解毒愈溃汤结合西医疗法治疗糜烂型口腔扁平苔藓40例  

Western Medicine Therapy in Treatment of Erosive Oral Lichen Planus and 40 Cases Combined with Jiedu Yukui Decoction

作　　者：王立新[1] 倪耀丰 李志华[1] 冯兴中[1] 李国菁[1] 

机构地区：[1]首都医科大学附属北京世纪坛医院,北京100038

出　　处：《中国实验方剂学杂志》2015年第2期200-203,共4页Chinese Journal of Experimental Traditional Medical Formulae

摘　　要：目的:探讨解毒愈溃汤联合西医常规疗法治疗糜烂型口腔扁平苔藓(OLP)的近期和远期疗效及对血清肿瘤坏死因子α(TNF-α)、白介素-2,4,10(IL-2,4,10)的影响。方法:将80例符合条件的患者随机按就诊前后分为对照组和中西医结合组各40例。对照组采用复方氯己定含漱液,3次/d,连续使用2周;醋酸曲安奈德1 m L+2%利多卡因2 m L,糜烂区黏膜下局部注射,连续使用4周;口服维生素A,C,连续服用12周。中西医结合组在对照组治疗的基础上加服解毒愈溃汤加减治疗,1剂/d,疗程12周。客观指标体征、主观症状和生活质量于治疗前及治疗后4周进行评价;血清TNF-α,IL-2,4,10水平在治疗前、后进行检测。结果:经Ridit分析,中西医结合组临床疗效优于对照组(P<0.05);治疗4周后两组客观指标征记分、疼痛评分及生活质量评分均较治疗前下降,中西医结合组下降更为显著(P<0.01);治疗后12周,中西医结合组TNF-α,IL-2,IL-4和IL-10水平均低于对照组(P<0.01);中西医结合组复发率为22.5%,低于对照组的45.0%(P<0.05)。结论:解毒愈溃汤配合西医常规疗法治疗糜烂型口腔扁平苔藓近期能减轻患者的症状、提高患者生活质量,提高临床疗效,远期能降低复发率。其作用可能通过调节T细胞介导的炎性反应来实现的。Objective：To discuss the curative efficacy of Jiedu Yukui decoction cooperated with conventional western medicine therapy in treating erosive oral lichen planus （OLP） and to investigate its influence on serous tumor necrosis factor-α （TNF-α）,and interleukin-2,4,10 （IL-2,4,10）.Method：Eighty eligible patients were randomly divided into control group （40 cases） and traditional Chinese combined western medicine group （40 cases） according to the order of being in hospital.Patients in control group received compound chlorhexidine gargle thrice daily for 2 weeks,1 mL triamcinolone acetonide combined with 2 mL 2％ lidocaine submucosally local injection for 4 weeks,and vitamin A,C orally for 12 weeks.Based on the treatment of control group,patients in traditional Chinese combined western medicine group added dialectical modified Jiedu Yukui decoction for 12 weeks.The objective index and signs,subjective symptoms and quality of life were evaluated before and after 4 weeks of treatment.The levels of TNF-α and IL-2,4,10 were detected before and after 12 weeks of treatment.Result：The clinical effect in traditional Chinese combined western medicine group was superior to that in control group （P ＜ 0.05）.After 4 weeks,scores of objective index and signs,subjective symptoms and quality of life were decreased,and the change was more obvious in traditional Chinese combined western medicine group as compared with before （P ＜ 0.01）.Levels of TNF-α and IL-2,4,10 in traditional Chinese combined western medicine group were less than those in control group after 12 weeks of treatment （P ＜ 0.01）.Recurrence rate was 22.5％ in traditional Chinese combined western medicine group,which was lower than 45％ in control group （P ＜0.05）.Conclusion：Jiedu Yukui decoction cooperated with conventional western medicine therapy could relieve the symptoms of patients,improve their quality of lives and clinical effect,and reduce the recurrence in treating erosive oral lichen planus.Its mechanism o

关 键 词：口腔扁平苔藓 糜烂型 解毒愈溃汤 免疫炎性反应 

分 类 号：R287[医药卫生—中药学]