低能量激光联合直流电离子导入曲安奈德治疗口腔黏膜下纤维性变的研究

The study of the effects of lower energy laser therapy combination with direct current iontophoresis of triamcinolone acetonide in treatment of oral submucous fibrosis

目的探讨低能量激光联合直流电离子导入曲安奈德治疗口腔黏膜下纤维性变(OSF)的疗效。方法选取2018年1月至2021年12月于南方医科大学口腔医学院附属郴州市第一人民医院三院区门诊就诊的78例OSF患者作为研究对象,根据不同治疗方案分为A组(n=40)与B组(n=38)。A组接受口腔病灶直流电离子导入曲安奈德(20mg/侧)前接受低能量激光病灶照射,B组使用低能量激光病灶不开机“照射”后再使用直流电药物离子导入曲安奈德(20mg/侧)。比较两组治疗前后上下颌前牙间最大开口度增加值、疼痛程度[视觉模拟评分法(VAS)]、治疗效果[口腔健康影响程度量表中文版(OHIP-14)]。结果两组进入试验时最大开口度比较差异无统计学意义;治疗第8、16周,A组开口度增加值高于B组,两组第16周开口度增加值小于第8周,差异有统计学意义(P<0.05)。治疗第1、8周,A组VAS评分均高于B组,且两组治疗第8周VAS评分低于治疗第1周,差异有统计学意义(P<0.05)。治疗16周,两组OHIP14评分均低于治疗前,且A组低于B组,差异有统计学意义(P<0.05)。结论低能量激光照射配合直流电离子导入能将曲安奈德导入黏膜下层发挥治疗效果,且治疗过程无明显疼痛感,对局部病灶无机械损伤,可作为治疗OSF的有效方法。

Objective To observe the effects of lower energy laser therapy combination with direct current iontophoresis of triamcinolone aceton-ide(DCI)in treatment of oral submucous fibrosis.Methods 79 patients with OSF treated in the outpatient department of the First People's Hospital of Chenzhou City,Stomatology College of the South Medical University from January 2018 to December 2021 were selected as the study subjects and they were divided into group A(n=40)and group B(n=38)according to different treatment regiments.The group A received low-energy laser fo-cus irradiation before direct current iontophoresis with triamcinolone acetonide(20 mg/side),the group B was irradiated with low energy laser with-out switching on and then treated with triamcinolone acetonide(20 mg/side).The maximum added value of maxillary anterior dental opening,pain degree(visual analogue scale[VAS])and therapeutic effect(oral health impact scale[OHIP-14])before and after treatment were compared between the two groups.Results There were no significant differences in the maximum opening degree between the two groups;at the 8th and 16th week of treatment,the increased value of maximum opening in the group A was higher than that in the group B,and the increased value of maximum opening in 16th week was lower than that 8th week,and the difference was statistically significant(P<0.05).At the 1st and 8th week of treatment,the VAS score in the group A was significantly higher than that in the group B,and the VAS score of the two groups at the 8th week of treatment was signifi-cantly lower than that at the 1st week,the differences were statistically significant(P<0.05).After 16 weeks of treatment,the OHIP14 scores of the two groups were lower than before treatment,and the group A was lower than the group B,and the difference was statistically significant(P<0.05).Conclusion Low energy laser irradiation combined with direct current drug iontophoresis can introduce therapeutic drugs into the submucosa to achieve therapeutic effect,and the treatment process has no obvious pain and no mechanical damage to local lesions,which can be an effective meth-od for the treatment of OSF.