半导体激光联合局部注射糖皮质激素治疗糜烂型口腔扁平苔藓患者的短期疗效及其机制  

Short-term efficacy and mechanism of semiconductor laser combined with local injection of glucocorticoids in treatment of erosive oral lichen planus

作　　者：孙银银 刘思宇 徐晓雨 卢恕来[3] SUN Yinyin;LIU Siyu;XU Xiaoyu;LU Shulai(Department of Stomatology,Qingdao Jimo District People’s Hospital,Qingdao 266299,China)

机构地区：[1]青岛市即墨区人民医院口腔内科,山东青岛266299 [2]大连医科大学口腔医学院 [3]青岛市市立医院口腔医学中心

出　　处：《精准医学杂志》2025年第2期108-111,共4页Journal of Precision Medicine

基　　金：山东省中医药科技项目(面上项目)(M-2023242)。

摘　　要：目的观察半导体激光联合局部注射糖皮质激素治疗糜烂型口腔扁平苔藓(erosive oral lichen planus,EOLP)患者的短期疗效及其对唾液中白细胞介素-18(IL-18)水平的影响。方法收集符合EOLP临床和病理诊断标准的EOLP患者90例,随机分为A、B、C三组,每组各30例,A组患者采用糖皮质激素药物进行治疗,B组患者采用半导体激光进行治疗,C组患者采用半导体激光联合糖皮质激素药物进行治疗。分别于治疗前和治疗4周时检测所有患者唾液中IL-18水平;分别于治疗前、治疗2周和治疗4周时评价患者病损区域基底部病损面积和疼痛程度,在治疗4周时评价患者临床疗效。结果三组患者治疗4周时与治疗前比较唾液中IL-18水平显著降低(F=90.456~697.671,P<0.05);治疗4周时,C组患者唾液中IL-18水平较A、B组显著降低(F=25.803,P<0.05)。与治疗前比较,三组患者治疗2周和4周时病损面积均显著减小(F=-104.445~54.096,P<0.05)。治疗2、4周时与治疗前比较、治疗4周时与治疗2周时比较,三组患者的VAS评分均显著降低(F=2.546~4.665,P<0.05)。治疗4周时,A、C组患者的临床疗效显著优于B组(H=7.561、23.262,P<0.05),B、C组患者比较差异无显著性(P>0.05)。结论半导体激光联合糖皮质激素治疗EOLP优于单一治疗方案,短期内即可明显改善患者临床症状,其治疗机制可能与降低唾液中炎症因子IL-18水平有关。Objective To investigate the short-term efficacy of semiconductor laser combined with local injection of glucocorticoids in the treatment of erosive oral lichen planus(EOLP)and its effect on the level of interleukin-18(IL-18)in saliva.[WTHX]Methods A total of 90 patients who met the clinical and pathological diagnostic criteria for EOLP were randomly divided into groups A,B,and C,with 30 patients in each group.The patients in group A were treated with glucocorticoids,those in group B were treated with semiconductor laser,and those in group C were treated with semiconductor laser combined with glucocorticoids.The level of IL-18 in saliva was measured for all patients before treatment and at week 4 of treatment;the area of lesion and the degree of pain at the base of the lesion area were measured before treatment and at weeks 2 and 4 of treatment;clinical outcome was assessed at week 4 of treatment.Results After 4 weeks of treatment,all three groups had a significant reduction in the level of IL-18 in saliva(F=90.456-697.671,P<0.05),and group C had a significantly lower level of IL-18 in saliva than groups A and B(F=25.803,P<0.05).At weeks 2 and 4 of treatment,all three groups had a significant reduction in the area of lesion(F=-104.445-54.096,P<0.05).All three groups had a significant reduction in VAS score from before treatment to weeks 2 and 4 of treatment and from week 2 to week 4 of treatment(F=2.546-4.665,P<0.05).At week 4 of treatment,groups A and C had a significantly better clinical outcome than group B(H=7.561,23.262,P<0.05),and there was no significant difference between groups B and C(P>0.05).Conclusion Semiconductor laser combined with glucocorticoid therapy has a better clinical effect than each therapy alone in the treatment of EOLP,and it can significantly improve clinical symptoms within a short period of time,possibly by reducing the level of the inflammatory factor IL-18 in saliva.

关 键 词：扁平苔癣 口腔 激光 半导体 糖皮质激素类 白细胞介素18 治疗结果 

分 类 号：R781.5[医药卫生—口腔医学]