半导体激光与他克莫司治疗糜烂型口腔扁平苔藓疗效比较研究

Comparison of diode laser and tacrolimus in the treatment of erosive-atrophic oral lichen planus

目的评价810 nm半导体激光与他克莫司软膏治疗糜烂型口腔扁平苔藓(oral lichen planus,OLP)的疗效。方法选择2016年1—12月中国医科大学口腔医学院急诊·黏膜病科收治患者中符合糜烂型OLP诊断标准的患者60例,随机分为试验组与对照组,每组30例。试验组应用波长为810 nm的半导体激光进行局部照射治疗,对照组应用他克莫司软膏进行局部涂擦治疗,两组患者分别治疗2个月,并在第3及第6个月进行随访。根据中华口腔医学会口腔黏膜病专业委员会的"OLP(萎缩型、糜烂型)疗效评价标准(试行)"进行疗效评价。结果治疗结束后两组患者病损面积、症状和体征得分均减小,总有效率差异无统计学意义(P>0.05);第3和第6个月随访时,激光治疗组的复发率低于他克莫司组,两组比较差异有统计学意义(P<0.05);他克莫司组9例患者出现不良反应,激光治疗组未发现有不良反应患者。结论半导体激光与他克莫司治疗糜烂型OLP即刻疗效无差异;与他克莫司相比,半导体激光治疗能更长时间地控制OLP,抑制复发,具有较好的疗效,且无不良反应,值得临床推广使用。

Objective To evaluate the efficacy between low-level diode laser of 810 nm and topical tacrolimus in the treatment of erosive-atrophic oral lichen planus （OLP）. Methods A total of 60 erosive-atrophic OLP patients were randomly divided into experimental and control groups, with 30 cases in each group. Experimental group received 810 nm diode laser as local irradiation therapy;the control group received drug treatmemt with tacrolimus gel （0.1%）. Evaluations were performed once a month during treatment and at the 3rd month and the 6th month. Results Sign score, pain score , and lesion severity were reduced in both groups. No significant differences were found between the two groups. But in the follow-up period after treatment, the recurrence rate of the experimental group was significantly lower than the control group （P 〈 0.05）. Meanwhile, nine patients of the control group reported side effects after the first one week of drug application. No side effects were found in the experimental group. Conclusion Diode laser treatment is as effective as topical tacrolimus therapy without any adverse effects in the treatment of erosive -atrophic OLP. Diode laser therapy can reduce recurrence and its post efficacy is superior to tacrolimus. Diode laser therapy can be a promising alternative therapy in the treatment of erosive -atrophic OLP.