丹参片治疗口腔黏膜白斑及对局部组织金属基质蛋白酶-2、基质金属蛋白酶-9表达的影响

目的:探讨丹参片治疗口腔黏膜白斑(OLK)的临床疗效及对局部组织细胞金属基质蛋白酶-2、9(MMP-2、MMP-9)表达的影响。方法:选取2014年5月至2016年3月南京中医药大学附属南京市中西医结合医院OLK患者136例,随机分为对照组与观察组,每组68例,同期进行口腔检查的20例健康人群作为健康对照组。对照组患者给予维甲酸和西瓜霜喷雾剂治疗,观察组则在对照组的基础上联合丹参片治疗。2个月为1个疗程,2组均连续治疗1个疗程,治疗后随访12个月。比较2组治疗后临床疗效,采用免疫组化法检测OLK患者及健康对照组局部黏膜组织中MMP-2、MMP-9表达情况。结果:治疗2个月后观察组总有效率为80.88%,显著高于对照组的63.24%(P0.05);治疗4个月后观察组总有效率较治疗2个月后明显升高,且高于对照组(P0.05)。与健康对照组比较,观察组局部黏膜组织中MMP-2和MMP-9阳性表达率明显升高(P0.05);与治疗前比较,治疗2个月及4个月后观察组局部黏膜组织中MMP-2和MMP-9阳性表达率明显降低(P0.05),且治疗4个月后观察组局部黏膜组织中MMP-2阳性表达率低于对照组(P0.05);对照组仅治疗4个月后局部黏膜组织中MMP-2阳性表达率较治疗前降低(P0.05)。2组随访期间观察组复发率明显低于对照组(P0.05),2组癌变率差异无统计学意义(P0.05)。结论:丹参片联合常规药物治疗OLK效果显著,可显著抑制局部组织MMP-2和MMP-9表达,并在短期内对抑制组织癌变具有一定的积极作用。

Effects of Danshen Tablet on Oral Leukoplakia and the Expression of MMP-2 and MMP-9 in Local Tissues

To explore the clinical efficacy of Danshen Tablet on oral leukoplakia (OLK) and its effects on the expression of metal matrix protease-2,9 (MMP-2 and MMP-9) in local tissues.Methods:A total of 136 patients with OLK treated in Nanjing Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Nanjing University of Traditional Chinese Medicine from May 2014 to March 2016 were selected and randomly divided into control group and observation group,with 68 cases in each group,and 20 cases of healthy people were chosen in the same period as healthy control group.The patients in the control group were treated with retinoic acid and watermelon frost spray,and the observation group was treated with Danshen Tablet on the basis of the same treatment.Both groups were treated for 1 course (2 months as a course) and followed up for 12 months after treatment.The clinical effects of the 2 groups were compared and the expressions of MMP-2 and MMP-9 in local mucosa of OLK patients and healthy controls were detected by immunohistochemistry.Results:After 2 months treatment,the total effective rate of the observation group was 80.88%,which was significantly higher than 63.24% of the control group (P<0.05).After 4 months'' treatment,compared with 2 months treatment,the total effective rate in the observation group was significantly increased which was higher than the control group (P<0.05).Compared with the healthy control group,the positive expression rates of MMP-2 and MMP-9 in the local mucosa tissues of OLK patients were significantly increased (P<0.01),and the positive expression rates of MMP-2 and MMP-9 in the local mucosa tissues in the observation group decreased more significantly after 2 months and 4 months treatment than before treatment (P<0.05 or P<0.01).The positive expression rate of MMP-2 in the local mucosa tissues of observation group was decreased more than control group (P<0.05),and the positive expression rate of MMP-2 in local mucosa tissues of the control group 4 months after treatment decreased more significantly than that before treatment (P<0.05).The recurrence rate of the observation group decreased more significantly than that of the control group during the follow-up period (P<0.05),and there was no significant difference in cancer rate between the 2 groups (P>0.05).Conclusion:The combination of Danshen Tablets and conventional drugs have significant effects on OLK.It can significantly inhibit the expression of MMP-2 and MMP-9 in local tissues,which has a positive effect on the inhibition of tissue cancer in the short term.