关于实施居家病房的多种看法 关键信息 - 在发展居家病房服务时，重要的是为医护专业人员建立一个简单的流程来转诊患者。这包括制定明确的指南，规定服务的适用人群。 - 居家病房服务需要一支训练有素的员工队伍，他们应具备在家中提供安全有效、以患者为中心的护理服务的技能，并在员工、病人和护理人员之间进行清晰一致的沟通。 - 我们提出了一些问题，供医护专业人员和管理人员在引入新的居家病房服务或运行现有服务时使用。这些问题旨在帮助规划和实施居家病房服务，并提高员工、患者和护理人员的满意度和效果。 什么是居家病房？ 居家病房为原本需要住院治疗的患者提供医院级别的居家护理。其中一种居家病房是为了避免入院。这就是所谓的“避免入院居家病房”。对于病情通常需要在居家病房上接受治疗的患者，例如肺部疾病复发的患者，这些服务可以取代入院治疗。相反，医生可以将其评估为适合在自己家中（或其通常居住的地方，包括寄宿护理机构）接受治疗的患者转介到医院，接受一段时间的治疗。另一种叫做“提前出院居家病房”。这些服务缩短了住院患者的住院时间，例如在手术或疾病治疗后。患者通常在医院病床上接受医护人员的护理，而这些护理将在患者家中提供，预计不会影响护理质量。 我们想了解什么？ 我们的目的是了解在引入、运行和接受居家病房服务时，什么是最重要的。我们希望探究一系列有关避免入院和提前出院服务的经验和观点。其中可能包括管理人员在计划...

Wednesday, March 13, 2024

Wednesday, March 13, 2024

Tuesday, March 12, 2024

In this blog for colorectal surgeons and health professionals involved in stoma reversals, Dr Stina Öberg, Dr Siv Fonnes, and Professor Jacob Rosenberg from the Cochrane Colorectal Group discuss new practice-changing Cochrane evidence, showing that a simple change of suture technique likely results in a large reduction in surgical site infections in people undergoing stoma reversal.

Take-home points

• The stoma closure site can be considered a clean-contaminated wound, and many patients develop a surgical site infection after having a temporary ileostomy or colostomy reversed.
• Surgeons often use linear skin closure after stoma reversal. In theory, a clean-contaminated wound can benefit from drainage, which is achieved by using the purse-string skin closure technique.
• A new Cochrane Review has demonstrated that the purse-string skin closure technique likely results in a large reduction in surgical site infections after stoma reversal compared with linear skin closure.
• This simple and inexpensive change of practice may also improve patient satisfaction slightly. Even though the evidence is very uncertain, there seems to be no difference in incisional hernias.

Can surgeons improve their skin closure technique after stoma reversal? Yes - in a straightforward way! Researchers have found clinically important evidence in a new Cochrane review, showing that a simple change of suture technique likely results in a large reduction of surgical site infections in people undergoing stoma reversal. This blog presents the key results from this Cochrane review.

Skin closure after stoma reversal
Temporary stomas are created to protect distal bowel segments. At the time of stoma reversal, the last step is to close the skin. Due to the proximity to intestinal content, the stoma closure site should be considered a clean-contaminated wound. This could also explain why surgical site infections are common after stoma reversal, occurring in up to 40% of patients. When a wound is potentially contaminated, it will in theory benefit from free drainage.

Linear skin closure
Most surgeons use linear (transverse) skin closure despite the possible contamination of the wound at the stoma reversal site. Linear skin closure provides poor or no wound drainage and is theoretically a poor choice for a clean-contaminated wound. The stoma reversal wound is often close to a circular shape, and there is an alternative skin closure technique that at the same time provides drainage - the purse-string technique.

Purse-string skin closure
The purse-string skin closure technique can be used for circular or ellipse-formed wounds. The technique is performed by using intradermal sutures that are drawn together like an old-fashioned drawstring purse (see illustration at the top of the page), leaving a small opening in the centre. The theoretical advantage of using purse-string skin closure for a clean-contaminated wound is that it provides free drainage. This advantage could lower the risk of developing surgical site infections compared with linear skin closure. A lower surgical site infection risk could also result in a better cosmetic result, a higher patient satisfaction, and fewer incisional hernias.

