Te kikorangi metilīni mō te lichen planus o te waha: ngā taunakitanga whakamātautau mō te haumanu whakahohe mā te aho

Ka pānui ngā tūroro tokorua i te hua kotahi, engari he rerekē ngā oati ka rangona e rāua. Ki tētahi, kua ora ngā tūwhenua, nō reira kua ngaro te mate. Ki tērā atu, kua heke te mamae, nō reira me kua ora ngā tūwhenua. Ka kite tētahi kaipānui tuatoru i te hekenga o te auau hokinga mai, ā, ka whakaaro e pā ana taua hua ki te katoa i tīmata i te maimoatanga. I ia pānuitanga, ka rangirua tētahi ariā ki tētahi atu. Ka wehewehea aua ariā i tēnei arotake.

Ko te kaupapa ko te haumanu whakahohe mā te aho me te kikorangi metilīni, e kīia nuitia ana ko MB-PDT, ka whakahaerehia e te mātanga haumanu mō te lichen planus horo o te waha kua tātaritia, e kīia nuitia ana ko OLP. Ko te taunakitanga i konei he whakamātautau tohatoha matapōkere mō te haumanu whakahohe mā te aho me te corticosteroid pani mō te lichen planus horo o te waha, i whakaputaina i te tau 2026, me ngā tūroro 74 i tohaina matapōkeretia. Ka whakamātauria te MB-PDT hei tāpiritanga ki te pūtaiaki, kaua hei whakakapi, kaua hoki hei maimoatanga i te kāinga. Me tīmata ngā kaipānui e hiahia ana ki ngā whakamārama mō te matū tairongo ki te aho i te tuatahi ki te pānui mō te āhua o te kikorangi metilīni hei matū tairongo ki te aho. Ko ngā kaipānui e whakataurite ana i ngā maimoatanga matua, me pānui hoki i ngā kōrero mō ngā corticosteroid pani mō ngā tūwhenua o te waha, i te taha o tēnei whārangi.

Ngā ariā e rua kei muri i te maimoatanga

He mate mauroa te OLP o te kiriuhi hūpē o te waha, nā te pūnaha ārai mate. Ko te OLP horo, te momo i tēnei whakamātautau, he pakaru mamae o te kiriuhi, he maha kei te mata o roto o ngā pāpāringa, ka ora, ka hoki mai anō. Ko te āhuatanga matua o te mate ko tōna hokinga mai. Ehara te oranga i te wā poto i te tohu ka taea te whakahaere i te mate mō te wā roa. Nō reira, me aroturuki motuhake ngā kōrero pono i te whakaora, ngā tohumate, me te hokinga mai.

E toru ngā wāhanga o te ariā MB-PDT: he matū tairongo ki te aho, he aho kei tētahi roangaru ka ngongohia e taua matū, me te hāora. Ki te tangohia tētahi wāhanga, ka kore te tukanga e mahi. Ka ngongo te kikorangi metilīni i te aho whero e tata ana ki te 660 nm. Ka whakawhiti te waikano kua whakaohohia i te pūngao, i ngā irahiko rānei, mā ngā ara e whakawhirinaki ana ki te hāora, ā, ka tūkino ngā momo matū hohe ka puta i te kiko whāinga i taua wāhi tonu. He ariā kē te whakamahi i taua waikano me te kore aho. Koia te take ka whakaatu ngā kōrero mō te haumanu whakahohe mā te aho me te kikorangi metilīni mō ngā mate kiri i te rongoā, te aho, te rahinga, me te wā i waenga i ngā maimoatanga mō ia whakamahinga. Mō te whakamahi i te waha, mā ngā mātanga haumanu te tukanga e whakahaere, me te āta kite tonu i te wāhi, me te whakamaroke me te wehe i te tūwhenua i mua i te tuku aho.

Ngā mahi tūturu o te whakamātautau

I whakahaerehia te whakamātautau i tētahi hōhipera kotahi i Shanghai. I whakaurua ngā pakeke he OLP horo tō rātou, kua whakaūngia mā te tango tauira kiko, ā, he nui ake i te 5 mm tapawhā i raro i ngā paearu WHO 2003 kua whakarerekētia. I tohaina matapōkeretia ngā tūroro 37 ki te MB-PDT me te pani triamcinolone acetonide 0.1 ōrau, me ngā tūroro 37 ki te pani anake. I pania te pani e toru ngā wā ia rā i ngā rōpū e rua i roto i te maimoatanga e whā wiki te roa. I tāpirihia ki te rōpū PDT te tuku aho 660 nm ia wiki, i te 13.2 J mō ia cm tapawhā, mō te 60 hēkona i ia hui maimoatanga, whai muri i te pani kikorangi metilīni 0.1 mg mō ia mL, kia kaua e neke atu i te whā ngā hui. Nā tētahi kaiaromatawai motuhake, kāore i mōhio ki te tohatoha maimoatanga, ngā putanga i ine. I mōhio ngā tūroro me ngā mātanga e maimoa ana ko tēhea maimoatanga i whiwhi rātou. He mea noa tēnei mō te tukanga whakamahi aho, engari ka taea tonu e ngā tūmanako te whakaawe i ngā pūrongo tohumate. Kei ngā kōrero mō te pānui pūrongo whakamātautau haumanu whakahohe mā te aho he whakamārama tuatahi mō ngā tikanga o tēnei momo hoahoa.

