丹参注射液联合曲安奈德局部注射治疗OSF的疗效及对血清TGF-β1、IL-6的影响

Clinical efficacy of Danshen injection in combined with local injection of triamcinolone acetonide in the treatment of OSF and the effect on serum TGF-β1 and IL-6

目的:探讨丹参注射液联合曲安奈德局部注射治疗口腔黏膜下纤维性变(OSF)临床疗效及对血清转化生长因子-β1(TGF-β1)、白细胞介素-6(IL-6)的影响。方法:选取2015年10月~2016年10月收治的OSF患者70例为研究对象,随机分为观察组和对照组,对照组于口腔黏膜病变区域基底部多点注射曲安奈德注射液40mg/次,观察组在对照组基础上联合丹参注射液4mL/次口腔黏膜病变区域基底部多点注射,2组均1次/周,共12次。2组治疗前后采用疼痛视觉模拟评分(VAS评分)进行评价,并测量口腔黏膜病损面积及张口度;采集2组治疗前后清晨空腹外周静脉血,血液流变仪测定全血黏度[高切(HS)、中切(MS)、低切(LS)]、血浆黏度(PV)、纤维蛋白原(FIB),采用ELISA法测定血清TGF-β1、IL-6水平。结果:观察组VAS评分明显降低,黏膜病损面积明显小于对照组,张口度明显大于对照组;观察组治疗后LS、MS、PV、FIB明显较治疗前降低,而对照组治疗后LS、MS、HS、PV、FIB无明显变化;观察组治疗后TGF-β1、IL-6水平明显低于对照组。结论:丹参注射液联合曲安奈德局部注射可有效降低OSF患者血清TGF-β1、IL-6水平,抑制结缔组织纤维化,改善疼痛、口腔黏膜病损面积及张口度,临床效果满意。

Objective： To explore the clinical efficacy of Danshen injection in combined with local injection of triamcinolone acetonide in the treatment of oral submucous fibrosis （OSF） and the effect on serum TGF-β1 and IL-6.Methods： A total of 70 patients with OSF who were admitted in our hospital from October, 2015 to October, 2016 were included in the study and randomized into the observation group and the control group.The patients in the control group were given multipoint injection of triamcinolone acetonide （40 mg/time） in the basal region of oral mucosal regions.On this basis, the patients in the observation group were given additional Danshen injection （4 mL/time）, 1 time/week, for 12 times.VAS was used for evaluation.The oral mucosa lesion area and mouth opening were measured.The morning fasting peripheral venous blood before and after treatment in the two groups was collected.The blood rheometer was used to detect the whole blood viscosity [high shear （HS）, moderate shear （MS）, and low shear （LS）], plasma viscosity （PV）, and fibrinogen （FIB）.ELISA was used to detect the serum TGF-β1 and IL-6 levels.Results： VAS score in the observation group was significantly reduced （P〈0.05）, mucosal lesion area was significantly less than that in the control group （P〈0.05）, and mouth opening was significantly greater than that in the control group （P〈0.05）.LS, MS, PV, and FIB after treatment in the observation group were significantly reduced when compared with before treatment （P〈0.05）, while LS, MS, HS, PV, and FIB after treatment in the control group were not significantly changed （P〉0.05）.TGF-β1 and IL-6 levels after treatment in the observation group were significantly lower than those in the control group （P〈0.05）.Conclusions： Danshen injection in combined with local injection of triamcinolone acetonide in the treatment of OSF can effectively reduce the serum TGF-β1 and IL-6 levels, inhibit the connective tissue fibrosis, and improve the pain, oral mucosal lesion area, and mouth opening, with a satisfactory clinical effect.