Therapy of Oral Lichen Planus: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

SUN Yuliang ¹ ,  ZHAO Jin ¹ , WU Taixiang ² , LI Yan ¹

1. Department of stomatology, the Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China2. Chinese Evidence-Based Medicine Center, West China Hospital of Sichuan University, Chengdu 610041,China;

Corresponding author：

ZHAO Jin, Email: merryljin@sina.com

Keywords：

Oral Lichen Planus; Therapy; Systematic review

DOI：

10.7507/1672-2531.20090062

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objectives 　To assess the effectiveness and safety of any form of therapy compared with glucocorticoid for the treatment of oral lichen planus.
Method 　The Cochrane Library (Issue 4, 2007), MEDLINE (1966-2007), EMbase (1966-2007), CBM (1978-2005), CNKI (1989-2007), and VIP (1989-2007) were searched for randomized controlled trials or quasi-randomized controlled trials. Quality assessment and data extraction were performed by two reviewers independently. Meta-analysis was performed for the results of homogeneous studies by RevMan 4.2.9 software.
Results 　Finally, 14 studies involving 9 therapy methods were included. Four studies were concerned with cyclosporine.
We performed a meta-analysis of 3 studies. The results showed there was no statistically significant difference in the curative effect of cyclosporine and the steroid with RR 2.94 and 95%CI 1.03 to 9.97. The results showed that the curative effect of total glucosides of paenia plus topical application of triamcinolone acetonide (RR0.21, 95%CI 0.10 to 0.44),
tacrolimu (RR 0.18 and 95%CI 0.05 to 0.72), and pimecrolimus (WMD –0.50 and 95%CI –0.85 to –0.15) were better than glucocorticoid. There was a statistically significant difference between fluocinolone acetonide and retinoic acid in terms of curative effect with RR 3.20 and 95%CI 1.03 to 9.97. The curative effect of mesalazine (RR 0.42 and 95%CI 0.05 to 3.54), Mycostatin paste plus desamethasone paste (RR 1.23 and 95%CI 0.93 to 1.61), triamcinolone acetonide plus vitamin B12 ( RR 0.50 and 95%CI 0.05 to 4.94), chitin (RR 1.30 and 95%CI 0.86 to 1.96) was similar with that of glucocorticoid.
Conclusion 　Statistical analysis showed the curative effect of total glucosides of paenia combined with triamcinolone
acetonide is better than glucocorticoid. Due to the mistakes of theincluded studies designs,,further high-quality,
largescale randomized controlled trials are required to confirm the effectiveness and safety of this therapy method.

Citation： SUN Yuliang,ZHAO Jin,WU Taixiang,LI Yan. Therapy of Oral Lichen Planus: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2009, 09(3): 323-330. doi: 10.7507/1672-2531.20090062 Copy

