甲壳质治疗糜烂型口腔扁平苔藓的临床应用研究

Treatment of erosive oral lichen planus with chitin

目的:将甲壳质医用敷料用于糜烂型口腔扁平苔藓(OLP)的局部治疗,同时分析糜烂愈合延迟的影响因素。方法:治疗组采用甲壳质贴敷于OLP糜烂面,3次/d×7 d。复诊未完全愈合者再用甲壳质7 d,然后评价2周疗效。对照组采用复方皮质散涂布于OLP糜烂面,3次/d。以上两组的全身治疗均采用抗生素和激素肌肉注射或口服3 d,随后口服氯喹片,0.125 g×2次/d。结果:治疗组糜烂面愈合率27.8%(5/18),对照组愈合率44.4%(16/36),两组愈合率无显著性差异(P>0.05);此外,愈合延迟组的平均年龄(59.5±12.0岁)比愈合组(45.8±12.2岁)大(P<0.01),愈合延迟组的平均糜烂面积(146.1±172.6 mm2)比愈合组(51.5±71.9 mm2)小(P<0.05)。结论:甲壳质医用敷料治疗糜烂型OLP无效,可能与口腔环境湿润、甲壳质不易粘附于糜烂面等方面的原因有关。而OLP糜烂愈合延迟与患者年龄大和糜烂面积小有关,提示老年OLP患者糜烂边缘的基底细胞增殖不活跃,不能为迁移的基底细胞提供新的来源。

Objective：To provide effective solution to accelerate healing of erosive oral lichen planus （OLP）, the present study applied chitin to treat erosive OLP and analyzed the factors that leaded to healing retard. Method：The patients assigned to test group were treated with chitin, three times daily for 7 days, and the patients of control group were treated with compound power of adrenocorticoids. If the erosive lesions of both the two groups had not healed after 7 days, the patients were given the same medicaments for another 7 days respectively. At the same time, antibiotic and adrenocorticolds were injected and taken orally in both groups for three days, and then taken cholroquinine tablets orally with the dose of 0.125 g two times daily. Result： The healing rate d test group was 27.8% （5/18） compared with the control group 44.4 % （16/36）. There was no difference between above two groups （P〉0.05 ）. In addition, the average age of patients with erosion healing retard was elder than healing group （P〈0.01）, and the average area of patients with erosion healing retard was smaller than healing group（P〈0.01）. Conclusion： Medical dressing of chitin is of no effect on erosive OLP because of the moist environment in mouth, moreover, this kind of dressing is difficult to cling to the surface of oral mucosa. The fact that the healing retard of erosive OLP is related to elder people and smaller erosive area suggest that the basal cells of erosive lesion of aged patients proliferate inactively.