| Objective:To research the clinical efficacy of Xipayi mouth rinse in combination with thalidomide in the treatment of erosive oral lichen planus(E-OLP)and to observe the changes in oral flora before and after treatment.Methods:1.60 patients were randomly assigned to two groups of experimental and control,with each group composed of 30 members,who had been diagnosed with E-OLP by clinical and histopathological confirmation.2.Patients were given Xipayi mouth rinse and thalidomide tablets in the experimental group for a period of four weeks,and patients in the control group were treated with only thalidomide for the same time limit,and rinsed distilled water in the same amount as Xipayi mouth rinse.3.Information on patients’ symptoms and pain levels at the initial consultation and after 1 and 4 weeks of medication were recorded by the same physician who was unaware of the specific subgroup,comparing the differences in objective symptoms(REU),subjective pain levels(VAS),and OHIP-14 between patients treated before and after treatment 1 and 4 and between the two groups at 1 and 4 weeks.4.Ten person in the experimental group were randomly selected to collect mixed cotton swabs of both cheek mucosa and saliva before and after four weeks of treatment.Saliva p H was tested and recorded before each collection,and the two groups of samples collected were marked as A(before rinsing)and B(after rinsing)respectively.5.The samples obtained from the two groups were amplified by the V3-V4 variable region of 16 Sr DNA and sequenced by a high-throughput Illumina Nova Seq sequencer to observe the composition of the oral flora between the two groups.Results:1.There were no statistically significant differences in age,sex,course of disease,oral hygiene status,and clinical observational indicators at the time of initial diagnosis between the experimental group and the control group(P>0.05).2.After 1 and 4 weeks of treatment in the two groups,intra-group comparisons were made: the REU score,VAS score and OHIP-14 scale scores decreased in both groups at weeks 1 and 4 compared to the pretreatment period,and the comparisons were statistically significant(P<0.05);inter-group comparisons were made: the REU score,VAS score and OHIP-14 scale scores were statistically significant(P<0.05).The comparison between the two groups was statistically significant(P<0.05).3.Salivary p H was not significantly different between the two groups by highthroughput sequencing(p>0.05).A total of 949,302 clear reads and 9245 signature sequences(ASVs)with an average length of 426 bp were obtained for both groups.4.The species analysis composition showed that: at the genus level,the B group had decreased abundance of Fusobacterium,Neisseria,Pre-votella,Haemophilus and Actinobacillus compared to the A group;and increased abundance of Streptococcus,Veillonella,Porphyromonas,Rothia and Leptotrichia.At the phylum level,the B group showed an decrease in the abundance of Fusobacteria,Bacteroidetess and Proteobacteria and a increase in the abundance of Fimicutes,Tenericutes,Actinobacteria,TM7,SR1,Spirochaetes and Synergisteetes compared to the B group.5.Analysis of differences between groups compared Beta diversity between the two groups and found significant differences between the two groups(p<0.05).Conclusion:1.Treatment with Xipayi mouth rinse in combination with thalidomide was more effective than treatment with thalidomide and distilled water.This suggests that this combination of treatment from flora and immunomodulation is effective and worth promoting.2.After four weeks of using Xipayi mouth rinse in combination with thalidomide orally,the oral flora of patients with erosive oral lichen planus was significantly different from that before treatment,indicating that Xipayi mouth rinse can play a role in regulating the oral flora of patients with erosive oral lichen planus. |
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