羟氯喹联合糖皮质激素治疗口腔扁平苔藓的有效性评价:一项探索性研究

Dose-depandant effect in treating oral lichen planus with hydroxychloroquine plus glucocorticoid:a pilot study

目的:评价短期口服羟氯喹和糖皮质激素治疗口腔扁平苔藓(oral lichen planus,OLP)临床疗效。方法:71例OLP患者被随机分为A、B、C 3组,分别接受不同剂量的羟氯喹(hydroxychloroquine,HCQ)联合糖皮质激素或单独使用HCQ治疗1个月。记录研究开始时(基线)和治疗1个月后的临床损害评分(REU评分),并分析各组之间疗效差异及治疗有效率。结果:A组(HCQ 400 mg/d+糖皮质激素8 mg/d)治疗前REU评分(8.56±6.34),治疗后为(4.64±3.37)(P<0.05);B组(HCQ 200 mg/d+糖皮质激素4 mg/d)治疗前REU评分(6.00±3.40),治疗后为(4.35±2.77)(P<0.05);而C组(HCQ 200 mg/d)治疗前REU评分(5.67±3.60),治疗后为(4.33±2.56)(P>0.05)。A组REU降低幅度显著大于B组、C组(P<0.05)。整个治疗过程中均未记录到明显的不良反应。结论:羟氯喹联合糖皮质激素治疗OLP有短期疗效,且可能存在剂量依赖性。单独使用羟氯喹在短期内对治疗OLP可能没有明显效果。

Objective:To evaluate the clinical efficacy of short-term oral hydroxychloroquine and glucocorticoid in patients with oral lichen planus(OLP).Methods:Seventy-one patients with OLP were randomized to group A,B and C,received different doses of hydroxychloroquine(HCQ)plus glucocorticoid or HCQ alone for one month.Clinical lesion score(REU score)was recorded at the beginning of the study(baseline)and one month later.Compare the difference of efficacy and the effective rate among the groups.Results:The REU score of group A was(8.56±6.34)before treatment and(4.64±3.37)after treatment(P<0.05).The REU score of group B was(6.00±3.40)before treatment and(4.35±2.77)after treatment(P<0.05).However,the REU score of group C was(5.67±3.60)before treatment and(4.33±2.56)after treatment(P>0.05).The reduction of REU in group A was significantly higher than group B and group C(P<0.05).No significant adverse reactions were recorded throughout the treatment.Conclusion:Hydroxychloroquine plus glucocorticoids could improve the therapeutic effect of OLP in a short term and probably had a dose-dependent.Hydroxychloroquine alone may have no obvious effective in treating OLP in a short term.