环孢素治疗口腔扁平苔藓的 Meta 分析

摘要

Objectives To assess the effectiveness and safety of cyclosporine to treat Oral lichen planus . Methods The Cochrane Library ,MEDLINE ,EMbase ,CBM ,CNKI ,were searched for randomized con-trolled trials or quasi-randomized controlled trials .Quality assessment and data extraction were performed by two reviewers independently .Meta-analysis were performed for the results of homogeneous studies by RevMan5 .2s oftware .Results 5 RCT were included at last .4 studies were about cyclosporine and glu-cocorticoid ,1 study was about cyclosporine and koutai ,Meta-analysis showed the differences between clini-cal response of cyclosporine and steroid had not statistical significance [RR= 2 .94(0 .69 ,12 .48)] .The differences between two medicine to improve pain [MD= 3 .90(-3 .71 ,11 .52)] and burning sensation [MD=13 .12(-9 .29 ,35 .54)] ,reduced erythema area [MD=26 .62(-4 .36 ,57 .60)] ,side-effect [RR=1 .16 (0 .14 ,10 .01)] had not statistical significance Glucocorticoid reduced ulcer [MD = 15 .76 (5 .48 , 26 .04)] and reticulatin area [MD=41 .41(13 .62 ,69 .20)] prior to cyclosporine ,cyclosporine was effective than koutai [RR=1 .53(1 .15 ,2 .02)] .Conclusion Cyclosporine appears no more effective than glucocorti-coid in the treatment of OLP ,cyclosporine was effective than koutai .Since the sample sizes of the included trials are relatively small ,more well-designed large-scale RCTs are required .%目的评价环孢素治疗口腔扁平苔藓的疗效和安全性。方法计算机检索Cochrane图书馆、M ED-LINE、EMbase、CBM、CNKI等数据库，收集所有相关随机对照试验（RCT）和半随机对照试验。由2名评价者独立评价研究质量和提取数据，对同质研究采用RevMan5．2软件进行Meta分析。结果纳入5篇环孢素治疗口腔扁平苔藓的RCT文献，其中4篇为比较环孢素和肾上腺皮质激素，1篇为比较环孢素和口泰。Meta分析显示，环孢素和肾上腺皮质激素临床反应的差异无统计学意义[RR ＝2．94（0．69，12．48）]，2种药物在改善患者疼痛[M D＝3．90（-3．71，11．52）]、烧灼感[M D＝13．12（-9．29，35．54）]、减少红斑面积[M D＝26．62（-4．36，57．60）]、降低不良反应发生率[RR ＝1．16（0．14，10．01）]方面的差异也无统计学意义。肾上腺皮质激素在减少溃疡[MD＝15．76（5．48，26．04）]和网纹面积[M D＝41．41（13．62，69．20）]方面优于环孢素。环孢素漱口液减轻病损的效果优于口泰[RR ＝1．53（1．15，2．02）]。结论环孢素与肾上腺皮质激素比较，在疗效和安全性方面无优势，环孢素的疗效优于口泰。