發(fā)布時(shí)間：2018-12-09 21:08

【摘要】：目的：本文將局部應(yīng)用0.03％他克莫司軟膏與傳統(tǒng)的醋酸曲安奈德治療糜爛型口腔扁平苔蘚的臨床短期療效進(jìn)行對(duì)比。進(jìn)而觀察0.03％他克莫司局部治療口腔扁平苔蘚的短期療效、不良反應(yīng)和復(fù)發(fā)情況，為口腔扁平苔蘚的局部治療提供一定的臨床依據(jù)。 方法：40例糜爛型口腔扁平苔蘚患者，隨機(jī)分為2組，每組20例，分別用0.03％他克莫司軟膏與醋酸曲安奈德局部治療4周。采用中華口腔醫(yī)學(xué)會(huì)口腔黏膜病專業(yè)委員會(huì)2004年頒布的關(guān)于糜爛萎縮性口腔扁平苔蘚療效評(píng)價(jià)試行標(biāo)準(zhǔn)，根據(jù)臨床癥狀和體征分別記分，對(duì)二者的臨床療效進(jìn)行綜合評(píng)價(jià)。通過觀察并記錄治療1周、2周、4周、3個(gè)月后的臨床療效（主要包括病損面積大小及患者疼痛程度的改變），比較治療前后臨床癥狀和體征改善情況，治療結(jié)束時(shí)的總有效率作為總體療效評(píng)價(jià)指標(biāo)，并同時(shí)觀察有無不良反應(yīng)和復(fù)發(fā)。 結(jié)果：局部應(yīng)用0.03％他克莫司軟膏和醋酸曲安奈德治療糜爛型口腔扁平苔蘚均有顯著的臨床療效：1.明顯減小病損面積；2.明顯減輕患者疼痛。他克莫司組總有效率95.0%，治療期間1位患者用藥后出現(xiàn)刺痛，持續(xù)十余分鐘后消失；醋酸曲安奈德組總有效率70.0%，6例出現(xiàn)局部輕微不良反應(yīng)，，兩者差異有統(tǒng)計(jì)學(xué)意義（P=0.046）。治療期間不良反應(yīng)有：局部黏膜萎縮，燒灼感或刺痛，白色念珠菌感染。二者在治療結(jié)束后的三個(gè)月隨訪期間，復(fù)發(fā)率分別為28.6%、42.9%，無顯著性差異（P＞0.05）。 結(jié)論：局部應(yīng)用0.03％他克莫司軟膏治療糜爛型口腔扁平苔蘚臨床療效優(yōu)于醋酸曲安奈德。
[Abstract]:Objective: to compare the short-term clinical effects of topical application of 0.03% tacrolimus ointment with traditional triamcinolone acetonide acetate in the treatment of erosive oral lichen planus. The short-term efficacy, adverse reactions and recurrence of 0.03% tacrolimus in local treatment of oral lichen planus were observed, which provided a clinical basis for local treatment of oral lichen planus. Methods: forty patients with erosive oral lichen planus were randomly divided into two groups, 20 patients in each group were treated with 0.03% tacrolimus ointment and triamcinolone acetonide acetate for 4 weeks. The clinical efficacy of erosive atrophic oral lichen planus (OLP) was evaluated according to the clinical symptoms and signs of oral lichen planus according to the experimental standard issued by the Chinese Stomatological Association Professional Committee of Oral Mucosal Disease in 2004. After 1 week, 2 weeks, 4 weeks and 3 months of treatment, the clinical effects were observed and recorded (including the changes of the lesion area and the pain degree of the patients), and the improvement of clinical symptoms and signs before and after treatment were compared. The total effective rate at the end of the treatment was taken as the index of the overall curative effect, and the adverse reaction and recurrence were observed at the same time. Results: topical application of 0.03% tacrolimus ointment and triamcinolone acetonide acetate had significant clinical effects on erosive oral lichen planus: 1. The area of lesion was obviously reduced; 2. The pain of the patients was significantly alleviated. The total effective rate of tacrolimus group was 95.0. During the treatment period, one patient appeared stinging pain, which lasted for more than ten minutes and disappeared. The total effective rate of triamcinolone acetonide acetate group was 70.0% and there was a significant difference between the two groups (P0. 046). Adverse reactions during treatment included local mucosal atrophy, burning or tingling, and Candida albicans infection. During the follow-up period of three months after the treatment, the recurrence rate of the two groups was 28.6% and 42.9%, respectively. There was no significant difference between the two groups (P > 0.05). Conclusion: local application of 0.03% tacrolimus ointment is superior to triamcinolone acetonide acetate in the treatment of erosive oral lichen planus.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R781.5

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