Abstract:

To explore the clinical effect of hydroxychloroquine sulfate, dexamethasone, and transfer factor (TF) for patients with oral lichen planus (OLP). Methods　A total of 180 patients with OLP treated in Mengyin County People's Hospital from January 2018 to January 2022 were selected for the random control trial. They were divided into an observation group and a control group by the random number table method, with 90 cases in each group. There were 41 males and 49 females in the observation group; they were (48.96±5.73) years old. There were 39 males and 51 females in the control group; they were (49.13±5.64) years old. The control group were treated with hydroxychloroquine sulfate and dexamethasone, and the observation group with hydroxychloroquine sulfate, dexamethasone, and TF. The curative effects, scores of Visual Analogue Scale (VAS), erosion areas, levels of nitrite ion (NO₂^-), inflammatory factors [interleukin-10 (IL-10), interleukin-17 (IL-17), and interferon-γ (IFN-γ)], immune function (CD3+, CD4+, CD8+, and CD4+/CD8+), and adverse reactions were compared between the two groups.t and χ² tests were applied. Results　The treatment efficacy of the observation group was higher than that of the control group [95.56% (86/90) vs. 85.56% (77/90); P<0.05]. After the treatment, the scores of VAS and Reticulation-Erosion-Ulcer Scale (REU) and the vesicular area in the observation group were lower than those in the control group [(0.64±0.15) vs. (1.21±0.23), (0.78±0.16) vs. (1.33±0.27), and (1.52±0.23) cm² vs. (1.74±0.27) cm²; all P<0.05]. After the treatment, the levels of NO₂^-, IL-17, and IL-10 in the observation group were lower than those in the control group [(10.31±1.65) µmol/L vs. (13.89±1.44) µmol/L, (0.18±0.06) ng/L vs. (0.31±0.09) ng/L, and (8.67±1.83) pg/L vs. (12.01±1.64) pg/L; all P<0.05]; the IFN-γ level in the observation group was higher than that in the control group [(12.03±2.62) pg/L vs. (8.52±2.12) µmol/L; P<0.05]. After the treatment, the CD3⁺, CD4⁺, and CD4⁺/CD8⁺ in the observation group were higher than those in the control group [(56.16±5.71)% vs. (51.73±5.20)%, (38.56±3.97)% vs. (36.21±3.74)%, and (1.46±0.27) vs. (1.32±0.25); all P<0.05]; the CD8⁺ in the observation group was lower than that in the control group [(26.26±3.20)% vs. (27.68±3.39)%; P<0.05]. There were no statistical difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion　The clinical curative effect of hydroxychloroquine sulfate, dexamethasone, and TF for patients with OLP is good and can effectively adjust the level of NO₂^- in saliva, improve their immune function and inflammatory response, and relieve their pain.

Key words:

Oral lichen planus, Transfer factor, Hydroxychloroquine sulfate, Dexamethasone, Nitric oxide, Interleukin-17

摘要：

目的　探讨硫酸羟氯喹、地塞米松、转移因子（TF）治疗口腔扁平苔藓（OLP）的临床效果。方法　选取蒙阴县人民医院2018年1月至2022年1月收治的180例OLP患者进行随机对照试验，采用随机数字表法将其分为观察组和对照组，各90例。观察组男41例，女49例，年龄（48.96±5.73）岁。对照组男39例，女51例，年龄（49.13±5.64）岁。对照组采用硫酸羟氯喹、地塞米松治疗，观察组在对照组的基础上给予TF治疗。比较两组治疗效果、视觉模拟评分（VAS）、糜烂面积、亚硝酸根离子（NO₂^－）、白细胞介素（IL）-10、IL-17、γ干扰素（IFN-γ）、免疫功能［CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺］和不良反应。采用t检验和χ²检验。结果　观察组治疗有效率为95.56%（86/90），高于对照组的85.56%（77/90）（P<0.05）。治疗后，观察组VAS、网纹-糜烂-溃疡评分量表（REU）评分、糜烂面积均低于对照组［（0.64±0.15）分比（1.21±0.23）分、（0.78±0.16）分比（1.33±0.27）分、（1.52±0.23）cm²比（1.74±0.27）cm²，均P<0.05］。治疗后，观察组NO₂^－、IL-17、IL-10均低于对照组［（10.31±1.65）µmol/L比（13.89±1.44）µmol/L、（0.18±0.06）ng/L比（0.31±0.09）ng/L、（8.67±1.83）pg/L比（12.01±1.64）pg/L，均P<0.05］；观察组IFN-γ高于对照组［（12.03±2.62）pg/L比（8.52±2.12）µmol/L，P<0.05］。治疗后，观察组CD3⁺、CD4⁺、CD4⁺/CD8⁺均高于对照组［（56.16±5.71）%比（51.73±5.20）%、（38.56±3.97）%比（36.21±3.74）%、（1.46±0.27）比（1.32±0.25），均P<0.05］；观察组CD8⁺为（26.26±3.20）%，低于对照组的（27.68±3.39）%（P<0.05）。两组不良反应发生率比较，差异无统计学意义（P>0.05）。结论　联合硫酸羟氯喹、地塞米松、TF治疗OLP临床疗效良好，可有效调节患者唾液中NO₂^－水平，改善免疫功能和炎性反应，缓解疼痛感。

关键词:

口腔扁平苔藓, 转移因子, 硫酸羟氯喹, 地塞米松, 一氧化氮, 白细胞介素-17