目的 观察沙利度胺与倍他米松协同治疗糜烂型口腔扁平苔藓临床疗效。方法 选取2022年9月—2024年10月唐山市妇幼保健院收治的118例患者，随机分为对照组（59例）和治疗组（59例）。对照组患者病变部位黏膜基底注射复方倍他米松注射液，2%利多卡因1 mL稀释后，0.2～0.4 mL/cm²，每2周1次。在对照组的基础上，治疗组口服沙利度胺片，2片/次，2次/d。两组患者用药8周。观察两组患者临床疗效，比较治疗前后两组患者症状好转时间、疼痛评分、氧化应激和炎性水平。结果 治疗后，治疗组总有效率（98.31%）明显高于对照组有效率（84.75%，P＜0.05）。治疗后，与对照组比，治疗组口腔烧灼感、口腔疼痛、口腔黏膜白斑、口腔粗涩感等症状好转时间均更快（P＜0.05）。治疗后，两组疼痛视觉模拟疼痛评分法（VAS）评分比治疗前明显下降（P＜0.05），且治疗后，与对照组对比，治疗组VAS评分降低更显著（P＜0.05）。治疗后，两组丙二醛（MDA）、8-羟基脱氧鸟苷（8-OHdG）、白细胞介素-1β（IL-1β）、IL-6、肿瘤坏死因子-α（TNF-α）、IL-18水平比治疗前明显下降，而总抗氧化能力（TAC）水平明显升高（P＜0.05）；且治疗后，与对照组对比，治疗组氧化应激和炎性水平显著好于对照组（P＜0.05）。结论 沙利度胺与倍他米松协同治疗糜烂型口腔扁平苔藓疗效显著，对临床症状有较大的改善，患者口腔局部炎症反应减弱，口腔疼痛降低。

Objective To explore the clinical effect of thalidomide combined with betamethasone in treatment of erosive oral lichen planus.Methods Patients (118 cases) with erosive oral lichen planus in Tangshan Maternal and Child Health Hospital from September 2022 to October 2024 were randomly divided into control (59 cases) and treatment (59 cases) group. Patients in the control group were injected with Compound Betamethasone Injection to the mucosal base of the lesion site, diluted with 1 mL of 2% lidocaine, 0.2 — 0.4 mL/cm², once every two weeks. Patients in the treatment group were po administered with Thalidomide Tablets on the basis of the control group, 2 tablets/time, twice daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical evaluations were evaluated, and the symptom relief time, oral pain scores, oxidative stress levels, inflammatory factors in two groups before and after treatment were compared.Results After treatment, the total effective rate in the treatment group (98.31%) was significantly higher than the control group (84.75%, P < 0.05). After treatment, compared with the control group, symptoms such as oral burning sensation, oral pain, oral leukoplakia, and oral astringent sensation in the treatment group all improved faster (P < 0.05). After treatment, the VAS scores in two groups were significantly decreased compared with those before treatment (P < 0.05), and after treatment, compared with the control group, the VAS scores were decreased more significantly in the treatment group (P < 0.05). After treatment, the levels of MDA, 8-OHdG, IL-1β, IL-6, TNF-α, and IL-18 in two groups were decreased significantly compared with those before treatment, while the level of TAC was significantly increased (P < 0.05), and compared with the control group, the levels of oxidative stress and inflammation in the treatment group were significantly better than those in the control group (P < 0.05).Conclusion The synergistic treatment of betamethasone and thalidomide has significant curative effects on erosive oral lichen planus, which has greatly improved clinical symptoms, weakened the local inflammatory reaction in the patient's mouth, and reduced oral pain.

R988.2

2023年度河北省医学科学研究课题计划（编号：20231762）