0.03%他克莫司软膏治疗糜烂型口腔扁平苔藓的临床疗效研究

发布时间：2018-12-09 21:08

【摘要】：目的：本文将局部应用0.03％他克莫司软膏与传统的醋酸曲安奈德治疗糜烂型口腔扁平苔藓的临床短期疗效进行对比。进而观察0.03％他克莫司局部治疗口腔扁平苔藓的短期疗效、不良反应和复发情况，为口腔扁平苔藓的局部治疗提供一定的临床依据。方法：40例糜烂型口腔扁平苔藓患者，随机分为2组，每组20例，分别用0.03％他克莫司软膏与醋酸曲安奈德局部治疗4周。采用中华口腔医学会口腔黏膜病专业委员会2004年颁布的关于糜烂萎缩性口腔扁平苔藓疗效评价试行标准，根据临床症状和体征分别记分，对二者的临床疗效进行综合评价。通过观察并记录治疗1周、2周、4周、3个月后的临床疗效（主要包括病损面积大小及患者疼痛程度的改变），比较治疗前后临床症状和体征改善情况，治疗结束时的总有效率作为总体疗效评价指标，并同时观察有无不良反应和复发。结果：局部应用0.03％他克莫司软膏和醋酸曲安奈德治疗糜烂型口腔扁平苔藓均有显著的临床疗效：1.明显减小病损面积；2.明显减轻患者疼痛。他克莫司组总有效率95.0%，治疗期间1位患者用药后出现刺痛，持续十余分钟后消失；醋酸曲安奈德组总有效率70.0%，6例出现局部轻微不良反应，，两者差异有统计学意义（P=0.046）。治疗期间不良反应有：局部黏膜萎缩，烧灼感或刺痛，白色念珠菌感染。二者在治疗结束后的三个月随访期间，复发率分别为28.6%、42.9%，无显著性差异（P＞0.05）。结论：局部应用0.03％他克莫司软膏治疗糜烂型口腔扁平苔藓临床疗效优于醋酸曲安奈德。
[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.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R781.5

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