口腔扁平苔蘚治療的系統評價_《中國循證醫學雜志》

作者：

孫玉亮 ¹ ,  趙今 ¹ , 吳泰相 ² , 李艷 ¹

1. 新疆醫科大學第一附屬醫院口腔科（烏魯木齊830054）2. 四川大學華西醫院中國循證醫學中心（成都610041）;

關鍵詞：

口腔扁平苔蘚治療系統評價

DOI：

10.7507/1672-2531.20090062

視頻：

導出 下載 收藏 掃碼 引用

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的　評價以糖皮質激素作對照的治療方法治療口腔扁平苔蘚的療效和安全性。
方法　計算機檢索Cochrane 圖書館（2007 年第 4 期）、MEDLINE（1966 ～ 2007）、EMbase（1966 ～ 2007）、CBM（1978 ～ 2005）、CNKI（1989 ～ 2007）、VIP（1989 ～ 2007）等數據庫，收集以糖皮質激素治療為對照的口腔扁平苔蘚治療相關隨機對照試驗和半隨機對照試驗。按Cochrane 系統評價方法評價納入研究質量和提取數據，對同質研究采用RevMan 4.2.10 軟件進行Meta 分析。
結果　最終納入14 個研究涉及9 種治療方法。關于環孢菌素的研究有4 個，將其中3 個進行了Meta 分析。結果發現，環孢菌素與類固醇的療效差異無統計學意義［RR=2.94，95%CI（0.69，12.48）］；中藥帕夫林聯合激素［RR=0.21，95%CI（0.10，0.44）］、他克莫司［RR=0.18，95%CI（0.05，0.72）］或吡美莫司［WMD= –0.50，95%CI（– 0.85，– 0.15）］三種療法的療效優于糖皮質激素，其差異有統計學意義；氟輕松的療效優于維甲酸，其差異有統計學意義［RR=3.20，95%CI（1.03，9.97）］；美沙拉秦、制霉菌素聯合地塞米松、曲安奈德聯合維生素B12 以及甲殼質4 種療法的療效與糖皮質激素療效差異無統計學意義。
結論　帕夫林聯合激素治療口腔扁平苔蘚的療效優于單純應用激素，但由于納入研究設計存在一些缺陷，還需要今后開展更多高質量，大樣本的隨機對照試驗來證實此療法的療效和安全性。

引用本文： 孫玉亮,趙今,吳泰相,李艷. 口腔扁平苔蘚治療的系統評價. 中國循證醫學雜志, 2009, 09(3): 323-330. doi: 10.7507/1672-2531.20090062 復制

