Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China.
Phytother Res. 2020 Sep;34(9):2180-2191. doi: 10.1002/ptr.6672. Epub 2020 Mar 16.
Glycosides from the roots of Tripterygium wilfordii Hook. f. are used for the treatment of oral lichen planus (OLP), a chronic inflammatory disease affecting the oral mucosa. To investigate the effectiveness and safety of Tripterygium glycosides (TGs) for OLP treatment, we conducted a systematic review of 18 randomized controlled trials, comprising 1,339 participants, from international and Chinese databases. We evaluated outcomes of TGs alone or in combination with conventional treatments. In combination with topical glucocorticoids (TGCs), including triamcinolone acetonide and prednisone, the total effectiveness rate (risk ratio [RR], 1.17; 95% confidence interval [CI], 1.09-1.25; p < .00001), symptom score reducing index (mean difference [MD], -2.44; 95% CI, -3.12 to -1.77; p < .0001), and visual analog scale score (MD, -1.61; 95% CI, -2.22 to -1.00; p < .0001) were significantly improved. Patients treated with TGs combined with TGCs experienced lower recurrence rates (RR, 0.37; 95% CI, 0.18-0.76; p = 0.007). The occurrence of adverse events was not significantly different between the TGs groups and controls. The combination of TG and TGCs improved clinical efficacy and reduced recurrence without increasing the risk of adverse events. A high-quality multicenter clinical study is needed to corroborate these findings.
雷公藤根的糖苷类化合物用于治疗口腔扁平苔藓（OLP），这是一种影响口腔黏膜的慢性炎症性疾病。为了研究雷公藤糖苷（TGs）治疗 OLP 的有效性和安全性，我们对国际和中国数据库中的 18 项随机对照试验（共 1339 名参与者）进行了系统评价。我们评估了 TGs 单独或与常规治疗联合使用的结果。与局部糖皮质激素（TGCs）联合使用时，包括曲安奈德和泼尼松，总有效率（风险比[RR]，1.17；95%置信区间[CI]，1.09-1.25；p<.00001）、症状评分降低指数（均数差[MD]，-2.44；95%CI，-3.12 至-1.77；p<.0001）和视觉模拟评分（MD，-1.61；95%CI，-2.22 至-1.00；p<.0001）显著改善。联合 TGCs 治疗的患者复发率较低（RR，0.37；95%CI，0.18-0.76；p=0.007）。TG 组和对照组的不良反应发生率无显著差异。TG 和 TGCs 的联合使用提高了临床疗效，降低了复发率，而没有增加不良反应的风险。需要一项高质量的多中心临床研究来证实这些发现。
