低功率半导体激光联合康复新液治疗糜烂型扁平苔藓疗效观察
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摘要
目的评价半导体激光对口腔糜烂型扁平苔藓(oral lichen planus,OLP)患者缓解疼痛、加速愈合、减小糜烂面积等方面的疗效。方法选取2016年1月-2017年10月在我院牙周黏膜科就诊的具有两处独立病损且病理确诊为糜烂型OLP的病例30例,随机挑选一处病损作为实验组,另外一处病损作同体对照。实验组和对照组均接受含漱康复新液治疗,同时实验组还应用低功率半导体激光照射治疗,治疗分4次进行,每次持续45 s,每次间隔1 min,评估治疗前后疼痛、病损尺寸、愈合时间等指标。结果实验组糜烂病损平均愈合时间为(3.05±1.10)d,对照组为(8.90±2.45)d(P=0.008);实验组30例患者中,28例治疗后疼痛即刻缓解,实验组VAS疼痛评分显著低于对照组(P均<0.05);与对照组相比,实验组病损尺寸明显减小(P<0.05)。结论低功率半导体激光治疗糜烂型口腔扁平苔藓疗效肯定,可加速病损愈合。
Objective To assess the efficacy of low-level laser therapy(LLLT) for patients with erosive oral lichen planus. Methods A total of 30 patients with two separate erosions in each person were included in this study from January 2016 to October 2017. The lesions were randomly assigned into active treatment group or sham control group for each patient. Lesions assigned to active group were treated with LLLT in a single sitting, which was divided into four sessions with 45 s as a session. Lesions in the sham control group received similar treatment without LLLT. Each patient was evaluated for pain, lesion size, and time to complete healing before and after each treatment. Results The average healing time of ulcers in treatment group was(3.05±1.10) days, significantly lower than(8.90±2.45) days in the control group(P=0.008); Of the 30 patients in the experimental group, 28 experienced immediate pain relief after first treatment. VAS was significantly lower, and the lesion size was significantly smaller in treatment group(all P <0.05). Conclusion LLLT is effective in relieving pain and reducing healing time in treatment of oral lichen planus.
Objective To assess the efficacy of low-level laser therapy(LLLT) for patients with erosive oral lichen planus. Methods A total of 30 patients with two separate erosions in each person were included in this study from January 2016 to October 2017. The lesions were randomly assigned into active treatment group or sham control group for each patient. Lesions assigned to active group were treated with LLLT in a single sitting, which was divided into four sessions with 45 s as a session. Lesions in the sham control group received similar treatment without LLLT. Each patient was evaluated for pain, lesion size, and time to complete healing before and after each treatment. Results The average healing time of ulcers in treatment group was(3.05±1.10) days, significantly lower than(8.90±2.45) days in the control group(P=0.008); Of the 30 patients in the experimental group, 28 experienced immediate pain relief after first treatment. VAS was significantly lower, and the lesion size was significantly smaller in treatment group(all P <0.05). Conclusion LLLT is effective in relieving pain and reducing healing time in treatment of oral lichen planus.
引文
1陈谦明.口腔黏膜病学[M].北京:人民卫生出版社,2012.
2 Lau P,Bidin N,Krishnan G,et al.Photobiostimulation effect on diabetic wound at different power density of near infrared laser[J].J Photochem Photobiol B:Biol,2015,151:201-207.
3 Pellicioli AC,Martins MD,Dillenburg CS,et al.Laser phototherapy accelerates oral keratinocyte migration through the modulation of the mammalian target of rapamycin signaling pathway[J].J Biomed Opt,2014,19(2):028002.
4 张永军,郭鹏.半导体激光与维甲酸软膏联合治疗非糜烂型口腔扁平苔藓疗效观察[J].河北医学,2014,20(12):2052-2054.
5 周政,孙施文,赵杰.氦氖激光治疗糜烂型口腔扁平苔藓疗效观察[J].中国冶金工业医学杂志,2013,30(6):647-648.
6 Correction for Coghill et al.,Neural correlates of interindividual differences in the subjective experience of pain[J].Proc Natl Acad Sci U S A.2017,114(48):E10507.
7 Hersheal A,Mohit Pal S,Prashant N,et al.Preface-Reactive Polymers Fundamentals and Applications(Second Edition)[J].J Clin Diagn Res,2014,8(2):218-221.
8 Debache S,Aidoud S,DjemaaA,et al.Evaluation of the effectiveness of a low-energy laser in the treatment of radiation-induced mucositis,versus conventional therapy in patients treated for undifferentiated carcinoma nasopharynx[J].J Afr Cancer,2015,7(3):101-107.
9 Dechaphunkul T,Martin L,Alberda C,et al.Malnutrition assessment in patients with cancers of the head and neck:a call to action and consensus[J].Crit Rev Oncol Hematol,2013,88(2):459-476.
10 Villabona EH,Lemos DMC.Effects of low level laser therapy and high voltage stimulation on diabetic wound healing[J].Revista De La Universidad Industrial De Santander Salud,2014,46(2):107-117.
11 Karu TI.Cellular and Molecular Mechanisms of Photobiomodulation(Low-Power Laser Therapy)[J].IEEE J Sel Top Quantum Electron,2013,20(2):143-148.
12 Gao D,Gu C,Wu Y,et al.Mesenchymal stromal cells enhance wound healing by ameliorating impaired metabolism in diabetic mice[J].Cytotherapy,2014,16(11):1467-1475.
13 Shimizu N,Yamaguchi M,Goseki T,et al.Inhibition of prostaglandin E2 and interleukin 1-beta production by low-power laser irradiation in stretched human periodontal ligament cells[J].J Dent Res,1995,74(7):1382-1388.
