自拟化湿行瘀清热方辅治口腔扁平苔藓疗效及对血清中结合珠蛋白浓度、T 淋巴细胞亚群的影响

摘要

目的：观察自拟化湿行瘀清热方辅治口腔扁平苔藓（ OLP）患者的治疗效果及其对血清中结合珠蛋白（ Hp）浓度和外周血T淋巴细胞亚群水平影响。方法选取2013年10月—2015年5月在河北医科大学第四医院口腔科和河北省直属机关第一门诊部口腔科门诊初诊的OLP患者42作为研究对象，按照随机数字表法分为治疗组和对照组，每组21例。2组患者均给予常规基础治疗，对照组予以鱼肝油局部涂抹和醋酸曲安奈德注射液口腔病灶基底部注射，治疗组在对照组基础上给予化湿行瘀清热方剂，治疗8周后观察比较2组疗效，检测治疗前后血清中Hp浓度和外周血T淋巴细胞亚群的变化。结果治疗组总有效率为90．5％，明显高于对照组61．9％（χ2＝4．725， P ＜0．05）；治疗8周后，治疗组患者血清Hp浓度高于治疗前（ t ＝3．933， P ＜0．01），且血清Hp浓度高于对照组（ t ＝2．247， P ＜0．05）；治疗8周后，2组患者外周血CD3＋、CD4＋均高于治疗前（ P ＜0．01），且治疗组患者外周血CD3＋、CD4＋高于对照组（ t ＝5．170、4．402， P ＜0．01）；而外周血CD8＋、CD4＋／CD8＋虽然较治疗前有所升高，但差异无统计学意义（ P ＞0．05）。结论化湿行瘀清热方剂对口腔扁平苔藓有一定的疗效，血清中Hp浓度、T淋巴细胞亚群水平变化可能对口腔扁平苔藓的发生发展有一定影响作用。%Objective To observe the therapeutic effect of self-made Huashixingyuqingre decoction ( HXQD) on o-ral lichen planus ( OLP) , and the effect on the serum haptoglobin concentration and the level of peripheral blood T lymphocyte subsets.Methods From October 2013 to May 2015, 42 OLP patients were collected from Department of Stomatology , the fourth hospital of Hebei Medical University and the first outpatient department of directly departments of Hebei Province .The subjects were divided into 2 groups, treatment group and control group , each group having 21 individuals.Both groups were given conventional treatment , the basal parts of oral lesions in control group were sealed by cod liver oil topical application and triamcinolone acetonaide acetate injection , while treatment group were given Huashixingyuqingre decoction .The serum hapto-globin concentration and the changes of peripheral blood T lymphocyte subsets before and after treatment were detected , and curative effects of two groups were compared .Results The total effective rate of treatment group was 90.5%, which was sig-nificantly higher than the control group ’s 61.9%(χ2 =4.725, P <0.05); After 8 weeks of treatment, the serum Hp con-centration of the treatment group was higher than that before treatment ( t =3.933, P <0.01), which higher than that in the control group as well ( t =2.247, P <0.05).After 8 weeks of treatment, peripheral blood CD3 +, CD4 +in two groups were not only higher than before treatment ( P <0.01), but also higher than the control group ( t =5.170, t =4.402, P <0.01).Although peripheral blood CD8 +and CD4 +/CD8 +were higher than before treatment, the difference was not statisti-cally significant ( P >0.05).Conclusions The HXQD has a certain curative effect on oral lichen planus , the serum hapto-globin concentration and changes of peripheral blood T lymph subsets , it may have some effect on the occurrence and develop-ment of oral lichen planus as well .