You Peng, Strychowsky Julie, Gandhi Karan, Chen Breanna A
Department of Otolaryngology - Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
Paediatr Child Health. 2021 Aug 27;27(2):82-87. doi: 10.1093/pch/pxab051. eCollection 2022 May.
Sialorrhea in children can be associated with adverse physical and social effects. Treatment using anticholinergic medications has been shown to offer symptomatic relief, but there is no consensus regarding which treatment is the most efficacious.
To examine the effectiveness of anticholinergic medications for sialorrhea in children.
A systematic review was carried out in Medline, EMBASE, Cochrane, Scopus, and the Web of Science from inception until April 29, 2020. Studies reporting original data on the efficacy of anticholinergic medications in the management of sialorrhea in children aged 0 to 17 years of age were included. This review adhered to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) standards. Data on study design, setting, population, pharmacologic intervention(s), comparator(s), outcomes, and results were extracted and summarized.
The search strategy identified 2,800 studies of which 27 articles were included in the synthesis, including five randomized controlled trials. Each anticholinergic undergoing experimental study (glycopyrrolate, scopolamine/hyoscine, trihexyphenidyl/benzhexol, benztropine, and atropine) showed evidence of efficacy. Adverse side effects were common. Significant heterogeneity exists in the studies' methodology and the variability of outcome measures used between studies precluded a meta-analysis.
Glycopyrrolate, scopolamine/hyoscine, trihexyphenidyl/benzhexol, benztropine, and atropine have all shown efficacy in the treatment of sialorrhea in children. The small number of reports and the variability in study design precluded a meta-analysis. More studies are needed with uniformity in outcome measures to help guide evidence-based decision making. A guidance table is presented.
儿童流涎可能会对身体和社交产生不良影响。已证明使用抗胆碱能药物治疗可缓解症状，但对于哪种治疗方法最有效尚无共识。
研究抗胆碱能药物治疗儿童流涎的有效性。
从数据库建立至2020年4月29日，在医学期刊数据库（Medline）、荷兰医学文摘数据库（EMBASE）、考克兰图书馆（Cochrane）、Scopus数据库和科学引文索引数据库（Web of Science）中进行了系统综述。纳入了报告抗胆碱能药物治疗0至17岁儿童流涎疗效原始数据的研究。本综述遵循系统评价和Meta分析的首选报告项目（PRISMA）标准。提取并总结了有关研究设计、研究地点、研究人群、药物干预、对照、结局和结果的数据。
检索策略共识别出2800项研究，其中27篇文章纳入综述，包括5项随机对照试验。每种接受实验研究的抗胆碱能药物（格隆溴铵、东莨菪碱、苯海索、苄托品和阿托品）均显示出疗效证据。不良反应很常见。研究方法存在显著异质性，且各研究使用的结局指标存在差异，因此无法进行Meta分析。
格隆溴铵、东莨菪碱、苯海索、苄托品和阿托品均显示出治疗儿童流涎的疗效。报告数量少且研究设计存在差异，因此无法进行Meta分析。需要更多结局指标统一的研究，以帮助指导循证决策。本文给出了一个指导表。