1.	und Klinik (KortingGW, ed) editor(s). Dermatologie. Vol. 2, Stuttgart: Thieme, 1990, 17.1-17.13.
2.	paste in thetreatment of oral lichen planus. J Am Acad Dermatol, 2007, 19.[Epub ahead of print].
3.	ht tp: / /www. c gmh.or g . tw/ int r / int r5/ c6700/OBGYN/F/Randomized%20tial/chapter1.html.
4.	李秉琦. 主编. 口腔黏膜病学. 第2 版. 北京: 人民卫生出版社, 2000. 85-90.
5.	Pindborg JJ, Mehta FS, Daftary DK, et al. Prevalence of oral lichen planus among 7639 Indian villagers in Kerala, South India. Acta Derm Venereol (Stockh), 1972, 52: 216-220.
6.	NasemannT. Lichen ruber planus und seine Varianten. In:Praxis.
7.	Silverman S Jr, Gorsky M, Lozada-Nur F. A prospective follow-up study of 570 patients with oral lichen planus: persistance, remission and malignant association. Oral Surg Oral Med Oral Pathol, 1985,60: 30-34.
8.	Axell T, Rundquist L. Oral lichen planus-a demographic study.Community Dent Oral Epidemiol, 1987, 15: 52-56.
9.	CribierB, FrancesC, Chosidow O. Treatment of lichen planus. An evidence-based medicine analysis of efficacy. Arch Denatol, 1998,134: 1512-1530.
10.	CarboneM, GossE, CarrozzoM, et al. Systemic and topical corticosteroid treatment of oral lichen planus:a comparative study with long-term follow-up. J Oral Pathol Med, 2003, 32: 323-329.
11.	Scully C, EisenD, CarrozzoM. Management of Oral lichen planus.Am Cli Dermatol, 2000, 1(5): 287.
12.	柳志文, 凌天牖, 贺建泽, 等. 复方环孢菌素A含漱液治疗口腔扁平苔藓的研究. 湖南医科大学学报, 2000, 25: 183.
13.	Laeijendecker R, Tank B, Dekker SK, et al. A comparison of treatment of oral lichen planus with topical tacrolimus and triamcinolone acetonide ointment. Acta Derm Venereol, 2006, 86(3):227-229.
14.	Gorouhi F, Solhpour A, Beitollahi JM, et al. Randomized trial of pimecrolimus cream versus triamcinolone acetonide.
15.	Sardella A, Demarosi F, Oltolina A, et al. Efficacy of topical mesalazine compared with clobetasol propionate in treatment of symptomatic oral lichen planus. Oral Dis, 1998, 4(4): 255-259.
16.	蔡华雄, 孔祥波, 朱越广, 等. 帕夫林联合确炎舒松治疗口腔扁平苔藓的初步观察. 广东牙病防治, 2003, 11(3): 163-165.
17.	于春梅, 张安玲, 陈巨锋, 等. 中西医结合治疗口腔扁平苔藓的临床疗效观察. 黑龙江医药科学, 2006, 29(6): 27-28.
18.	吴泰相, 刘关键. 隐蔽分组（分配隐藏）和盲法的概念, 实施与报告. 中国循证医学杂志 2007, 7(3): 222-224.
19.	Alderson P, Green S, Higgins JPT, editors. Cochrane Reviews Handbook 4.2.2 (updated March 2004). The Cochrane Library.Chichester,UK:John Wiley sons, Ltd, 2004.
20.	王阅春, 贺凌飞, 朱友家. 曲安奈德和维生素B12联合局部注射治疗口腔扁平苔藓的临床疗效观察. 数理医药学杂志, 2004, 17(6):508-509.
21.	魏昕, 李秉琦, 周学东, 等. 制霉菌素与地塞米松糊剂联合治疗OLP疗效观察. 临床口腔医学杂志, 2003, 9(19): 568-569.
22.	唐国瑶, 周曾同. 甲壳质治疗糜烂型口腔扁平苔藓的临床应用研究. 临床口腔医学杂志, 2005, 21(10): 626-628.
23.	杜申钊, 王何伟, 苏平. 中西医结合治疗口腔扁平苔藓46例. 中国民间疗法, 2007, 15(2): 6-7.
24.	Buajeeb W, Kraivaphan P, Pobrurksa C. Efficacy of topical retinoic acid compared with topical fluocinolone acetonide in the treatment of oral lichen planus. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 1997, 83(1): 21-25.
25.	Conrotto D, Carbone M, Carrozzo M, et al. Ciclosporin vs clobetasol in the topical management of atrophic and erosive oral lichen planus: a double-blind, randomized controlled trial. Br J Dermatol, 2006, 154(1): 139-145.
26.	Thongprasom K, Chaimusig M, Korkij W, et al. A randomizedcontrolled trial to compare topical cyclosporin with triamcinolone acetonide for the treatment of oral lichen planus. J Oral Pathol Med, 2007, 36(3): 142-146.
27.	Yoke PC, Tin GB, Kim MJ, et al. A randomized controlled trial to compare steroid with cyclosporine for theopical treatment of oral lichen planus. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2006, 102(1): 47-55.
28.	Sieg P, Von Domarus H, Von Zitzewitz V, et al. Topical cyclosporin in oral lichen planus: a controlled, randomized, prospective trial. Br J Dermatol, 1995, 132(5): 790-794.
29.	Jadad AR Randomised controlled trials, A users guide. [2007-01-26].
30.	Chalmers TC, Celano P, Sacks HS, et al. Bias in treatment assignment in controlled clinical trials. N Engl J Med, 1983, 309: 1359-1361.
31.	Schulz Kf, Chalmers I, Hayes RJ, et al. Empirical evidence of bias dimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA, 1995, 273: 408-412.

