Comparison of efficacy of topical Coconut-Licorice-Purslane cream with topical 0.1% triamcinolone acetonide gel for the treatment of oral lichen planus: A randomised controlled trial

比较外用椰子-甘草-马齿苋乳膏与外用0.1%曲安奈德凝胶治疗口腔扁平苔藓的疗效:一项随机对照试验

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Abstract

BACKGROUND: Oral lichen planus is a chronic inflammatory cell-mediated immunological disease. As it has a multifactorial aetiology, treatment is symptomatic. Corticosteroids are used as first-line treatment; however, it has various side effects, resulting in the search for new therapeutic options. Coconut has therapeutic, anti-inflammatory, antioxidant and immunomodulatory effects. Liquorice reduces the enzymatic activity of cyclooxygenase and lipoxygenase, limits the generation of oxygen free radicals and cell migration and inhibits arachidonic acid metabolism. Thus, it lessens the inflammatory response and pain. Purslane has wound healing, antibacterial, antiulcerogenic, anti-inflammatory and antioxidant qualities. Thus, all the above properties suggest the use of coconut-liquorice-purslane in the management of oral lichen planus (OLP). METHOD: Following approval from the Institutional Ethical Committee, 40 participants who met the inclusion criteria and were seeking treatment at the research hospital were randomly assigned to two groups. 'Group A' received coconut-liquorice-purslane cream, while 'Group B' received topical 0.1% triamcinolone acetonide gel. Both groups were instructed to apply the ointment to the affected area thrice a day for 90 days and were to refrain from eating and drinking for 15 minutes after application. The intensity of pain was measured using a visual analogue scale at baseline before treatment and on days 14, 30, 60 and 90. RESULTS: Both groups showed statistically significant reduction in pain intensity, but the coconut-liquorice-purslane group showed better results when compared to the 0.1% Triamcinolone Acetonide group. CONCLUSION: Coconut-Liquorice-Purslane cream can be safely used as an alternative treatment modality in the management of OLP for reducing pain intensity as compared to topical 0.1% triamcinolone acetonide gel with no systemic, as well as topical side effects.

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