CLINICAL EFFICACY AND SAFETY OF HERBAL MEDICINE THERAPY IN RECURRENT APHTHOUS STOMATITIS: A SYSTEMATIC REVIEW

Novia Tri Hasanah,Wahyu Hidayat

doi:10.22159/ijap.2021.v13s4.43811

Abstract

Recurrent aphthous stomatitis is the most common oral mucous ulcerative lesion with challenging treatment. Herbal medicine therapy can propose clinical efficacy and safety due to its large biological activities. The objective was to review the clinical efficacy and safety of herbal medicine therapy in terms of ulcer size, pain score, healing duration, and adverse effects in recurrent aphthous stomatitis. A systematic was conducted based on the PRISMA statement. The search was performed using four electronic databases, namely PubMed, Cochrane, Science Direct, and Google Scholar for articles published from 2016 until 2021 using specific keywords. The search was limited to randomized controlled trials (RCTs), in English, full text, and study in humans. The main outcome is expected to be ulcer size, pain score, healing duration, and adverse effects. Quality assessment of selected articles was conducted using the Quality Appraisal of Randomized Trials Checklist (Cochrane Risk of Bias tool). The methodology quality of studies was evaluated using the Cochrane Handbook for Systematic Review of Interventions and Rev Man software. Five articles were eligible for analysis. The population of the sample study ranged from 34-70 patients of 15-65 y old. The herbs used were Aloe vera (Aloe barbadensis Miller), curcumin (Curcuma longa), licorice (Glycyrrhiza glabra), tobacco (Nicotiana tabacum L.), and pomegranate (Punica granatum Linn.). This review showed that there is some evidence of the clinical efficacy and safety of herbal medicine therapy in improved outcomes of recurrent aphthous stomatitis treatment with minimum adverse effects.

Highlights

Recurrent aphthous stomatitis (RAS) is the most common painful oral mucosal disease characterized by recurring ulcers confined to the oral mucosa in patients with no other signs of systemic disease [1, 2]
The search strategy performed a total of 9786 articles from electronic databases and one article from hand searching
According to the exclusion criteria, screening of the titles and abstracts resulted from the removal of 9750 articles

Summary

Introduction

Recurrent aphthous stomatitis (RAS) is the most common painful oral mucosal disease characterized by recurring ulcers confined to the oral mucosa in patients with no other signs of systemic disease [1, 2]. There is no specific etiology has been identified, so that the treatment of RAS is non-specific and symptom-based [5]. The goal is to decrease symptoms, reduce ulcer number and size, increase disease-free periods. The best treatment is that which will control ulcers for the longest period with minimal adverse side effects. The treatment approach should be determined by disease severity (pain), the patient’s medical history, the frequency of flare-ups, and the patient’s ability to tolerate the medication. In all patients with RAS, it is important to rule out predisposing factors and treat any such factors, where possible, before introducing more specific therapy [6, 7]

Methods

Results

Conclusion