1. und Klinik (KortingGW, ed) editor(s). Dermatologie. Vol. 2, Stuttgart: Thieme, 1990, 17.1-17.13.
2. paste in thetreatment of oral lichen planus. J Am Acad Dermatol, 2007, 19.[Epub ahead of print].
3. ht tp: / /www. c gmh.or g . tw/ int r / int r5/ c6700/OBGYN/F/Randomized%20tial/chapter1.html.
4. 李秉琦. 主编. 口腔黏膜病学. 第2 版. 北京: 人民卫生出版社, 2000. 85-90.
5. Pindborg JJ, Mehta FS, Daftary DK, et al. Prevalence of oral lichen planus among 7639 Indian villagers in Kerala, South India. Acta Derm Venereol (Stockh), 1972, 52: 216-220.
6. NasemannT. Lichen ruber planus und seine Varianten. In:Praxis.
7. Silverman S Jr, Gorsky M, Lozada-Nur F. A prospective follow-up study of 570 patients with oral lichen planus: persistance, remission and malignant association. Oral Surg Oral Med Oral Pathol, 1985,60: 30-34.
8. Axell T, Rundquist L. Oral lichen planus-a demographic study.Community Dent Oral Epidemiol, 1987, 15: 52-56.
9. CribierB, FrancesC, Chosidow O. Treatment of lichen planus. An evidence-based medicine analysis of efficacy. Arch Denatol, 1998,134: 1512-1530.
10. CarboneM, GossE, CarrozzoM, et al. Systemic and topical corticosteroid treatment of oral lichen planus:a comparative study with long-term follow-up. J Oral Pathol Med, 2003, 32: 323-329.
11. Scully C, EisenD, CarrozzoM. Management of Oral lichen planus.Am Cli Dermatol, 2000, 1(5): 287.
12. 柳志文, 凌天牖, 贺建泽, 等. 复方环孢菌素A含漱液治疗口腔扁平苔藓的研究. 湖南医科大学学报, 2000, 25: 183.
13. Laeijendecker R, Tank B, Dekker SK, et al. A comparison of treatment of oral lichen planus with topical tacrolimus and triamcinolone acetonide ointment. Acta Derm Venereol, 2006, 86(3):227-229.
14. Gorouhi F, Solhpour A, Beitollahi JM, et al. Randomized trial of pimecrolimus cream versus triamcinolone acetonide.
15. Sardella A, Demarosi F, Oltolina A, et al. Efficacy of topical mesalazine compared with clobetasol propionate in treatment of symptomatic oral lichen planus. Oral Dis, 1998, 4(4): 255-259.
16. 蔡华雄, 孔祥波, 朱越广, 等. 帕夫林联合确炎舒松治疗口腔扁平苔藓的初步观察. 广东牙病防治, 2003, 11(3): 163-165.
17. 于春梅, 张安玲, 陈巨锋, 等. 中西医结合治疗口腔扁平苔藓的临床疗效观察. 黑龙江医药科学, 2006, 29(6): 27-28.
18. 吴泰相, 刘关键. 隐蔽分组（分配隐藏）和盲法的概念, 实施与报告. 中国循证医学杂志 2007, 7(3): 222-224.
19. Alderson P, Green S, Higgins JPT, editors. Cochrane Reviews Handbook 4.2.2 (updated March 2004). The Cochrane Library.Chichester,UK:John Wiley sons, Ltd, 2004.
20. 王阅春, 贺凌飞, 朱友家. 曲安奈德和维生素B12联合局部注射治疗口腔扁平苔藓的临床疗效观察. 数理医药学杂志, 2004, 17(6):508-509.
21. 魏昕, 李秉琦, 周学东, 等. 制霉菌素与地塞米松糊剂联合治疗OLP疗效观察. 临床口腔医学杂志, 2003, 9(19): 568-569.
22. 唐国瑶, 周曾同. 甲壳质治疗糜烂型口腔扁平苔藓的临床应用研究. 临床口腔医学杂志, 2005, 21(10): 626-628.
23. 杜申钊, 王何伟, 苏平. 中西医结合治疗口腔扁平苔藓46例. 中国民间疗法, 2007, 15(2): 6-7.
24. Buajeeb W, Kraivaphan P, Pobrurksa C. Efficacy of topical retinoic acid compared with topical fluocinolone acetonide in the treatment of oral lichen planus. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 1997, 83(1): 21-25.
25. Conrotto D, Carbone M, Carrozzo M, et al. Ciclosporin vs clobetasol in the topical management of atrophic and erosive oral lichen planus: a double-blind, randomized controlled trial. Br J Dermatol, 2006, 154(1): 139-145.
26. Thongprasom K, Chaimusig M, Korkij W, et al. A randomizedcontrolled trial to compare topical cyclosporin with triamcinolone acetonide for the treatment of oral lichen planus. J Oral Pathol Med, 2007, 36(3): 142-146.
27. Yoke PC, Tin GB, Kim MJ, et al. A randomized controlled trial to compare steroid with cyclosporine for theopical treatment of oral lichen planus. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2006, 102(1): 47-55.
28. Sieg P, Von Domarus H, Von Zitzewitz V, et al. Topical cyclosporin in oral lichen planus: a controlled, randomized, prospective trial. Br J Dermatol, 1995, 132(5): 790-794.
29. Jadad AR Randomised controlled trials, A users guide. [2007-01-26].
30. Chalmers TC, Celano P, Sacks HS, et al. Bias in treatment assignment in controlled clinical trials. N Engl J Med, 1983, 309: 1359-1361.
31. Schulz Kf, Chalmers I, Hayes RJ, et al. Empirical evidence of bias dimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA, 1995, 273: 408-412.

Previous Article
Investigation of Clinical Practice and Side Effects of Shenfu Injection
Next Article
Conservative in the Treatment of Protrusion of Cervical Vertebra Intervertebral Disc: A Systematic Review

Chinese Journal of Evidence-Based Medicine

Therapy of Oral Lichen Planus: A Systematic Review

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content