雷公藤多苷片联合曲安奈德治疗糜烂型口腔扁平苔藓近期疗效观察

Curative efficacy of tripterygium combined with triamcinolone acetonide in the treatment of oral lichen planus

目的研究雷公藤多苷片联合曲安奈德治疗糜烂型口腔扁平苔藓近期疗效。方法选择2015年9月至2017年3月在义乌市中心医院口腔科治疗的糜烂型口腔扁平苔藓患者124例为研究对象。采用随机数字表法分为两组，每组62例，对照组给予曲安奈德治疗，观察组给予曲安奈德联合雷公藤多苷片治疗，两组患者均治疗4周。观察两组临床疗效及不良反应，以及治疗前后体征、疼痛评分和血液流变学变化。结果治疗后，观察组总有效率（90．3％），明显高于对照组（75．8％），差异有统计学意义（χ2=4．643，P=0．031）；与治疗前相比，两组患者体征（t=14．046，P=0．000；t=34．585，P=0．000）、疼痛评分（t=31．165，P=0．000；t=49．270，P=0．000）均显著降低，且高切全血黏度、低切全血黏度、血浆黏度以及红细胞沉降率均较低；治疗后，观察组体征、疼痛评分以及高切全血黏度、低切全血黏度、血浆黏度以及红细胞沉降率均显著低于对照组（均P〈0．05）；两组治疗后总不良反应发生率比较差异元统计学意义（P〉0．05）。结论雷公藤多苷片联合曲安奈德治疗糜烂型口腔扁平苔藓可有效缓解患者临床症状，提高临床疗效，且安全性较好。

Objective To study the curative efficacy of tripterygium combined with triamcinolone acetonide in the treatment of oral lichen planus. Methods 124 patients with erosive oral lichen planus who were treated in Department of Stomatology of Yiwu Central Hospital from September 2015 to March 2017 were selected as the research subjects, and they were randomly divided into two groups according to the digital table,with 62 cases in cash group. The control group was treated with triamcinoione acetonide, while the observation group was treated with triamcinolone acetonide combined with tipterygium. Two groups were treated for 4 weeks. The clinical efficacy and adverse reactions were observed in the two groups after treatment, and the symptoms and changes of blood rheology were observed before and after treatment. Results After treatment, the total effective rate of observation group was statistically higher than that of the control group （90.3% vs. 75.8% , χ2 = 4. 643 ,P = 0.031 ）. Compared with before treatment, the signs （t = 14.046,P =0. ooo;t =34.585 ,P =0.000） ,pain score （t = 31. 165 ,P =0. 000;t =49. 270,P = 0. 000） of the two groups were significantly decreased, and the high shear whole blood viscosity, low shear whole blood viscosity, plasma viscosity and erythrocyte sedimentation rate were decreased. After treatment, the above indicators in the observation group were significantly lower than those in the control group （ all P 〈 0.05 ）. There was no statistically significant difference between the two groups in incidence rate of adverse reactions （P 〉 0. 05 ）. Conclusion Tripterygium combined with triamcinolone acetonide in the treatment of oral lichen planus can effectively alleviate the patients＇ clinical symptoms and blood rheology, significantly improve the clinical curative effect, and has good security.