OBJECTIVE:To systematically review the efficacy of isotretinoin in the treatment of acne vulgaris,and to provide evidence-based reference for clinical treatment. METHODS:Retrieved from PubMed, Cochrane Library, Wanfang, VIP and CJFD,randomized controlled trials (RCT) about isotretinoin (test group) versus viaminati,macrolides,tetracyclines antibiotics and other drugs (control group) in the treatment of acne vulgaris were collected. Meta-analysis was performed by using Rev Man 5.2 software after data extract and quality evaluation by Cochrane 5.1.0. RESULTS:Totally 28 RCTs were enrolled,involving 3 534 patients. Results of Meta-analysis showed,the total effective rate of isotretinoin was significantly higher than viaminati [RR=1.56, 95%CI(1.27,1.91),P<0.001],macrolides[RR=1.44,95%CI(1.31,1.58),P<0.001] and tetracyclines antibiotics [RR=3.05,95%CI(2.29,4.07),P<0.001];improvement of skin lesions scores was significantly better than control group [MD=0.33,95%CI(0.04, 0.62),P<0.05],the differences were statistically significant. Dry lips,cheilitis,dry skin and nasal mucosa and pruritus were the main adverse reactions,and no serious adverse reactions were showed. CONCLUSIONS:Isotretinoin has better efficacy and safety than viaminati,macrolides and tetracyclines antibiotics.%目的：系统评价异维A酸治疗寻常痤疮的疗效与安全性，以为临床提供循证参考。方法：计算机检索PubMed、Cochrane图书馆、中文科技期刊数据库、中国期刊全文数据库和万方数据库，收集异维A酸对比维胺酯、大环内酯类抗菌药物、其他药物（对照组）治疗寻常痤疮的随机对照试验（RCT），对符合纳入标准的临床研究进行资料提取，并采用Cochrane系统评价员手册5.1.0进行质量评价，采用Rev Man 5.2统计软件进行Meta分析。结果：共纳入28项RCT，合计3534例患者。Meta分析结果显示，异维A酸组患者有效率显著高于维胺酯组[RR＝1.56，95％CI（1.27，1.91），P＜0.001]、大环内酯类组[RR＝1.44，95％CI（1.31，1.58），P＜0.001]和四环素类抗菌药物组[RR＝3.05，95％CI（2.29，4.07），P＜0.001]；皮损积分改善显著优于对照组[MD＝0.33，95％CI（0.04，0.62），P＜0.05]，差异均有统计学意义。异维A酸的主要不良反应是口唇干燥、唇炎、皮肤干燥、鼻黏膜干燥、皮肤瘙痒等，未见严重不良反应的发生。结论：异维A酸在治疗寻常痤疮方面的疗效优于维胺酯、大环内酯类和四环素类抗菌药物等，且安全性较好。
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