Background

Burning mouth syndrome is a chronic idiopathic intractable intraoral dysaesthesia that remains a challenge to clinicians due to its poorly understood pathogenesis and inconsistent response to various treatments.

Aim

This review aimed to study the short- (≤3 months) and long-term (>3 months) effectiveness and sustainable benefit of different burning mouth syndrome treatment strategies and the associated side effects.

Materials and methods

Randomised controlled trials of burning mouth syndrome treatment compared with placebo or other interventions with a minimum follow up of 2 months were searched from the PubMed, Embase and Cochrane database (published to July 2020).

Results

Twenty-two studies were selected based on the inclusion and exclusion criteria and analysed. Nine categories of burning mouth syndrome treatment were identified: Anticonvulsant and antidepressant agents, phytomedicine and alpha lipoic acid supplements, low-level laser therapy, saliva substitute, transcranial magnetic stimulation, and cognitive behaviour therapy. Cognitive behaviour therapy, topical capsaicin and clonazepam, and laser therapy demonstrated favourable outcome in both short- and long-term assessment. Phytomedicines reported a short-term benefit in pain score reduction. The pooled effect of alpha lipoic acid (ALA) pain score improvement was low, but its positive effects increased in long term assessment.

Conclusion

A more significant volume in terms of sample size, multi-centres, and multi-arm comparison of therapeutic agents with placebo and longitudinal follow-up studies is recommended to establish a standardised burning mouth syndrome treatment protocol. Further studies are required to assess the analgesic benefits of topical clonazepam and capsaicin, alternative medicines with neurodegenerative prevention capability and psychology support in treating burning mouth syndrome and reducing systemic adverse drug reactions.

Registration International Prospective Register of Systematic Reviews (PROSPERO):

Protocol ID - CRD42020160892.

中文翻译：

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灼口综合征患者治疗的系统评价

背景

灼口综合征是一种慢性特发性难治性口腔内感觉障碍，由于对其发病机制知之甚少，对各种治疗的反应不一致，这仍然是临床医生面临的挑战。

目的

本综述旨在研究不同灼口综合征治疗策略的短期（≤ 3 个月）和长期（> 3 个月）有效性和可持续益处以及相关副作用。

材料和方法

从 PubMed、Embase 和 Cochrane 数据库（发布至 2020 年 7 月）中检索了灼口综合征治疗与安慰剂或其他干预措施相比的随机对照试验，至少随访 2 个月。

结果

根据纳入和排除标准选择并分析了 22 项研究。确定了九类灼口综合征治疗方法：抗惊厥药和抗抑郁药、植物药和硫辛酸补充剂、低强度激光疗法、唾液替代品、经颅磁刺激和认知行为疗法。认知行为疗法、外用辣椒素和氯硝西泮以及激光疗法在短期和长期评估中均显示出良好的结果。Phytomedicines 报告了减少疼痛评分的短期益处。α-硫辛酸 (ALA) 疼痛评分改善的综合效应较低，但在长期评估中其积极效应增加。

结论

建议在样本量、多中心和多臂比较治疗药物与安慰剂和纵向随访研究方面进行更重要的研究，以建立标准化的灼口综合征治疗方案。需要进一步的研究来评估外用氯硝西泮和辣椒素、具有神经退行性预防能力和心理支持的替代药物在治疗灼口综合征和减少全身性药物不良反应方面的镇痛效果。

注册国际前瞻性系统评价注册 (PROSPERO)：

协议 ID - CRD42020160892。