清利湿热方联合曲安奈德对口腔扁平苔藓患者血清炎症因子及sIL-2R水平的影响分析

Effect of Clearing Heat and Removing Dampness Recipe Combined with Triamcinolone Acetonide on Serum Inflammatory Factors and Sil-2R Levels for Patients with Oral Lichen Planus

目的:观察清利湿热方联合曲安奈德对口腔扁平苔藓(OLP)患者血清炎症因子及可溶性白细胞介素2受体(sIL-2R)水平的影响。方法:选择2013年5月~2015年5月医院收治的74例OLP患者作为研究对象,按随机数字表法分为对照组与观察组各37例,对照组采用曲安奈德治疗,于病灶黏膜基底部注射曲安奈德10mg+2%利多卡因2.5 mL,1次/周;观察组加用清利湿热方治疗,日1剂,分早晚2次口服,疗程为8周,比较两组治疗效果及治疗前后中医症候积分的变化,测定两组治疗前后血清白介素-2(IL-2)、白介素-4(IL-4)、白介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)及sIL-2R水平的变化,统计两组治疗不良反应发生率。结果:观察组治疗总有效率为94.59%,明显高于对照组的72.97%(P<0.05);治疗前,两组各中医症候积分比较差异无统计学意义(P>0.05),治疗后,两组客观体征(黏膜糜烂、红斑水肿、充血)、主观症状(局部疼痛、胸胁闷胀、胃脘嘈杂)等积分均降低(P<0.05),观察组上述积分均低于对照组(P<0.05);治疗前,两组IL-2、IL-4、IL-8、TNF-α及sIL-2R水平比较差异无统计学意义(P>0.05),治疗后,两组上述指标均降低,观察组降低幅度高于对照组(P<0.05);两组治疗不良反应发生率比较差异无统计学意义(P>0.05)。结论:清利湿热方联合曲安奈德治疗OLP效果肯定,可改善患者中医症候及体征,下调血清炎症因子水平及sIL-2R水平,且安全性肯定。

Objective: To investigate the effect of Clearing Heat and Removing Dampness Recipe combined with Triamcinolone Acetonide on serum inflammatory factors and soluble interleukin 2recepter ( sIL-2R) levels for patients with oral lichen planus (OLP). Methods: 74patients with OLP who were admitted to the hospital from May 2013to May 2015were selected as the subjects. They were divided into controlled group and observation group by the random number table method with 37cases in each group. The controlled group was treated with triamcinolone Acetonide,and the mucosal basal part of lesions was injected with triamcinolone Acetonide 10mg+2% Lidocaine 2. 5ml,once per week. The observation group was additionally treated with Clearing Heat and Removing Dampness Recipe,a dose daily,2times of oral administration in the morning and evening,and the course of treatment was 8weeks. Therapeutic effects and changes of TCM syndrome scores before and after treatment in the two groups were compared. Changes in levels of serum interleukin-2 ( IL-2),interleukin-4 ( IL-4),interleukin-8 ( IL-8),tumor necrosis factor alpha ( TNF-α) and sIL-2R in the two groups before and after treatment were determined. The incidence rate of adverse reactions in the two groups was statistically analyzed. Results: The total effective rate in the observation group was significantly higher than that in the controlled group ( 94. 59% vs 72. 97%)( P<0. 05). Before treatment,there was no statistical difference between the two groups in TCM syndrome scores ( P>0. 05). After treatment,scores of objective signs ( mucosal erosion,erythema,edema,hyperemia) and subjective symptoms ( local pain,chest and rib-side stuffiness,epigastric noisy) in the two groups were decreased ( P<0. 05),and the scores of the observation group were lower than those of the controlled group ( P<0. 05). Before treatment,there was no significant difference in levels of IL-2,IL-4,IL-8,TNF-α or sIL-2R between the two groups ( P >0. 05). After treatment,the above indexes in the two groups were decreased,and the decrease in the observation group was greater than that in the controlled group ( P<0. 05). There was no significant difference in the incidence of adverse reactions between the two groups ( P>0. 05). Conclusion: Clearing Heat and Removing Dampness Recipe combined with Triamcinolone Acetonide is effective in the treatment of OLP. It can improve TCM symptoms and signs,decrease levels of serum inflammatory factors and sIL-2R,with safety.