Greater therapeutic efficacy of prednisolone plus medicinal herbs than prednisolone or medicinal herbs alone in patients with oral lichen planus

Background/purpose: Various treatment regimens have been attempted to improve oral lichen planus (OLP) lesions; however, a complete cure has not been found. The most commonly employed and useful agents for treating OLP are topical corticosteroids. The aim of this study was to determine if the use of prednisolone plus traditional medicinal herbs could improve OLP symptoms, reduce recurrent severity, and prolong the time to flare-up, thus providing evidence for future prospective randomized clinical trials. Materials and methods: A retrospective study of 78 patients with OLP was conducted. The resources of 2 hospital departments (Oral and Maxillofacial Surgery and Chinese Medicine) were combined to treat these patients. Thirty OLP patients (group A) were given a low dose (20 mg/d) of prednisolone plus 3 medicinal herbs (gan-lu-yin, jia-wei-xiao-yao-san, and zhibai-di-huang-wan), 26 OLP patients (group B) were administered prednisolone alone, and 22 OLP patients (group C) were administered the medicinal herbs only. Differences among the patient groups were compared after a 4-week treatment course and after follow-up observations which occurred at 6 and 12 months. Results: The 24 patients (87.7%) in group A experienced no symptom recurrence of OLP within 6 months of follow-up, and neither did 10 patients (38.5%) in group B nor 8 patients (36.4%) in group C. Likewise, 17 patients (56.7%) in group A had no recurrence of OLP at 1 year, and neither did 7 patients (27.8%) in group B nor 6 patients (27.3%) in group C. The average time to flare-up for group A (within 1 year) was 30.9 ± 7.4 weeks, while those for groups B and C were 19.5 ± 5.7 and 20.8 ± 5.0 weeks, respectively. The times to flare-up for groups A versus B and A versus C significantly differed. With the exception of 2 patients with mild oral candidiasis in group A (6.7%), no other obvious side-effects or complaints were reported. The recurrent OLP severity also significantly differed for groups A versus B and A versus C. Conclusion: Our results suggest that treatment consisting of prednisolone plus traditional medicinal herbs can improve OLP symptoms, relieve pain, reduce recurrent severity, and increase the disease-free period. The benefits of combined therapy for OLP should be investigated by conducting a prospective randomized clinical trial in the future.