1 2 3 4 5
6 A B 1 2 α β 3
表 1 ClinicalQuestion CQ1 男性型脱毛症にミノキシジルの外用は有用か? (CQ1.1) 男性の男性型脱毛症 (CQ1.2) 女性の男性型脱毛症 CQ2 男性型脱毛症に塩化カルプロニウムの外用は有用か? CQ3 男性型脱毛症に医薬部外品 化粧品の育毛剤の外用は有用か? CQ3.1t- フラバノン CQ3.2 アデノシン CQ3.3 サイトプリン ペンタデカン CQ3.4 セファランチン CQ3.5 ケトコナゾール CQ4 男性型脱毛症にフィナステリド内服は有用か? (CQ4.1) 男性の男性型脱毛症 (CQ4.2) 女性の男性型脱毛症 CQ5 男性型脱毛症に植毛術は有用か? (CQ5.1) 自毛植毛術 (CQ5.2) 人工毛植毛術 推奨度 A A C1 C1 C1 C1 C2 C1 A D B D Clinical Questions JAmAcad Dermatol Dermatol Clin J Am Acad Dermatol Disorders of hair growth : diagnosis and treatment J Am Acad Dermatol Hair Research
図 1 Am JAnatomy Nat Genet J Invest Dermatol Symp Proc CQ1
J Am Acad Dermatol J Am Acad Dermatol J Am Acad Dermatol J Am Acad Dermatol JAmAcad Dermatol J Dermatol Eur J Dermatol Int J Dermatol Arch Dermatol JCutan Med Surg CQ2 γ γ
CQ3 CQ3.1 t- µ CQ3.2 µ µ µ J Dermatol
CQ3.3 CQ3.4 CQ3.5 µ
J Dermatol Sci Dermatology CQ4 α J Am Acad Dermatol
J Am Acad Dermatol JAmAcadDermatol α J Am Acad Dermatol Br J Dermatol Eur J Dermatol Eur J Dermatol Eur J Dermatol J Am Acad Dermatol Eur J Dermatol J Am Acad Dermatol Lancet Oncol J Am Acad Dermatol CQ5
Hair Transplantation J Am Acad Dermatol
terminal hair placebo (93) terminal hair 118 246 placebo- vellus hair 24 base line 8.5 cm, 12 7.1 cm, 24 6.1cm
2 30 ( 12 ) 10 38% 11 15 30% non vellus hair (intermediate hair terminal hair ) placebo (4) total hair 21 372 placebo- vellus hair 12 placebo-3%minoxidil (83%)
1-32 10.2 placebo 61.0 179.9 placebo-
48 nonvellus hair placebo 3.9 5%minoxidil 5%minoxidil 5%minoxidil placebo
96 placebo
Nonvellus hair count: 5%minoxidil 26.4, 1% 21.2 p=0.02 5% Terminal hair count: 5%minoxidil 16.1, 1% 12.2 p=0.026 5% total hair count: 5%minoxidil 22.3, 1% 17.2 p=0.009 5%
minoxidil 56.3 plasebo 57.2 minoxidil Grade I 56.9% Grade II 43.1% plasebo Grade I 61.8% Grade II 38.2% minoxidil 6.86 plasebo 7.03 minoxidil 189.27 /cm2 plasebo 192.49 /cm2 6 non vellus hair 8.18 (placebo 2.03), vellus hair 7.00 (placebo 0.83), total hair 15.15 (placebo 2.85) placebo 29.
18-45 33.6 minoxidil 33.1 placebo 34.2 minoxidil Grade I 52 Grade II 48 placebo Grade I 47 Grade II 53 minoxidil 8.0 placebo 8.6 32 non vellus hair 33 placebo 19 44
17-46 34 minoxidil 33.6 placebo 34.4 minoxidil Grade I 48 Grade II 52 placebo Grade I 53 Grade II 47 minoxidil 9.5 plasebo 9.0 32 non vellus hair 23 placebo 11 minimal 63
2%minoxidil 18-34 48.7% 35-44 32.4% 45-54 12.7% 55-64 4.4% 65 1.8% placebo 18-34 47.3% 35-44 32.8% 45-54 12.6% 55-64 5.0% 65 2.3% 12 excellent : 20.7%, 27.2% good: 43.4% 37.8% 447 (4.0%) placebo 547 (4.9%) 0.07% placebo 22 (0.20%) placebo 59 minoxidil
10 1-3
5
20%, 60.0%
2ml
t-
t-
3 (7%) CTP(47%)
5% 1% 4
RCT 3-alphadiol-glucuronide DHT 13.0%, 0.01, 0.05, 0.2, 1, 5 mg / 14.9%, 61.6%, 56.5%, 64.1%, 69.4%. 0.05, 0.2, 1, 5 mg /. DHT 0.01 /, 0.05, 0.2, 1, 5 mg / 49.5%, 68.6%, 71.4%, 72.2%. 3%, 1 mg 2.7%, 4.5%, 0.01 mg 2.7%, 0.05 mg 2.9%, 0.2 mg 8.3%, 1mg 0%, 5mg 2.6% II
α RCT II
RCT1 + 1 II
α RCT II
α RCT II
α
α
α
α RCT II
RCT II
RCT III
6 3 α RCT II
RCT II