肿痛安胶囊联合他克莫司治疗糜烂型口腔扁平苔藓的临床研究

Clinical study of Zhongtong’an Capsules combined with tacrolimus in treatment of erosive oral lichen planus

目的 探讨肿痛安胶囊联合他克莫司软膏治疗糜烂型口腔扁平苔藓的临床疗效。方法 选取2019年5月—2022年7月天津市第三中心医院分院收治的86例糜烂型口腔扁平苔藓患者,依据用药情况将所有患者分为对照组和治疗组,每组各43例。对照组患者将他克莫司软膏涂抹至患处,1次/d。治疗组在对照组的基础上口服肿痛安胶囊,3粒/次,3次/d。两组用药28 d观察治疗效果。观察两组的临床疗效和临床症状缓解时间,比较两组治疗前后疼痛视觉模拟评分(VAS)、病灶糜烂面积、转化生长因子β1(TGF-β1)、白细胞介素17(IL-17)、丙二醛(MDA)、肿瘤坏死因子-α(TNF-α)的变化情况。结果 治疗后,治疗组总有效率是95.35%,显著高于对照组的79.06%(P<0.05)。治疗后,治疗组局部灼痛、口干、黏膜木涩感、黏膜充血缓解时间均显著短于对照组(P<0.05)。治疗后,两组VAS评分、病灶糜烂面积均较同组治疗前显著降低(P<0.05);治疗后,治疗组VAS评分、病灶糜烂面积均低于对照组(P<0.05)。治疗后,两组血清TGF-β1、IL-17、TNF-α、MDA水平显著降低(P<0.05);治疗后,治疗组血清学指标显著低于对照组(P<0.05)。结论 肿痛安胶囊联合他克莫司软膏治疗糜烂型口腔扁平苔藓具有较好的临床疗效,改善患者的临床症状,明显缩小口腔溃疡面积,降低疼痛程度,减弱局部炎性反应,值得借鉴与应用。

Objective To investigate the therapeutic effect of Zhongtong’an Capsules combined with tacrolimus in treatment of erosive oral lichen planus. Methods A total of 86 erosive oral lichen planus patients admitted to Tianjin Third Central Hospital Branch from May 2019 to July 2022 were selected, and all patients were divided into control group and treatment group according to drug use, with 43 cases in each group. Patients in control group applied Tacrolimus Ointment to the affected area, once daily. Patients in treatment group were po administered with Zhongtong’an Capsules on the basis of control group, 3 grains/time, three times daily. Two groups were treated for 28 d to observe the therapeutic effect. The clinical efficacy and duration of clinical symptom remission in two groups were observed, and the changes of pain visual analogue scale (VAS), lesion erosion area, transforming growth factor β1 (TGF-β1), interleukin17 (IL-17), malondialdehyde (MDA), and tumor necrosis factor-α (TNF-α) before and after treatment were compared between two groups. Results After treatment, the total effective rate of the treatment group was 95.35%, which was significantly higher than that of control group (79.06%, P < 0.05). After treatment, the relief time of local burning pain, dry mouth, mucosal astringency and mucosal congestion in treatment group was significantly shorter than that in control group (P < 0.05). After treatment, VAS score and lesion erosion area in 2 groups were significantly decreased compared with before treatment (P < 0.05). After treatment, VAS score and lesion erosion area in treatment group were lower than those in control group (P < 0.05). After treatment, the serum levels of TGF-β1, IL-17, TNF-α and MDA in 2 groups were significantly decreased (P < 0.05). After treatment, serological indexes in treatment group were significantly lower than those in control group (P < 0.05). Conclusion Zhongtong’an Capsules combined with tacrolimus has a good clinical effect in treatment of erosive oral lichen planus, and can improve the clinical symptoms of patients, reduce the area of oral ulcer and the pain degree, and weaken the local inflammatory response, which is worthy of reference and application.