目的 觀察沙利度胺與倍他米松協(xié)同治療糜爛型口腔扁平苔蘚臨床療效。方法 選取2022年9月—2024年10月唐山市婦幼保健院收治的118例患者，隨機(jī)分為對照組（59例）和治療組（59例）。對照組患者病變部位黏膜基底注射復(fù)方倍他米松注射液，2%利多卡因1 mL稀釋后，0.2～0.4 mL/cm²，每2周1次。在對照組的基礎(chǔ)上，治療組口服沙利度胺片，2片/次，2次/d。兩組患者用藥8周。觀察兩組患者臨床療效，比較治療前后兩組患者癥狀好轉(zhuǎn)時間、疼痛評分、氧化應(yīng)激和炎性水平。結(jié)果 治療后，治療組總有效率（98.31%）明顯高于對照組有效率（84.75%，P＜0.05）。治療后，與對照組比，治療組口腔燒灼感、口腔疼痛、口腔黏膜白斑、口腔粗澀感等癥狀好轉(zhuǎn)時間均更快（P＜0.05）。治療后，兩組疼痛視覺模擬疼痛評分法（VAS）評分比治療前明顯下降（P＜0.05），且治療后，與對照組對比，治療組VAS評分降低更顯著（P＜0.05）。治療后，兩組丙二醛（MDA）、8-羥基脫氧鳥苷（8-OHdG）、白細(xì)胞介素-1β（IL-1β）、IL-6、腫瘤壞死因子-α（TNF-α）、IL-18水平比治療前明顯下降，而總抗氧化能力（TAC）水平明顯升高（P＜0.05）；且治療后，與對照組對比，治療組氧化應(yīng)激和炎性水平顯著好于對照組（P＜0.05）。結(jié)論 沙利度胺與倍他米松協(xié)同治療糜爛型口腔扁平苔蘚療效顯著，對臨床癥狀有較大的改善，患者口腔局部炎癥反應(yīng)減弱，口腔疼痛降低。

Objective To explore the clinical effect of thalidomide combined with betamethasone in treatment of erosive oral lichen planus.Methods Patients (118 cases) with erosive oral lichen planus in Tangshan Maternal and Child Health Hospital from September 2022 to October 2024 were randomly divided into control (59 cases) and treatment (59 cases) group. Patients in the control group were injected with Compound Betamethasone Injection to the mucosal base of the lesion site, diluted with 1 mL of 2% lidocaine, 0.2 — 0.4 mL/cm², once every two weeks. Patients in the treatment group were po administered with Thalidomide Tablets on the basis of the control group, 2 tablets/time, twice daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical evaluations were evaluated, and the symptom relief time, oral pain scores, oxidative stress levels, inflammatory factors in two groups before and after treatment were compared.Results After treatment, the total effective rate in the treatment group (98.31%) was significantly higher than the control group (84.75%, P < 0.05). After treatment, compared with the control group, symptoms such as oral burning sensation, oral pain, oral leukoplakia, and oral astringent sensation in the treatment group all improved faster (P < 0.05). After treatment, the VAS scores in two groups were significantly decreased compared with those before treatment (P < 0.05), and after treatment, compared with the control group, the VAS scores were decreased more significantly in the treatment group (P < 0.05). After treatment, the levels of MDA, 8-OHdG, IL-1β, IL-6, TNF-α, and IL-18 in two groups were decreased significantly compared with those before treatment, while the level of TAC was significantly increased (P < 0.05), and compared with the control group, the levels of oxidative stress and inflammation in the treatment group were significantly better than those in the control group (P < 0.05).Conclusion The synergistic treatment of betamethasone and thalidomide has significant curative effects on erosive oral lichen planus, which has greatly improved clinical symptoms, weakened the local inflammatory reaction in the patient's mouth, and reduced oral pain.

R988.2

2023年度河北省醫(yī)學(xué)科學(xué)研究課題計劃（編號：20231762）