曲安奈德联合硫酸羟氯喹、西吡氯铵治疗口腔扁平苔藓的临床效果观察  

Clinical effect observation of triamcinolone acetonide combined with hydroxychloroquine sulfate and ciprofloxacin in the treatment of oral lichen planus

作　　者：马晓君 刘梦娟 路静文 MA Xiao-jun;LIU Meng-juan;LU Jing-wen(Department of Stomatology,Suzhou Hospital of Traditional Chinese Medicine,Suzhou Anhui 234000,China)

机构地区：[1]宿州市中医医院口腔科,安徽宿州234000

出　　处：《临床和实验医学杂志》2025年第6期656-660,共5页Journal of Clinical and Experimental Medicine

基　　金：2021年度安徽省卫生健康委科研项目(编号:AHWJ2021a004)。

摘　　要：目的观察曲安奈德联合硫酸羟氯喹、西吡氯铵治疗口腔扁平苔藓(OLP)的临床效果。方法前瞻性选取2021年2月至2024年2月宿州市中医医院收治的90例OLP患者作为研究对象,采用掷硬币法将其分为对照组和综合组,每组各45例。对照组采用硫酸羟氯喹、西吡氯铵治疗,综合组在对照组基础上给予曲安奈德治疗,两组均连续治疗28 d。比较两组治疗前、治疗28 d后的唾液酸碱度、唾液流、炎症因子[唾液白细胞介素(IL)-8、IL-17、肿瘤坏死因子-α(TNF-α)]水平、唾液念珠菌的检出率、病损面积、疼痛情况[视觉模拟评分法(VAS)评分]、口腔健康状况[口腔健康影响程度量表(OHIP)-14评分]差异,统计两组的不良反应发生情况。结果治疗前、治疗28 d后,两组患者唾液酸碱度、唾液流率比较,差异均无统计学意义(P>0.05)。治疗28 d后,两组唾液IL-8、IL-17、TNF-α水平均较治疗前下降,且综合组的唾液IL-8、IL-17、TNF-α水平分别为(32.23±6.17)ng/L、(3.77±1.22)pg/mL、(20.53±4.17)ng/L,均低于对照组[(40.15±8.06)ng/L、(4.65±1.41)pg/mL、(25.83±4.45)ng/L],差异均有统计学意义(P<0.05)。治疗28 d后,两组唾液念珠菌的检出率均较治疗前下降,差异均有统计学意义(P<0.05),但两组组间唾液念珠菌的检出率比较,差异无统计学意义(P>0.05)。治疗28 d后,两组病损面积、VAS评分、OHIP-14评分均较治疗前下降,且综合组的病损面积、VAS评分、OHIP-14评分分别为(10.08±2.18)mm^(2)、(2.61±0.88)分、(23.00±4.21)分,均低于对照组[(14.11±3.53)mm^(2)、(3.26±1.04)分、(27.41±5.03)分],差异均有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论曲安奈德联合硫酸羟氯喹、西吡氯铵治疗OLP可抑制炎症因子的表达,减轻患者疼痛,并改善患者口腔健康状况,安全性较好。Objective To observe the clinical effect of triamcinolone acetonide combined with hydroxychloroquine sulfate and ciprofloxacin in the treatment of oral lichen planus(OLP).Methods A total of 90 patients with OLP admitted to Suzhou Hospital of Traditional Chinese Medicine from February 2021 to February 2024 were prospectively selected as the research objects.They were divided into the control group and the comprehensive group by coin tossing method,with 45 cases in each group.The control group was treated with hydroxychloroquine sulfate and ciprofloxacin,and the comprehensive group was treated with triamcinolone acetonide on the basis of the control group.Both groups were treatment continuously for 28 d.The differences in salivary pH,salivary flow,inflammatory factors[salivary interleukin(IL)-8,IL-17,tumor necrosis factor-α(TNF-α)]levels,detection rate of salivary Candida,lesion area,pain[visual analogue scale(VAS)score]and oral health status[oral health impact profile(OHIP)-14 score]were compared between the two groups before treatment and after 28 days of treatment.The occurrence of adverse reactions of the two groups were counted.Results Before treatment and after 28 days of treatment,there were no statistically significant differences in salivary pH and salivary flow rate between the two groups(P>0.05).After 28 days of treatment,the levels of salivary IL-8,IL-17 and TNF-α in the two groups were lower than those before treatment,and the levels of salivary IL-8,IL-17 and TNF-α in the comprehensive group were(32.23±6.17)ng/L,(3.77±1.22)pg/mL,(20.53±4.17)ng/L,respectively,which were lower than those in the control group[(40.15±8.06)ng/L,(4.65±1.41)pg/mL,(25.83±4.45)ng/L],the differences were statistically significant(P<0.05).After 28 days of treatment,the detection rate of salivary Candida in the two groups was lower than that before treatment,and the differences were statistically significant(P<0.05);but there was no statistically significant difference in the detection rate of salivary Candida between t

关 键 词：扁平苔藓 口腔 曲安奈德 疼痛 硫酸羟氯喹 西吡氯铵 炎症因子 

分 类 号：R781.5[医药卫生—口腔医学]