丹参酮联合曲安奈德治疗口腔黏膜下纤维性变疗效评价

Clinical Evaluation on Tanshinone Combined with Triamcinolone Acetonide in the Treatment of Oral Submucous Fibrosis

目的探讨丹参酮联合曲安奈德治疗口腔黏膜下纤维性变(OSF)的临床疗效。方法选取医院2015年2月至2017年12月收治的OSF患者103例,按随机数学表法分为观察组(51例)和对照组(52例)。对照组予曲安奈德治疗,观察组在对照组基础上予丹参酮治疗,均治疗3个疗程,随访4个月。结果观察组总有效率为98.04%,明显高于对照组的86.54%(P<0.05);治疗后,两组患者的黏膜病损面积均明显小于治疗前,且观察组小于对照组(P<0.05);两组患者的最大张口度明显大于治疗前,且观察组大于对照组(P<0.05);两组患者转化生长因子-β1(TGF-β1)和白细胞介素6(IL-6)水平均明显低于治疗前,且观察组低于对照组(P<0.05);两组患者低切全血黏度(LS)、中切全血黏度(MS)、高切全血黏度(HS)、血浆黏度(PV)及纤维蛋白原(FIB)水平均明显低于治疗前,且观察组患者的LS,MS,PV及FIB水平均明显低于对照组(P<0.05),但两组HS水平相比无明显差异(P>0.05);两组患者视觉模拟评分(VAS)及口腔健康影响程度量表(OHIP-14)评分均明显低于治疗前,且观察组低于对照组(P<0.05)。结论丹参酮联合曲安奈德治疗OSF,疗效较好,可有效改善血液流变学及生化指标水平,并有利于提高患者的生活质量,值得推广。

Objective To investigate the clinical efficacy of tanshinone combined with triamcinolone acetonide in the treatment of oral submucosal fibrosis( OSF). Methods Totally 103 patients with OSF admitted to our hospital from February 2015 to December 2017 were selected and divided into the observation group( n = 51) and the control group( n = 52) according to the random number table method. The patients in the control group were treated with triamcinolone acetonide,on this basis,the patients in the observation group were treated with tanshinone. The patients in the two groups were treated for 3 courses and followed up for 4 months. Results The total effective rate of the observation group was 98. 04%,which was significantly higher than 86. 54% of the control group( P < 0. 05).After treatment,the mucosal lesion area in the two groups was significantly smaller than that before treatment,and that in the observation group was smaller than that in the control group( P < 0. 05). The maximal mouth opening in the two groups was significantly larger than those before treatment,and that in the observation group was larger than that in the control group( P < 0. 05). The levels of transforming growth factor-β1( TGF-β1) and interleukin-6( IL-6) in the two groups were significantly lower than those before treatment,and those in the observation group were lower than those in the control group( P < 0. 05). The low shear whole blood viscosity( LS),the medium shear whole blood viscosity( MS),the high shear whole blood viscosity( HS),plasma viscosity( PV) and fibrinogen( FIB) in the two groups were significantly lower than those before treatment( P < 0. 05),and the levels of LS,MS,PV and FIB in the observation group were significantly lower than those in the control group( P < 0. 05),but there was no significant difference in the level of HS between the two groups( P > 0. 05). The scores of Visual Analogue Scale( VAS) and Oral Health Impact Profile-14( OHIP-14) in the two groups were significantly lower than those before treatment,and those in the observation group were significantly lower than those in the control group( P < 0. 05). Conclusion Tanshinone combined with triamcinolone acetonide is effective in the treatment of patients with OSF,it can effectively improve the levels of hemorheology and blood biochemical indexes,and it is conducive to improving the quality of life of patients,which is worthy of promotion.