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光动力疗法治疗口腔念珠菌病的疗效:系统评价和荟萃分析。

Efficacy of photodynamic therapy in the treatment of oral candidiasis: a systematic review and meta-analysis.

机构信息

Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, 050017, China.

Department of Preventive Dentistry, School and Hospital of Stomatology, Hebei Medical University, No. 383, Zhongshan East Road, Shijiazhuang, 050017, PR China.

出版信息

BMC Oral Health. 2023 Oct 26;23(1):802. doi: 10.1186/s12903-023-03484-z.

Abstract

OBJECTIVE

To evaluate the clinical efficacy of photodynamic therapy (PDT) as an adjunct or alternative to traditional antifungal drugs in the treatment of oral candidiasis, and to provide evidence-based medical evidence for its use in the treatment of oral candidiasis.

METHODS

Computer combined with manual retrieval of China Academic Journals Full-text Database (CNKI), China Biomedical Literature Database (CBM), Chinese Science and Technology Journal Database (VIP), Wanfang Database, PubMed, Web of Science, Cochrane Library, Embase, Scopus retrieval for articles published before January 2023, basic information and required data were extracted according to the inclusion and exclusion criteria, and the Revman V5.4 software was used to conduct Meta-analysis of the included literature.

RESULTS

A total of 11 articles were included, 7 of which used nystatin as an antifungal drug, 2 of which were combined treatment of PDT and nystatin, 2 of the remaining 4 articles were treated with fluconazole, and 2 were treated with miconazole. Meta results showed that PDT was superior to nystatin in reducing the number of oral candida colonies in the palate of patients MD = -0.87, 95%CI = (-1.52,-0.23), P = 0.008, the difference was statistically significant, and the denture site MD = -1.03, 95%CI = (-2.21, -0.15), P = 0.09, the difference was not statistically significant; compared with the efficacy of fluconazole, RR = 1.01, 95%CI = (0.56,1.83), P = 0.96; compared with miconazole RR = 0.55, 95%CI = (0.38, 0.81), P = 0.002; PDT combined with nystatin RR = 1.27, 95%CI = (1.06, 1.52), P = 0.01; recurrence rate RR = 0.28, 95%CI = (0.09, 0.88), P = 0.03.

CONCLUSIONS

PDT was effective in the treatment of oral candidiasis; PDT was more effective than nystatin for the treatment of denture stomatitis in the palate, while there was no significant difference between the two for the denture site; The efficacy of PDT for oral candidiasis was similar to that of fluconazole; PDT was less effective than miconazole for oral candidiasis; Compared with nystatin alone, the combination of PDT and nystatin is more effective in treating oral candidiasis with less risk of recurrence.

摘要

目的

评价光动力疗法(PDT)作为口腔念珠菌病传统抗真菌药物的辅助或替代治疗的临床疗效,为其治疗口腔念珠菌病提供循证医学证据。

方法

计算机检索中国学术期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、中文科技期刊数据库(VIP)、万方数据库、PubMed、Web of Science、Cochrane 图书馆、Embase、Scopus 中 2023 年 1 月以前发表的文献,按照纳入和排除标准提取基本信息和所需数据,采用 Revman V5.4 软件对纳入文献进行 Meta 分析。

结果

共纳入 11 篇文献,其中 7 篇使用制霉菌素作为抗真菌药物,2 篇为 PDT 联合制霉菌素治疗,其余 4 篇中的 2 篇为氟康唑治疗,2 篇为咪康唑治疗。Meta 分析结果显示,PDT 组在降低患者腭部口腔念珠菌菌落数方面优于制霉菌素组 MD=-0.87,95%CI=-1.52,-0.23,P=0.008,差异有统计学意义,义齿部位 MD=-1.03,95%CI=-2.21,-0.15,P=0.09,差异无统计学意义;与氟康唑的疗效相比,RR=1.01,95%CI=(0.56,1.83),P=0.96;与咪康唑相比,RR=0.55,95%CI=(0.38,0.81),P=0.002;PDT 联合制霉菌素 RR=1.27,95%CI=(1.06,1.52),P=0.01;复发率 RR=0.28,95%CI=(0.09,0.88),P=0.03。

结论

PDT 治疗口腔念珠菌病有效;PDT 治疗腭部义齿性口炎较制霉菌素更为有效,而在义齿部位二者无显著差异;PDT 治疗口腔念珠菌病的疗效与氟康唑相当;PDT 治疗口腔念珠菌病的疗效不如咪康唑;与单独使用制霉菌素相比,PDT 联合制霉菌素治疗口腔念珠菌病的疗效更优,复发风险更小。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/afee/10605952/8ab776e9ddba/12903_2023_3484_Fig1_HTML.jpg

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