维生素E对放疗或化疗导致的口腔黏膜炎有效性的meta分析

doi:10.3969/j.issn.1674-8115.2023.02.010

上海交通大学学报（医学版） ›› 2023, Vol. 43 ›› Issue (2): 208-214.doi: 10.3969/j.issn.1674-8115.2023.02.010

• 论著 · 循证医学 • 上一篇

维生素E对放疗或化疗导致的口腔黏膜炎有效性的meta分析

梁妍景¹^,²(), 黄楚贤¹^,³, 李红艳¹^,³, 侯黎莉¹^,²()

^1.上海交通大学护理学院，上海 200025
^2.上海交通大学医学院附属第九人民医院护理部，上海 200011
^3.上海交通大学医学院附属精神卫生中心护理部，上海 200032

收稿日期:2022-05-20 接受日期:2022-11-30 出版日期:2023-02-28 发布日期:2023-02-28
通讯作者: 侯黎莉 E-mail:16yjliang3@alumni.stu.edu.cn;pisces_liz@163.com
作者简介:梁妍景(1998—)，女，硕士生；电子信箱：16yjliang3@alumni.stu.edu.cn。
基金资助:
上海市高水平地方高校创新团队项目(SHSMU-ZDCX20212802)

Effectiveness of vitamin E on oral mucositis caused by radiotherapy and chemotherapy: a meta-analysis

LIANG Yanjing¹^,²(), HUANG Chuxian¹^,³, LI Hongyan¹^,³, HOU Lili¹^,²()

^1.School of Nursing, Shanghai Jiao Tong University, Shanghai 200025, China
^2.Nursing Department, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
^3.Nursing Department, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200032, China

Received:2022-05-20 Accepted:2022-11-30 Online:2023-02-28 Published:2023-02-28
Contact: HOU Lili E-mail:16yjliang3@alumni.stu.edu.cn;pisces_liz@163.com
Supported by:
Innovation Research Team of High-level Local Universities in Shanghai(SHSMU-ZDCX20212802)

摘要/Abstract

摘要：

目的·评价维生素E在治疗放射治疗或化学治疗（放化疗）导致的口腔黏膜炎（oral mucositis，OM）中的有效性。方法·计算机检索PubMed、Embase、Cochrane Library、Web of Science、CINAHL、OpenGrey、中国生物医学文献数据库、中国知网、万方数据库和维普中文期刊数据库中关于维生素E用于放化疗后的OM有效性的随机对照研究，检索时限为建库至2022年3月。由2位研究者独立按照纳入和排除标准筛选文献、提取资料和评价纳入文献的方法学质量后，采用RevMan 5.4软件进行meta分析。结果·共检索出563篇文献，最终纳入7项随机对照试验。Meta分析结果显示：使用维生素E治疗放化疗导致的OM的效果，相较于对照组，差异无统计学意义（RR=0.44，95%CI 0.15~1.25，Z=1.54，P=0.120）；维生素E对于重度OM可能有一定的效果（RR=0.22，95%CI 0.11~0.43，Z=4.33，P=0.000），差异具有统计学意义。结论·暂不能说明使用维生素E能够有效治疗放化疗导致的OM，但维生素E对于重度OM可能有效。

关键词: 维生素E, 口腔黏膜炎, 随机对照试验, meta分析

Abstract:

Objective ·To examine, using a systematic review and meta-analysis, the effectiveness of vitamin E on treating oral mucositis caused by radiotherapy and chemotherapy. Methods ·A systematic literature search was performed by using PubMed, Embase, Cochrane Library, Web of Science, CINAHL, OpenGrey, Chinese biomedical literature database (CBM), Chinese national knowledge infrastructure (CNKI), Wanfang Data, and China Science and Technology Journal Database (VIP). The retrieval time was up to March 2022. The risk of bias was assessed by using the Cochrane Risk-of-Bias tool, version 2.0. RevMan 5.4 was used for meta-analysis. Results ·A total of 563 literatures were retrieved. A total of 7 randomized controlled trials were included. The results of meta-analysis revealed that vitamin E supplementation did not significantly affect oral mucositis caused by chemoradiotherapy (RR=0.44, 95%CI 0.15?1.25, Z=1.54, P=0.120). However, vitamin E may have some effect on severe oral mucositis (RR=0.22, 95%CI 0.11?0.43, Z=4.33, P=0.000). Conclusion ·It cannot be explained that vitamin E can effectively treat oral mucositis caused by radiotherapy and chemotherapy, but vitamin E may be effective for severe oral mucositis.

Key words: vitamin E, oral mucositis, randomized controlled trial, meta analysis

中图分类号:

R730.6

梁妍景, 黄楚贤, 李红艳, 侯黎莉. 维生素E对放疗或化疗导致的口腔黏膜炎有效性的meta分析[J]. 上海交通大学学报（医学版）, 2023, 43(2): 208-214.

LIANG Yanjing, HUANG Chuxian, LI Hongyan, HOU Lili. Effectiveness of vitamin E on oral mucositis caused by radiotherapy and chemotherapy: a meta-analysis[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2023, 43(2): 208-214.

