口腔黏膜下纤维性变病损黏膜下曲安奈德联合丹参酮液注射方法及疗效探讨  

Methods and effects of injection of salvianolic acid B combined with triamcinolone acetonide in the treatment of oral submucous fibrosis

作　　者：肖益彩[1] 翦新春[2,3] 郑廉[2] 周超[2] 杜永秀[3] 周婷[3] 王彬娉[3] 

机构地区：[1]中南大学湘雅三医院肿瘤科,湖南长沙410013 [2]中南大学湘雅医院口腔医学中心口腔颌面外科,中南大学口腔癌前病变研究所,湖南长沙410008 [3]中南大学湘雅医学院附属海口医院口腔医学中心口腔黏膜病科,海南海口570208

出　　处：《上海口腔医学》2017年第2期188-192,共5页Shanghai Journal of Stomatology

基　　金：国家自然科学基金(81041052,30572044)

摘　　要：目的 :评价曲安奈德联合丹参酮注射液口腔黏膜病变下注射治疗口腔黏膜下纤维性变的方法和效果。方法 :对127例口腔黏膜下纤维性变患者,采用曲安德奈联合丹参酮注射液行双侧颊黏膜病变下局部注射。每周注射1次,每10次为1个疗程,每注射10次后间隔30 d,然后进行第2个疗程10次,间隔30 d,再进行第3个疗程的治疗,共注射30次。对临床疗程完成后12、24和36个月的开口度及双侧颊黏膜由灰白变红色面积进行评估,应用SPSS21.0软件包对数据进行统计学处理。结果:114例患者完成治疗全过程的疗效观察。早期组治疗3 a后获净开口度(12.0±1.2)mm,中期组治疗3 a后获净开口度(14.5±2.4)mm,后期组治疗3 a后获净开口度(15.5±1.5)mm。颊黏膜的颜色和血管数量增多的程度,早期组在治疗追踪的第3年结束时,19例患者毛细血管数量增多程度的有效率为100%,中期组为94.7%,后期组为90.7%。结论:曲安德奈联合丹参酮注射液注射治疗口腔黏膜下纤维性变,对患者开口度、病变黏膜颜色及毛细血管数量的恢复有良好效果。PURPOSE： To introduce the methods of triamcinolone acetonide（TA） and salvianolic acid B（SA-B）intralesional injection in the treatment of oral submucous fibrosis and evaluate the treatment effects. METHODS： TA combined with SA-B were consecutively applied intralesionally 1 time weekly for 30 times. The technique of intralesional injection was that syringe needle be emptied into submucous tissues 1 cm posterior to the corner of oral cavity running from the front to retromolar area by pushing the injection, then the syringe needle retained to the original point and upward from the front to retromolar area by pushing the injection, finally the syringe needle returned to the starting point and downward from the front to retromolar area by pushing the injection. Mouth opening, the color change of the buccal mucosa and the increase of capillary vessels as determined by degree I-IV visual analog scale were evaluated at 12, 24,and 36 month. The data were analyzed with SPSS 21.0 software package. RESULTS： One hundred and fourteen subjects fulfilled the study without obvious adverse reactions. After treatment for 36 months, the net gain in mouth opening of the early stage group,middle stage group and advanced stage group was（12.0 ±1.2） mm,（14.5 ±2.4） mm and（15.5 ±1.5） mm,respectively. The response rate of color change of the buccal mucosa and the increase of capillary vessels in early stage group, middle stage group and advanced stage group after treatment for 36 months was 100%, 94.7% and 90.7%,respectively. CONCLUSIONS： Triamcinolone acetonide and salvianolic acid B intralesional injection is effective in the treatment of oral submucous fibrosis.

关 键 词：口腔黏膜病 口腔黏膜下纤维性变 曲安奈德 丹参酮 

分 类 号：R781.5[医药卫生—口腔医学]