中西医免疫治疗口腔扁平苔藓的临床对比研究

A clinical comparative study on immune treatment of oral lichen planus by integrated traditional Chinese and western medicine

目的:观察中西医和临床免疫治疗口腔扁平苔藓的疗效。方法:125例口腔扁平苔藓患者随机分为4组,第1组(治疗对照组)(32例):VitC、VitBco治疗。第2组(31例):单纯西药治疗。第3组(31例):中医治疗。第4组(31例):中西医结合临床免疫治疗。8周后观察近期疗效,1年后观察远期疗效,并测定治疗前后IL-8、TNF-a、IL-6水平,观察患者免疫功能变化情况。并观察各组治疗期间不良反应。结果:近期疗效:第4组显效率为84.4%,总有效率为96.88%,第4组、第3组、第2组与第1组比较P<0.0l,第4组与第2组、第3组比较P<0.0l,第2组与第3组比较P﹥0.05。远期疗效:第4组显效率为78.1%,总有效率为93.75%;第4组、第3组、第2组与第1组比较P<0.0l,第4组与第2组、第3组比较P<0.0l,第2组与第3组比较P﹥0.05。与正常对照组比较,4个组的IL-8、TNF-a、IL-6均升高(P<0.01),第4组治疗后IL-8较治疗前明显降低(P<0.01),TNF-a、IL-6治疗后较治疗前降低(P<0.05)。第2组、第3组治疗后IL-8、TNF-a、IL-6较治疗前降低(P<0.05),第1组治疗后IL-8、TNF-a、IL-6与治疗前比较P﹥0.05。第4组与第2组、第3组治疗后II-8比较P<0.01,TNF-a、lI-6比较P<0.05。结论:中西医临床免疫治疗口腔扁平苔藓疗效高、疗程短、复发率低、无明显不良反应,能快速有效地改善口腔扁平苔藓患者免疫功能,值得临床广泛应用。

To observe the clinical efficacy of integrated traditional China and western medicine in the immune treatment of oral lichen planus（OLP） and the effectiveness of this method on iraproving immune state of patients with OLP. Methods：A total of 125 patients with OLP were randomly divided into four groups： treatment group （group 1, 31cases） which was treated with VitminC.VitminBco; group 2 （31 cases）, treated with western medicine alone; group 3 （31 cases）, treated with traditional Chinese medicine; group 4 （31 cases） treated with integrated traditional China and western medicine. All patients were treated for 8 weeks, and longterm efficacy was observed 1 year later. IL-8, TNF-a and IL-6 levels were examined before and after the treatment to observe the changes of immune state and side effects. Results：Shortterm effect, group 4 showed obvious effective rate of 84.4% ,and total effective rate of 96.88%, significant different from group 2 and 3 （P〈0.01）. Obvious effective rate and total effective rate of group 2, 3, and 4 were all significant different from that of group I（P〈0.01）. Long term efficiency. group 4 showed obvious effective rate of 78.1% ,and total effective rate of 93.75%, significant different from group 2 and 3 （P〈0.01）. Obvious effective rate and total effective rate of group 2, 3, and 4 were all significant different from that of group 1（P〈0.01）. But no significant difference was observed between group 2 and 3 （P〈0.05）. Comparing with the normal control group, IL-8, TNF-a,IL-6 all in creased in all groups （P〈0.01）, but group 4 showed significantly decreased IL-8 level （P〈0.01）, and TNF-a,IL-6 （P〈0.05）. In group 1, IL-8.TNF-a.IL-6 levels were not significant different before and after treatment （P〈0. 05） for group 4, 3 and 2, changes in II-8 （P〈0. 01） TNF-a.II-6 （P〈0. 05） was significant after treatment. Conclusions：With shorter treatment course, and less side effects, the integrated traditional China and western medicine is more effective on OLP, it can effectively improve imnmne state of patients with OLP and is worth for application in large scale.