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目的评价810 nm半导体激光与他克莫司软膏治疗糜烂型口腔扁平苔藓(oral lichen planus,OLP)的疗效。方法选择2016年1—12月中国医科大学口腔医学院急诊·黏膜病科收治患者中符合糜烂型OLP诊断标准的患者60例,随机分为试验组与对照组,每组30例。试验组应用波长为810 nm的半导体激光进行局部照射治疗,对照组应用他克莫司软膏进行局部涂擦治疗,两组患者分别治疗2个月,并在第3及第6个月进行随访。根据中华口腔医学会口腔黏膜病专业委员会的“OLP(萎缩型、糜烂型)疗效评价标准(试行)”进行疗效评价。结果治疗结束后两组患者病损面积、症状和体征得分均减小,总有效率差异无统计学意义(P>0.05);第3和第6个月随访时,激光治疗组的复发率低于他克莫司组,两组比较差异有统计学意义(P<0.05);他克莫司组9例患者出现不良反应,激光治疗组未发现有不良反应患者。结论半导体激光与他克莫司治疗糜烂型OLP即刻疗效无差异;与他克莫司相比,半导体激光治疗能更长时间地控制OLP,抑制复发,具有较好的疗效,且无不良反应,值得临床推广使用。
Objective To evaluate the efficacy of 810 nm semiconductor laser and tacrolimus ointment in the treatment of erosive oral lichen planus (OLP). Methods Sixty patients with erosive OLP diagnosed in Department of Emergency and Mucomatology, School of Stomatology, China Medical University from January to December in 2016 were randomly divided into test group and control group, with 30 cases in each group. The experimental group was treated with semi-conductor laser with a wavelength of 810 nm for local irradiation. The control group was treated with tacrolimus ointment for local rubbing treatment. The two groups were treated for 2 months and followed up on the 3rd and 6th months respectively. According to the Chinese Stomatological Association Oral Mucosal Disease Committee “OLP (atrophic erosive type) efficacy evaluation criteria (Trial) ” effect evaluation. Results After the treatment, the lesion area, symptoms and signs scores of both groups decreased, but the total effective rate had no significant difference (P> 0.05). The recurrence rate of the laser treatment group was low at the 3rd and 6th month follow-up In the tacrolimus group, the differences between the two groups were statistically significant (P <0.05). Nine patients in the tacrolimus group developed adverse reactions and no adverse reactions were found in the laser treatment group. Conclusion Compared with tacrolimus, tacrolimus has no difference in immediate curative effect on erosive OLP. Compared with tacrolimus, semiconductor laser can control OLP for a longer time and inhibit relapse with good curative effect and no adverse reactions. It is worth to promote clinical use.