I whakamahi ngā tātari wā poto tae noa ki te wiki 4 i te aronga intention to treat, arā, te tātari i runga i te maimoatanga i whakaritea i te tīmatanga, me te whakatau uara mō ngā raraunga ngaro. I te aroturuki roa ake i ngā wiki 8 me te 12, ko ngā tūroro i urupare ki te maimoatanga anake i whāia. He mea tino nui tēnei mō te hokinga mai, e whakaaturia ana i raro nei. Kei ngā pātai auau mō te haumanu whakahohe mā te aho i te waha ngā whakautu ki ngā pātai noa mō te whakarite maimoatanga i te whare haumanu me te aroturuki haumaru.

Ripanga whakataurite o te whakamātautau

He motuhake ngā panoni o te whakaora, te mamae, te hokinga mai, me te oranga o ia rā

I te wiki 4, he pai ake te whakaora i te maimoatanga whakakotahi. I tae te whaihua haumanu ki ngā tūroro 35 o te 37 (94.6 ōrau) i te MB-PDT me te pūtaiaki, ki te whakataurite ki te 26 o te 37 (70.3 ōrau) i te pūtaiaki anake. He āputa 24.3 ira tēnei, ā, ko P he 0.006. Ko te katinga katoa te take nui o taua rerekētanga, arā, 27 o te 37 ki te 21 o te 37. I te wiki 4, he nui ake, he whai tikanga ā-tauanga hoki, te tere whakaheke i te rahinga o te tūwhenua i te rōpū whakakotahi. I kore taua rerekētanga e whai tikanga ā-tauanga i te wiki 8, ā, i whai tikanga anō i te wiki 12. I pai ake te kaute REU mō te taumaha whānui o te mate i ngā rōpū e rua, engari kāore he rerekētanga whai tikanga ā-tauanga i waenga i ngā rōpū i tētahi wā. He whakamaharatanga tēnei, ehara te tūwhenua nui rawa i te waha katoa.

He pōturi ake te ara o te mamae. I te wiki 4, ko te hekenga toharite o te whakatauranga ā-tau he 3.97 ira mō te maimoatanga whakakotahi, ki te whakataurite ki te 2.62 mō te pūtaiaki anake, ā, ko P he 0.004. Kāore ngā rōpū i rerekē i ngā wiki tuatahi e rua. I puta te rerekētanga i te wiki 3, ā, i mau tonu i ngā wiki 8 me te 12. E hāngai ana taua tauira ki tētahi maimoatanga tāpiri me tukurua, kaua ki te whakamāmā wawe tonu, ā, he whakatūpato kia kaua e whakawā i te tukanga i muri i te haerenga kotahi anake.

Mō te hokinga mai, mā te tauraro e whakatau te tikanga o te hua. Ka tautuhi te pūrongo whakamātautau mō tēnei rangahau OLP horo i te hokinga mai i waenga i ngā tūroro kua ora. E whakaatu ana ngā tatau ko te tikanga o te kupu kua ora ko te hunga i tino urupare: 27 ki te 21 i te wiki 8, ka heke ki te 26 ki te 20 i te wiki 12. I te wiki 8, ko te hokinga mai he 2 o te 27 (7.4 ōrau) ki te 5 o te 21 (23.8 ōrau), kāore i whai tikanga ā-tauanga. I te wiki 12, he 3 o te 26 (11.5 ōrau) ki te 8 o te 20 (40.0 ōrau), ā, ko P he 0.038. He hua tēnei nō tētahi rōpū iti o te hunga i urupare, ehara i te hua intention to treat, nā te mea i wehe ngā tūroro kāore anō kia ora i te tātari hokinga mai kia whiwhi maimoatanga kē. Ko te kaituhi e pūrongo ana i te 11.5 ki te 40.0 ōrau me te kore whakahua i ngā tauraro 26 me te 20, e tārua ana i te hapa tino kitea i ngā pūrongo tuarua mō tēnei tuhinga rangahau.

