Abstract: Objective    To analyse the clinical efficacy of photodynamic therapy（PDT）in the treatment of oral lichen planus（OLP）. Methods    A computer search was conducted in the Cochrane Library，PubMed，Embase，CNKI，Wanfang database，and China Biomedical Literature Database to find prospective cohort studies and randomised controlled trials（RCTs）of PDT in the treatment of OLP；the retrieval time is from the database establishment to August 30，2022. Meta analysis was applied to analyse the efficacy of PDT with methylene blue（MB）and 5-aminolevulinic acid（5-ALA）as photosensitizers on OLP，and to compare the effect of PDT with that of steroid hormones in the treatment of OLP. Results    A total of 19 papers，including 11 prospective cohort studies and 8 RCTs，were included. Meta analysis revealed that the patients′ visual analogu scale（VAS）scores，Thongprasom sign scoring（TH），and lesion areas were all smaller in the patients after treatment with PDT，using MB as a photosensitising agent； the VAS scores and lesion areas of patients treated with PDT with 5-ALA as photosensitiser were also smaller than before treatment；there were statistically significant differences（all P < 0.05）. The results of subgroup analysis of the two groups showed that the VAS scores of patients treated with PDT with 5-ALA as photosensitiser were smaller than those treated with PDT with MB as photosensitiser，with statistically significant differences（SMD = 2.78，95%CI：1.70 -3.87，P = 0.003）. Analysis of eight RCTs found that the differences in patients′ VAS scores，TH scores，lesion area，and treatment efficacy after treatment were not statistically significant when PDT treatment was compared with steroid hormone treatment（all P > 0.05）. Conclusion    The efficacy of PDT in the treatment of OLP is reliable，and it can be used as a replacement and auxiliary therapy for hormones.

Key words: photodynamic therapy, oral lichen planus, Meta analysis, therapeutic effects

摘要： 目的    分析光动力疗法（photodynamic therapy，PDT）治疗口腔扁平苔藓（oral lichen planus，OLP）的临床效果。方法    计算机检索Cochrane Library、PubMed、Embase、中国知网（CNKI）、万方数据库及中国生物医学文献数据库，检索时间均从建库起至2022-08-30。查找PDT治疗OLP的前瞻性队列研究及随机对照试验（randomized controlled trial，RCT）。应用Meta分析以亚甲基蓝（methylene blue，MB）及5-氨基酮戊酸（5-aminolevulinic acid，5-ALA）为光敏剂的PDT对OLP疗效，并用PDT与皮质类固醇激素治疗OLP的效果进行比较。结果    共纳入19篇文献，包括11篇前瞻性队列研究及8篇RCT研究。Meta分析结果显示，经以MB为光敏剂的PDT治疗后患者视觉模拟量表（visual analogu scale，VAS）评分、体征评分（Thongprasom sign scoring，TH）、病损面积均小于治疗前，且经以5-ALA为光敏剂的PDT治疗后患者的VAS评分及病损面积也均小于治疗前，差异均有统计学意义（均P < 0.05）；且两者亚组分析结果表明，经以5-ALA为光敏剂的PDT治疗后患者VAS评分小于以MB为光敏剂的PDT，差异有统计学意义（SMD = 2.78，95%CI：1.70～3.87，P = 0.003）。分析8篇RCT研究发现，PDT治疗与皮质类固醇激素治疗相比，患者治疗后VAS评分、TH、病损面积及两者治疗有效率的差异均无统计学意义（均P > 0.05）。结论    PDT治疗OLP效果较佳，可作为激素的替代或辅助疗法。

关键词: 光动力疗法, 口腔扁平苔藓, Meta分析, 疗效