1.	und Klinik (KortingGW, ed) editor(s). Dermatologie. Vol. 2, Stuttgart: Thieme, 1990, 17.1-17.13.
2.	paste in thetreatment of oral lichen planus. J Am Acad Dermatol, 2007, 19.[Epub ahead of print].
3.	ht tp: / /www. c gmh.or g . tw/ int r / int r5/ c6700/OBGYN/F/Randomized%20tial/chapter1.html.
4.	李秉琦. 主編. 口腔黏膜病學. 第2 版. 北京: 人民衛生出版社, 2000. 85-90.
5.	Pindborg JJ, Mehta FS, Daftary DK, et al. Prevalence of oral lichen planus among 7639 Indian villagers in Kerala, South India. Acta Derm Venereol (Stockh), 1972, 52: 216-220.
6.	NasemannT. Lichen ruber planus und seine Varianten. In:Praxis.
7.	Silverman S Jr, Gorsky M, Lozada-Nur F. A prospective follow-up study of 570 patients with oral lichen planus: persistance, remission and malignant association. Oral Surg Oral Med Oral Pathol, 1985,60: 30-34.
8.	Axell T, Rundquist L. Oral lichen planus-a demographic study.Community Dent Oral Epidemiol, 1987, 15: 52-56.
9.	CribierB, FrancesC, Chosidow O. Treatment of lichen planus. An evidence-based medicine analysis of efficacy. Arch Denatol, 1998,134: 1512-1530.
10.	CarboneM, GossE, CarrozzoM, et al. Systemic and topical corticosteroid treatment of oral lichen planus:a comparative study with long-term follow-up. J Oral Pathol Med, 2003, 32: 323-329.
11.	Scully C, EisenD, CarrozzoM. Management of Oral lichen planus.Am Cli Dermatol, 2000, 1(5): 287.
12.	柳志文, 凌天牖, 賀建澤, 等. 復方環孢菌素A含漱液治療口腔扁平苔蘚的研究. 湖南醫科大學學報, 2000, 25: 183.
13.	Laeijendecker R, Tank B, Dekker SK, et al. A comparison of treatment of oral lichen planus with topical tacrolimus and triamcinolone acetonide ointment. Acta Derm Venereol, 2006, 86(3):227-229.
14.	Gorouhi F, Solhpour A, Beitollahi JM, et al. Randomized trial of pimecrolimus cream versus triamcinolone acetonide.
15.	Sardella A, Demarosi F, Oltolina A, et al. Efficacy of topical mesalazine compared with clobetasol propionate in treatment of symptomatic oral lichen planus. Oral Dis, 1998, 4(4): 255-259.
16.	蔡華雄, 孔祥波, 朱越廣, 等. 帕夫林聯合確炎舒松治療口腔扁平苔蘚的初步觀察. 廣東牙病防治, 2003, 11(3): 163-165.
17.	于春梅, 張安玲, 陳巨鋒, 等. 中西醫結合治療口腔扁平苔蘚的臨床療效觀察. 黑龍江醫藥科學, 2006, 29(6): 27-28.
18.	吳泰相, 劉關鍵. 隱蔽分組（分配隱藏）和盲法的概念, 實施與報告. 中國循證醫學雜志 2007, 7(3): 222-224.
19.	Alderson P, Green S, Higgins JPT, editors. Cochrane Reviews Handbook 4.2.2 (updated March 2004). The Cochrane Library.Chichester,UK:John Wiley sons, Ltd, 2004.
20.	王閱春, 賀凌飛, 朱友家. 曲安奈德和維生素B12聯合局部注射治療口腔扁平苔蘚的臨床療效觀察. 數理醫藥學雜志, 2004, 17(6):508-509.
21.	魏昕, 李秉琦, 周學東, 等. 制霉菌素與地塞米松糊劑聯合治療OLP療效觀察. 臨床口腔醫學雜志, 2003, 9(19): 568-569.
22.	唐國瑤, 周曾同. 甲殼質治療糜爛型口腔扁平苔蘚的臨床應用研究. 臨床口腔醫學雜志, 2005, 21(10): 626-628.
23.	杜申釗, 王何偉, 蘇平. 中西醫結合治療口腔扁平苔蘚46例. 中國民間療法, 2007, 15(2): 6-7.
24.	Buajeeb W, Kraivaphan P, Pobrurksa C. Efficacy of topical retinoic acid compared with topical fluocinolone acetonide in the treatment of oral lichen planus. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 1997, 83(1): 21-25.
25.	Conrotto D, Carbone M, Carrozzo M, et al. Ciclosporin vs clobetasol in the topical management of atrophic and erosive oral lichen planus: a double-blind, randomized controlled trial. Br J Dermatol, 2006, 154(1): 139-145.
26.	Thongprasom K, Chaimusig M, Korkij W, et al. A randomizedcontrolled trial to compare topical cyclosporin with triamcinolone acetonide for the treatment of oral lichen planus. J Oral Pathol Med, 2007, 36(3): 142-146.
27.	Yoke PC, Tin GB, Kim MJ, et al. A randomized controlled trial to compare steroid with cyclosporine for theopical treatment of oral lichen planus. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2006, 102(1): 47-55.
28.	Sieg P, Von Domarus H, Von Zitzewitz V, et al. Topical cyclosporin in oral lichen planus: a controlled, randomized, prospective trial. Br J Dermatol, 1995, 132(5): 790-794.
29.	Jadad AR Randomised controlled trials, A users guide. [2007-01-26].
30.	Chalmers TC, Celano P, Sacks HS, et al. Bias in treatment assignment in controlled clinical trials. N Engl J Med, 1983, 309: 1359-1361.
31.	Schulz Kf, Chalmers I, Hayes RJ, et al. Empirical evidence of bias dimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA, 1995, 273: 408-412.

