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目的 :探讨大剂量甲氨蝶呤结合皮质激素治疗口腔黏膜扁平苔藓临床效果。方法 :选取2012年6月到2014年6月在我院口腔科治疗的66例口腔黏膜扁平苔藓患者为研究对象,随机表法分为对照组与观察组,每组33例,对照组行小剂量甲氨蝶呤结合皮质激素治疗,观察组行大剂量甲氨蝶呤结合皮质激素治疗,比较两组患者治疗效果及治疗前后血清指标TNF-á、IL-6、IL-8水平。结果 :治疗前,两组血清TNF-á、IL-6、IL-8水平相差不大,组间不具有统计学意义(P>0.05);治疗后,两组患者病情均好转,观察组的总有效率为93.94%显著高于对照组的75.76%,组间对比差异显著(P<0.05),两组患者血清指标均下降,观察组的TNF-á、IL-6、IL-8显著低于对照组,差异比较显著(P<0.05)。结论 :大剂量甲氨蝶呤结合皮质激素治疗口腔黏膜扁平苔藓疗效显著,不良反应发生率未低,减轻患者痛苦,值得广泛推广。
Objective: To investigate the clinical effect of high-dose methotrexate combined with corticosteroids in the treatment of oral lichen planus. Methods: Sixty-six patients with oral mucosal lichen planus who were treated in our department from June 2012 to June 2014 were selected as study subjects. The randomized patients were divided into control group and observation group, with 33 cases in each group. The control group was small The combination of methotrexate and corticosteroids was administered to the observation group. The observation group was given high-dose methotrexate combined with corticosteroids. The therapeutic effect and the serum levels of TNF-α, IL-6 and IL-8 before and after treatment were compared between the two groups. Results: Before treatment, the serum levels of TNF-á, IL-6 and IL-8 in the two groups were similar, with no significant difference between the two groups (P> 0.05). After treatment, The total effective rate was 93.94%, which was significantly higher than that of the control group (75.76%). The difference between the two groups was significant (P <0.05). The serum indexes decreased in both groups. The levels of TNF-Á, IL-6 and IL- In the control group, the difference was significant (P <0.05). Conclusion: The high dose of methotrexate combined with corticosteroids in the treatment of oral lichen planus significantly, the incidence of adverse reactions is not low, reduce the suffering of patients, it is worth widely disseminated.