中药控制扁平苔藓患者白色念珠菌检出率及分离株毒力的临床研究

Clinical research on the traditional Chinese medicine effect for control the prevalence of candida albicans and toxiticy of isolated strain in OLP patients

目的:阐明口腔扁平苔藓(oral lichen planus,OLP)与白色念珠菌(candida albicans,CA)关系的同时,研究自制中药含漱液在控制OLP患者CA检出率的作用,及对CA分离株毒力的控制。方法:选取糜烂型OLP患者、非糜烂型OLP患者及健康对照组各100例。用药前和用药7天后分别采用浓缩含漱液沙堡平皿培养法,并结合应用芽管试验、厚膜孢子形成试验及温度试验常规培养等方法分离、鉴定各组中念珠菌菌种。将分离、纯化的CA,接种于血琼脂平板上,厌氧培养,检测其溶血活性。结果:用药前糜烂型OLP患者念珠菌培养阳性率和阳性样本的菌落数显著高于非糜烂型OLP患者和对照组(均为P<0.01);3组之间CA检出率比较,糜烂型OLP(66%)显著高于非糜烂型OLP(26%)和健康对照组(12%)(P<0.01)。采用两种不同药物含漱7天后,CA检出率显著降低,中药组较口泰组减少更为显著,差异有统计学意义(P<0.01);用药前所有CA在接种于血琼脂平板培养48 h后均产生了溶血,用药后溶血活性均显著降低,中药组较口泰组降低更为显著(P<0.01)。结论:糜烂型OLP真菌培养阳性率较高,菌落数也较多,尤其是致病性CA分离阳性率高,提示OLP糜烂型的发生发展与CA感染有关。中药能有效控制OLP患者CA检出率,减少OLP患者口腔内CA含量,并能抑制CA毒力,提示中药含漱液对OLP患者有一定的抗真菌治疗作用。

Objective：In order to identify the relationship between oral lichen planus （OLP） and eandida albicans （CA）,the effects of home-made Chinese-medicine solutions on controlling the prevalence of CA in patients with OLP,and the toxicity of CA isolates were studied. Methods：In our research,3 groups were as follows：patients with erosive OLP,patients with non,erosive OLP and healthy control,and each group bad 100 cases. Before and after administration,concentrated rinse culture was used by Sabouraud plate, and combined with germ tube test, chlamydospore formation test and temperature test in order to isolate and identify the type of candida. The separated and purified CA was inoculated on blood agar and cultured in anaerobic environment,and was its hemolytic activity detected. Results：Before the treatment,the prevalence of candida and colony forming unit （CFU） in erosive OLP group （66%）were significantly higher than that in non-erosive OLP group （26%） and control group （12%） （P 〈 0.01）;after using traditional Chinese medicine （TCM） solution on chlorhexidine solution,for 7 days the prevalence of CA significantly decreased,and there was more significant decreased in the group using TCM solution than that in the group using chlorhexidine solution （P 〈 0.01 ）. Before the treatment, hemolysis was detected in all the CA cultured plate after 48 hours, and the hemolysis activity significantly decreased after the use of solution. And the decrease was more significant in the group using TCM solution than that in the group using chlorhexidine solution （P 〈 0.01 ）. Conclusion：The prevalence of candida and CFU were significant in the group with erosive OLP,especially the prevalence of pathogenic CA. It indicates the occurrence and development of erosive OLP are associated with the infection of CA, and the TCM can reduce the prevalence of CA in OLP patients and the amount of CA in oral cavity of OLP patients and inhibit the toxicity of CA. The TCM solution may have anti-fungal activity in OLP patients.