Clinical Efficacy Of Compound Betamethasone Combined With Befusine In The Treatment Of Erosive Oral Lichen Planus And Its Effect On TNF-α,IL-4 And IL-18

Backgroundoral lichen planus(OLP)is a very common chronic inflammatory disease of oral mucosa that affects patients’ physical and mental health and quality of life,among which erosive oral lichen planus,EOLP is one of the most serious clinical symptoms and the highest rate of malignancy among all the types of OLP.The cause of OLP is unknown,but it is thought to be an immune disease mediated by T cells.Previous studies have shown that Th1 and Th2 cells and their secreted cytokines,such as tumor necrosis factor(TNF),interleukin cells(IL),and interferon(IFN),are associated with the pathogenesis of OLP.TNF-α and IL-4 are the major cytokines secreted by Th1 cells,while IL-18 plays an important role in regulating the balance between Th1 and Th2 cells.Studies have shown that TNF-α,IL-4 and IL-18 are involved in a variety of inflammatory and autoimmune diseases.Currently,there is no cure for OLP.Currently,the main treatment methods include drug therapy,laser therapy,photodynamic therapy,surgery and psychological intervention.Among them,drug treatment can be divided into systemic and local drugs.Currently,drugs that can be used to treat OLP mainly include corticosteroids,immunomodulators and Chinese patent medicines,among which corticosteroids are considered as the first-line treatment drugs for OLP.ObjectiveBy comparing the levels of TNF-α,IL-4 and IL-18 in saliva of erosive oral lichen planus(EOLP)patients and normal healthy individuals,to evaluate whether there is a correlation between EOLP and TNF-α,IL-4 and IL-18.On this basis,the clinical efficacy of compound Betamethasone combined with Befusine in the treatment of EOLP and its effects on TNF-α,IL-4 and IL-18 in saliva were evaluated.Methods1.Sixty EOLP patients admitted to the oral mucosa Department of Qingdao Municipal Hospital and 30 healthy individuals admitted to the physical examination center of Qingdao Municipal Hospital were selected,and there were no significant differences in gender and age between the two groups(P>0.05).The levels of inflammatory cytokines TNF-α,IL-4 and IL-18 in saliva of the two groups were detected by ELISA.The correlation with EOLP was evaluated by comparing the differences in levels of inflammatory cytokines between the two groups.2.60 patients with EOLP were randomly assigned to group A and group B,with30 patients in each group.There was no significant difference in gender,age or course of disease between the two groups(P>0.05).Patients in group B were treated with submucosal injection of compound betamethasone in the lesion area only.After 28 days of initial treatment,the erosion area,pain degree,clinical signs,total effective rate and significant efficiency of the drug,adverse reactions,and the changes of inflammatory factors TNF-α,IL-4 and IL-18 in saliva before and after medication were compared between groups A and B.Result1.The inflammatory factors TNF-α,IL-4 and IL-18 in saliva were significantly correlated with EOLP.2.Before treatment,there was no significant difference in erosion area between group A and Group B(P>0.05),and after treatment,the erosion area of group A was significantly reduced(P<0.05),and after treatment,the erosion area of group A was less than that of group B(P<0.05).3.Before treatment,there was no significant difference in pain degree between group A and Group B(P>0.05),and after treatment,the pain degree in both groups was relieved(P<0.05),but there was no significant difference in pain degree score between the two groups after treatment(P>0.05).4.Before treatment,there was no significant difference in physical signs between group A and Group B(P>0.05),and after treatment,the scores of physical signs in both groups decreased(P<0.05),and the scores of physical signs in group A after treatment were significantly lower than those in group B(P<0.05).5.Both groups were effective on EOLP,and there was no significant difference in the total response rate(P>0.05),but the significant efficiency of group A was higher than that of group B(P<0.05).6.Adverse reactions occurred in group A and Group B,and there was no statistical difference in the incidence of adverse reactions(P>0.05).7.There was no significant difference in the levels of TNF-α,IL-4 and IL-18 in saliva between group A and group B before treatment(P>0.05).After treatment,the levels of TNF-α,IL-4 and IL-18 in saliva of group A decreased significantly(P<0.05).However,only the levels of TNF-α and IL-4 in saliva of patients in group B decreased after treatment(P<0.05),and there was no significant difference in the level of IL-18 before and after treatment(P>0.05).Moreover,the levels of TNF-α and IL-4 in saliva of patients in group A were much lower than those in group B(P<0.05).Conclusions1.The inflammatory cytokines TNF-α,IL-4 and IL-18 in saliva were significantly increased in EOLP.2.Compound Betamethasone combined with Befusine in the treatment of EOLP can effectively promote the healing of erosive surface,relieve pain and inhibit related inflammatory factors.3.The clinical effect of compound betamethasone combined with befusine on EOLP is better than that of compound Betamethasone monotherapy.