Sun Kai, Liu Lijun, Chen Xiaojie, Jiang Weiwen
J Tradit Chin Med. 2017 Apr;37(2):147-58. doi: 10.1016/s0254-6272(17)30038-9.
To systematically review treatments of exfoliative cheilitis based on symptom patterns in terms of Traditional Chinese Medicine.
PubMed, Cochrane Central Register of Controlled Trials and Wanfang data were screened for case reports, case series or clinical trials that were published in English or Chinese from January, 1973 to September, 2015. The keyword of "exfoliative cheilitis or scaling cheilitis or factitious cheilitis" was used. Effectiveness or ineffectiveness was investigated as outcome for Meta analysis, which is based on effective index in each study. Response to treatment was described for case reports or case series.
From 38 screened studies, 17 were randomized controlled trials (RCTs), 5 were single-arm trials, and 16 were case reports or case series. Three RCTs were eligible for Meta analysis and all of them compared managements between Traditional Chinese Medicine and corticosteroids for exfoliative cheilitis, which involved 223 participants. Interestingly, data of Meta analysis showed similar effect of Traditional Chinese Medicine and corticosteroids for patients with exfoliative cheilitis [relative risk ratio: 1.10; 95% CI (1.00-1.21), P = 0.06].
Traditional Chinese Medicine might be a substitute for corticosteroids on exfoliative cheilitis. However, the evidence and recommendation of exfoliative cheilitis managements need to be taken with caution because of the low quality of evidence in the studies obtained.
基于中医症状模式系统评价剥脱性唇炎的治疗方法。
检索PubMed、Cochrane对照试验中心注册库和万方数据,筛选1973年1月至2015年9月以英文或中文发表的病例报告、病例系列或临床试验。使用“剥脱性唇炎或鳞屑性唇炎或人工性唇炎”作为关键词。以各研究中的有效指标为基础,将有效性或无效性作为Meta分析的结果进行研究。对病例报告或病例系列描述治疗反应。
在38项筛选出的研究中,17项为随机对照试验(RCT),5项为单臂试验,16项为病例报告或病例系列。3项RCT符合Meta分析条件,均比较了中医和皮质类固醇治疗剥脱性唇炎的效果,共涉及223名参与者。有趣的是,Meta分析数据显示,中医和皮质类固醇对剥脱性唇炎患者的疗效相似[相对危险比:1.10;95%可信区间(1.00 - 1.21),P = 0.06]。
中医可能是剥脱性唇炎皮质类固醇治疗的替代方法。然而,由于所获研究证据质量较低,剥脱性唇炎治疗的证据和建议需谨慎对待。