丹参联合曲安奈德局部注射治疗口腔黏膜下纤维性变的meta分析
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摘要
目的评价丹参联合曲安奈德局部注射治疗口腔黏膜下纤维性变(oral submucous fibrosis,OSF)是否比单独应用曲安奈德局部注射治疗OSF有效。方法通过检索相关文献进行meta分析,最后有3篇文献符合纳入标准并均属于随机对照试验。视觉模拟评分法(Visual Analogue Scale/Score,VAS)分值、张口度改变各纳入172例病例(实验组86例,对照组86例),口腔黏膜病损面积变化纳入152例病例(实验组76例,对照组76例)。分别比较丹参联合曲安奈德局部注射与单独应用曲安奈德局部注射治疗OSF前后患者口腔灼痛感VAS值、张口度和口腔黏膜病损面积变化。结果丹参联合曲安奈德局部注射组的VAS减少量与单独应用曲安奈德局部注射组差异无统计学意义(P>0.05);丹参联合曲安奈德局部注射组的张口度增加量高于单独应用曲安奈德局部注射组(P=0.05);丹参联合曲安奈德局部注射组的口腔黏膜病损面积减小量高于单独应用曲安奈德局部注射组(P<0.05)。结论丹参联合曲安奈德治疗OSF比单独应用曲安奈德的疗效更好。
Objective To evaluate the efficacy of the local injection of Salvia miltiorrhiza combined with triamcino-lone acetonide and triamcinolone acetonide alone in the treatment of oral submucous fibrosis(OSF). Methods A meta-analysis was performed by searching the related literature. Three randomized controlled trials meeting the inclusion crite-ria were identified. Changes in the Visual Analogue Scale(VAS) score and the degree of mouth opening were included in172 cases(86 cases in the experimental group and 86 in the control group), and changes in the oral mucosal lesion areawere included in 152 cases(76 cases in the experimental group and 76 in the control group). Changes in the VAS score,the degree of mouth opening and the oral mucosal lesion area were compared in the context of the local injection of Salviamiltiorrhiza combined with triamcinolone acetonide and triamcinolone acetonide alone. Results There were no signifi-cant differences between the treatment with Salvia miltiorrhiza combined with triamcinolone acetonide and triamcinoloneacetonide alone in reducing the VAS score(P > 0.05). Salvia miltiorrhiza combined with triamcinolone acetonide resultedin a greater increase in the degree of mouth opening than did triamcinolone acetonide(P = 0.05). The reduction in the oralmucosal lesion area induced by Salvia miltiorrhiza combined with triamcinolone acetonide was significantly greater thanthat induced by triamcinolone acetonide alone(P < 0.05). Conclusion The local injection of Salvia miltiorrhiza com-bined with triamcinolone acetonide is more effective than triamcinolone acetonide alone in the treatment of OSF.
Objective To evaluate the efficacy of the local injection of Salvia miltiorrhiza combined with triamcino-lone acetonide and triamcinolone acetonide alone in the treatment of oral submucous fibrosis(OSF). Methods A meta-analysis was performed by searching the related literature. Three randomized controlled trials meeting the inclusion crite-ria were identified. Changes in the Visual Analogue Scale(VAS) score and the degree of mouth opening were included in172 cases(86 cases in the experimental group and 86 in the control group), and changes in the oral mucosal lesion areawere included in 152 cases(76 cases in the experimental group and 76 in the control group). Changes in the VAS score,the degree of mouth opening and the oral mucosal lesion area were compared in the context of the local injection of Salviamiltiorrhiza combined with triamcinolone acetonide and triamcinolone acetonide alone. Results There were no signifi-cant differences between the treatment with Salvia miltiorrhiza combined with triamcinolone acetonide and triamcinoloneacetonide alone in reducing the VAS score(P > 0.05). Salvia miltiorrhiza combined with triamcinolone acetonide resultedin a greater increase in the degree of mouth opening than did triamcinolone acetonide(P = 0.05). The reduction in the oralmucosal lesion area induced by Salvia miltiorrhiza combined with triamcinolone acetonide was significantly greater thanthat induced by triamcinolone acetonide alone(P < 0.05). Conclusion The local injection of Salvia miltiorrhiza com-bined with triamcinolone acetonide is more effective than triamcinolone acetonide alone in the treatment of OSF.