What are the benefits of the purse-string skin closure?
In the Cochrane review comparing purse-string skin closure versus linear skin closure in people undergoing stoma reversal, surgical site infection was assessed in nine randomised controlled trials including almost 800 patients. The purse-string technique likely results in a large reduction in surgical site infections compared with linear skin closure. The anticipated risk within 30 days after linear closure was 243 surgical site infections per 1000 patients versus 52 (95% confidence interval 28 to 85) per 1000 patients after purse-string skin closure.

Purse-string closure may also have other advantages over linear closure. Patients who received the purse-string skin closure seemed to be slightly more satisfied six and twelve months after surgery: the anticipated effect in two randomised controlled trials was 885 satisfied or very satisfied patients per 1000 patients having linear skin closure versus 994 (95% confidence interval 894 to 1000) per 1000 patients having purse-string skin closure.

Finally, a reduced risk of surgical site infections could reduce the risk of incisional hernias. This outcome was reported by four randomised controlled trials with nearly 300 patients followed between three and twelve months, showing an anticipated risk of 55 incisional hernias per 1000 patients after linear skin closure versus 29 (95% confidence interval 4 to 177) per 1000 patients having purse-string skin closure. Even though the purse-string skin closure theoretically could lower the risk of incisional hernias, this was not shown, and there seems to be little to no difference in the risk of developing incisional hernias regardless of the skin closure technique used. However, the evidence is very uncertain, and further randomised controlled trials with longer follow-up might alter this result.

What are the benefits of linear skin closure?
The Cochrane review showed no advantage of using linear skin closure compared with purse-string skin closure in patients undergoing stoma reversal.

What are the risks of the purse-string skin closure?
The Cochrane review suggested that there was no evidence of an increased risk when patients received the purse-string technique compared with linear skin closure.

Pros and cons of purse-string versus linear skin closure
To summarise:

The benefits of using purse-string skin closure:

• likely results in a large reduction in surgical site infections
• may improve patient satisfaction slightly

The benefits of using linear skin closure:

• none found

There seems to be no evidence of a difference between purse-string and linear skin closure regarding:

• incisional hernia (but the evidence is very uncertain)
• operative time (but the evidence is very uncertain)
• length of hospital stay (but the certainty of evidence is unknown)
• anastomotic leak (but the certainty of evidence is unknown)
• intestinal obstruction (but the certainty of evidence is unknown)

Which skin closure technique is best to use after stoma reversal?
Purse-string skin closure both has the theory and the evidence to back up a lower risk of surgical site infections compared with linear skin closure, seemingly without any risks of complications. The result from this Cochrane review could make surgeons reconsider their skin closure method in patients undergoing stoma reversal. A change of practice from linear to purse-string skin closure is both straightforward and inexpensive.

Clinical reflections on the implications of the review
When asking Professor Jacob Rosenberg, the co-ordinating editor of the Cochrane Colorectal Group, about the clinical implications of this Cochrane Review, he stated that:

• This review clearly shows that a simple change in skin closure technique can have a large impact on patient outcome after stoma reversal.
• The purse-string skin closure technique for the stoma site is simple, effective, and seemingly without negative effects.
• These results have the potential to change clinical practice around the world.
• The recommendation to use the purse-string method for skin closure of stoma sites should be included in future clinical guidelines.

Read the full Cochrane Review and plain language summary in the Cochrane Library 

Listen to the lead author, Shahab Hajibandeh from Health Education and Improvement Wales, to tell us more about this review in three minutes

Hajibandeh S, Hajibandeh S, Maw A. Purse‐string skin closure versus linear skin closure in people undergoing stoma reversal. Cochrane Database of Systematic Reviews 2024, Issue 3. Art. No.: CD014763. DOI: 10.1002/14651858.CD014763.pub2. 

Image: The featured image at the top of the page was created by Malene Agnete Højland and Louise Rosengaard from the Cochrane Colorectal Group.

 

