Zhang Yang, Huang Lei, Zhang Jinmei, De Souza Rastelli Alessandra Nara, Yang Jingmei, Deng Dongmei
Department of Periodical Press and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China.
Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China.
Front Pharmacol. 2022 Jan 24;13:808460. doi: 10.3389/fphar.2022.808460. eCollection 2022.
Curcumin has been used as an adjunct to non-surgical periodontal treatment. However, the efficacy of curcumin in the periodontal therapy remained controversial. This study aimed to evaluate the anti-inflammatory efficacy of curcumin as an adjunct to non-surgical periodontal treatment (NPT) by systematic review. Databases including Embase, PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials.gov were searched to identify relevant RCTs on the use of curcumin as an adjunct to NPT for the treatment of periodontal disease from inception to July 21, 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed using Review Manager 5.3 software. A total of 18 RCTs involving 846 patients/sites were included in this meta-analysis. The results of the meta-analysis revealed that as compared to NPT alone, curcumin as an adjunct to NPT resulted in significant reduction in gingival index (GI) at the 1-week (mean differences (MD) = -0.15, 95% confidence intervals (CI) -0.26 to -0.05, = 0.005), 2-week (MD = -0.51, 95%CI -0.74 to -0.28, < 0.0001), 3-week (MD = -0.34, 95%CI -0.66 to -0.02, = 0.03), 4-week (MD = -0.25, 95%CI -0.48 to -0.02, = 0.04) or 6-week (MD = -0.33, 95%CI -0.58 to -0.08, = 0.01) follow-ups. Similar significant reductions were also observed for sulcus bleeding index (SBI) at 1, 2, 4, and 12 weeks. However, there were no statistically significant differences in reducing bleeding on probing (BOP) between curcumin as an adjunct and NPT alone at 4, 12, and 24 weeks. Based on the current evidence, curcumin demonstrates anti-inflammatory efficacies in terms of reducing GI and SBI compared with NPT alone. Moreover, curcumin is a natural herbal medicine with few side effects, and it is a good candidate as an adjunct treatment for periodontal disease.
姜黄素已被用作非手术牙周治疗的辅助手段。然而，姜黄素在牙周治疗中的疗效仍存在争议。本研究旨在通过系统评价评估姜黄素作为非手术牙周治疗（NPT）辅助手段的抗炎疗效。检索了包括Embase、PubMed、Cochrane对照试验中央注册库（CENTRAL）和ClinicalTrials.gov在内的数据库，以确定从开始到2021年7月21日使用姜黄素作为NPT辅助手段治疗牙周疾病的相关随机对照试验（RCT）。两名研究者独立筛选文献、提取数据并评估纳入研究的偏倚风险。然后使用Review Manager 5.3软件进行荟萃分析。本荟萃分析共纳入18项涉及846例患者/位点的RCT。荟萃分析结果显示，与单纯NPT相比，姜黄素作为NPT的辅助手段在1周（平均差（MD）=-0.15，95%置信区间（CI）-0.26至-0.05，P=0.005）、2周（MD=-0.51，95%CI-0.74至-0.28，P<0.0001）、3周（MD=-0.34，95%CI-0.66至-0.02，P=0.03）、4周（MD=-0.25，95%CI-0.48至-0.02，P=0.04）或6周（MD=-0.33，95%CI-0.58至-0.08，P=0.01）随访时，牙龈指数（GI）显著降低。在1、2、4和12周时，龈沟出血指数（SBI）也观察到类似的显著降低。然而，在4、12和24周时，姜黄素作为辅助手段与单纯NPT相比在减少探诊出血（BOP）方面没有统计学显著差异。基于目前的证据，与单纯NPT相比，姜黄素在降低GI和SBI方面显示出抗炎疗效。此外，姜黄素是一种副作用少的天然草药，是牙周疾病辅助治疗的良好候选药物。
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