引文
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[15]Jiang XW,Zhang Y,Yang SK,et al.Efficacy of salvianolic acid B combined with triamcinolone acetonide in the treatment of oral submucous fibrosis[J].Oral Surg Oral Med Oral Pathol Oral Radiol,2013,115(3):339-344.
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[17]Zheng L,Guan ZJ,Pan WT,et al.Tanshinone suppresses arecoline-induced epithelial-mesenchymal transition in oral submucous fibrosis by epigenetically reactivating the p53 pathway[J].Oncol Res,2017.
[18]Dai JP,Zhu DX,Sheng JT,et al.Inhibition of tanshinone IIA,salvianolic acid a and salvianolic acid B on areca nut extract-induced oral submucous fibrosis in vitro[J].Molecules,2015,20(4):6794-6807.
[2]刘蜀凡,翦新春,沈子华,等.口腔粘膜下纤维性变系列研究[J].医学研究通讯,2002,31(8):18-19.
[3]尹晓敏,黄琰,高义军,等.长沙地区2749例体检者咀嚼槟榔及口腔粘膜下纤维性变患病情况调查分析[J].实用预防医学,2007,14(03):715-716.
[4]Khanna JN,Andrade NN.Oral submucous fibrosis:a new concept in surgical management.Report of 100 cases[J].Int J Oral Maxillofac Surg,1995,24(6):433-439.
[5]刘锦丽,陈方曼,江潞.口腔黏膜下纤维性变的药物治疗进展[J].国际口腔医学杂志,2017,44(3):325-331.
[6]马丙祥,董宠凯.丹参的药理作用研究新进展[J].中国药房,2014,5(7):663-665.
[7]刘丽芳,彭解英,徐锡萍.丹参治疗前后口腔黏膜下纤维性变超微结构的研究[J].临床口腔医学杂志,2008,24(12):751-753.
[8]刘鸣.系统评价、Meta-分析设计与实施方法[M].北京:人民卫生出版社,2011:90.
[9]吕逢源,王宏峰,许春姣,等.分泌型卷曲相关蛋白1在口腔黏膜下纤维化治疗前后唾液和龈沟液中的表达[J].中华口腔医学杂志,2016,51(10):616-622.
[10]薛洪权,衣红梅.联用丹参注射液和曲安奈德注射液治疗口腔黏膜下纤维性变的效果观察[J].齐齐哈尔医学院学报,2016,37(29):3681-3682.
[11]赵雁焕,徐梅,陆洋.丹参注射液联合曲安奈德局部注射治疗OSF的疗效及对血清TGF-β1、IL-6的影响[J].海南医学院学报,2017,23(5):673-675.
[12]Wollina U,Verma SB,Ali FM,et al.Oral submucous fbrosis:an update[J].Clin Cosmet Investig Dermatol,2015,8:193-204.
[13]Yadav M,Aravinda K,Saxena VS,et al.Comparison of curcumin with intralesional steroid injections in oral submucous fibrosis-a randomized,open-label interventional study[J].J Oral Biol Craniofac Res,2014,4(3):169-173.
[14]Daga D,Singh RK,Pal US,et al.Efficacy of oral colchicine with intralesional hyaluronidase or triamcinolone acetonide in the grade II oral submucous fibrosis[J].Natl J Maxillofac Surg,2017,8(1):50-54.
[15]Jiang XW,Zhang Y,Yang SK,et al.Efficacy of salvianolic acid B combined with triamcinolone acetonide in the treatment of oral submucous fibrosis[J].Oral Surg Oral Med Oral Pathol Oral Radiol,2013,115(3):339-344.
[16]刘慧,开金龙.丹参的现代研究进展[J].甘肃中医,2010,23(2):70-72.
[17]Zheng L,Guan ZJ,Pan WT,et al.Tanshinone suppresses arecoline-induced epithelial-mesenchymal transition in oral submucous fibrosis by epigenetically reactivating the p53 pathway[J].Oncol Res,2017.
[18]Dai JP,Zhu DX,Sheng JT,et al.Inhibition of tanshinone IIA,salvianolic acid a and salvianolic acid B on areca nut extract-induced oral submucous fibrosis in vitro[J].Molecules,2015,20(4):6794-6807.