Tuesday, March 12, 2024

Tuesday, March 12, 2024

认知行为疗法加标准护理治疗首发和近期发病的精神病 关键信息 认知行为疗法（Cognitive behavioural therapy，CBT）可有效减轻精神分裂症的症状，并改善患者在初期的功能。 关于这一干预措施可能产生的不良影响的信息很少。 引言 精神分裂症是一种严重的精神障碍，因为其症状会对患者的日常生活造成严重影响。患有这种疾病的人很难区分自己的想法、信念和观念与现实之间的差异。例如，他们可能在自己脑中听到声音，但感觉就像真的有人在跟他们说话。疾病初期的治疗至关重要、以预防或减少慢性病程的风险。这一阶段通常被定义为 “首次发病”，“近期发病”一词也被用来描述首次发作病后的三至五年。 心理干预，如认知行为疗法，可以有效治疗一般精神分裂症患者的症状；目前尚不清楚这种干预是否对处于疾病初期阶段的患者也有帮助。 我们想知道什么？ 我们想知道认知行为疗法与标准疗法相结合对首次发病或近期发病的精神分裂症患者的治疗效果。 我们做了什么？ 我们检索了研究，这些研究对单独给予标准治疗或其它社会心理干预措施，与标准疗法（通常是药物）和认知行为疗法相结合进行了比较。 我们对研究结果进行了比较和总结，并对证据的可信度进行了评级。例如，研究中的某些因素（如受试者太少或结果不显著）会降低证据的可信度。 我们发现了什么？ 我们发现了28项研究，其中26项研究拥有2407名近期发病或首次发病精神分裂症受试...

比较造口复原术中两种伤口闭合方法：荷包缝合与线性缝合皮肤闭合术 关键信息 • 与线性缝合皮肤闭合术（LSC）相比，荷包缝合皮肤闭合术（PSSC）可能降低伤口感染的风险。 • 与接受LSC的患者相比，接受PSSC的患者可能对手术结果更满意。 造口复原术是什么意思？ 肠造口是通过手术在腹部表面创建的肠道开口。有临时造口的人将在初次手术（造口形成时）后的几个月进行造口复原。多达 40% 的造口复原患者会出现伤口感染，这主要是由于造口部位周围存在细菌。 有哪些技术可以关闭造口？ 复原造口的传统技术是线性皮肤闭合（LSC；直线闭合伤口），但该技术存在较高的伤口感染风险。另一种替代技术称为荷包缝合皮肤闭合（PSSC；一种连续缝合圆形造口伤口的技术，类似于用线缝合荷包袋的方式）。PSSC 在伤口中心留下一个小开口，允许污染物自由排出，从而可能降低伤口感染的风险。 我们想发现什么？ 我们想要了解 PSSC 技术是否比 LSC 技术更能改善以下方面： • 伤口感染的风险； • 患者满意度； • 切口疝（组织戳破手术伤口）风险；以及； • 手术时间。 我们做了什么？ 我们检索了对接受造口复原术的患者进行PSSC与LSC比较的研究。我们对研究结果进行了比较和总结，并根据研究方法和样本量等因素对证据的质量进行了评级。 我们发现了什么？ 我们发现了9项研究共涉及757名接受造口复原术的患者。 与 LSC ...

Monday, March 11, 2024

Cochrane marks the second anniversary of the commitment to Public Involvement in Health and Social Care Research, a pledge launched in March 2022. This commitment underscores Cochrane's ongoing efforts to enhance its practice of public involvement in health and social care research.

Cochrane is one of twenty-one organizations signed up to the pledge, including the UK’s National Institute for Health and Care Research (NIHR) and the Health Research Authority (HRA).

Richard Morley, Cochrane's Consumer Engagement Officer, reflects on this initiative: “Making a public commitment to involving the users of our evidence sets out our serious intent to build on our past achievements and deepen and broaden our work.”

A notable achievement is the establishment of the Co-Production Methods Group, launched in October 2023. Aligned with the ‘Putting People First’ commitment, this group will spearhead methods research, share resources for best practice, and supports learning and dissemination activities to help systematic review authors engage with and respond to the needs of consumers. 

To help people make sense of health evidence, Cochrane provides a free Evidence Essentials learning module. This free online resource offers an introduction to health evidence and how to use it to make informed health choices. The module has been co-produced by healthcare consumers, researchers and Cochrane's specialists, with contributions from a range of experts in their fields.

The Learning Live series builds on this, offering free webinars aimed at a range of audiences. Some webinars are aimed at Cochrane review authors, to help them make their research more widely accessible and understood. Others are aimed at helping people to engage with Cochrane research, such as webinars for teachers on using Cochrane Crowd in school projects. 

Looking ahead, Cochrane has a framework for consumer engagement and involvement that runs until 2027. This comprehensive approach revolves around five key elements. It emphasizes proactive engagement strategies, including communication, evidence dissemination, recruitment, and learning. Cochrane aims to elevate co-production by intensifying consumer involvement in the evidence production process, aligning reviews with user needs, and supporting consumer governance.

