双地苔藓饮加减治疗口腔扁平苔藓的疗效观察

Clinical Efficacy of Modified Shuangdi Taixian Decoction on Oral Lichen Planus

目的观察双地苔藓饮加减治疗口腔扁平苔藓(Oral lichen planus,OLP)的临床疗效。方法选取2018年6月—2019年8月期间商丘市中医院口腔科收治的84例OLP患者,分为对照组和观察组,每组各42例。对照组常规西药治疗,观察组给予双地苔藓饮加减治疗。治疗3个月后,观察比较两组患者的中医证候积分、口腔健康程度评定量表(Oral health impact profile,OHIP-14)评分、血液学指标[血清白细胞介素-12(IL-12)、可溶性白细胞介素2受体(Soluble interleukin 2 receptor,sIL-2R)]、OLP症状面积、疼痛视觉模拟评分(Visual analogue scale,VAS),以及两组患者不良反应与复发情况。结果治疗后观察组有效率为92.86%(39/42),明显高于对照组76.19%(32/42),差异有统计学意义(P<0.05)。治疗后两组患者中医证候积分、OHIP-14评分、血清IL-12水平、sIL-2R水平、OLP症状面积、VAS评分均较治疗前降低,差异有统计学意义(P<0.05);且观察组中医证候积分、OHIP-14评分、血清IL-12水平、sIL-2R水平、OLP症状面积、VAS评分均明显低于对照组,差异有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05);随访1年后,观察组复发率为4.76%明显低于对照组21.43%,差异有统计学意义(P<0.05)。结论双地苔藓饮加减治疗OLP,疗效良好,能改善中医证候与口腔黏膜环境,炎症反应少,复发率低。

Objective To observe the clinical efficacy of modified Shuangdi Taixian Decoction on oral lichen planus(OLP).Methods Eighty-four OLP patients admitted to the stomatology department of Shangqiu City Hospital of Traditional Chinese Medicine from June 2018 to August 2019 were enrolled and divided into a control group(n=42,routine western medicine)and an observation group(n=42,modified Shuangdi Taixian Decoction).After treatment for 3 months,the scores of traditional Chinese medicine(TCM)syndromes and oral health impact profile(OHIP)-14,serum levels of IL-12 and soluble interleukin 2 receptor(sIL-2R),area of OLP symptom,and score of visual analogue scale(VAS)of the two groups were compared.Adverse reactions and recurrences in both groups were recorded.Results After treatment,the response rate of the observation group was higher than that of the control group[92.86%(39/42)vs 76.19%(32/42),P<0.05].After treatment,scores of TCM syndromes and OHIP-14,serum levels of IL-12 and sIL-2R,areas of OLP symptom,and VAS scores were lower than those before treatment in both groups(P<0.05),and the above indicators in the observation group were lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).After 1 year of follow-up,the recurrence rate of theobservation group was lower than that of the control group(4.76%vs 21.43%,P<0.05).Conclusion The modified Shuangdi Taixian Decoction is effective in treating OLP.It can improve TCM syndromes and oral mucosal environment,with few inflammatory reactions and low recurrence rate.