图/表 4

参考文献 28

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Study （year）	Study design	Country	Population	No. of patients （T/C）	Extracted data （T/C）	Intervention		Intervention Content	Outcome
Study （year）	Study design	Country	Population	No. of patients （T/C）	Extracted data （T/C）	T	C	Intervention Content	Outcome
SAYED, et al.,2020^［14］	RCT	Egypt	Head and neck cancer	30/30	22/25	a+b+c	a	T: Vitamin E （oral soft gelatin capsules） 1 000 mg once daily + pentoxifylline （oral tablets） 400 mg twice daily for 6 to 7 weeks C: Blank control for 6 to 7 weeks	①②③ ④⑧
KHURANA, et al., 2013^［15］	RCT	India	Hematological cancer	24/24/24	24/24	a+b+d	a+d	T: Vitamin E （prepared by using the same vehicle as the control group） 200 mg daily for a week C: Vehicle （glycerine plus water in a 1∶1 ratio） for a week	①②③④
LI, et al., 2007^［16］	RCT	China	Nasopharyngeal cancer	30/30	30/30	a+b+h+i	a	T: Vitamin E one tablet daily + compound vitamin B two tablets 3 times a day + Gene time spray 2 to 4 times a day C: Routine oral care	①②③
LIN, 2005^［17］	RCT	China	General cancer	80/80	80/80	a+b	a+k	T: Using a sterile needle to puncture the ulcer， and applying a cotton swab dipped in vitamin E to the affected area after meals or before bedtime C: Rinsing the mouth with 2% boric acid solution for 5 to 10 minutes 3 to 6 times a day	①④
FERREIRA, et al., 2004^［18］	RCT	Brazil	Head and neck cancer	28/26	167/161	a+b	a+g	T: Vitamin E （oral capsule） 400 mg from the first to the last day of radiotherapy C: Placebo （oral Efamol Pure Evening Primrose Oil） 500 mg from the first to the last day of radiotherapy	①③④⑤⑥⑦
ZHU, et al.,1994^［19］	RCT	China	General cancer	14/14	18/21	a+b	a+f+j	T: Vitamin E （topically） 10 mg twice daily for a week C: Vitamin B2 （orally） 10 mg 3 times a day for a week	③
WADLEIGH, et al., 1992^［7］	RCT	USA	General cancer	9/9	9/9	a+b	a+g	T: Vitamin E （topically） 400 mg twice daily for 5 d C: Placebo （coconut and soybean oil containing less than 1 mg of vitamin E） twice daily for 5 d	①③⑨

Study （year）	Study design	Country	Population	No. of patients （T/C）	Extracted data （T/C）	Intervention		Intervention Content	Outcome
Study （year）	Study design	Country	Population	No. of patients （T/C）	Extracted data （T/C）	T	C	Intervention Content	Outcome
SAYED, et al.,2020^［14］	RCT	Egypt	Head and neck cancer	30/30	22/25	a+b+c	a	T: Vitamin E （oral soft gelatin capsules） 1 000 mg once daily + pentoxifylline （oral tablets） 400 mg twice daily for 6 to 7 weeks C: Blank control for 6 to 7 weeks	①②③ ④⑧
KHURANA, et al., 2013^［15］	RCT	India	Hematological cancer	24/24/24	24/24	a+b+d	a+d	T: Vitamin E （prepared by using the same vehicle as the control group） 200 mg daily for a week C: Vehicle （glycerine plus water in a 1∶1 ratio） for a week	①②③④
LI, et al., 2007^［16］	RCT	China	Nasopharyngeal cancer	30/30	30/30	a+b+h+i	a	T: Vitamin E one tablet daily + compound vitamin B two tablets 3 times a day + Gene time spray 2 to 4 times a day C: Routine oral care	①②③
LIN, 2005^［17］	RCT	China	General cancer	80/80	80/80	a+b	a+k	T: Using a sterile needle to puncture the ulcer， and applying a cotton swab dipped in vitamin E to the affected area after meals or before bedtime C: Rinsing the mouth with 2% boric acid solution for 5 to 10 minutes 3 to 6 times a day	①④
FERREIRA, et al., 2004^［18］	RCT	Brazil	Head and neck cancer	28/26	167/161	a+b	a+g	T: Vitamin E （oral capsule） 400 mg from the first to the last day of radiotherapy C: Placebo （oral Efamol Pure Evening Primrose Oil） 500 mg from the first to the last day of radiotherapy	①③④⑤⑥⑦
ZHU, et al.,1994^［19］	RCT	China	General cancer	14/14	18/21	a+b	a+f+j	T: Vitamin E （topically） 10 mg twice daily for a week C: Vitamin B2 （orally） 10 mg 3 times a day for a week	③
WADLEIGH, et al., 1992^［7］	RCT	USA	General cancer	9/9	9/9	a+b	a+g	T: Vitamin E （topically） 400 mg twice daily for 5 d C: Placebo （coconut and soybean oil containing less than 1 mg of vitamin E） twice daily for 5 d	①③⑨

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维生素E对放疗或化疗导致的口腔黏膜炎有效性的meta分析

Effectiveness of vitamin E on oral mucositis caused by radiotherapy and chemotherapy: a meta-analysis

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