庞功采 孙毓晗 米光熙

[摘要] 目的 探究升阳散火汤治疗复发性口腔溃疡的临床疗效及作用机制。 方法 将2017年10月至2018年12月就诊于牡丹江医学院附属红旗医院耳鼻咽喉科的60例ROU患者随机分成两组，每组各30例，对照组给予常规的复方氯己定含漱液治疗，治疗组给予升阳散火汤治疗，比较两组患者治疗前后临床疗效、血清中炎症因子、氧化应激因子、外周血T淋巴细胞亚群、治疗总有效率及复发率。 结果 两组患者治疗后溃疡个数、溃疡面积、充血面积、中医症候评分较治疗前明显下降（P<0.05），治疗组较对照组下降更为明显（P<0.05）。两组患者治疗后IL-2、SOD、CD3+、CD4+及CD4+/CD8+水平与治疗前相比均升高（P<0.05），且治疗组较对照组升高更加明显（P<0.05），但治疗组治疗后CD8+水平与对照组比较，差异无统计学意义（P>0.05）。疗程期间治疗组的ROU总有效率（96.97%）明显优于对照组（76.67%）（P<0.05），治疗组复发率（10.00%）优于对照组（33.33%）（P<0.05）。 结论 升阳散火汤治疗复发性口腔溃疡疗效肯定。

[关键词] 升阳散火汤;复发性口腔溃疡;中医证候;白介素;超氧化物歧化酶

[Abstract] Objective To explore the clinical efficacy and mechanism of Shengyang Sanhuo Decoction in treating recurrent oral ulcers. Methods A total of 60 patients with ROU in the Department of Otorhinolaryngology in the Hongqi Hospital Affiliated to Mudanjiang Medical College from October 2017 to December 2018 were randomly divided into two groups， with 30 cases in each group. The control group was given conventional compound chlorhexidine gargle treatment： The treatment group was treated with Shengyang Sanhuo Decoction. The clinical efficacy， serum inflammatory factors， oxidative stress factors， peripheral blood T lymphocyte subsets， total effective rate of treatment and recurrence rate were compared between the two groups before and after treatment. Results The clinical efficacy indicators of the two groups including the number of ulcers， ulcer area， hyperemia area， TCM syndrome score after treatment were significantly lower than those before treatment（P<0.05）， and the treatment group decreased more significantly than the control group（P<0.05）. The levels of IL-2， SOD， CD3+， CD4+ and CD4+/CD8+ in the two groups after treatment increased compared with those before treatment（P<0.05）， and the increase in the treatment group was more significant than the control group（P<0.05）. But there was no significant difference in CD8+ levels between the treatment group and the control group after treatment（P>0.05）. During the course of treatment， the total effective rate of ROU in the treatment group（96.97%） was significantly better than that of the control group（76.67%）（P<0.05）， and the recurrence rate of the treatment group（10.00%） was better than that of the control group（33.33%）（P<0.05）. Conclusion Shengyang Sanhuo Decoction is effective in treating recurrent oral ulcers.

[Key words] Shengyang Sanhuo Decoction; Recurrent oral ulcer; TCM syndrome; Interleukin; Superoxide dismutase

復发性口腔溃疡（Recurrent oral ulcer，ROU）又称“复发性阿弗他溃疡”，是口腔黏膜病中最常见的溃疡类疾病，调查显示，社会中约20%的普通人群患有该病，而在特殊易感人群中其患病率可达50%，居口腔黏膜疾病的首位，其好发于口唇、舌侧缘、咽侧壁、咽后壁、软腭、悬雍垂等，具有周期性、局限性、复发性及自限性的特点[1]。西医治疗方式由临床症状的频率、分布和严重程度所决定，旨在减轻疼痛，促进溃疡愈合，减少复发及降低复发的严重性，目前可行的治疗方法只能减少溃疡发生频率和减轻溃疡发生严重程度，尚无理想方法阻止其复发。虽然绝大多数ROU不会对患者的生命造成威胁，但对其生命质量的影响显而易见，我国传统医学对ROU的研究源远流长，历代中医名家们结合自己的经验及体会总结其分类，即胃火炽盛型、心脾积热型、阴虚火旺型、寒热错杂型及脾虚阴火型[2]。……