Prioritizing accessibility, the framework strives to enhance health literacy among healthcare consumers while making Cochrane's evidence more easily accessible. Strategic partnerships, particularly with patient groups, aim to enhance engagement, co-production, advocacy, and health literacy activities.

Finally, the framework incorporates an observatory to ensure evidence-based practices, monitor, and evaluate the impact of Cochrane's ongoing efforts in engagement and involvement.

• Learn more about Cochrane’s commitment to healthcare consumers
• Join Cochrane’s work as a patient, carer, or member of the public
• Email the Cochrane Consumers Network at consumers@cochrane.org 

 

Monday, March 11, 2024

Specifications: Permanent – Full Time
Salary:  £55,000 - £57,000 per Annum  
Location: Remote - Ideally based in the UK, Germany or Denmark. Candidates from the rest of the world will be considered; however, Cochrane’s Central Executive Team is only able to offer consultancy contracts outside these countries.
Closing date: 24 March 2024

Cochrane is an international charity. For 30 years we have responded to the challenge of making vast amounts of research evidence useful for informing decisions about health. We do this by synthesising research findings and our work has been recognised as the international gold standard for high quality, trusted information.

Cochrane's strength is in its collaborative, global community. We have 110,000+ members and supporters around the world. Though we are spread out across the globe, our shared passion for health evidence unites us. Our Central Executive Team supports this work and is divided into four directorates: Evidence Production and Methods, Publishing and Technology, Development, and Finance and Corporate Services.

The Executive Editor will be expected to prioritise and delegate editorial tasks as appropriate. The role holder will need to be an advocate for the Editorial Service internally and externally to Cochrane and remain alert to immediate demands of delivering high-quality review content for publication in a timely fashion.        

Don’t have every single qualification? We know that some people are less likely to apply for a job unless they are a perfect match. At Cochrane, we’re not looking for “perfect matches.” We’re looking to welcome people to our diverse, inclusive, and passionate workplace. So, if you’re excited about this role but don’t have every single qualification, we encourage you to apply anyway. Whether it’s this role or another one, you may be just the right candidate.

Our organization is built on four core values: Collaboration: Underpins everything we do, locally and globally. Relevant: The right evidence at the right time in the right format. Integrity: Independent and transparent. Quality: Reviewing and improving what we do, maintaining rigour and trust.  

You can expect:  

• An opportunity to truly impact health globally  
• A flexible work environment  
• A comprehensive onboarding experiences
• An environment where people feel welcome, heard, and included, regardless of their differences

Cochrane welcomes applications from a wide range of perspectives, experiences, locations and backgrounds; diversity, equity and inclusion are key to our values.

How to apply

• For further information on the role and how to apply, please click here
• The deadline to receive your application is 24th March 2024
• The supporting statement should indicate why you are applying for the post, and how far you meet the requirements, using specific examples.  Read our Recruitment Privacy Statement

Friday, March 8, 2024 Category: Jobs

Thursday, March 7, 2024

基于运动的心脏康复对于心力衰竭患者的益处和风险是什么？ 关键信息 - 与不运动相比，没有证据表明基于运动的心脏康复会改变心衰患者的全因死亡率。基于运动的心脏康复可能会降低心衰患者因任何原因入院和心衰相关入院的风险，并可能显著改善“明尼苏达心力衰竭患者生活质量”问卷评估的健康相关生活质量。 - 重要的是，本次更新的系统评价提供了额外的证据支持使用替代的基于运动的心脏康复的干预模式，包括基于家庭和数字支持的干预项目。 未来的研究应该招募在现有研究中代表性较低的群体，例如老年心衰患者、女性心衰患者，以及射血分数保留型心衰患者。 什么是心衰？ 心衰是指心脏无法正常地将血液泵送到全身各处的情况。心衰患者会感觉到疲劳和呼吸短促。心衰会导致患者的日常活动变得困难，并会影响患者生活质量。心衰患者的住院风险和死亡风险较高。 什么是心脏康复？ 心脏康复旨在帮助人们从心脏疾病（包括心衰）中恢复。心脏康复项目包括运动训练，还可能包括生活方式和危险因素管理相关的教育，以及咨询和心理支持。 我们想要发现什么？ 我们想知道与不运动相比，基于运动的康复是否能够更好地改善心衰患者的健康结局： - 死亡事件 - 再入院事件 - 健康相关的生活质量 我们做了什么？ 我们检索了评估基于运动的心脏康复对心衰患者干预效果的研究。我们比较和总结了相关研究的结果，并根据研究方法和规模等因素对证据的质量进行了评级。 我们发现了什...

