CAJ | 학술논문

【目的】探讨局部注射曲安奈德及卡介菌多糖核酸（BCG‐PSN ）治疗口腔扁平苔藓的可行性和安全性。【方法】选择口腔扁平苔藓患者268例，按数字随机法分为观察组（ n ＝134）和对照组（ n＝134）。观察组根据病理检查结果分为A组（糜烂型，n＝66）和B组（非糜烂型，n＝68）两个亚组，对照组则分为C组（糜烂型，n＝65）和D组（非糜烂型，n＝69）两个亚组。对照组在病损基底部注射曲安奈德40 mg和2％利多卡因2 mL治疗。观察组在对照组的基础上在病损基底部注射BCG‐PSN 1 mL治疗。统计分析两组疗效、治疗前后血清炎症因子水平、复发及不良反应发生情况。【结果】A组和B组疗效显效率和总有效率均高于C组和D组，差异均有统计学意义（均 P＜0．05）。A组和B组、C组和D组治疗效果比较差异均无统计学意义（均 P ＞0．05）。A组和B组、C组和D组治疗前后血清IL‐6和TNF‐α等炎症因子水平比较差异无统计学意义（ P ＞0．05）。与A组和B组比较，C组治疗1周、3周和6周的血清炎症因子水平均较高，D组同期血清炎症因子水平亦均较高（ P＜0．05）。A组治疗后1个月、3个月、6个月复发率均低于C组；B组治疗后1个月、3个月、6个月复发率均低于D组（ P ＜0．05）。【结论】局部注射曲安奈德及BCG‐PSN治疗口腔扁平苔藓疗效显著，可有效抗炎并预防术后复发，其对非糜烂型口腔扁平苔藓复发的预防效果更佳，且不增加不良反应，具有良好的可行性和安全性。
【목적】탐토국부주사곡안내덕급잡개균다당핵산（BCG‐PSN ）치료구강편평태선적가행성화안전성。【방법】선택구강편평태선환자268례，안수자수궤법분위관찰조（ n ＝134）화대조조（ n＝134）。관찰조근거병리검사결과분위A조（미란형，n＝66）화B조（비미란형，n＝68）량개아조，대조조칙분위C조（미란형，n＝65）화D조（비미란형，n＝69）량개아조。대조조재병손기저부주사곡안내덕40 mg화2％리다잡인2 mL치료。관찰조재대조조적기출상재병손기저부주사BCG‐PSN 1 mL치료。통계분석량조료효、치료전후혈청염증인자수평、복발급불량반응발생정황。【결과】A조화B조료효현효솔화총유효솔균고우C조화D조，차이균유통계학의의（균 P＜0．05）。A조화B조、C조화D조치료효과비교차이균무통계학의의（균 P ＞0．05）。A조화B조、C조화D조치료전후혈청IL‐6화TNF‐α등염증인자수평비교차이무통계학의의（ P ＞0．05）。여A조화B조비교，C조치료1주、3주화6주적혈청염증인자수평균교고，D조동기혈청염증인자수평역균교고（ P＜0．05）。A조치료후1개월、3개월、6개월복발솔균저우C조；B조치료후1개월、3개월、6개월복발솔균저우D조（ P ＜0．05）。【결론】국부주사곡안내덕급BCG‐PSN치료구강편평태선료효현저，가유효항염병예방술후복발，기대비미란형구강편평태선복발적예방효과경가，차불증가불량반응，구유량호적가행성화안전성。
[Objective]To explore the therapeutic efficacy of local injection of triamcinolone acetonide injection ,BCG polysaccharideand nucleic acid injection for oral lichen planus .[Methods]A total of 268 patients with oral lichen planus confirmedby pathological examination were randomly divided into observation ( n = 134) and control ( n = 134) groups by number randommethod .Observation group were divided into subgroup A (erosion type ,n = 66) and subgroup B (non‐erosion type ,n =68) according to the results of pathological examination .And control group were also divided into subgroups C (erosion type , n = 65) and D (non‐erosion type ,n = 69) according to the results of pathological examination .The control group received 40mg triamcinolone acetonide and 2 mL 2% lidocaine injection in lesion base .On the basis of control group ,observation grouphad 1 mL BCG polysaccharide and nucleic acid injection in lesion base .The efficacies ,serum levels of inflammatory factors ,recurrenceand occurrence of adverse reactions of two groups were statistically analyzed .[Results]The rates of efficacy and totalefficacy were 58 .21% and 58 .21% in observation group versus 40 .30% and 84 .33% in control group ( P < 0 .05) .Therapeuticefficacy and adverse reactions of groups A and B and groups C and D had no significant statistical differences ( P > 0 .05) .The serum levels of interleukin‐6 (IL‐6) ,tumor necrosis factor‐alpha (TNF‐α) and other inflammatory factor levels before andafter treatment of group A and group B and serum IL‐6 and TNF‐α and other inflammatory factor levels before and after treatmentof group C and group D had no statistical significant difference ( P > 0 .05) .Compared with group A and group B ,serumlevels of group C were higher after treatment with 1 week ,3 weeks and 6 weeks .And the serum level of group D were alsohigher during the same period ( P < 0 .05) .Recurrence rates 1 month ,3 months ,6 months after treatment of group A werelower than those .And recurrence rates 1 month ,3 months ,6 months after treatment in group B were also lower than those ingroup D ( P < 0 .05) .[Conclusion]Local injection of triamcinolone acetonide ,BCG polysaccharide and nucleic acid injection ismarkedly efficacious for oral lichen planus .And it can effectively anti‐inflammatory ,prevent postoperative recurrence without ahigher incidence of adverse reactions .It is recommended for patients without erosive oral lichen planus .