Faculty of Dentistry, King Abdulaziz University, P.O. Box 80209, Jeddah 21589, Saudi Arabia.
Oral Oncol. 2013 Feb;49(2):102-7. doi: 10.1016/j.oraloncology.2012.08.008. Epub 2012 Sep 7.
This systematic review investigated, critically appraised, and rated the evidence on agents used to prevent oral mucositis in children. A comprehensive search of the relevant literature was performed up to December 2011. Articles were included according to the inclusion/exclusion criteria and were critically appraised for validation and quality assessment using a checklist consisting of 18 categories. Each article was then rated for its strength of evidence. 16,471 articles were retrieved from 19 different databases and then reduced to 27 articles that fit the inclusion criteria. Five articles on oral care protocols supported their use to prevent oral mucositis in children. Seven articles on chlorhexidine mouthwash and three on laser therapy had conflicting evidence of its use. The preventative agents that were supported by one or two articles included: benzydamine mouthwash, iseganan mouthwash, granulocyte-macrophage colony-stimulating factor (GM-CSF) mouthwash, oral/enteral glutamine, oral propantheline and cryotherapy, oral cryotherapy, oral sucralfate suspension, prostaglandin E2 tablets, and chewing gum. The reduction in the rates of occurrence of oral mucositis when using agents of fair (B) to good (A) evidence ranged from 22% to 52%. In conclusion, this review suggests the use of oral care protocols to prevent oral mucositis in children because of their strength of evidence (fair to good). The authors suggest avoiding agents with fair to good evidence against their use (oral sucralfate suspension, prostaglandin E2 tablets, and GM-CSF mouthwash). Agents with conflicting evidence (chlorhexidine mouthwash (used solely), laser therapy, and glutamine) should also be avoided until further research confirms their efficacy.
本系统评价研究了用于预防儿童口腔黏膜炎的药物，并对其进行了批判性评价和分级。我们对相关文献进行了全面检索，检索时间截至 2011 年 12 月。根据纳入/排除标准选择文献，并使用包含 18 个类别的检查表进行验证和质量评估。然后根据证据强度对每个文献进行评分。从 19 个不同的数据库中检索到 16471 篇文章，然后将其减少到符合纳入标准的 27 篇文章。5 篇关于口腔护理方案的文章支持其用于预防儿童口腔黏膜炎。7 篇关于洗必泰漱口液和 3 篇关于激光治疗的文章对其使用效果存在相互矛盾的证据。有 1 或 2 篇文章支持的预防药物包括：苯扎氯铵漱口水、依沙吖啶漱口水、粒细胞-巨噬细胞集落刺激因子（GM-CSF）漱口水、口服/肠内谷氨酰胺、口服丙哌维林和冷冻疗法、口腔冷冻疗法、口腔蔗糖酸酯悬浮液、前列腺素 E2 片剂和口香糖。使用证据等级为良（B）至优（A）的药物降低口腔黏膜炎发生率的范围为 22%至 52%。总之，本综述建议使用口腔护理方案预防儿童口腔黏膜炎，因为其证据强度较高（良至优）。作者建议避免使用证据等级为良至优的药物（口腔蔗糖酸酯悬浮液、前列腺素 E2 片剂和 GM-CSF 漱口水）。证据相互矛盾的药物（单独使用洗必泰漱口液、激光治疗和谷氨酰胺）也应避免使用，直到进一步的研究证实其疗效。
