蜂蜜预防放化疗导致的口腔黏膜炎及相关疼痛的系统评价

Prophylactic effects of honey use on radio or chemotherapy-induced oral mucositis and associated pain: a systematic review

目的:评价蜂蜜在预防放化疗导致的口腔黏膜炎及相关疼痛中的作用。方法:计算机检索TheCochrane Library、 PubMed、Web of Science.中国生物医学文献数据库(CBM)、维普信息资源系统(VIP)、中国知网(CNKI)和万方数据库(Wanfang Data),检索时限均截止于2018年9月,纳入关于蜂蜜用于放化疗后口腔黏膜炎及相关疼痛的随机对照试验。由2位研究者独立按照纳入与排除标准筛选文献、提取资料和评价纳入研究的方法学质量后,采用RevMan 5.3软件进行Meta分析。结果:最终纳入15篇文献,共856例患者。Meta分析结果显示,蜂蜜可降低重度口腔黏膜炎[RR=0.48,95%CI(0.35, 0.66),P<0.001]、黏膜炎相关疼痛(P<0.05)、口腔真菌定植[RR=0.21, 95%C1 (0.09, 0.49), P<0.001]、治疗中断[RR=0.10, 95%CI(0.01, 0.75), P=0.02]、体质量减轻[MD=-3.72, 95%CI(-6.86,-0.57), P=0.02]的发生风险,并延缓重度口腔黏膜炎的发生。结论:当前证据表明,蜂蜜是一种合理的辅助治疗放化疗口腔黏膜炎及缓解相关疼痛的方法,需要开展更多的随机对照试验证实其效果。

Objective: To evaluate the prophylactic effects of honey use on radio or chemotherapy-induced oral mucositis and associated pain. Methods: Such databases as The Cochrane Library, PubMed, Web of Science, CBM, VIP, CNKI and Wanfang Data were searched up to September 2018 for randomized controlled trials (RCTs) about honey use on radio or chemotherapy-induced oral mucositis and associated pain. According to the inclusion and exclusion criteria, two reviewers independently screened each database, extracted data, and assessed the methodological quality of included studies. Then meta-analysis was performed using RevMan 5.3 software. Results: Fifteen RCTs involving 856 patients were included. The meta-analysis showed that honey was significantly better in lowering the risk of mucositis [RR=0AS, 95% CI (0.35, 0.66), P<0.001], pain associated with mucositis (P<0.05), mouth fungal colonization [RR=0.21,95% CI (0.09,0.49), P<0.001], treatment interruptions [RR=0A0, 95% CI (0.01, 0.75), P=0.02] and weight loss [MD=-3.72, 95% CI (-6.86,-0.57), P=0.02]. And honey use could also delay the onset of severe mucositis. Conclusion: Current evidence shows that honey is a reasonable treatment for radio or chemotherapy-induced oral mucositis and associated pain, but more RCTs are still needed.