A Comparison of Traditional Chinese Medicine and Multiple Conventional Therapy in Treating Oral Lichen Planus: A Network Meta-analysis.

Purpose: To evaluate and compare the efficacy of seven conventional treatments and traditional Chinese medicine (TCM) combined therapies for oral lichen planus.

Materials and methods: This study employs PubMed, Web of Science, Cochrane Library, and Cnki to collect studies. After evaluating the quality and bias risk, RevMan 5.4.1 and R Gemtc package was utilised with a visual analogue scale and side effects as outcomes, to compare the efficacy of the seven treatments.

Results: This study included 20 studies, with a sample size of 1669. Our results suggest that photodynamic therapy and TCM demonstrate the most significant decrease in visual analogue scale and the rank is as follows: photodynamic therapy > TCM > TCM combined with non-hormonal immunosuppressive drugs > TCM combined with glucocorticoids > chloroquine combined with glucocorticoids > non-hormonal immunosuppressive drugs > glucocorticoids. Among them, compared to glucocorticoids, photodynamic therapy (-1.55, 95% CI: (-3.09, -0.02)), TCM (-1.25, 95% CI: (-2.46, -0.06)) significantly outperform in statistics. Moreover, no side effects were reported by the photodynamic therapy treatment. In the comparison with non-hormonal immunosuppressive drugs, the result indicates TCM (-4.17, 95% CI (-8.24, -0.34)), glucocorticoids (-2.78, 95% CI (-5.69, -0.17)) and their combination (-2.83, 95% CI (-5.93, -0.05)) have a significantly lower probability of the appearance of side effects.

Conclusion: This study indicates that TCM, from the perspectives of efficacy and the likelihood of side effects, outperforms all other common therapies, besides photodynamic therapy, in treating oral lichen planus.