rb-bFGF辅助治疗儿童口腔溃疡的疗效及其对免疫功能和炎症因子的影响
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摘要
目的:探讨重组牛碱性成纤维细胞生长因子(rb-bFGF)辅助治疗儿童口腔溃疡的疗效及其对机体免疫功能和炎症因子的影响。方法:将78例口腔溃疡患儿随机分为研究组和对照组各39例,对照组给予西地碘含片,研究组在对照组基础上给予rb-b FGF外用凝胶,两组均连续治疗7 d,随访6个月,观察比较两组患儿临床症状缓解情况及临床疗效、治疗前后免疫功能及血清炎症因子水平,随访期间复发情况。结果:治疗后研究组总有效率92.31%,明显高于对照组的69.23%(P<0.05)。与对照组比较,治疗后研究组疼痛缓解时间、溃疡面愈合时间、进食改善时间明显缩短(P<0.01)。治疗后两组患儿CD_3~+、CD_4~+T淋巴细胞比例和研究组CD_4~+/CD_8~+均较治疗前升高(P<0.05或P<0.01),且研究组高于对照组(P<0.01)。治疗后两组患儿CD_8~+T淋巴细胞比例降低(P<0.05或P<0.01),且研究组低于对照组(P<0.01)。治疗后两组患儿IL-2、IL-8、TNF-α水平均比治疗前降低(P<0.05或P<0.01),且研究组明显低于对照组(P<0.01);两组患儿INF-γ较治疗前升高,且研究组高于对照组(P<0.01)。两组患儿治疗后1~4个月复发率比较差异无统计学意义(P>0.05),但治疗后5~6个月研究组复发率明显低于对照组(P<0.05)。结论:rb-bFGF辅助治疗儿童口腔溃疡可提高疗效,缩短临床症状改善时间,降低复发率,可能与提高口腔溃疡患儿免疫功能、降低血清炎症因子水平有关。
Objective: To explore the effect of recombinant bovine basic fibroblast growth factor( rb-b FGF) on the auxiliary treatment of children's oral ulcer and its effect on immune function and inflammatory factors. Methods: Sixty-eight children with oral ulcer were randomly divided into study group( n = 39) and control group( n = 39),the control group was given cydiodine buccal tablets,the study group was treated with rb-b FGF based on the control group,all children were treated for 7 days and followed up for 6 months. The remission and clinical curative effect,the levels of immune function and serum inflammatory factors before and after treatment of two groups were observed and compared,and the recurrence during the follow-up period were analyzed. Results: After treatment,the total effective rate of the study group was 92. 31%,which was significantly higher than 69. 23% of the control group( P< 0. 05). Compared with the control group,the time of pain relief,the healing time of the ulcer surface and the time for eating improvement were significantly shortened in the study group( P<0. 05). After treatment,the ratio of CD3+,CD4+T lymphocytes and CD4+/CD8+in the two groups were higher than before treatment( P<0. 05 or P<0. 01),and the ratio of the study group were higher than those of the control group( P<0. 01),the ratio of CD8+T lymphocytes of the two group decreased( P<0. 05 or P<0. 01),and the study group was lower than the control group( P<0. 01). After treatment,the levels of IL-2,IL-8 and TNF-α in the two groups were lower than those before treatment( P<0. 05 or P<0. 01),and the study group were significantly lower than those of the control group( P<0. 01). The levels of INF-γ in the two groups were higher than before treatment,and the study group was higher than the control group( P < 0. 01). There was no significant difference in the recurrence rate between the two groups in 1 to 4 months after treatment( P>0. 05),but the recurrence rate of the study group was significantly lower than that of the control group in 5 to 6 months after treatment( P < 0. 05). Conclusion:rb-b FGF auxiliary treatment of children's oral ulcer can improve curative effect,shorten the time of clinical symptoms improved and the recurrence rate is low. It may be related to improve oral ulcer in children with immune function,reduce the serum levels of inflammatory cytokines.
Objective: To explore the effect of recombinant bovine basic fibroblast growth factor( rb-b FGF) on the auxiliary treatment of children's oral ulcer and its effect on immune function and inflammatory factors. Methods: Sixty-eight children with oral ulcer were randomly divided into study group( n = 39) and control group( n = 39),the control group was given cydiodine buccal tablets,the study group was treated with rb-b FGF based on the control group,all children were treated for 7 days and followed up for 6 months. The remission and clinical curative effect,the levels of immune function and serum inflammatory factors before and after treatment of two groups were observed and compared,and the recurrence during the follow-up period were analyzed. Results: After treatment,the total effective rate of the study group was 92. 31%,which was significantly higher than 69. 23% of the control group( P< 0. 05). Compared with the control group,the time of pain relief,the healing time of the ulcer surface and the time for eating improvement were significantly shortened in the study group( P<0. 05). After treatment,the ratio of CD3+,CD4+T lymphocytes and CD4+/CD8+in the two groups were higher than before treatment( P<0. 05 or P<0. 01),and the ratio of the study group were higher than those of the control group( P<0. 01),the ratio of CD8+T lymphocytes of the two group decreased( P<0. 05 or P<0. 01),and the study group was lower than the control group( P<0. 01). After treatment,the levels of IL-2,IL-8 and TNF-α in the two groups were lower than those before treatment( P<0. 05 or P<0. 01),and the study group were significantly lower than those of the control group( P<0. 01). The levels of INF-γ in the two groups were higher than before treatment,and the study group was higher than the control group( P < 0. 01). There was no significant difference in the recurrence rate between the two groups in 1 to 4 months after treatment( P>0. 05),but the recurrence rate of the study group was significantly lower than that of the control group in 5 to 6 months after treatment( P < 0. 05). Conclusion:rb-b FGF auxiliary treatment of children's oral ulcer can improve curative effect,shorten the time of clinical symptoms improved and the recurrence rate is low. It may be related to improve oral ulcer in children with immune function,reduce the serum levels of inflammatory cytokines.
