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中华口腔医学研究杂志(电子版) ›› 2021, Vol. 15 ›› Issue (06) : 355 -359. doi: 10.3877/cma.j.issn.1674-1366.2021.06.005

临床研究

铒激光联合曲安奈德治疗口腔黏膜下纤维化的疗效评价
马慧颖1,(), 何志良1, 李士辉1, 岳琳1, 李春佳1   
  1. 1. 承德市中心医院口腔科 067000
  • 收稿日期:2021-09-28 出版日期:2021-12-01
  • 通信作者: 马慧颖

Effect of erbium laser combined with triamcinolone acetonide on oral function in patients with oral submucosal fibrosis

Huiying Ma1,(), Zhiliang He1, Shihui Li1, Lin Yue1, Chunjia Li1   

  1. 1. Department of Stomatology, Chengde Central Hospital, Chengde 067000, China
  • Received:2021-09-28 Published:2021-12-01
  • Corresponding author: Huiying Ma
  • Supported by:
    Technology Support Programme of Chengde(202006A018)
引用本文:

马慧颖, 何志良, 李士辉, 岳琳, 李春佳. 铒激光联合曲安奈德治疗口腔黏膜下纤维化的疗效评价[J]. 中华口腔医学研究杂志(电子版), 2021, 15(06): 355-359.

Huiying Ma, Zhiliang He, Shihui Li, Lin Yue, Chunjia Li. Effect of erbium laser combined with triamcinolone acetonide on oral function in patients with oral submucosal fibrosis[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2021, 15(06): 355-359.

目的

研究铒激光联合曲安奈德治疗对口腔黏膜下纤维化(OSF)患者口腔功能及低氧诱导因子1α(HIF-1α)、黏膜成纤维细胞(NM-FB)因子的影响。

方法

本研究采用前瞻性研究方法,以2017年2月至2020年1月在承德市中心医院口腔科进行治疗的120例OSF患者作为研究对象;采用信封法,按照随机分组原则,将全部患者随机分为观察组及对照组,每组60例,所有患者均采用曲安奈德进行治疗,观察组患者在此基础上联合采用铒激光进行治疗,两组患者均治疗9周。比较两组患者的疼痛情况、口腔健康影响程度量表(OHIP-14)中文版评分、治疗效果、HIF-1α、NM-FB水平、白细胞介素1β(IL-1β)、肿瘤坏死因子α(TNF-α)和IL-6之间的差异。

结果

经过治疗后,2组患者的视觉模拟评分(VAS)值显著下降,且观察组VAS值[(1.21 ± 0.95)分]显著低于对照组[(2.60 ± 0.96)分],差异有统计学意义(t = 7.972,P<0.001);两组患者的OHIP-14评分显著下降,且观察组OHIP-14评分[(24.65 ± 1.45)分]显著低于对照组[(29.21 ± 1.33)分],差异有统计学意义(t = 17.952,P<0.001);观察组患者的治疗总有效率(91.67%)显著高于对照组(78.33%),差异有统计学意义(χ2 = 4.182,P = 0.041);两组患者的HIF-1α、NM-FB水平均显著下降,且观察组患者的HIF-1α、NM-FB水平显著低于对照组;两组患者的IL-1β、TNF-α及IL-6均显著下降,且观察组患者的IL-1β、TNF-α及IL-6均显著低于对照组。

结论

采用铒激光联合曲安奈德治疗OSF,患者HIF-1α、NM-FB水平显著下调,口腔功能显著改善,治疗效果显著。

Objective

To investigate the effect of erbium laser combined with triamcinolone acetonide on oral function, hypoxia-inducible factor-1α (HIF-1α) and normal mucous fibroblasts (NM-FB) in patients with oral submucosal fibrosis (OSF) .

Methods

In this prospective study, 120 cases of oral submucosal fibrosis treated in our hospital from February 2017 to January 2020 were selected as the research objects. According to the principle of random grouping, the above patients were randomly divided into observational group and control group, 60 cases in each group. All patients were treated for 9 weeks. The observational group was treated with combined with triamcinolone acetonide, while the control group with triamcinolone acetonide only. The differences of pain, oral health impact profile (OHIP-14) score, treatment effect, HIF-1α, NM-FB level and inflammatory reaction between the two groups were compared.

Results

After treatment, the visual analogue scale (VAS) of the two groups decreased significantly. The VAS of the observational group was significantly lower than that of the control group[ (1.21 ± 0.95) vs (2.60 ± 0.96) ] (t = 7.972, P<0.001) . The OHIP-14 score in the observational group was significantly lower than that in the control group[ (24.65 ± 1.45 vs (29.21 ± 1.33) ] (t = 17.952, P<0.001) . The total effective rate in the observational group (91.67%) was significantly higher than that in the control group (78.33%) , where there was significant difference (χ2 = 4.182, P = 0.041) . The levels of HIF-1α and NM-FB in the observational group were significantly lower than those in the control group. The levels of IL-1β, TNF-α and IL-6 in the two groups were significantly decreased. The levels of IL-1β, TNF-α and IL-6 in the observational group were significantly lower than those in the control group.

Conclusions

Erbium laser combined with triamcinolone acetonide was used in the treatment of oral submucosal fibrosis. The HIF-1α and NM-FB were significantly decreased, and the oral function was significantly improved.

表1 本研究120例口腔黏膜下纤维化患者的一般资料(±s
表2 本研究120例口腔黏膜下纤维化患者治疗前后疼痛情况比较(分,±s
表3 本研究120例口腔黏膜下纤维化患者治疗前后口腔健康程度比较(±s
表4 不同严重程度口腔黏膜下纤维化患者的治疗效果比较[例(%)]
表5 本研究120例口腔黏膜下纤维化患者治疗前后低氧诱导因子1α(HIF-1α)、黏膜成纤维细胞(NM-FB)水平比较(ng/L,±s
表6 本研究120例口腔黏膜下纤维化患者治疗前后炎性因子水平比较(ng/L,±s
图1 口腔黏膜下纤维化患者治疗前后口内照片 A:治疗前,箭头示左侧颊部黏膜至咽部黏膜大面积色白,黏膜轻度不透明,局部少量黏膜呈条索状;B:治疗后,箭头示左侧颊部黏膜有明显改善,黏膜病变范围明显缩小。
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