Clinical observation on the treatment of oral lichen planus with total glucosides of paeony capsule combined with corticosteroids

Abstract

Introduction: Oral lichen planus (OLP) is a relatively common, chronic immune-mediated disease. The main treatment for OLP has been the administration of topical or systemic corticosteroids, but side effects have limited their use. We aimed to assess the effect and adverse reaction of total glucosides of paeony capsule (TGPC) in combination with corticosteroids for the treatment of OLP.

Methods: Eighty one patients with a confirmed clinical and histopathologic diagnosis of OLP (44 reticular OLP [ROLP] patients, 37 erythematous/erosive OLP [EOLP] patients) were enrolled. Patients were treated with topical or systemic corticosteroids, with or without 1200mg TGPC in the ROLP and EOLP groups, respectively. Patients were followed for 6months. The pain and severity of the lesions were recorded at the initial visit and monthly thereafter during the follow-up period.

Results: Seventy three of 81 patients completed the scheduled treatment period. In the ROLP patient group, combined treatment significantly reduced the visual analogue scale (VAS) at months 3, 5, and 6. The clinical signs (CS) of ROLP patients worsened during the follow-up period in control group. However, CS in the combined treatment group remained largely unchanged at months 4-6. In the EOLP patient group, the VAS decreased almost equally in patients with and without combined treatment at months 1-2, but continued to significantly decrease in the combined treatment group in months 4-6. The CS of the combined treatment group decreased gradually over time in the study period, with significantly lower scores in the treatment versus control group (which decreased slightly in the first three months, then remained almost unchanged during the following visits). The effective rates of combined treatment were statistically higher versus control groups both in ROLP and EOLP patients.

Conclusions: TGPC is a safe and effective drug for OLP with rare side effects. Combined treatment of TGPC with corticosteroids shows a definite therapeutic effect. More than four months of medical treatment of TGPC is recommended to achieve the full effect.

Keywords: Clinical observation; Combined therapy; Corticosteroids; Oral lichen planus; Total glucosides of paeony capsule.