清利湿热方联合曲安奈德对口腔扁平苔藓患者血清炎症因子及sIL-2R水平的影响分析
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摘要
目的:观察清利湿热方联合曲安奈德对口腔扁平苔藓(OLP)患者血清炎症因子及可溶性白细胞介素2受体(sIL-2R)水平的影响。方法:选择2013年5月～2015年5月医院收治的74例OLP患者作为研究对象,按随机数字表法分为对照组与观察组各37例,对照组采用曲安奈德治疗,于病灶黏膜基底部注射曲安奈德10mg+2%利多卡因2.5 mL,1次/周;观察组加用清利湿热方治疗,日1剂,分早晚2次口服,疗程为8周,比较两组治疗效果及治疗前后中医症候积分的变化,测定两组治疗前后血清白介素-2(IL-2)、白介素-4(IL-4)、白介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)及sIL-2R水平的变化,统计两组治疗不良反应发生率。结果:观察组治疗总有效率为94.59%,明显高于对照组的72.97%(P<0.05);治疗前,两组各中医症候积分比较差异无统计学意义(P>0.05),治疗后,两组客观体征(黏膜糜烂、红斑水肿、充血)、主观症状(局部疼痛、胸胁闷胀、胃脘嘈杂)等积分均降低(P<0.05),观察组上述积分均低于对照组(P<0.05);治疗前,两组IL-2、IL-4、IL-8、TNF-α及sIL-2R水平比较差异无统计学意义(P>0.05),治疗后,两组上述指标均降低,观察组降低幅度高于对照组(P<0.05);两组治疗不良反应发生率比较差异无统计学意义(P>0.05)。结论:清利湿热方联合曲安奈德治疗OLP效果肯定,可改善患者中医症候及体征,下调血清炎症因子水平及sIL-2R水平,且安全性肯定。
Objective:To investigate the effect of Clearing Heat and Removing Dampness Recipe combined with Triamcinolone Acetonide on serum inflammatory factors and soluble interleukin 2 recepter(sIL-2 R) levels for patients with oral lichen planus(OLP).Methods:74 patients with OLP who were admitted to the hospital from May 2013 to May 2015 were selected as the subjects.They were divided into controlled group and observation group by the random number table method with 37 cases in each group.The controlled group was treated with triamcinolone Acetonide, and the mucosal basal part of lesions was injected with triamcinolone Acetonide 10 mg+2% Lidocaine 2.5 ml, once per week.The observation group was additionally treated with Clearing Heat and Removing Dampness Recipe, a dose daily, 2 times of oral administration in the morning and evening, and the course of treatment was 8 weeks.Therapeutic effects and changes of TCM syndrome scores before and after treatment in the two groups were compared.Changes in levels of serum interleukin-2(IL-2), interleukin-4(IL-4), interleukin-8(IL-8), tumor necrosis factor alpha(TNF-α) and sIL-2 R in the two groups before and after treatment were determined.The incidence rate of adverse reactions in the two groups was statistically analyzed.Results:The total effective rate in the observation group was significantly higher than that in the controlled group(94.59% vs 72.97%)(P<0.05).Before treatment, there was no statistical difference between the two groups in TCM syndrome scores(P>0.05).After treatment, scores of objective signs(mucosal erosion, erythema, edema, hyperemia) and subjective symptoms(local pain, chest and rib-side stuffiness, epigastric noisy) in the two groups were decreased(P<0.05), and the scores of the observation group were lower than those of the controlled group(P<0.05).Before treatment, there was no significant difference in levels of IL-2, IL-4, IL-8, TNF-α or sIL-2 R between the two groups(P>0.05).After treatment, the above indexes in the two groups were decreased, and the decrease in the observation group was greater than that in the controlled group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Clearing Heat and Removing Dampness Recipe combined with Triamcinolone Acetonide is effective in the treatment of OLP.It can improve TCM symptoms and signs, decrease levels of serum inflammatory factors and sIL-2 R, with safety.
Objective:To investigate the effect of Clearing Heat and Removing Dampness Recipe combined with Triamcinolone Acetonide on serum inflammatory factors and soluble interleukin 2 recepter(sIL-2 R) levels for patients with oral lichen planus(OLP).Methods:74 patients with OLP who were admitted to the hospital from May 2013 to May 2015 were selected as the subjects.They were divided into controlled group and observation group by the random number table method with 37 cases in each group.The controlled group was treated with triamcinolone Acetonide, and the mucosal basal part of lesions was injected with triamcinolone Acetonide 10 mg+2% Lidocaine 2.5 ml, once per week.The observation group was additionally treated with Clearing Heat and Removing Dampness Recipe, a dose daily, 2 times of oral administration in the morning and evening, and the course of treatment was 8 weeks.Therapeutic effects and changes of TCM syndrome scores before and after treatment in the two groups were compared.Changes in levels of serum interleukin-2(IL-2), interleukin-4(IL-4), interleukin-8(IL-8), tumor necrosis factor alpha(TNF-α) and sIL-2 R in the two groups before and after treatment were determined.The incidence rate of adverse reactions in the two groups was statistically analyzed.Results:The total effective rate in the observation group was significantly higher than that in the controlled group(94.59% vs 72.97%)(P<0.05).Before treatment, there was no statistical difference between the two groups in TCM syndrome scores(P>0.05).After treatment, scores of objective signs(mucosal erosion, erythema, edema, hyperemia) and subjective symptoms(local pain, chest and rib-side stuffiness, epigastric noisy) in the two groups were decreased(P<0.05), and the scores of the observation group were lower than those of the controlled group(P<0.05).Before treatment, there was no significant difference in levels of IL-2, IL-4, IL-8, TNF-α or sIL-2 R between the two groups(P>0.05).After treatment, the above indexes in the two groups were decreased, and the decrease in the observation group was greater than that in the controlled group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Clearing Heat and Removing Dampness Recipe combined with Triamcinolone Acetonide is effective in the treatment of OLP.It can improve TCM symptoms and signs, decrease levels of serum inflammatory factors and sIL-2 R, with safety.
