比较环孢菌素与糖皮质激素治疗口腔扁平苔藓的系统评价

目的：评价和比较环孢菌素与糖皮质激素治疗口腔扁平苔藓的疗效和安全性。方法：计算机检索Cochrane图书馆、MEDLINE、EMbase、CBM、CNKI、VIP等数据库，收集所有相关随机对照试验和半随机对照试验。统计分析采用RevMan4．2．9软件。结果：最终纳入4个RCT，Meta分析显示与糖皮质激素比较，环孢菌素治疗口腔扁平苔藓的临床反应并不显著[RR=2．42（0．61，9．54）]。在改善患者疼痛[WMD=4．46（-4．33，13．25）]和烧灼感[WMD=7．63（-2．23，17．48）]、减少红斑面积[WMD=26．62（-4．36，57．60）]、降低副反应发生率[RR=1．34（0．18，10．27）]方面也无优势。糖皮质激素在减少溃疡[WMD=15．76（5．48，26．04）]和网纹面积[WMD=41．41（13．62，69．20）]方面优于环孢菌素。结论：环孢菌素治疗OLP并不优于糖皮质激素，在安全性方面也不如个别研究报道的安全。但是，由于纳入研究存在不同程度的缺陷，此结论还需要今后更多高质量、大样本的随机对照试验进一步验证。

Comparison between cyclosporine and glucocorticoid in treatment of oral lichen planus: a systematic review

Objectives： To assess and compare the effectiveness and safety of cyclosporine and glucocorticoid to treat Oral lichen planus. Methods： The Cochrane Library, MEDLINE, EMbase, CBM, CNKI, VIP were searched for randomized controlled trials or quasi-randomized controlled trials. Statistical analysis was performed by RevMan4.2.9 software.Results： 4 RCT were included at last. Meta-analysis showed that clinical response of OLP to cyclosporine were not distinguished from glucocorticoid [RR=2.42 （0.61, 9.54）]. Cyclosporine has no obvious advantages in alleviating pain [WMD=4.46 （-4.33,13.25）] and burning sensation [WMD=7.63 （-2.23, 17.48）], reducing erythema [WMD=26.62（-4.36, 57.60）] and side-effect incidence [RR=1.34 （0.18,10.27）] over glucocorticoid. Glucocorticoid had better effects of reducing ulcer [WMD=15.76 （5.48, 26.04）] and reticulatin area [WMD=41.41 （13.62, 69.20）] than cyclosporine. Conclusions： Cyclospofine appears to have no more satisfying effect than glucocorticoid in the treatment of OLP. Some study report the safety ofcyclosporine is better is not real. Due to the disadvantage of present studies design, further high-quality, large-scale randomized controlled trials are required to confirm this result.