| Objective:To investigate the efficacy of botulinum toxin type A alone or combined with steroid hormone local injection in the treatment of keloid and hypertrophic scar,they were compared with the local injection of steroid hormone by meta-analysis.Methods:We searched PubMed,Cochrane Library,EMBASE,Wanfang database,CBM,CNKI and VIP database,collect published before January2018 about botulinum toxin type A alone or combined with steroid injection in the treatment of keloid and hypertrophic scar random control test and quasi-randomized control trial.According to the inclusion and exclusion criteria,2 researchers independently screened and extracted information,and used Review Manager 5.3 software provided by Cochrane collaboration to evaluate quality of selected papers and meta-analysis.By combining VAS score,patient satisfaction and effective rate,weighted average difference(WMD),odds ratio(OR)and 95%confidence interval(95%CI)were used to evaluate.The bias is judged by the funnel plot.Result:A total of 262 articles were selected,and 206 articles were deleted after repeated deletion.After reading titles,abstracts and full texts,9articles were included,including 1 English articles and 8 Chinese literatures.A total of 451 patients were included.Meta-analysis showed that:1.the VAS score of local injection of botulinum toxin type A was lower than that of local injection of steroid hormones(WMD=-4.50[95%CI:(-7.28,-1.72),P=0.002]),and the effective rate was higher than that of the latter(Chi2=0.42,P=0.52,I~2=0%<50%).2.The local injection of botulinum toxin type A combined with steroid VAS score,patient satisfaction,and efficiency were better than steroid injections alone.Conclusion:In the treatment of keloids and hypertrophic scars,local injection of botulinum toxin type A or combination of botulinum toxin type A and steroids is superior to steroid hormone injection alone on effect and the degree of acceptance of the patient. |
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