摘要
【目的】探讨局部注射曲安奈德及卡介菌多糖核酸（BCC-PSN）治疗口腔扁平苔藓的可行性和安全性。【方法】选择口腔扁平苔藓患者268例，按数字随机法分为观察组（n=134）和对照组（n=134）。观察组根据病理检查结果分为A组（糜烂型，n=66）和B组（非糜烂型，n=68）两个亚组，对照组则分为C组（糜烂型，n=65）和D组（非糜烂型，n=69）两个亚组。对照组在病损基底部注射曲安奈德40mg和2％利多卡因2mL治疗。观察组在对照组的基础上在病损基底部注射BCG-PSN1mL治疗。统计分析两组疗效、治疗前后血清炎症因子水平、复发及不良反应发生情况。【结果】A组和B组疗效显效率和总有效率均高于C组和D组，差异均有统计学意义（均P〈0．05）。A组和B组、C组和D组治疗效果比较差异均无统计学意义（均P〉0．05）。A组和B组、C组和D组治疗前后血清IL-6和TNF-α等炎症因子水平比较差异无统计学意义（P〉0．05）。与A组和B组比较，C组治疗1周、3周和6周的血清炎症因子水平均较高，D组同期血清炎症因子水平亦均较高（P〈0．05）。A组治疗后1个月、3个月、6个月复发率均低于C组；B组治疗后1个月、3个月、6个月复发率均低于D组（P〈0．05）。【结论】局部注射曲安奈德及BCG-PSN治疗口腔扁平苔藓疗效显著，可有效抗炎并预防术后复发，其对非糜烂型口腔扁平苔藓复发的预防效果更佳，且不增加不良反应，具有良好的可行性和安全性。
[Objective] To explore the therapeutic efficacy of local injection of triamcinolone acetonide injection, BCG poly- saccharide and nucleic acid injection for oral lichen planus. [Methods] A total of 268 patients with oral lichen planus confirmed by pathological examination were randomly divided into observation （ n = 134） and control （ n = 134） groups by number random method. Observation group were divided into subgroup A （erosion type, n =66） and subgroup B （non-erosion type, n = 68） according to the results of pathological examination. And control group were also divided into subgroups C （erosion type, n =65） and D （non-erosion type, n =69） according to the results of pathological examination. The control group received 40 mg triamcinolone acetonide and 2 mL 2% lidocaine injection in lesion base. On the basis of control group, observation group had 1 mL BCG polysaccharide and nucleic acid injection in lesion base. The efficacies, serum levels of inflammatory factors, recurrence and occurrence of adverse reactions of two groups were statistically analyzed. [Results] The rates of efficacy and total efficacy were 58.21% and 58.21% in observation group versus 40.30% and 84.33% in control group （ P 〈0.05）. Therapeutic efficacy and adverse reactions of groups A and B and groups C and D had no significant statistical differences （ P 〉0.05）. The serum levels of interleukin-6 （IL-6）, tumor necrosis factor-alpha （TNF-α） and other inflammatory factor levels before and after treatment of group A and group B and serum IL-6 and TNF-α and other inflammatory factor levels before and after treatment of group C and group D had no statistical significant difference （ P 〉0.05）. Compared with group A and group B, serum levels of group C were higher after treatment with 1 week, 3 weeks and 6 weeks. And the serum level of group D were also higher during the same period （ P 〈0.05）. Recurrence rates 1 month, 3 months, 6 months after treatment of group A were lower than those. And recurrence rates 1 month, 3 months, 6 months after treatment in group B were also lower than those in group D （ P 〈0.05）. [Conclusion] Local injection of triamcinolone acetonide, BCG polysaccharide and nucleic acid injection is markedly efficacious for oral lichen planus. And it can effectively anti-inflammatory, prevent postoperative recurrence without a higher incidence of adverse reactions. It is recommended for patients without erosive oral lichen planus.
出处
《医学临床研究》
CAS
2015年第7期1264-1267,共4页
Journal of Clinical Research
基金
佛山市卫生局医学科研课题（2013027）
