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第六届世界口腔医学研讨会:药物性唾液腺功能障碍的系统评价:患病率、诊断和治疗

World Workshop on Oral Medicine VI: a systematic review of medication-induced salivary gland dysfunction: prevalence, diagnosis, and treatment.

作者信息

Villa Alessandro, Wolff Andy, Aframian Doron, Vissink Arjan, Ekström Jörgen, Proctor Gordon, McGowan Richard, Narayana Nagamani, Aliko Ardita, Sia Ying Wai, Joshi Revan Kumar, Jensen Siri Beier, Kerr Alexander Ross, Dawes Colin, Pedersen Anne Marie Lynge

机构信息

Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, USA.

出版信息

Clin Oral Investig. 2015 Sep;19(7):1563-80. doi: 10.1007/s00784-015-1488-2. Epub 2015 May 22.

Abstract

OBJECTIVES

Medication-induced salivary gland dysfunction (MISGD) causes significant morbidity resulting in decreased quality of life. This systematic review assessed the literature on the prevalence, diagnosis, treatment, and prevention of MISGD.

MATERIALS AND METHODS

Electronic databases were searched for articles related to MISGD through June 2013. Four independent reviewers extracted information regarding study design, study population, interventions, outcomes, and conclusions for each article. Only papers with acceptable degree of relevance, quality of methodology, and strength of evidence were retained for further analysis.

RESULTS

There were limited data on the epidemiology of MISGD. Furthermore, various methods were used to assess salivary flow rate or xerostomia. Preventive and therapeutic strategies included substitution of medications, oral, or systemic therapy with sialogogues, use of saliva substitutes or of electro-stimulating devices. Although there are promising approaches to improve salivary gland function, most studies are characterized by small numbers and heterogeneous methods.

CONCLUSIONS

Physicians and dentists should identify the medications associated with xerostomia and salivary gland dysfunction through a thorough medical history. Preferably, health care providers should measure the unstimulated and stimulated whole salivary flow rates of all their patients so that these values can be used as a baseline to rate the complaints of patients who subsequently claim to experience xerostomia or salivary gland dysfunction as well as the possibilities of effectively treating this condition.

CLINICAL RELEVANCE

MISGD remains a major burden for the population. This systematic review provides a contemporary in-depth description of the diagnosis and treatment of MISGD.

摘要

目的

药物性唾液腺功能障碍(MISGD)会导致严重的发病率,进而降低生活质量。本系统评价评估了关于MISGD的患病率、诊断、治疗及预防的文献。

材料与方法

检索电子数据库,查找截至2013年6月与MISGD相关的文章。四位独立评审员提取了每篇文章有关研究设计、研究人群、干预措施、结果及结论的信息。仅保留相关性、方法学质量及证据强度可接受的论文用于进一步分析。

结果

关于MISGD流行病学的数据有限。此外,评估唾液流速或口干症使用了多种方法。预防和治疗策略包括更换药物、使用催涎剂进行口服或全身治疗、使用唾液替代品或电刺激装置。尽管有改善唾液腺功能的有前景的方法,但大多数研究的特点是样本量小且方法各异。

结论

医生和牙医应通过详尽的病史识别与口干症和唾液腺功能障碍相关的药物。最好,医疗服务提供者应测量所有患者的非刺激性和刺激性全唾液流速,以便这些值可作为基线,用于评估随后声称有口干症或唾液腺功能障碍的患者的主诉以及有效治疗这种情况的可能性。

临床意义

MISGD仍然是人群的主要负担。本系统评价对MISGD的诊断和治疗进行了当代深入描述。

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