光动力疗法对口腔白斑的疗效及影响因素的meta分析  

Effect and influencing factors of photodynamic therapy in the treatment of oral leukoplakia:a meta-analysis

作　　者：周珊珊 孔宇航 张劲松[1] ZHOU Shanshan;KONG Yuhang;ZHANG Jinsong(Department of Oral and Maxillofacial Surgery,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院颌面外科,400016

出　　处：《重庆医学》2023年第6期906-912,共7页Chongqing medicine

摘　　要：目的探讨光动力疗法(PDT)对口腔白斑的疗效及其影响参数。方法计算机检索PubMed、EMBASE、ISI Web of Knowledge、Cochrane图书馆、OVID、中国知网、中国生物医学文献数据库、万方、美国临床试验数据库和中国临床试验注册中心,检索时限截至2021年12月。筛选文献和提取资料后进行meta分析。结果纳入13篇文献,共352例患者,520个白斑病变,meta分析结果提示经过PDT后80%的白斑病变达到完全或部分缓解(效应量=0.80,95%CI:0.72~0.88,P<0.05),38%的白斑病变达到完全缓解(效应量=0.38,95%CI:0.19~0.59,P<0.05),87%的患者达到完全或部分缓解(效应量=0.87,95%CI:0.71~0.98,P<0.05),PDT后白斑病变减少了0.770 cm^(3)(标准化均数差=-0.770,95%CI:-1.085~-0.456,P<0.05)。亚组分析显示不同光源、光敏剂、ALA涂药时长、光源波长、能量密度、病变部位对疗效有影响。PDT治疗的不良反应较少且轻微。结论PDT是治疗白斑的有效方法,其疗效受多个因素影响。Objective To investigate the effect and influencing factors of photodynamic therapy(PDT)on oral leukoplakia.Methods Relevant studies were searched in PubMed,EMBASE,ISI Web of Knowledge,the Cochrane,OVID,China National Knowledge Infrastructure,China Biomedical Literature Database,Wanfang,American Clinical Trials Database,and the Chinese Clinical Trials registry from inception to December 2021.After literature screening and data extraction,meta-analysis was performed.Results A total of 13 studies were included,involving 352 patients and 520 leukoplakia lesions.Meta-analysis results suggested that 80%of leukoplakia lesions achieved complete or partial remission after PDT(effect size=0.80,95%CI:0.72-0.88,P<0.05),38%of leukoplakia lesions achieved complete remission(effect size=0.38,95%CI:0.19-0.59,P<0.05),and 87%of patients achieved complete or partial remission(effect size=0.87,95%CI:0.71-0.98,P<0.05).Leukoplakia decreased by 0.770 cm^(3) after PDT(standard mean difference=-0.770,95%CI:-1.085--0.456,P<0.05).Subgroup analysis showed that different light source,photosensitizer,ALA duration,light source wavelength,energy density and lesion site had influence on the curative effect.The adverse reactions of PDT treatment were few and mild.Conclusion PDT is an effective treatment for leukoplakia,and its overall efficacy is influenced by several factors.

关 键 词：光动力疗法 口腔白斑 治疗效果 影响因素 META分析 

分 类 号：R781.5[医药卫生—口腔医学]