I kitea taua tauira wehe anō i te kounga o te oranga me te āhua o te hinengaro. I nui ake te whakapainga o te kounga o te oranga e pā ana ki te waha i runga i te OHIP-14 mō te maimoatanga whakakotahi, ā, ko P he 0.002. I nui ake hoki te whakapainga o te manawapā i runga i te GAD-7, ā, ko P he 0.007. Kāore he rerekētanga o te mate pāpōuri i runga i te PHQ-9. He iti ngā kaute manawapā me te mate pāpōuri i te tīmatanga, nō reira e ine ana ēnei tauine i ngā panoni iti i tētahi rōpū he ngāwari noa te pānga ki a rātou, ehara i te maimoatanga mō te manawapā haumanu, mō te mate pāpōuri haumanu rānei.

Ngā herenga me maumahara te kaipānui tūpato

Ko te rahinga o te rōpū te herenga tuatahi. I whakapae te tātaitanga he 37 ki te 79 ōrau te whaihua, i whakarite i te mana ā-tauanga ki te 80 ōrau mō te putanga matua i te wiki 4, ā, i puta ko ngā tūroro 74 katoa. Kāore taua rahinga e āhei ki te tautoko i ngā kerēme pakari mō ngā rōpū iti hokinga mai o te 26 ki te 20, ngā tauine kounga o te oranga, ngā kino onge rānei. Nā te kore pānga kino i roto i ngā tūroro 74 mō ngā wiki 12, kāore i kitea he kino auau, engari he iti noa ngā kōrero e tukuna ana mō ngā pānga onge. I ngā tikanga rangahau, i āta uia te mamae o te waha, te mumura o te kiriuhi hūpē, me te panoni o te rongo tāwara i raro i ngā paearu paerewa mō te paitini.

Ko te roanga o te aroturuki te herenga tuarua. Ko te tekau mā rua wiki mai i te tohatoha matapōkere he tata ki te waru wiki i muri i te hui tuku aho whakamutunga. Ka hoki mai te OLP i roto i ngā marama me ngā tau, nō reira he taunakitanga tōmua te whakataurite hokinga mai i te 12 wiki, ehara i te kerēme mō te mauroa o ngā hua. Ko te hoahoa rangahau i tētahi pokapū kotahi te herenga tuatoru. Kotahi te tīma, kotahi te pūrere, kotahi te hōtaka pūtaiaki, ā, neke atu i te 80 ōrau o te rōpū he wāhine e tata ana ki te 59 tau te pakeke. He pai te whakaahua o taua whare haumanu e ēnei āhuatanga, engari he iti ake tōna hāngai ki ētahi atu wāhi.

E rua ngā hapa pūrongo me āta kite, kia kaua ngā kaituhi e tārua. Ka whakapiri te tuhinga i tētahi awhe whakapono ā-ira ōrau o te 7.9 ki te 40.7 ōrau ki tētahi ōwehenga tūraru o te 1.35. Engari, e hāngai ana taua awhe ki te rerekētanga pū o te 24.3 ira, kaua ki te ōwehenga. Waihoki, e kī ana te wāhanga matapakinga kāore i tutuki tētahi rerekētanga nui o te 10 ira i whakaritea i mua, ahakoa he nui ake i te 10 ira te āputa whaihua i pūrongotia. Kāore tētahi o ēnei hapa e whakarerekē i ngā tatau taketake, koia ngā meka pūmau: 35 o te 37 ki te 26 o te 37 mō te whaihua, me te 3 o te 26 ki te 8 o te 20 mō te hokinga mai i te wiki 12 i waenga i te hunga i tino urupare.

He whāiti tonu te whakatau matua, ā, koirā tōna kaha. Mō ngā pakeke he OLP horo kua whakaūngia mā te tango tauira kiko, nā te tāpiri i ngā hui haumanu PDT me te kikorangi metilīni ia wiki, kia whā, kia iti ake rānei, ki te triamcinolone pani, i pai ake ai te whakaora me te whakaheke mamae i te wiki 4. He tohu mō te hokinga mai i te wiki 12 i herea ki te hunga i tino urupare, ā, he painga mō te kounga o te oranga i ngā inenga pānga ā-waha me te manawapā. Kāore i whakamātauria te waikano anake, ngā pūrere kāinga, ētahi atu roangaru, te whakahaere mō te wā roa rānei. Me pātai ngā tūroro e whakaaro ana ki tēnei maimoatanga ki tō rātou mātanga haumanu mō te whakaū i te tātaritanga, te maha o ngā hui maimoatanga, te ara mamae e tūmanakohia ana i roto i te toru ki te whā wiki, me te āhua o te aroturuki i te hokinga mai i tua atu i te kaupeka tuatahi.