Tuesday, March 5, 2024

Tuesday, March 5, 2024

“居家医疗”服务，旨在避免入院 本系统评价的目的是什么？ 本Cochrane系统评价的目的是探讨在避免入院的居家医疗环境中提供医疗保健是否能改善患者的健康结局并降低医疗服务成本。 关键信息 避免入院的居家医疗可能对死亡风险影响很小或没有影响；可能增加六个月随访时住在家里的机会；而且可能稍微便宜一点。 本系统评价研究了什么？ 对医院急症病床的需求仍然远远超过可用的床位数量。减少对医院床位依赖的一种方法是为人们在家中提供急症治疗，有时称为“避免入院的居家医疗”。相比之下，“早期出院的居家医疗”指的是患者提前出院回家接受治疗；这个主题已经单独进行了系统评价。 我们想发现什么？ 我们想要了解居家医疗是否对患者的健康结局和在家独立生活有所影响。我们还想知道它是否比住院治疗更便宜，以及它是否会影响住院治疗的时间和患者的满意度。 我们做了什么？ 我们检索了与急性健康事件相关的居家医疗与住院医疗相比的研究。我们比较和总结了研究结果，并根据研究方法和规模等因素对证据质量进行了评级。 我们发现了什么？ 我们找到了20项研究，包括四项新的研究，共包括3100名患有各种急性疾病患者。四项研究招募了患有慢性阻塞性（肺）疾病的受试者；两项研究招募了脑卒中恢复期的受试者；七项研究招募了患有（突发或短期）疾病的受试者，他们大多为老年人群；而其余的研究则招募了患有多种疾病的受试者。 与住院护理相比，为特定患者群提...

Cochrane's strength is in its collaborative, global community. Cochrane Geographic Groups represent Cochrane in their host country, advocate for the use of Cochrane evidence in health policy and practice, and support Cochrane's members and supporters who live there.  Here we look more closely at the impact of Cochrane Thailand, exploring its initiatives and contributions to advancing healthcare not only within Thailand but also across the Southeast Asian region.

Since its inception in 2002, initially as the Thai Cochrane Network before evolving into Cochrane Thailand in 2003, the group has been steadfast in its commitment to disseminating the fundamental concepts of research synthesis and championing the importance of evidence-based healthcare. Located at Khon Kaen University in Northeast Thailand, Cochrane Thailand shares information about Cochrane, translates Cochrane plain language summaries into Thai, and provides workshops about preparing Cochrane reviews and how to use the Cochrane related software. 

"We are dedicated to promoting the use of Cochrane evidence in healthcare decision-making, with a focus not only on local but also global impact," states Professor Pisake Lumbiganon, Convenor of Cochrane Thailand. "Our designation as the WHO Collaborating Centre for Research Synthesis in Reproductive Health in 2014 and as the WHO HRP Alliance Hub for research capacity strengthening for WHO/SEARO in 2017 underscores our commitment to driving change on a global scale. The reviews we contribute to have a far-reaching impact, with many being incorporated into WHO guidelines. Cochrane Thailand takes pride in its role in shaping healthcare practices both within Thailand and beyond." 

One of the group's primary objectives is to facilitate training workshops on Cochrane review preparation and the utilization of related software tools like RevMan and GRADE. These workshops have been instrumental in empowering healthcare researchers across Asia, fostering a community of those equipped with the necessary skills to conduct rigorous research synthesis.

In addition to training initiatives, Cochrane Thailand actively collaborates with various national and international organizations to generate evidence and inform healthcare policies and guidelines. Notably, the group has been invited to support WHO guideline development groups on critical health issues, contributing to the formulation of recommendations that impact healthcare practices globally. Another notable project was working with Cochrane Australia on the five-year 'South East Asia - Optimising Reproductive and Child Health in Developing Countries' project that helped to improve the clinical practice of treating pregnancy and childbirth-related disorders and enhance the health outcomes of mothers and infants in South East Asia. 

 

Cochrane Thailand has also been instrumental in translating Cochrane evidence into Thai, ensuring accessibility for Thai-speaking healthcare professionals, patients and families, and policymakers. With over 1,000 translated Cochrane reviews, the group has significantly enhanced the dissemination and utilization of evidence-based information in the region. "We believe that language should not be a barrier to accessing high-quality healthcare information. Our translation efforts aim to bridge this gap and empower healthcare stakeholders with valuable evidence. We are very proud and thankful to all our volunteer Thai translators who are helping make an impact," emphasizes Nampet Jampathong who helps coordinate the Thai translation.