引文
[1]李梓镛,余昕.匹多莫德联合曲安奈德治疗口腔扁平苔藓的临床观察[J].中国药房,2015,26(27):3772~3773
[2]王立新,倪耀丰,李志华,等.解毒愈溃汤结合西医疗法治疗糜烂型口腔扁平苔藓40例[J].中国实验方剂学杂志,2015,21(2):200~203
[3]余剑锋,章&&,方芳,等.曲安奈德联合卡介素多糖核酸对治疗口腔扁平苔藓的临床疗效评价[J].中华医院感染学杂志,2015,25(8):1767~1769
[4]刘青兰,刘琳,李留炀,等.曲安奈德口腔软膏治疗充血糜烂型口腔扁平苔藓的疗效及安全性观察[J].实用口腔医学杂志,2017,33(4):536~540
[5]李秉琦.口腔粘膜病学-第2版[M].人民卫生出版社,2003:55~56
[6]郑筱萸.中药新药临床研究指导原则[M].中国医药科技出版社,2002:126~128
[7]国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:123~126
[8]林梅,唐国瑶.中华口腔医学会第三届口腔黏膜病专业委员会第二次全体委员会会议纪要[J].中华口腔医学杂志,2005,40(6):520~520
[9]杨弘雯,李桂芝,赵鹏,等.曲安奈德联合白芍总苷胶囊治疗口腔扁平苔藓的疗效及对血液流变学的影响[J].医学综述,2016,22(22):4549~4551
[10]毛治芳,易鸿.曲安奈德联合胸腺肽治疗口腔扁平苔癣的观察[J].医学临床研究,2012,29(7):1374~1375
[11]梅君,梅和平.中西医结合治疗口腔扁平苔藓82例临床疗效观察[J].时珍国医国药,2016,27(5):1158~1159
[12]杨欣.中西医结合疗法治疗口腔扁平苔藓临床治疗观察[J].湖北中医药大学学报,2014,16(4):93~94
[13]李轶,朱琳.清利湿热方治疗糜烂型口腔扁平苔藓临床研究[J].新中医,2015,47(10):163~165
[14]秦昌娟,徐强,孙玉婷.自拟中药汤剂口服、漱口辅助治疗口腔扁平苔藓40例[J].山东医药,2013,53(28):90~91
[15]李其玉.中西医临床免疫结合法治疗口腔扁平苔癣的短期疗效分析[J].河北医学,2013,19(2):214~217
[2]王立新,倪耀丰,李志华,等.解毒愈溃汤结合西医疗法治疗糜烂型口腔扁平苔藓40例[J].中国实验方剂学杂志,2015,21(2):200~203
[3]余剑锋,章&&,方芳,等.曲安奈德联合卡介素多糖核酸对治疗口腔扁平苔藓的临床疗效评价[J].中华医院感染学杂志,2015,25(8):1767~1769
[4]刘青兰,刘琳,李留炀,等.曲安奈德口腔软膏治疗充血糜烂型口腔扁平苔藓的疗效及安全性观察[J].实用口腔医学杂志,2017,33(4):536~540
[5]李秉琦.口腔粘膜病学-第2版[M].人民卫生出版社,2003:55~56
[6]郑筱萸.中药新药临床研究指导原则[M].中国医药科技出版社,2002:126~128
[7]国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:123~126
[8]林梅,唐国瑶.中华口腔医学会第三届口腔黏膜病专业委员会第二次全体委员会会议纪要[J].中华口腔医学杂志,2005,40(6):520~520
[9]杨弘雯,李桂芝,赵鹏,等.曲安奈德联合白芍总苷胶囊治疗口腔扁平苔藓的疗效及对血液流变学的影响[J].医学综述,2016,22(22):4549~4551
[10]毛治芳,易鸿.曲安奈德联合胸腺肽治疗口腔扁平苔癣的观察[J].医学临床研究,2012,29(7):1374~1375
[11]梅君,梅和平.中西医结合治疗口腔扁平苔藓82例临床疗效观察[J].时珍国医国药,2016,27(5):1158~1159
[12]杨欣.中西医结合疗法治疗口腔扁平苔藓临床治疗观察[J].湖北中医药大学学报,2014,16(4):93~94
[13]李轶,朱琳.清利湿热方治疗糜烂型口腔扁平苔藓临床研究[J].新中医,2015,47(10):163~165
[14]秦昌娟,徐强,孙玉婷.自拟中药汤剂口服、漱口辅助治疗口腔扁平苔藓40例[J].山东医药,2013,53(28):90~91
[15]李其玉.中西医临床免疫结合法治疗口腔扁平苔癣的短期疗效分析[J].河北医学,2013,19(2):214~217