- 期刊
Medical Therapy on Patients with Oral Lichen Planus
口腔扁平苔癬患者的藥物治療
摘要
本扁平苔癬是一種與T細胞免疫反應相關的慢性發炎疾病，臨床上主要以網狀、紅斑狀、侵襲性三種形式呈現。扁平苔癬的患者常抱怨患處有燒灼感(70.10%)、疼痛(37.11%)與粗糙感(11.34%)，大多數患者若症狀明顯就需要加以治療。目前針對這種頑固型的疾病有多種藥物治療，特別是治療紅斑狀或侵襲狀的扁平苔癬，但是因為它的頑固性所以很難完全根治。在多種治療藥物中，皮質類固醇類被廣泛使用，特別是去氫化可體松(prednisolone)更是最常被使用，但是在接受皮質類固醇類治療的患者中卻有高達1/3的患者會產生繼發性的口腔念珠球菌感染而須接受治療，且若長期使用常會併發腎上腺性抑制，而須對患者長期追蹤觀察。對扁平苔癬患者給予較強力的免疫抑制劑或免疫調節劑如cyclosporine、retinoids、tacrolimus等藥物也被認為是有效的。比較以上各種藥物，針對扁平苔癬患者以去氫化可體松結合中藥的治療，可以增強免疫力，抵抗扁平苔癬的發炎反應，延長復發時間，減少副作用並且價格較便宜。
並列摘要
Oral lichen planus (OLP) is a T cell-mediated chronic inflammatory disorder. It may manifest one of three clinical forms: reticular, erythematous and erosive. OLP patients complained of a burning sensation (70.10%) and pain (37.11%), while others complained of roughness (11.34%). Most patients with symptomatic should be treated if symptoms are significant. Various treatment regimens have been attempted to improve the refractory lesions, especially in atrophic–erosive OLP, but a complete cure has not been accomplished because of its recalcitrant nature. The most commonly employed and useful agents for the treatment of OLP are corticosteroids, among which prednisolone is widely available. But, one third of OLP patients treated with topical corticosteroids develop secondary candidiasis which necessitates treatment. The potential for adrenal suppression from prolonged use, especially for a chronic disease, demands careful and frequent follow-up examinations. The addition of potent immunosuppressants or immunomodulatory agents such as cyclosporine, retinoids, tacrolimus may be beneficial in this group of patients. Compared with other medicines, prednisolone plus Chinese medicinal herbs could enhance more immune function, resist OLP inflammation, prolong the recurrent time, reduce side effect and is more cost effective.