Topical Chinese herbal compound in the treatment of oral candidiasis: A systematic review and meta-analysis of randomized controlled trials

OBJECTIVE: A meta-analysis was performed to systematically review the clinical efficacy of external traditional Chinese medicine compounds in the treatment of oral candidiasis to provide a reference for the clinical treatment of this disease. METHODS: We systematically searched relevant Chinese and English databases, including the Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Chinese Scientific Journal Database, Wanfang Database, PubMed, Web of Science, the Cochrane Library and Scopus, from inception to September 2022 to identify all clinical randomized controlled studies of oral candidiasis treated with external Chinese medicine compounds. The inclusion criteria were a randomized controlled study of an experimental group with the intervention of an external traditional Chinese medicine compound, and the results of the literature were clear. Duplicate publications, literature on single or proprietary Chinese medicine treatment, literature from which relevant data could not be extracted and studies without rigorous experimental designs were excluded. Two researchers independently screened relevant studies that met the inclusion and exclusion criteria and conducted quality evaluation and data extraction for the included studies. The total effective rate, Candida negative conversion rate and recurrence rate were statistically analysed by RevMan 5.3 software. RESULTS: This study included 29 studies and 30 studies, involving 2553 patients with oral candidiasis, with 1320 in the experimental group and 1233 in the control group. The total effective rate of the experimental group was better than that of the control group (RR = 1.21 [1.15, 1.27], P < 0.000). The negative rate of Candida in the experimental group was better than that in the control group (RR = 1.25 [1.05, 1.50], P=0.01). The recurrence rate of the experimental group was lower than that of the control group (RR = 0.34 [0.18, 0.63], P=0.0007). The difference was statistically significant. CONCLUSION: Compared with Western medicine alone, external traditional Chinese medicine in the treatment of oral candidiasis has certain advantages in improving the total effective rate, increasing the negative conversion rate of Candida and reducing the recurrence rate. However, larger samples and high-quality clinical studies are needed to obtain further support and verification.