目的:评估光动力疗法(PDT)作为传统抗真菌药物的辅助或替代治疗口腔念珠菌病的临床疗效。并为其用于口腔念珠菌病的治疗提供循证医学证据。
方法:计算机结合手工检索中国学术期刊全文数据库(CNKI),中国生物医学文献数据库(CBM),中国科技期刊数据库(VIP),万方数据库,PubMed,WebofScience,科克伦图书馆,Embase,对2023年1月之前发表的文章进行Scopus检索,根据纳入和排除标准提取基本信息和所需数据,采用RevmanV5.4软件对纳入文献进行Meta分析。
结果:共纳入11篇文章,其中7种使用制霉菌素作为抗真菌药物,其中2例联合治疗PDT和制霉菌素,其余4件物品中有2件用氟康唑治疗,和2用咪康唑治疗。meta结果显示,PDT在减少患者腭中口腔念珠菌菌落数量方面优于制霉菌素,MD=-0.87,95CI=(-1.52,-0.23),P=0.008,差异有统计学意义,义齿部位MD=-1.03,95CI=(-2.21,-0.15),P=0.09,差异无统计学意义;与氟康唑疗效比较,RR=1.01,95CI=(0.56,1.83),P=0.96;与咪康唑RR=0.55,95CI=(0.38,0.81)相比,P=0.002;PDT联合制霉菌素RR=1.27,95CI=(1.06,1.52),P=0.01;复发率RR=0.28,95CI=(0.09,0.88),P=0.03。
结论:PDT治疗口腔念珠菌病有效;PDT比制霉菌素治疗上颚义齿性口炎更有效,而在义齿部位,两者无显著差异;PDT治疗口腔念珠菌病的疗效与氟康唑相似;PDT治疗口腔念珠菌病的疗效不如咪康唑;与单纯制霉菌素相比,PDT和制霉菌素联合治疗口腔念珠菌病更有效,复发风险较低.
To evaluate the clinical efficacy of photodynamic therapy (PDT) as an adjunct or alternative to traditional antifungal drugs in the treatment of oral candidiasis, and to provide evidence-based medical evidence for its use in the treatment of oral candidiasis.
Computer combined with manual retrieval of China Academic Journals Full-text Database (CNKI), China Biomedical Literature Database (CBM), Chinese Science and Technology Journal Database (VIP), Wanfang Database, PubMed, Web of Science, Cochrane Library, Embase, Scopus retrieval for articles published before January 2023, basic information and required data were extracted according to the inclusion and exclusion criteria, and the Revman V5.4 software was used to conduct Meta-analysis of the included literature.
A total of 11 articles were included, 7 of which used
nystatin as an antifungal drug, 2 of which were combined treatment of PDT and
nystatin, 2 of the remaining 4 articles were treated with fluconazole, and 2 were treated with miconazole. Meta results showed that PDT was superior to
nystatin in reducing the number of oral candida colonies in the palate of patients MD = -0.87, 95%CI = (-1.52,-0.23), P = 0.008, the difference was statistically significant, and the denture site MD = -1.03, 95%CI = (-2.21, -0.15), P = 0.09, the difference was not statistically significant; compared with the efficacy of fluconazole, RR = 1.01, 95%CI = (0.56,1.83), P = 0.96; compared with miconazole RR = 0.55, 95%CI = (0.38, 0.81), P = 0.002; PDT combined with nystatin RR = 1.27, 95%CI = (1.06, 1.52), P = 0.01; recurrence rate RR = 0.28, 95%CI = (0.09, 0.88), P = 0.03.
PDT was effective in the treatment of oral candidiasis; PDT was more effective than
nystatin for the treatment of denture stomatitis in the palate, while there was no significant difference between the two for the denture site; The efficacy of PDT for oral candidiasis was similar to that of fluconazole; PDT was less effective than miconazole for oral candidiasis; Compared with nystatin alone, the combination of PDT and
nystatin is more effective in treating oral candidiasis with less risk of recurrence.