目的:这篇综述的目的是评估可用于口腔粘膜下纤维化(OSF)治疗的不同药物干预措施。
方法:我们在PubMed上进行了全面的电子搜索,WebofScience,和Cochrane图书馆数据库提供2011年12月至2022年9月与接受药物治疗的OSF患者相关的文章。采用GRADE系统评价证据质量。系统审查的报告符合系统审查和荟萃分析(PRISMA)方案的首选报告项目。主要结果是最大张口的改善,灼烧感,脸颊的灵活性,舌头突出。
结果:29项随机对照试验(RCT),包括五项临床试验(CCT),并评估了OSF治疗药物的使用情况。像类固醇这样的药物,透明质酸酶,己酮可可碱,番茄红素,姜黄素,dpirulina,芦荟,omega3,oxitard,大蒜素,秋水仙碱已被使用。发现有证据的高质量药物是丹参联合曲安奈德,番茄红素,己酮可可碱,姜黄素,还有芦荟,那些有中等质量证据的是大蒜素,秋水仙碱,欧米茄3和oxitard.
结论:根据我们的综合分析结果,长期治疗,我们发现番茄红素副作用小,而对于缓解严重烧灼感的症状,芦荟是最有效的。尽管最近的审查取得了一些进展,OSF的药物治疗仍不清楚,需要更多高质量的随机对照试验来确定更好的OSF治疗方法。
The aim of this review is to evaluate the different medicinal interventions available for the management of oral submucous fibrosis (OSF).
We conducted a comprehensive electronic search on PubMed, Web of Science, and Cochrane Library databases for articles related to OSF patients treated with medications from December 2011 to September 2022. GRADE system was used to evaluate the evidence quality. The reporting of the systematic review is in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. The main outcomes were the improvement of maximum mouth opening, burning sensation, cheek flexibility, and tongue protrusion.
Twenty-nine randomized controlled trials (RCTs), five clinical trials (CCTs) were included, and the use of drugs for OSF treatment were evaluated. Drugs like steroids, hyaluronidase, pentoxifylline, lycopene, curcumin, dpirulina, aloe vera, omega3, oxitard, allicin, colchicine have been used. It was found that drugs with evidence high quality were salvia miltiorrhiza combined with triamcinolone acetonide, lycopene, pentoxifylline, curcumin, and aloe vera, and those with evidence moderate quality were allicin, colchicine, omega 3, and oxitard.
Based on the results of our comprehensive analysis, for long-term treatment, we found lycopene with low side effects, whereas for relieving the symptoms of severe burning sensation, aloe vera is the most effective. Although the recent review has made some progress, drug therapy for OSF remains unclear, and more high-quality RCTs are needed to identify better treatments for OSF.