单次大剂量曲安奈德局部封闭治疗外阴白色病变28例临床观察

Application of subcutaneous injection of large dose of triamcinolone acetonide in the treatment of vulvar lichen sclerosus and squamous hyperplasia

关键词:  外阴白色病变  曲安奈德  局部封闭治疗

Key words:  triamcinolone acetonide  vulvar lichen sclerosus  vulvar squamous hyperplasia

摘要:

［目的］探讨单次大剂量曲安奈德局部封闭治疗外阴白色病变安全性和可行性。［方法］随机选取28例治疗组和30例对照组外阴白色病变患者分别给与曲安奈德单次50 mg皮下注射和5 mg 1次/周皮下注射，4~6次为1疗程，治疗后3~6个月随访局部皮颜色，搔痒症状改善情况。［结果］治疗组临床治愈18例，显效8例，好转2例，显效率92.85%，其中鳞状细胞增生型治愈9例，显效3例，好转1例；硬化苔藓型治愈9例，显效5 例，好转1例，两者差异无显著性意义（P>0.05）。停止治疗6个月后有2例患者又出现明显的外阴瘙痒，占7.14%。对照组临床治愈12例，显效14例，好转4例，显效率86.67%，其中鳞状细胞增生型治愈6例，显效7例，好转6例；硬化苔藓型治愈6例，显效8例，好转2例。停止治疗6个月，有8例又出现明显的外阴瘙痒，占20%。治疗组与对照组两组的治愈率差异无统计学意义，P>0.05，治疗组的复发率低于对照组，P<0.05。［结论］单次大剂量曲安奈德局部封闭治疗外阴白色病变安全可行，方法简便，无明显并发症出现，疗效可靠。

Abstract:

［Objective］ To evaluate the efficiency and safety of subcutaneous injection of large dose of triamcinolone acetonide (TA) in the treatment of vulvar lichen sclerosus and squamous hyperplasia.［Method］ Patients with symptoms of vulvar pruritus that lasted more than 6 months were studied. After appropriate biopsies were performed, 58 patients were divided into treatment and control groups randomly. In the treatment group, 28 patients were subcutaneously injected with 50 mg of TA only once. In the control group, 30 patients were subcutaneously injected with 5 mg of TA in each week for 4 to 6 weeks. The patients' pretreatment and post treatment clinical symptoms and gross physical findings were followed up. In all patients pretreatment and some post treatment biopsies were performed.［Results］ There was a decrease in severity scores in the categories of symptoms and physical findings. In ten patients who consented to post treatment biopsy,there was a decrease in severity scores on histo-pathologic findings. The duration of subcutaneous TA effects on the relief of symptoms of chronic vulvar pruritus was increased with enhanced dosage.［Conclusion］ The application of subcutaneous injection 50 mg TA in the treatment of vulvar lichen sclerosus and squamous hyperplasia is effective, less complications, and low cost.