脉冲Nd:YAG激光联合TA治疗口腔糜烂型扁平苔藓临床疗效观察

发布时间：2018-03-31 15:33

本文选题：糜烂型OLP　切入点：曲安奈德　出处：《北华大学》2017年硕士论文

【摘要】：目的:本文将曲安奈德联合脉冲Nd:YAG激光照射治疗与常规单纯曲安奈德封闭治疗口腔糜烂型扁平苔藓的临床疗效进行对比,进而观察TA联合脉冲Nd:YAG激光照射治疗口腔糜烂型扁平苔藓的短期临床疗效,为临床上治疗口腔糜烂型扁平苔藓提供新的思路和方法。方法:选择2014年~2015年在北华大学附属医院口腔黏膜病科就诊的患者,经过临床以及病理检查结果确诊为口腔糜烂型扁平苔藓的患者40例,随机分为两组,即A组、B组,每组患者20例。A组应用脉冲Nd:YAG激光照射联合TA疗法,设为实验组,B组应用单纯TA封闭疗法,设为对照组。通过对比观察并记录初始状态,治疗3周、6周、9周、12周后两组病例平均病损面积改变,治疗12周后两组患者疼痛程度改变,以及治疗12周后临床疗效及有效率的改变,进而评价TA联合脉冲Nd:YAG激光照射治疗糜烂OLP的短期临床疗效,以及应用脉冲Nd:YAG激光照射治疗后有无不良反应。结果:在平均病损面积改变方面,第6周A、B两组平均病损面积减小率分别为85.29%,63.53%,第9周A、B两组平均病损面积减小率分别为89.25%,80.92%,第12周A、B两组平均病损面积减小率分别为93.45%,86.47%,TA联合脉冲Nd:YAG激光照射组与单纯TA封闭组比较于治疗后第6周,第9周,第12周存在显著统计学差异(P0.05),说明TA联合脉冲Nd:YAG激光照射治疗糜烂型OLP疗效优于单纯TA封闭治疗;TA联合脉冲Nd:YAG激光照射组与单纯TA封闭组在疼痛值改变和临床疗效应答方面比较均无显著统计学差异(P0.05),治疗12周后A、B两组总有效率分别为95%、90%,说明在对疼痛的控制以及临床症状和体征的缓解方面,两种治疗方法并无明显差异。结论:应用TA联合脉冲Nd:YAG激光照射治疗糜烂型OLP,能够减少TA总用药量,减轻患者痛苦,降低不良反应,为临床治疗糜烂型OLP提供新的思路。
[Abstract]:Objective: to compare the clinical effects of triamcinolone acetonide combined with pulsed Nd:YAG laser irradiation on oral erosive lichen planus (OLP) treated with triamcinolone acetonide alone. Then the short-term clinical effect of TA combined with pulsed Nd:YAG laser irradiation on oral erosive lichen planus was observed. To provide a new method for the treatment of oral erosive lichen planus (OLP). Methods: from 2014 to 2015, we selected patients with oral mucosal diseases in the affiliated Hospital of North China University. Forty patients with oral erosion lichen planus diagnosed by clinical and pathological examination were randomly divided into two groups: group A (n = 20) and group A (n = 20) were treated with pulsed Nd:YAG laser irradiation combined with TA. Group B was divided into two groups: group B was treated with simple TA block therapy, and group B was set up as control group. After 3 weeks, 6 weeks, 9 weeks and 12 weeks of treatment, the mean lesion area of the two groups was changed, and the pain degree of the two groups was changed after 12 weeks of treatment. To evaluate the short-term clinical effect of TA combined with pulsed Nd:YAG laser irradiation in the treatment of erosive OLP, and the changes of clinical efficacy and effective rate after 12 weeks of treatment. And whether there were adverse reactions after pulsed Nd:YAG laser irradiation. Results: the mean lesion area was changed, At the 6th week, the average lesion area decreased by 85.293.53 in group A and B, 89.25 and 80.92 in group A at the 9th week, respectively, and by the 12th week, the average lesion area in group A and B were 93.45% and 86.45%, respectively, and those in group A and group B were 93.45% and 86.45%, respectively, at the end of week 9, the average lesion area of group A and B was 89.25% and 80.92% respectively, and that of group A and group B was 93.45% and 86.45% respectively at the 12th week. The TA blocking group was compared with that in the 6th week after treatment. Week 9, There was significant statistical difference in the 12th week (P 0.05), which indicated that TA combined with pulsed Nd:YAG laser irradiation was superior to TA block therapy in the treatment of erosive OLP in pain value and clinical treatment. After 12 weeks of treatment, the total effective rates of the two groups were 95 / 90, respectively, indicating that there was no significant difference in the control of pain and the relief of clinical symptoms and signs. Conclusion: TA combined with pulsed Nd:YAG laser irradiation can reduce the total dosage of TA, alleviate the pain of patients, reduce adverse reactions, and provide a new idea for clinical treatment of erosive OLP.
【学位授予单位】：北华大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R781.5

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