Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China.
Suzhou Stomatological Hospital, Suzhou, China.
J Oral Pathol Med. 2023 Oct;52(9):811-825. doi: 10.1111/jop.13480. Epub 2023 Sep 27.
The present network meta-analysis aims to answer the question "what is the best topical intervention for the treatment of recurrent aphthous stomatitis that can provide an acceptable pain relief and promote wound healing?"
From inception to October 2022, PubMed, Embase, Scopus, Cochrane Library, and China National Knowledge Infrastructure were searched to identify all potentially eligible randomized controlled trials. The primary outcomes were pain scores and/or healing time, while the secondary outcomes were the associated side effects. The Bayesian network meta-analysis accompanied by a random effect model and 95% credible intervals were calculated.
Forty-three randomized controlled trials with a total of 3067 participants, comparing 20 different topical medications, were included. Concerning pain reduction, the network meta-analysis failed to show any statistically significant differences when different topical treatments were compared together or even with a placebo at different time intervals. Except for doxycycline, which showed a statistically significant difference in terms of accelerating healing time, other topical interventions showed no statistically significant differences when compared with placebo or with each other.
Within the limitations of the current network meta-analysis, it seems that: A low to moderate quality of evidence showed no superiority of any topical treatment over others concerning pain reduction, although rank probability tests revealed sucralfate, doxycycline, hyaluronic acid, and chamomile as the most efficacious treatment options at different evaluation times. Hence, further well-designed clinical trials with larger sample sizes are warranted. Topical doxycycline was shown to be the most efficacious intervention in promoting healing of recurrent aphthous stomatitis.
本网络荟萃分析旨在回答“对于复发性阿弗他口腔溃疡的治疗，哪种局部干预措施最好，可以提供可接受的止痛效果并促进伤口愈合？”这一问题。
从开始到 2022 年 10 月，检索了 PubMed、Embase、Scopus、Cochrane 图书馆和中国知网，以确定所有潜在的合格随机对照试验。主要结局指标是疼痛评分和/或愈合时间，次要结局指标是相关的副作用。计算了贝叶斯网络荟萃分析，并伴有随机效应模型和 95%可信区间。
纳入了 43 项随机对照试验，共 3067 名参与者，比较了 20 种不同的局部药物。关于疼痛减轻，网络荟萃分析显示，在不同的局部治疗之间进行比较，甚至与不同时间间隔的安慰剂进行比较时，没有任何统计学上的显著差异。除了多西环素在加速愈合时间方面表现出统计学上的显著差异外，其他局部干预措施与安慰剂或彼此之间没有统计学上的显著差异。
在当前网络荟萃分析的局限性内，似乎：低到中等质量的证据表明，任何局部治疗在减轻疼痛方面都没有优于其他治疗，尽管等级概率检验显示，在不同的评估时间，硫糖铝、多西环素、透明质酸和甘菊作为最有效的治疗选择。因此，需要进一步设计良好、样本量更大的临床试验。局部多西环素被证明是促进复发性阿弗他口腔溃疡愈合的最有效干预措施。
