光动力疗法或低水平激光疗法对抗激素治疗在治疗糜烂型萎缩性口腔扁平苔藓中的疗效。

Efficacy of photodynamic therapy or low level laser therapy against steroid therapy in the treatment of erosive-atrophic oral lichen planus.

机构信息

Department of Oral Pathology, Faculty of Dentistry, Ziauddin University, Karachi, Pakistan.

Private Practice, Wahat Alshifa Medical Center, Medina, Saudi Arabia.

出版信息

Photodiagnosis Photodyn Ther. 2018 Mar;21:404-408. doi: 10.1016/j.pdpdt.2018.02.001. Epub 2018 Feb 4.

DOI:10.1016/j.pdpdt.2018.02.001

PMID:29414735

Abstract

BACKGROUND

The efficacy of photodynamic therapy (PDT) or low level laser therapy (LLLT) in the treatment of oral lichen planus (OLP) is debatable. The aim of this study was to compare the effects of PDT, LLLT or topical corticosteroid application in the treatment of erosive-atrophic OLP.

MATERIALS AND METHODS

Forty-five adult patients with erosive-atrophic biopsy-proven OLP on the tongue or buccal mucosa (size ≤3 cm) were randomly divided into three groups. Group-1: patients receiving PDT topical application of 50 μl toluidine blue (1 mg/ml) with micropipette and after 10 min treated by laser irradiation using GaAlAs laser (630 nm, 10 mW/cm, continuous wave, spot size: 1 cm); Group-2: patients receiving LLLT using diode laser (630 nm, 10 mW, continuous wave, spot size: 1 cm); and Group-3: patients receiving topical corticosteroid applications consisting of dexamethasone (0.5 mg in 5 ml water) mouthwash for 5 min. Demographic data, type, and severity of the lesions and pain were recorded before and after treatment and then at the 1 year follow-up.

RESULTS

There was a significant difference in sign score changes before and after the treatment in the PDT group (p = 0.03), LLLT group (p = 0.04) and in the control group (p = 0.02). There was a statistically significant difference between group-1 (p = 0.001) and group-2 (p = 0.001) against group-3 before and after treatment. Mean amount of improvement in pain was significantly greater in the control group in comparison with the PDT and LLLT groups (p < 0.001). The efficacy index of the PDT group improved significantly more than the LLLT (p = 0.001) and corticosteroid groups (p = 0.001).

CONCLUSION

Within the limits of the present RCT, it is indicated that PDT and LLLT are effective in the treatment of erosive-atrophic forms of OLP in adult patients. However, further comparative clinical trials are needed to obtain strong conclusions in this regard.

摘要

背景

光动力疗法（PDT）或低水平激光疗法（LLLT）治疗口腔扁平苔藓（OLP）的疗效存在争议。本研究旨在比较 PDT、LLLT 或局部皮质类固醇治疗糜烂型萎缩性 OLP 的疗效。

材料与方法

45 例成人糜烂型萎缩性 OLP 患者（舌或颊黏膜，大小≤3cm），随机分为三组。组 1：患者用微量移液器将 50μl 甲苯胺蓝（1mg/ml）涂于口腔，10 分钟后用 GaAlAs 激光（630nm，10mW/cm，连续波，光斑大小：1cm）照射；组 2：患者用二极管激光（630nm，10mW，连续波，光斑大小：1cm）治疗；组 3：患者接受地塞米松（5ml 水 0.5mg）漱口水治疗，5 分钟。记录治疗前后及 1 年随访时的人口统计学数据、病变类型和严重程度及疼痛情况。

结果

PDT 组（p=0.03）、LLLT 组（p=0.04）和对照组（p=0.02）治疗前后体征评分均有显著差异。治疗前后，组 1（p=0.001）与组 2（p=0.001）与组 3 之间存在统计学差异。与 PDT 组和 LLLT 组相比，对照组疼痛缓解程度显著更大（p<0.001）。PDT 组的疗效指数明显优于 LLLT（p=0.001）和皮质类固醇组（p=0.001）。