Sivaramakrishnan Gowri, Sridharan Kannan
1Department of Oral Health, College of Medicine, Nursing and Health Sciences, Fiji National University, Brown Street, Suva, Fiji.
2Department of Health Sciences, Fiji National University, Extension Street, Suva, Fiji.
J Maxillofac Oral Surg. 2018 Jun;17(2):122-128. doi: 10.1007/s12663-017-0996-9. Epub 2017 Jan 18.
Serratiopeptidase for pain, facial swelling and trismus associated with surgical removal of impacted molar is under investigation. However conclusive evidence on the use of serratiopeptidase is lacking. Hence a systematic review and meta-analysis of randomized controlled studies was carried out.
Electronic databases were searched for eligible studies and necessary data extracted. The data were analysed using non-Cochrane mode in RevMan 5.0. 95% confidence interval (95% CI) was used to represent the deviation from the point estimate. The heterogeneity between the studies was assessed using Forest plot visually, I statistics and Chi square test with a statistical value of <0.10 to indicate statistical significance. Random-effect models were used in case of moderate to severe heterogeneity.
Five studies were included for final review. Serratiopeptidase improved trismus better than corticosteroids with the MD, 95% as 4.42 [3.84, 5]. As regards to swelling, no significant difference was observed for serratiopeptidase when compared to corticosteroids. Paucity of studies precludes any conclusion for other outcome measures as well as for other comparator drugs.
Serratiopeptidase could be used safely and effectively to improve trismus and facial swelling after surgical removal of impacted molar.
对沙雷氏菌蛋白酶用于与拔除阻生磨牙手术相关的疼痛、面部肿胀和牙关紧闭的研究正在进行中。然而，关于使用沙雷氏菌蛋白酶的确凿证据仍然缺乏。因此，开展了一项对随机对照研究的系统评价和荟萃分析。
检索电子数据库以查找符合条件的研究并提取必要数据。在RevMan 5.0中使用非Cochrane模式对数据进行分析。采用95%置信区间（95%CI）来表示与点估计值的偏差。通过森林图直观地评估研究之间的异质性，使用I统计量和卡方检验，统计值<0.10表示具有统计学意义。在存在中度至重度异质性的情况下，使用随机效应模型。
五项研究纳入最终评价。沙雷氏菌蛋白酶在改善牙关紧闭方面比皮质类固醇效果更好，MD为4.42[3.84，5]，95%CI。至于肿胀，与皮质类固醇相比，沙雷氏菌蛋白酶未观察到显著差异。由于研究数量有限，无法就其他结局指标以及其他对照药物得出任何结论。
沙雷氏菌蛋白酶可安全有效地用于改善拔除阻生磨牙手术后的牙关紧闭和面部肿胀。
