内科

目的分析他克莫司软膏联合胸腺肽治疗慢性乙型肝炎合并口腔扁平苔藓的疗效及对患者免疫功能的影响。方法选取2015年9月至2017年1月我院收治的慢性乙型肝炎合并口腔扁平苔藓患者118例作为研究对象，按入院顺序分为两组。对照组给予曲安奈德口腔软膏联合胸腺肽治疗，观察组患者给予他克莫司软膏联合胸腺肽治疗，比较两组患者的临床疗效；检测比较两组患者的T淋巴细胞亚群水平、ALT复常率、HBeAg和乙肝病毒DNA（HBV DNA）转阴率及不良反应发生情况。结果治疗4个月后，观察组患者的治疗总有效率（86.4%）显著高于对照组（67.8%），临床疗效显著优于对照组，差异有统计学意义（P＜0.05）；两组患者的CD4+和CD4+/CD8+水平均有所升高、CD8+水平有所下降，观察组患者的CD4+和CD4+/CD8+水平显著高于对照组、CD8+水平显著低于对照组，差异有统计学意义（P＜0.05）；观察组患者的HBeAg转阴率（66.1%）显著高于对照组（42.4%），HBV DNA转阴率（76.3%）显著高于对照组（55.9%），差异有统计学意义（P＜0.05）。治疗过程中，观察组患者的不良反应发生率（11.9%）显著低于对照组（28.8%），差异有统计学意义（P＜0.05）。结论他克莫司软膏联合胸腺肽进治疗慢性乙型肝炎合并口腔扁平苔藓患者能取得较好的临床治疗效果，能有效提高患者的免疫功能，提高HBeAg、HBV DNA转阴率，促进患者康复。

ObjectiveTo analyze the tacrolimus ointment combined with thymic peptide on the treatment of patients with chronic hepatitis B complicated with lichen planus of mouth and its influence on immunologic function. MethodsA total of 118 patients with chronic hepatitis B complicated with lichen planus of mouth treated in our hospital from September 2015 to January 2017 were selected as the subjects and randomly divided into two groups according to the order of admission.Control group was given triamcinolone acetonide dental pastetreatment combined with thymic peptide,while observation group was treated with tacrolimus ointment combined with thymic peptide.The clinical efficacy,T lymphocyte subgroup,alanine transaminase (ALT) recurrence rate,hepatitis B virus surface e antigen (HBeAg),hepatitis B virus DNA (HBV DNA) negative rate and the incidence of adverse reactions were compared between two groups. ResultsAfter 4 month treatment,the total effective rate of the observation group (83.05%) was significantly higher than that of control group (67.80%),with statistical significance(P＜0.05).The levels of CD4+ and CD4+/CD8+ in the two groups were higher than those before treatment,the level of CD8+ was lower than that before treatment (P＜0.05),while the levels of CD4+ and CD4+/CD8+ in the observation group were significantly higher than those in the control group,the level of CD8+ was significantly lower than that in the control group,with statistical significance(P＜0.05).The HBeAg negative rate of observation group (66.10%) was significantly higher than that in control group (42.37%),the negative rate of HBV DNA (76.27%) was significantly higher than that in control group (55.93%),with statistical significance(P＜0.05).The incidence of adverse reactions of observation group (11.86%) was significantly lower than that of control group (28.81%),with statistical significance(P＜0.05). ConclusionTacrolimus ointment combined with thymic peptide is effective in the treatment of patients with chronic hepatitis B complicated with lichen planus of mouth,which can effectively improve immune dysfunction,enhance HBeAg and HBV DNA negative rate, improve the prognosis of patients.