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高强度激光治疗和光生物调节疗法对口腔扁平苔藓的影响——一项系统评价和荟萃分析

Effect of high-intensity laser therapy and photobiomodulation therapy on oral lichen planus-a systematic review and meta-analysis.

作者信息

Liu Panpan, Zhou Qi, Bao Jie, Chen Muni, Xu Mengting, Bian Jiamin, Wen Yueqiang, Yan Jiayu

机构信息

School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China.

Sichuan Integrative Medicine Hospital, Chengdu, China.

出版信息

Lasers Med Sci. 2025 Mar 20;40(1):151. doi: 10.1007/s10103-025-04398-8.

Abstract

This study evaluates the efficacy and safety of High-Intensity Laser Therapy (HILT) and Photobiomodulation (PBM) in treating Oral Lichen Planus (OLP), and explores optimal PBM parameter settings. A search of PubMed, Embase, Cochrane Library, Web of Science, CNKI, and SinoMed was conducted for randomized controlled trials (RCTs) on laser therapy for OLP up to October 30, 2024. Study quality was assessed using the Cochrane risk of bias tool and the Jadad score. Eighteen studies were identified, with 16 involving 742 participants included in the meta-analysis. Eleven studies compared PBM with topical corticosteroids (TCS), and five compared HILT with TCS. HILT provided superior pain relief compared to TCS (SMD = -0.51, 95% CI [-0.79,-0.23]), while PBM showed comparable outcomes (SMD = -0.41, 95% CI [-0.87, 0.04]). PBM was more effective at pain relief with total energy density below 120 J/cm. Both HILT and PBM reduced recurrence rates (RR = 0.33,95%CI [0.15,0.73]; RR = 0.43, 95% CI [0.25, 0.74]) and improved cure rates (RR = 1.44, 95% CI [1.01, 2.06]; RR = 1.47, 95% CI [1.05, 2.05]). PBM had no adverse reactions, while HILT and TCS had associated adverse events. HILT and PBM may be considered effective alternatives to TCS. For PBM treatment of OLP, a total energy density below 120 J/cm is advisable. Further large-scale studies are required to confirm these findings and refine laser parameters.

摘要

本研究评估高强度激光治疗(HILT)和光生物调节(PBM)治疗口腔扁平苔藓(OLP)的疗效和安全性,并探索最佳的PBM参数设置。检索了截至2024年10月30日关于激光治疗OLP的随机对照试验(RCT)的PubMed、Embase、Cochrane图书馆、Web of Science、中国知网和中国生物医学文献数据库。使用Cochrane偏倚风险工具和Jadad评分评估研究质量。共识别出18项研究,其中16项涉及742名参与者纳入荟萃分析。11项研究比较了PBM与外用糖皮质激素(TCS),5项研究比较了HILT与TCS。与TCS相比,HILT在缓解疼痛方面更具优势(标准化均数差[SMD]= -0.51,95%置信区间[-0.79,-0.23]),而PBM显示出相似的结果(SMD = -0.41,95%置信区间[-0.87, 0.04])。当总能量密度低于120 J/cm时,PBM在缓解疼痛方面更有效。HILT和PBM均降低了复发率(风险比[RR]= 0.33,95%置信区间[0.15,0.73];RR = 0.43,95%置信区间[0.25, 0.74])并提高了治愈率(RR = 1.44,95%置信区间[1.01, 2.06];RR = 1.47,95%置信区间[1.05, 2.05])。PBM无不良反应,而HILT和TCS有相关不良事件。HILT和PBM可被视为TCS的有效替代方案。对于PBM治疗OLP,建议总能量密度低于120 J/cm。需要进一步的大规模研究来证实这些发现并优化激光参数。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e66/11922975/754a70a26161/10103_2025_4398_Fig1_HTML.jpg

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