14 Abed AM,Naghsh N,Birang R,et al.Clinical Evaluation of the Efficacy of Neodymium-Doped Yttrium Aluminium Garnet(Nd:YAG)Laser Therapy and Sensikin in Treatment of Dentine Hypersensitivity[J].J Lasers Med Sci,2012,3(2):61-66.
15 Moosavi H,Maleknejad F,Sharifi M,et al.A randomized clinical trial of the effect of low-level laser therapy before composite placement on postoperative sensitivity in class V restorations[J].Lasers Med Sci,2015,30(4):1245-1249.
16 Hoseini Sanati M,Torkaman G,Hedayati M,et al.Effect of Ga-As Laser on Decrease of Wound Surface Area and ABI Value in Diabetic Foot Ulcers[J].J Neurophysiol,2016,103(2):667-676.
17 Rosa CB,Habib FA,De Araújo TM,et al.Laser and LED phototherapy on midpalatal suture after rapid maxilla expansion:Raman and histological analysis[J].Lasers Med Sci,2017,32(2):263-274.
18 Darwesh AA,El-Marakby AA,Khalifa DA,et al.Low intensity laser therapy versus ultrasound diathermy on hand grip strength,pain sensation and psychological well-being in patients with lateral epicondylitis[J].Adv Environ Biol,2012,6(3):1112-1116.
19 Kasai K,Chou MY,Yamaguchi M.Molecular effects of low-energy laser irradiation during orthodontic tooth movement[J].Semin Orthod,2015,21(3):203-209.
2 Lau P,Bidin N,Krishnan G,et al.Photobiostimulation effect on diabetic wound at different power density of near infrared laser[J].J Photochem Photobiol B:Biol,2015,151:201-207.
3 Pellicioli AC,Martins MD,Dillenburg CS,et al.Laser phototherapy accelerates oral keratinocyte migration through the modulation of the mammalian target of rapamycin signaling pathway[J].J Biomed Opt,2014,19(2):028002.
4 张永军,郭鹏.半导体激光与维甲酸软膏联合治疗非糜烂型口腔扁平苔藓疗效观察[J].河北医学,2014,20(12):2052-2054.
5 周政,孙施文,赵杰.氦氖激光治疗糜烂型口腔扁平苔藓疗效观察[J].中国冶金工业医学杂志,2013,30(6):647-648.
6 Correction for Coghill et al.,Neural correlates of interindividual differences in the subjective experience of pain[J].Proc Natl Acad Sci U S A.2017,114(48):E10507.
7 Hersheal A,Mohit Pal S,Prashant N,et al.Preface-Reactive Polymers Fundamentals and Applications(Second Edition)[J].J Clin Diagn Res,2014,8(2):218-221.
8 Debache S,Aidoud S,DjemaaA,et al.Evaluation of the effectiveness of a low-energy laser in the treatment of radiation-induced mucositis,versus conventional therapy in patients treated for undifferentiated carcinoma nasopharynx[J].J Afr Cancer,2015,7(3):101-107.
9 Dechaphunkul T,Martin L,Alberda C,et al.Malnutrition assessment in patients with cancers of the head and neck:a call to action and consensus[J].Crit Rev Oncol Hematol,2013,88(2):459-476.
10 Villabona EH,Lemos DMC.Effects of low level laser therapy and high voltage stimulation on diabetic wound healing[J].Revista De La Universidad Industrial De Santander Salud,2014,46(2):107-117.
11 Karu TI.Cellular and Molecular Mechanisms of Photobiomodulation(Low-Power Laser Therapy)[J].IEEE J Sel Top Quantum Electron,2013,20(2):143-148.
12 Gao D,Gu C,Wu Y,et al.Mesenchymal stromal cells enhance wound healing by ameliorating impaired metabolism in diabetic mice[J].Cytotherapy,2014,16(11):1467-1475.
13 Shimizu N,Yamaguchi M,Goseki T,et al.Inhibition of prostaglandin E2 and interleukin 1-beta production by low-power laser irradiation in stretched human periodontal ligament cells[J].J Dent Res,1995,74(7):1382-1388.
14 Abed AM,Naghsh N,Birang R,et al.Clinical Evaluation of the Efficacy of Neodymium-Doped Yttrium Aluminium Garnet(Nd:YAG)Laser Therapy and Sensikin in Treatment of Dentine Hypersensitivity[J].J Lasers Med Sci,2012,3(2):61-66.
15 Moosavi H,Maleknejad F,Sharifi M,et al.A randomized clinical trial of the effect of low-level laser therapy before composite placement on postoperative sensitivity in class V restorations[J].Lasers Med Sci,2015,30(4):1245-1249.
16 Hoseini Sanati M,Torkaman G,Hedayati M,et al.Effect of Ga-As Laser on Decrease of Wound Surface Area and ABI Value in Diabetic Foot Ulcers[J].J Neurophysiol,2016,103(2):667-676.
17 Rosa CB,Habib FA,De Araújo TM,et al.Laser and LED phototherapy on midpalatal suture after rapid maxilla expansion:Raman and histological analysis[J].Lasers Med Sci,2017,32(2):263-274.
18 Darwesh AA,El-Marakby AA,Khalifa DA,et al.Low intensity laser therapy versus ultrasound diathermy on hand grip strength,pain sensation and psychological well-being in patients with lateral epicondylitis[J].Adv Environ Biol,2012,6(3):1112-1116.
19 Kasai K,Chou MY,Yamaguchi M.Molecular effects of low-energy laser irradiation during orthodontic tooth movement[J].Semin Orthod,2015,21(3):203-209.