Objective To evaluate efficacy and safety of topical tacrolimus（FK506）for atopic dermatitis. Methods Randomized controlled trials (RCTs) were identified from specialized trials registered in Cochrane Skin Group (July, 2003), the Cochrane Library (issue 2, 2003), Medline (1996-2003), Embase (1984-2003) and CBM (1978-2003). We handsearched the published and unpublished data and Cochrane Skin Group 8th Annual Meeting. RCTs comparing tacrolimus with placebo or hormone were included. Data were extracted and evaluated by two reviewers independently. Results Eight randomized controlled trials involving 4 122 patients were included, with all trials of high methodological quality. Meta-analysis indicated that 0.03% tacrolimus was more effective than placebo, 1% hydrocortisone acetate and 0.1% hydrocortisone butyrate with odds ratio of 3.03 [95%CI (1.05, 8.73), P=0.04], 0.1% tacrolimus was more effective than placebo, 1% hydrocortisone acetate and 0.1% hydrocortisone butyrate with odds ratio of 3.84 [95%CI (1.43, 10.32), P=0.008], 0.3% tacrolimus was more effective than placebo with odds ratio of 3.20 [95%CI (1.31, 7.79), P=0.01], the odds ratio of 0.1% tacrolimus vs 0.03% tacrolimus was 1.40 [95%CI (1.13, 1.72), P=0.002]. No serious adverse effects were identified. Conclusions Topical tacrolimus for atopic dermatitis is more effective than placebo and 1% hydrocortisone acetate. 0.1% tacrolimus is more effective than 0.03% tacrolimus. No conclusion could be drawn when tacrolimus is compared with 0.1% hydrocortisone butyrate. Tacrolimus tends to improve EASI scores, head and neck scores as well as HRQL scores, but more randomized controlled trials are necessary to draw definite conclusions.
目的 通过对白芍总苷治疗前后寻常型银屑病患者血清中白介素（IL）-22水平的研究，探讨其治疗寻常型银屑病的作用机制。 方法 2009年10月－2010年8月采用双抗体夹心酶联免疫吸附法，检测30例寻常型银屑病患者，经白芍总苷治疗前后及健康对照组20例外周血清中IL-22浓度的变化，分析其在治疗前、后与银屑病皮损面积和严重程度指数（PASI）评分的相关性。 结果 寻常型银屑病患者血清IL-22浓度[（90.50 ± 51.80）pg/mL]较对照组[（40.10 ± 17.20）pg/mL]升高，白芍总苷治疗后血清中IL-22水平[（48.70 ± 23.90）pg/mL]较治疗前降低（P＜0.05），并与对照组差异无统计学意义（P＞0.05）；治疗前、后患者血清IL-22水平与PASI评分呈正相关。结论 白芍总苷可能通过调节IL-22发挥治疗寻常型银屑病的作用。