Department of Pharmacy, Changsha Stomatological Hospital, Changsha, 410006, China.
School of Stomatology, Hunan University of Chinese Medicine, Changsha, 410006, China.
BMC Oral Health. 2023 Oct 12;23(1):748. doi: 10.1186/s12903-023-03488-9.
The aim of this review is to evaluate the different medicinal interventions available for the management of oral submucous fibrosis (OSF).
We conducted a comprehensive electronic search on PubMed, Web of Science, and Cochrane Library databases for articles related to OSF patients treated with medications from December 2011 to September 2022. GRADE system was used to evaluate the evidence quality. The reporting of the systematic review is in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. The main outcomes were the improvement of maximum mouth opening, burning sensation, cheek flexibility, and tongue protrusion.
Twenty-nine randomized controlled trials (RCTs), five clinical trials (CCTs) were included, and the use of drugs for OSF treatment were evaluated. Drugs like steroids, hyaluronidase, pentoxifylline, lycopene, curcumin, dpirulina, aloe vera, omega3, oxitard, allicin, colchicine have been used. It was found that drugs with evidence high quality were salvia miltiorrhiza combined with triamcinolone acetonide, lycopene, pentoxifylline, curcumin, and aloe vera, and those with evidence moderate quality were allicin, colchicine, omega 3, and oxitard.
Based on the results of our comprehensive analysis, for long-term treatment, we found lycopene with low side effects, whereas for relieving the symptoms of severe burning sensation, aloe vera is the most effective. Although the recent review has made some progress, drug therapy for OSF remains unclear, and more high-quality RCTs are needed to identify better treatments for OSF.
本综述旨在评估治疗口腔黏膜下纤维性变（OSF）的各种医学干预措施。
我们对 2011 年 12 月至 2022 年 9 月期间在 PubMed、Web of Science 和 Cochrane 图书馆数据库中与接受药物治疗的 OSF 患者相关的文章进行了全面的电子搜索。使用 GRADE 系统评估证据质量。系统评价的报告符合系统评价和荟萃分析的首选报告项目（PRISMA）协议。主要结局是改善最大张口度、烧灼感、颊部灵活性和舌伸出。
共纳入 29 项随机对照试验（RCT）和 5 项临床试验（CCT），评估了药物治疗 OSF 的效果。研究中使用了类固醇、透明质酸酶、己酮可可碱、番茄红素、姜黄素、藻蓝蛋白、芦荟、欧米伽 3、奥昔他汀、大蒜素、秋水仙碱等药物。研究发现，丹参酮联合曲安奈德、番茄红素、己酮可可碱、姜黄素和芦荟等药物具有高质量证据，大蒜素、秋水仙碱、欧米伽 3 和奥昔他汀等药物具有中等质量证据。
根据我们全面分析的结果，对于长期治疗，我们发现低副作用的番茄红素，而对于缓解严重烧灼感的症状，芦荟是最有效的。尽管最近的综述取得了一些进展，但 OSF 的药物治疗仍不清楚，需要更多高质量的 RCT 来确定更好的 OSF 治疗方法。