Looking ahead, Cochrane Thailand is excited about being a Centre of Research Excellence for the project called Accelerating Research and Progress in maternal And Newborn health (ARPAN). This project will help to address the major gaps across the Asia-Pacific region to improve outcomes for women and newborns. 

Cochrane Thailand welcomes collaboration and support from individuals and organizations passionate about making a difference in healthcare. they are looking for funding opportunities to continue to expand their impact throughout South Asia.  Whether through training workshops, research collaborations, or translation efforts, Cochrane Thailand remains dedicated to its vision of enhancing healthcare practices and policies through rigorous research synthesis and evidence dissemination.

• Visit the Cochrane Thailand website
• Follow Cochrane Thailand on X
• View Cochrane Evidence in Thai
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Wednesday, March 13, 2024

为居住在老年照护机构的老年人提供医疗保健服务的替代方法 本综述的目的是什么？ 本Cochrane综述旨在确定为老年护理机构（Aged Care Facilities, ACF）的居民提供与常规治疗相同内容但以不同方式的照护（替代照护模式）是否在急诊科转运、非计划性住院、不良事件、遵循临床指南推荐照护、健康相关生活质量、死亡率和成本方面优于常规治疗。例如，相较于由个别执业医生提供照护（常规治疗），多学科团队（替代模式）是否是向ACF居民提供照护的一种更优方式？ 关键信息 与常规治疗相比，替代照护模式可能减少非计划性入院次数，但对于急诊科就诊次数和ACF居民健康相关生活质量影响很小或几乎没有影响，对死亡率影响也很小或几乎没有影响。我们不确定替代照护模式对不良事件（如跌倒、压力性损伤、感染）和遵循指南推荐照护的影响。重要的是，由于现有数据有限且存在矛盾，我们不确定替代照护模式是否具有成本效益。 各研究在描述干预特征、医疗环境和常规治疗时存在很大差异，这阻碍了本综述中的许多分析。未来的研究应详细描述其研究环境中干预措施和常规治疗的具体内容。 本综述研究了哪些内容？ 世界人口正在老龄化，全球居住式ACFs的人数正在增加。ACF居民通常是身体虚弱、有多种健康问题的老年人，他们需要特别医疗照护。当ACF无法提供充足的医疗保健时，居民往往被转到医院接受治疗。这种转移往往给ACF的居民及其家人带来...

Wednesday, February 28, 2024

口腔黏膜下纤维化治疗的干预措施 综述问题 哪些治疗方法可有效改善口腔黏膜下纤维化相关的症状？ 关键信息 -总体结果不一致，但表明使用抗氧化药物可能有助于治疗张口受限，并可能改善口腔黏膜下纤维化患者的口腔烧灼感。 什么是口腔黏膜下纤维化？ 口腔黏膜下纤维化是一种导致脸颊和嘴巴越来越紧绷的疾病。患有这种疾病的人通常会感到持续口腔灼痛。这些问题会使进食、说话和吞咽更加困难。已有许多药物被建议用于控制这种情况，这些药物可以口服（全身用药）、局部涂抹（局部用药）或直接注射到患处。除此，还可以进行不同形式的手术或物理治疗。 我们想知道什么？ 我们想知道哪些治疗方法对改善口腔黏膜下纤维化的症状有效，哪些治疗方法最有效。我们还想知道每种治疗的风险和副作用可能是什么，以及这些风险和副作用有多普遍。 我们做了什么？ 我们检索了医学和牙科期刊以及研究试验的数据库。我们只选择了被称为随机对照临床试验的研究。在这种类型的试验中，受试者被随机分配到组中。一组接受干预，另一组接受不同的治疗或根本不接受治疗。这些试验旨在降低在临床试验中引入偏倚的风险。 我们重点关注治疗效果如何，以便让口腔黏膜下纤维化患者恢复正常的饮食、咀嚼和说话。由于没有试验对这些指标进行研究，我们选择了张口度增加（以毫米为单位测量上下切牙之间的距离）和减少口腔烧灼感（以0到100的等级测量）作为最有可能改善口腔黏膜下纤维化患者生活质量的指标...