目的 探讨白芍总苷胶囊联合醋酸地塞米松口腔贴片治疗口腔扁平苔藓的临床疗效。方法 纳入2023年3月—2025年5月安徽医科大学第五附属医院收治的116例口腔扁平苔藓患者，按随机数字表法分为对照组和治疗组，每组各58例。对照组采用醋酸地塞米松口腔贴片治疗，1片/次，1次/d。在对照组的基础上，治疗组口服白芍总苷胶囊，2粒/次，3次/d。两组均治疗4周。比较两组临床疗效、临床表现缓解时间，治疗前后视觉模拟量表（VAS）评分、14项口腔健康影响程度量表（OHIP-14）评分及唾液中白细胞介素-17A（IL-17A）、β防御素2（HBD-2）、基质金属蛋白酶-13（MMP-13）水平和外周血CD4⁺/CD8⁺值。结果 治疗后，治疗组总有效率（96.55%）较对照组（86.21%）更高（P＜0.05）。治疗后，治疗组各项临床表现（黏膜充血、局部灼痛等）的缓解时间均短于对照组（P＜0.05）。治疗后，两组患者疼痛VAS评分和OHIP-14评分均减少（P＜0.05）；且治疗组上述评分均低于对照组（P＜0.05）。治疗后，两组患者唾液中IL-17A、HBD-2、MMP-13水平均降低（P＜0.05），外周血CD4⁺/CD8⁺值升高（P＜0.05）；且治疗组上述指标均优于对照组（P＜0.05）。结论 白芍总苷胶囊联合醋酸地塞米松口腔贴片治疗口腔扁平苔藓，能有效调节免疫功能及口腔局部微环境，进而减轻免疫炎症损害，促进患者恢复及症状和疼痛缓解，利于生活质量改善。

Objective To evaluate the clinical efficacy of Total Glucosides of Paeony Capsules combined with Dexamethasone Acetate Oral Patches in treatment of oral lichen planus.Methods A total of 116 patients with oral lichen planus admitted to the Fifth Affiliated Hospital of Anhui Medical University between March 2023 and May 2025 were enrolled. The patients were divided into a control group and a treatment group using the random number table method, with 58 cases in each group. Patients in the control group were treated with Dexamethasone Acetate Oral Patches, one patch once daily. On the basis of the control regimen, patients in the treatment group were po administered with Total Glucosides of Paeony Capsules, 2 capsules/time, three times daily. Both groups underwent a 4-week treatment course. The two groups were compared in terms of clinical efficacy, relief time of clinical manifestations, Visual Analogue Scale (VAS) scores, 14-item Oral Health Impact Profile (OHIP-14) scores before and after treatment, salivary levels of interleukin-17A (IL-17A), human beta-defensin 2 (HBD-2), matrix metalloproteinase-13 (MMP-13), as well as the peripheral blood CD4⁺/CD8⁺ ratio. Results After treatment, the total effective rate of the treatment group was significantly higher than that of the control group (96.55%) vs (86.21%, P < 0.05). The relief time of clinical manifestations including mucosal congestion and local burning pain in the treatment group was markedly shorter than that in the control group (P < 0.05). Post-treatment VAS pain scores and OHIP-14 scores were decreased in both groups (P < 0.05), and these scores were lower in the treatment group relative to the control group (P< 0.05). Salivary IL-17A, HBD-2 and MMP-13 levels declined, while the peripheral blood CD4⁺/CD8⁺ ratio increased in both groups after treatment (P < 0.05); all indicators in the treatment group were superior to those in the control group (P < 0.05). Conclusion Total Glucosides of Paeony Capsules combined with Dexamethasone Acetate Oral Patches in treatment of oral lichen planus can effectively regulate immune function and the local oral microenvironment for oral lichen planus. It further alleviates immune inflammatory injury, accelerates symptom and pain relief and patient recovery, and contributes to the improvement of patients’ quality of life.

R988.2

安徽省教育厅高等学校科研计划项目（2024AH050689）