关键词: 富血小板血浆凝胶, 富血小板纤维蛋白, 复方倍他米松, 糜烂型口腔扁平苔藓, 炎性因子

Abstract: Objective    To investigate the clinical efficacy of platelet-rich plasma（PRP）gel combined with compound betamethasone on erosive oral lichen planus（OLP）. Methods    A total of 80 patients with erosive OLP who were admitted to Xuzhou Central Hospital from September 2020 to September 2023 were enrolled and divided into the study group（40 cases）and the control group（40 cases）according to the random number table method. The study group was treated with compound betamethasone combined with PRP gel，and the control group was treated with compound betamethasone，the lesion area and pain visual analogue scale（VAS）before treatment and after 4 and 8 weeks of treatment，interleukin 17（IL-17），tumor necrosis factor-α（TNF-α） and the ratio of CD4+ T cells to CD8+ T cells（CD4/CD8）before and after 8 weeks of treatment，the clinical efficacy after 8 weeks of treatment，and the occurrence of adverse reactions during treatment were recorded. Results    There were no significant differences in lesion area，VAS score，IL-17 and TNF-α expressions，and CD4/CD8 between the two groups before treatment（all P > 0.05）. After 4 and 8 weeks of treatment，the lesion area in the study group were（2.40 ± 0.84）cm2 and （1.37 ± 0.61）cm2，respectively，which were smaller than that of the control group with the same treatment time ［（2.93 ± 0.85）cm2 and（2.33 ± 0.91）cm2］，both were significantly smaller than those before treatment；the VAS scores in the study group were（2.50 ± 0.65）and（1.74 ± 0.57）， respectively，which were smaller than that of the control group with the same treatment time ［（3.00 ± 0.68）and（2.47 ± 0.85）］，both were significantly lower than those before treatment，the differences were statistically significant（all P < 0.05）. After 8 weeks of treatment，in the study group，29 cases（72.5%）had significant effective treatment，9 cases（22.5%）had effective treatment，and 2 cases（5.0%）had ineffective treatment，while 20 cases（50.0%）had significant effective treatment，12 cases（30.0%）had effective treatment and 8 cases（20.0%）had ineffective treatment in the control group，there was a statistically significant difference between the two groups（Z = 2.266，P = 0.023）. The expressions of IL-17 and TNF-α in the study group were lower than those in the control group，the CD4/CD8 levels were higher than those in the control group，the differences were statistically significant（all P < 0.05）. There were no serious adverse reactions in the two groups during the treatment，the incidence of adverse reactions was 10%（4/40）in the study group and 15%（6/40）in the control group，there was no statistically significant difference between the two groups（χ2 = 0.114，P = 0.735）. Conclusion    In the 8-week clinical treatment，PRP gel combined with compound betamethasone has a better therapeutic effect on erosive OLP than compound betamethasone is used alone，which is worthy of clinical promotion and in-depth research.

Key words: platelet-rich plasma gel, platelet-rich fibrin, compound betamethasone, erosive oral lichen planus, inflammatory factors