目的 探討一清膠囊聯(lián)合曲安奈德對扁平苔蘚患者的臨床療效。方法 選取2017年5月-2018年7月秦皇島市第一醫(yī)院收治的78例口腔黏膜扁平苔蘚患者作為研究對象，按照就診順序隨機分為對照組與觀察組，每組各39例。對照組患者采用曲安奈德注射液10 mg，加入2%鹽酸利多卡因1 mL混合，制成懸濁液，注射于口腔粘膜病損區(qū)基底部，1次/10 d。觀察組在對照組治療的基礎(chǔ)上口服一清膠囊，2粒/次，3次/d。兩組患者均連續(xù)治療3個月。觀察兩組患者的臨床療效，比較治療前后兩組患者口腔黏膜癥狀面積、疼痛程度評分、Th1、Th2、Th1/Th2比值、腫瘤壞死因子-α（TNF-α）、白細胞介素（IL）-2、IL-10水平和1年復(fù)發(fā)率。結(jié)果 治療后，觀察組患者的總有效率為92.31%，顯著高于對照組的69.23%，差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組患者的潰瘍、糜爛、白紋面積及VAS評分均顯著降低，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；治療后，觀察組患者的潰瘍、糜爛、白紋面積及VAS評分均顯著低于對照組，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組患者的Th1、Th2及Th1/Th2水平均降低，同組比較差異有統(tǒng)計學(xué)意義（P<0.05），治療后，觀察組患者的Th1、Th2及Th1/Th2水平明顯較對照組低，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組患者的血清TNF-α、IL-2及IL-10水平均顯著降低，同組比較差異有統(tǒng)計學(xué)意義（P<0.05），與對照組比較，治療后觀察組患者的TNF-α、IL-2及IL-10水平較低，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療后1年，觀察組患者的復(fù)發(fā)率為10.26%，顯著低于對照組的51.28%，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 一清膠囊聯(lián)合曲安奈德治療口腔扁平苔蘚可有效降低患者癥狀面積，減輕疼痛，調(diào)節(jié)機體Th1/Th2平衡，降低炎性反應(yīng)，同時可提高臨床療效，降低復(fù)發(fā)率。

Objective To explore the clinical effects of Yiqing Capsules combined with triamcinolone acetonide in treatment of lichen planus. Methods Patients (78 cases) with lichen planus in First Hospital of Qinhuangdao from May 2017 to July 2018 were divided into control group and observation group according to the order of visit, with 39 cases in each group. Patients in the control group were given Triamcinolone Acetonide Injection of 10 mg, mixed with 2% lidocaine hydrochloride 1 mL. The suspension was injected into the base of the lesion area of oral mucosa, once for 10 days. Patients in the observation group were po administered with Yiqing Capsules on the basis of control group, 2 pills/time, three times daily. Patients in two groups were treated continuously for 3 months. The clinical efficacy in two groups was observed, and the oral mucosal symptom area, pain degree score, Th1, Th2, Th1/Th2 ratio, TNF-α, IL-2, IL-10 levels, and 1-year recurrence rate in two groups were compared before and after treatment. Results After treatment, the total effective rate of patients in the observation group was 92.31%, significantly higher than 69.23% of the control group, and the difference was statistically significant (P<0.05). After treatment, the ulcer, erosion, white grain area, and VAS score in two groups were significantly reduced, and the differences before and after treatment were statistically significant (P<0.05). After treatment, the ulcer, erosion, white grain area, and VAS score in the observation group were significantly lower than those in the control group, and the difference between two groups was statistically significant (P<0.05). After treatment, the levels of Th1, Th2, and Th1/Th2 in two groups were decreased, and there was a significant difference in the same group (P<0.05). After treatment, the levels of Th1, Th2, and Th1/Th2 in the observation group were significantly lower than those in the control group, and there was a significant difference between the two groups (P<0.05). After treatment, the serum levels of TNF-α, IL-2, and IL-10 in two groups were significantly reduced, the difference before and after treatment in the same group was statistically significant (P<0.05). Compared with the control group, the levels of TNF-α, IL-2, and IL-10 in the observation group after treatment were lower, with statistically significant differences between the two groups (P<0.05). One year after treatment, the recurrence rate of the observation group was 10.26%, significantly lower than 51.28% of the control group, the difference between the two groups was statistically significant (P<0.05). Conclusions Yiqing Capsules combined with triamcinolone acetonide in treatment of oral lichen planus can effectively reduce the patient's symptom area, relieve pain, regulate the Th1/Th2 balance of the body, reduce the inflammatory response, and improve the clinical efficacy and reduce the recurrence rate.

R988.2

秦皇島市科學(xué)技術(shù)研究與發(fā)展計劃項目（201805A 102）