血府逐瘀汤联合糖皮质激素治疗急性期气滞血瘀证糜烂型口腔扁平苔藓疗效及作用机制分析

目的:观察血府逐瘀汤联合糖皮质激素治疗急性期气滞血瘀证糜烂型口腔扁平苔藓(OLP)的疗效及可能的作用机制。方法:随机抛掷硬币方式将86例确诊为气滞血瘀证糜烂型OLP的急性期患者分为两组。对照组单纯使用西药进行治疗; 研究组在糖皮质激素使用基础上,服用血府逐瘀汤。观察比较两组临床效果、症状体征、血液流变性血浆黏度(PV)、血沉(ESR)、纤维蛋白原(Fib)]、1min血小板聚集率(PAG)、细胞(CD₃⁺、CD₄⁺、CD₄⁺/CD₈⁺)和体液免疫(IgM、补体C₃)功能。结果:研究组临床效果显著优于对照组(P<0.01)。治疗后,VAS评分和灰白花纹、充血糜烂和溃疡面积明显小于对照组(P<0.01)。血液流变性指标PV、ESR、Fib、1minPAG、CD₄⁺/CD₈⁺和IgM水平明显低于对照组(P<0.01)。CD₃⁺、CD₄⁺、补体C₃水平明显高于对照组(P<0.01)。结论:血府逐瘀汤联合糖皮质激素治疗气滞血瘀证糜烂型OLP急性期疗效较好,可有效改善口腔黏膜症状,缓解口腔疼痛,其机制可能与改变血液流变性和血流变聚集率,调节机体免疫功能等有关。

Therapeutic effect and mechanism of Xuefu Zhuyu decoction combined with glucocorticoid on erosive oral lichen planus in Qizhi Xueyu type syndrome

Objective:To observe the efficacy and possible mechanism of Xuefu Zhuyu decoction combined with glucocorticoids in the treatment of erosive oral lichen planus(OLP)with Qizhi Xueyu type.Methods:86 patients with acute phase of erosive OLP diagnosed as Qizhi Xueyu type were divided into two group by randomly coin tossing method.The control group was treated with western medicine alone.The research group took Xuefu Zhuyu decoction with glucocorticoid.The clinical effects,symptoms and signs,blood rheology plasma viscosity(PV),ESR,fibrinogen(Fib)],platelet aggregation rate(PAG),cells(CD₃⁺,CD₄⁺,CD₄⁺/CD₈⁺)and humoral immunity(IgM,complement C₃)function indexs were observed and compared.Results:The clinical effect of the study group was significantly better than that of the control group(P<0.01).After treatment,the VAS score and gray pattern,hyperemic erosion,and ulcer area were significantly smaller than those in the control group(P<0.01).The levels of PV,ESR,Fib,1min PAG,CD₄⁺/CD₈⁺,and IgM were significantly lower than those in the control group(P<0.01).CD₃⁺,CD₄⁺ and complement C₃ level was significantly higher than the control group(P<0.01).Conclusion:Xuefu Zhuyu decoction combined with glucocorticoids is effective in the acute phase of erosive OLP due to Qizhi Xueyu type.It can effectively improve oral mucosa symptoms and relieve oral pain.The mechanism may be related to changing blood rheology and hemorheological aggregation rate,and regulating the body's immune function.