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 We handsearched the published and unpublished data and Cochrane Skin Group 8th Annual Meeting.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 通過對白芍總苷治療前后尋常型銀屑病患者血清中白介素（IL）-22水平的研究，探討其治療尋常型銀屑病的作用機制。 方法 2009年10月－2010年8月采用雙抗體夾心酶聯免疫吸附法，檢測30例尋常型銀屑病患者，經白芍總苷治療前后及健康對照組20例外周血清中IL-22濃度的變化，分析其在治療前、后與銀屑病皮損面積和嚴重程度指數（PASI）評分的相關性。 結果 尋常型銀屑病患者血清IL-22濃度[（90.50 ± 51.80）pg/mL]較對照組[（40.10 ± 17.20）pg/mL]升高，白芍總苷治療后血清中IL-22水平[（48.70 ± 23.90）pg/mL]較治療前降低（P＜0.05），并與對照組差異無統計學意義（P＞0.05）；治療前、后患者血清IL-22水平與PASI評分呈正相關。結論 白芍總苷可能通過調節IL-22發揮治療尋常型銀屑病的作用。