1. und Klinik (KortingGW, ed) editor(s). Dermatologie. Vol. 2, Stuttgart: Thieme, 1990, 17.1-17.13.
2. paste in thetreatment of oral lichen planus. J Am Acad Dermatol, 2007, 19.[Epub ahead of print].
3. ht tp: / /www. c gmh.or g . tw/ int r / int r5/ c6700/OBGYN/F/Randomized%20tial/chapter1.html.
4. 李秉琦. 主編. 口腔黏膜病學. 第2 版. 北京: 人民衛生出版社, 2000. 85-90.
5. Pindborg JJ, Mehta FS, Daftary DK, et al. Prevalence of oral lichen planus among 7639 Indian villagers in Kerala, South India. Acta Derm Venereol (Stockh), 1972, 52: 216-220.
6. NasemannT. Lichen ruber planus und seine Varianten. In:Praxis.
7. Silverman S Jr, Gorsky M, Lozada-Nur F. A prospective follow-up study of 570 patients with oral lichen planus: persistance, remission and malignant association. Oral Surg Oral Med Oral Pathol, 1985,60: 30-34.
8. Axell T, Rundquist L. Oral lichen planus-a demographic study.Community Dent Oral Epidemiol, 1987, 15: 52-56.
9. CribierB, FrancesC, Chosidow O. Treatment of lichen planus. An evidence-based medicine analysis of efficacy. Arch Denatol, 1998,134: 1512-1530.
10. CarboneM, GossE, CarrozzoM, et al. Systemic and topical corticosteroid treatment of oral lichen planus:a comparative study with long-term follow-up. J Oral Pathol Med, 2003, 32: 323-329.
11. Scully C, EisenD, CarrozzoM. Management of Oral lichen planus.Am Cli Dermatol, 2000, 1(5): 287.
12. 柳志文, 凌天牖, 賀建澤, 等. 復方環孢菌素A含漱液治療口腔扁平苔蘚的研究. 湖南醫科大學學報, 2000, 25: 183.
13. Laeijendecker R, Tank B, Dekker SK, et al. A comparison of treatment of oral lichen planus with topical tacrolimus and triamcinolone acetonide ointment. Acta Derm Venereol, 2006, 86(3):227-229.
14. Gorouhi F, Solhpour A, Beitollahi JM, et al. Randomized trial of pimecrolimus cream versus triamcinolone acetonide.
15. Sardella A, Demarosi F, Oltolina A, et al. Efficacy of topical mesalazine compared with clobetasol propionate in treatment of symptomatic oral lichen planus. Oral Dis, 1998, 4(4): 255-259.
16. 蔡華雄, 孔祥波, 朱越廣, 等. 帕夫林聯合確炎舒松治療口腔扁平苔蘚的初步觀察. 廣東牙病防治, 2003, 11(3): 163-165.
17. 于春梅, 張安玲, 陳巨鋒, 等. 中西醫結合治療口腔扁平苔蘚的臨床療效觀察. 黑龍江醫藥科學, 2006, 29(6): 27-28.
18. 吳泰相, 劉關鍵. 隱蔽分組（分配隱藏）和盲法的概念, 實施與報告. 中國循證醫學雜志 2007, 7(3): 222-224.
19. Alderson P, Green S, Higgins JPT, editors. Cochrane Reviews Handbook 4.2.2 (updated March 2004). The Cochrane Library.Chichester,UK:John Wiley sons, Ltd, 2004.
20. 王閱春, 賀凌飛, 朱友家. 曲安奈德和維生素B12聯合局部注射治療口腔扁平苔蘚的臨床療效觀察. 數理醫藥學雜志, 2004, 17(6):508-509.
21. 魏昕, 李秉琦, 周學東, 等. 制霉菌素與地塞米松糊劑聯合治療OLP療效觀察. 臨床口腔醫學雜志, 2003, 9(19): 568-569.
22. 唐國瑤, 周曾同. 甲殼質治療糜爛型口腔扁平苔蘚的臨床應用研究. 臨床口腔醫學雜志, 2005, 21(10): 626-628.
23. 杜申釗, 王何偉, 蘇平. 中西醫結合治療口腔扁平苔蘚46例. 中國民間療法, 2007, 15(2): 6-7.
24. Buajeeb W, Kraivaphan P, Pobrurksa C. Efficacy of topical retinoic acid compared with topical fluocinolone acetonide in the treatment of oral lichen planus. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 1997, 83(1): 21-25.
25. Conrotto D, Carbone M, Carrozzo M, et al. Ciclosporin vs clobetasol in the topical management of atrophic and erosive oral lichen planus: a double-blind, randomized controlled trial. Br J Dermatol, 2006, 154(1): 139-145.
26. Thongprasom K, Chaimusig M, Korkij W, et al. A randomizedcontrolled trial to compare topical cyclosporin with triamcinolone acetonide for the treatment of oral lichen planus. J Oral Pathol Med, 2007, 36(3): 142-146.
27. Yoke PC, Tin GB, Kim MJ, et al. A randomized controlled trial to compare steroid with cyclosporine for theopical treatment of oral lichen planus. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2006, 102(1): 47-55.
28. Sieg P, Von Domarus H, Von Zitzewitz V, et al. Topical cyclosporin in oral lichen planus: a controlled, randomized, prospective trial. Br J Dermatol, 1995, 132(5): 790-794.
29. Jadad AR Randomised controlled trials, A users guide. [2007-01-26].
30. Chalmers TC, Celano P, Sacks HS, et al. Bias in treatment assignment in controlled clinical trials. N Engl J Med, 1983, 309: 1359-1361.
31. Schulz Kf, Chalmers I, Hayes RJ, et al. Empirical evidence of bias dimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA, 1995, 273: 408-412.

《中國循證醫學雜志》

口腔扁平苔蘚治療的系統評價

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

上一篇

下一篇

Format

Content

《中國循證醫學雜志》

口腔扁平苔蘚治療的系統評價

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

上一篇

下一篇

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料