来氟米特和糖皮质激素治疗糜烂型口腔扁平苔藓的临床疗效比较

Comparison of the clinical efficacies of leflunomide with glucocorticoid on patients with oral lichen planus

目的:比较来氟米特和糖皮质激素治疗糜烂型口腔扁平苔藓(erosive oral lichen planus,eOLP)的临床疗效,为临床治疗eOLP提供一种新的激素替代疗法。方法:49例OLP患者,随机分成来氟米特治疗组(25例)和糖皮质激素治疗组(24例),按相同评估标准评定临床疗效,结果进行统计分析。结果:(1)治疗4周后两组比较,两组的总有效率差异无统计学意义(P=56.84);(2)治疗4周期间,来氟米特治疗组疼痛指数为5.32±2.55;糖皮质激素治疗组疼痛指数为5.42±2.48,两组疼痛指数比较差异无统计学意义(P>0.05)。(3)两组用药后不良反应:来氟米特治疗组3例出现了皮肤瘙痒,5例头晕乏力症状,后自行逐步消失;糖皮质激素治疗组有7例口腔黏膜麻木不适感,15例出现食欲增加、体重增加等症状。结论:来氟米特具有和糖皮质激素等同的治疗OLP疗效,可作为治疗OLP的新手段。

Objective To compare the clinical effectiveness of leflunomide with glucocorticoid on patients with erosive oral lichen planus（eOLP）. Methods 49 patients with eOLP were randomly divided into 2 groups. 25 cases in group A were treated with leflunomide, while 24 cases in group B were treated with prednisone. All cases were evaluated with the same standard,which was recommended by the National Academic Committee of Oral Medicine. Results After 4 weeks of treatment, the total effective rate of the two groups were 92.0% in group A and 91.7% in group B （P = 56.84）, respectively. During the process of treatment, the VAS index in group A was 5.32± 2.55 and that in group B was 5.42 ± 2.48（P 〉 0.05）. 3 cases with cutaneous pruritus and 5 cases with dizziness and debilitation were found in group A, while 7 cases with oral mueosal numbness and 15 cases with appetite and body mass increase were found in group B. Conclusions The overall clinical efficacy of leflunomide is equal to glucocorticoid, prednisone, which is the aherative therapeutic measure for eOLP.