引文
[1]孙旦江.匹多莫德对复发性口腔溃疡患儿外周血T淋巴细胞亚群的影响及疗效观察[J].中国药师,2013,16(7):1048-1049.
[2]LIU H,GAO Z,YANG S,et al.Absorbale shanching satin rbb FGF prepreg sheet and expansion hemostatic sponge together to cure epistaxis with blood disease[J].Journal of clinical otorhinolaryngology head&neck surgery,2014,28(2):126-128.
[3]张立平,端礼荣.NGF和b FGF对小鼠免疫细胞功能的影响[J].实验与检验医学,2011,29(1):9-11.
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[5]BENOIT S,HAMM H.Differential diagnosis of oral mucosal erosions and ulcers in children[J].Der Hautarzt,2015,66(4):258-266.
[6]孙旋,杜秀平,韩正祥.重组人粒细胞巨噬细胞集落刺激因子联合重组牛碱性成纤维细胞生长因子治疗化疗性口腔溃疡的临床观察[J].肿瘤研究与临床,2015,27(4):263-265.
[7]张凤英,吴莲香,刘月泉,等.藻酸盐银离子敷料联合rbb FGF在肠造口粘膜皮肤分离中的应用研究[J].赣南医学院学报,2016,36(4):624-625.
[8]刘院斌,武忠华,郭俊儿,等.重组牛碱性成纤维细胞生长因子对白内障超声乳化联合IOL植入术后干眼的治疗[J].中华实验眼科杂志,2016,34(2):175-180.
[9]乔鸿飞,张巧俊,袁海峰,等.超短波对糖尿病大鼠溃疡创面碱性成纤维细胞生长因子表达的影响[J].中华物理医学与康复杂志,2015,37(9):653-657.
[10]孙旋,杜秀平,韩正祥.重组人粒细胞巨噬细胞集落刺激因子联合重组牛碱性成纤维细胞生长因子治疗化疗性口腔溃疡的临床观察[J].肿瘤研究与临床,2015,27(4):263-265.
[11]李锦绵,周桂荣.思密达联合半导体激光治疗复发性口腔溃疡的临床观察及护理[J].世界中医药,2016,11(B06):2054-2055.
[2]LIU H,GAO Z,YANG S,et al.Absorbale shanching satin rbb FGF prepreg sheet and expansion hemostatic sponge together to cure epistaxis with blood disease[J].Journal of clinical otorhinolaryngology head&neck surgery,2014,28(2):126-128.
[3]张立平,端礼荣.NGF和b FGF对小鼠免疫细胞功能的影响[J].实验与检验医学,2011,29(1):9-11.
[4]李秉琦.口腔黏膜病学[M].第2版.北京:人民卫生出版社,2003:49-61.
[5]BENOIT S,HAMM H.Differential diagnosis of oral mucosal erosions and ulcers in children[J].Der Hautarzt,2015,66(4):258-266.
[6]孙旋,杜秀平,韩正祥.重组人粒细胞巨噬细胞集落刺激因子联合重组牛碱性成纤维细胞生长因子治疗化疗性口腔溃疡的临床观察[J].肿瘤研究与临床,2015,27(4):263-265.
[7]张凤英,吴莲香,刘月泉,等.藻酸盐银离子敷料联合rbb FGF在肠造口粘膜皮肤分离中的应用研究[J].赣南医学院学报,2016,36(4):624-625.
[8]刘院斌,武忠华,郭俊儿,等.重组牛碱性成纤维细胞生长因子对白内障超声乳化联合IOL植入术后干眼的治疗[J].中华实验眼科杂志,2016,34(2):175-180.
[9]乔鸿飞,张巧俊,袁海峰,等.超短波对糖尿病大鼠溃疡创面碱性成纤维细胞生长因子表达的影响[J].中华物理医学与康复杂志,2015,37(9):653-657.
[10]孙旋,杜秀平,韩正祥.重组人粒细胞巨噬细胞集落刺激因子联合重组牛碱性成纤维细胞生长因子治疗化疗性口腔溃疡的临床观察[J].肿瘤研究与临床,2015,27(4):263-265.
[11]李锦绵,周桂荣.思密达联合半导体激光治疗复发性口腔溃疡的临床观察及护理[J].世界中医药,2016,11(B06):2054-2055.