰当	不清楚	恰当	有	5
Gong, et al	2015	恰当	不清楚	恰当	有	5
赵启飞,等	2013	恰当	不清楚	恰当	无	6

作者	发表年份	研究人群的选择	组间可比性	结果测量	NOS得分
Diana B. et al	2019	3	2	1	6
Wu, et al	2018	3	2	0	5
郝媛媛,等	2020	2	2	1	5
张凯驰,等	2017	3	2	1	6
Zhao, et al	2016	3	2	1	6

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