Comparison Of Clinical Effect After Treatment Erosive Oral Lichen Planus With Thalidomide Or Methylprednisolone Together With Tripterygium Hypoglaucum Hutch Respectively

Objective It’s designed to observe the changes of clinical symptoms and signs of erosive oral lichen planus(EOLP)treated with thalidomide combined with tripterygium hypoglaucum hutch and methylprednisolone combined with tripterygium hypoglaucum hutch respectively.To compare the clinical efficacy of thalidomide combined with tripterygium hypoglaucum hutch and methylprednisolone combined with tripterygium hypoglaucum hutch in the treatment of erosive oral lichen planus,and to provide further clinical basis for systemic drug use of erosive oral lichen planus.Methods 100 patients with erosive oral lichen planus who were selected to visit the department of oral mucosa disease of stomatological hospital,General Hospital of Ningxia Medical University in September 2019~ December 2020,Randomly divided into two groups(group A,group B)according to the order of visits.Systemic treatment short-term medication:group A for Thalidomide tablets,50 mg,take orally every night before bedtime,discontinue use after erosion heals;group B was Methylprednisolone tablets,8 mg,take orally in the morning on an empty stomach,discontinue use after erosion heals.General treatment long-term medication: group A and group B all used Tripterygium hypoglaucum hutch tablets,0.56 g,take orally 3 times a day,2 months as a course of treatment.Local treatment: both groups A and groups B used Compound chlorhexidine gargle,rinse the mouth,3~5 minutes and 2 times a day;and used Recombinant human epidermal growth factor,Spray erosion surface of the mouth,no eating and swallowing in 30 minutes after treatment,fasting,once a day.The subjective pain degree,the lesion erosion area and T cell subpopulation level before and after medication,the adverse reactions during treatment and the recurrence after stopping short-term medication were observed and recorded in group A and group B;the clinical symptoms and signs of EOLP patients were compared between group A and group B before and after treatment,and whether there was any difference in the efficacy of the two groups after treatment,and the adverse reactions and the recurrence were observed in the two groups.SPSS 26.0 professional statistical software package was used to process data.Results After 4 weeks of treatment,the clinical efficacy were compared between the two groups,among the 50 EOLP patients in group A,15 cases were obvious effective,26 cases were effective,9 cases were ineffective,and the total effective rate was 82.0%;among the 50 patients in group B,24 cases were obvious effective,23 cases were effective,3 cases were ineffective,the total effective rate was 94.0%,the difference was statistically significant(P<0.05).Comparison of mean difference of T lymphocyte subsets before and after treatment in 2 groups,CD4+/CD8+ mean difference in group A was significantly higher than that in group B,the difference was statistically significant(P < 0.05).During the treatment process,3 EOLP patients had adverse reactions in group A,1 EOLP patients had adverse reactions in group B,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).After 3 months of short-term treatment,the recurrence of the two groups was observed,2 cases of the 15 obvious effective patients recurred in the group A,and 1 cases of the 24 obvious effective patients recurred in the group B,there was no significant difference between the two groups(P>0.05).Conclusion Both Thalidomide combined with Tripterygium hypoglaucum hutch and Methylprednisolone combined with Tripterygium hypoglaucum hutch treat erosive oral lichen planus can obtain the better curative effect.However,the clinical effect of Methylprednisolone combined with Tripterygium hypoglaucum hutch in the treatment of erosive oral lichen planus was better than that of Thalidomide combined with Tripterygium hypoglaucum hutch.According to the results of this study,the systemic treatment of erosive oral lichen planus patients: Methylprednisolone is used for short term,Chinese patent medicine with immune regulation should be selected for long-term use(such as Tripterygium hypoglaucum hutch tablet);if the patient has hormone contraindication,in the absence of Thalidomide contraindication,Thalidomide can be replaced with Methylprednisolone for treatment.