针刺治疗湿热蕴滞型复发性口腔溃疡的临床研究
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摘要
【目的】观察针刺治疗湿热蕴滞型复发性口腔溃疡(ROU)患者的临床疗效,并探讨其作用机制。【方法】将160例ROU患者随机分为对照组与观察组,每组各80例。对照组患者给予白芍总苷胶囊(0.6 g/次,每日3次)治疗,观察组患者在对照组的基础上对双侧合谷、足三里、天枢、丰隆穴进行针刺治疗,2组均连续治疗1个月。比较治疗后2组的临床疗效及复发率;比较2组的愈合时间、疼痛消失时间;比较治疗前后2组的肿瘤坏死因子α(TNF-α)、白细胞介素2(IL-2)、白细胞介素6(IL-6)、补体C3、C4水平;观察不良反应情况。【结果】经1个月治疗并随访1年后,观察组的总有效率和复发率分别为88.75%和28.75%,对照组分别为77.50%与57.50%,观察组的疗效优于对照组,复发率低于对照组,差异均有统计学意义(P <0.05或P <0.01)。观察组的愈合时间、疼痛消失时间均明显短于对照组(P <0.05)。治疗后,2组血清TNF-α、IL-2水平均明显降低(P <0.05),血清IL-6、C3、C4水平均明显增高(P <0.05);组间比较,观察组的血清TNF-α、IL-2水平均明显低于对照组(P <0.05),血清IL-6、C3、C4水平均明显高于对照组(P <0.05)。2组的不良反应发生率比较,差异无统计学意义(P> 0.05)。【结论】针刺治疗湿热蕴滞型ROU临床疗效好,复发率低,能明显缩短溃疡愈合时间及疼痛时间,其作用机制可能与上调补体水平及抑制炎症有关。
Objective To observe the clinical efficacy of acupuncture in treating recurrent oral ulceration(ROU)patients with damp-heat accumulation type,and to explore its therapeutic mechanism. Methods A total of 160 cases of ROU patients were randomly divided into control group and observation group,80 cases in each group.The patients in the control group received Total Glucosides of Paeony Capsules(0.6 g per time,3 times per day),and the patients in the observation group received acupuncture on bilateral acupoints of Hegu(LI4), Zusanli(ST36),Tianshu(ST25),and Fenglong(ST40)based on the treatment for the control group. The treatmentcovered one continuous month and the follow-up lasted for one year in both groups. After treatment,the clinicalefficacy and recurrence rate were evaluated,and the healing time and time for pain disappearance were observedin the two groups. Before and after treatment, and the serum levels of tumor necrosis factor α(TNF-α),interleukin 2(IL-2),interleukin 6(IL-6),and complement C3,C4 in the two groups were examined. And theadverse effects in the two gruops were also observed. Results The total effective rate and recurrence rate were88.75% and 28.75% in the observation group and were 77.50% and 57.50% in the control group,respectively,and the observation group had stronger effect and lower recurrence rate than the control group,the differencesbeing statistically significant between the two groups(P < 0.05 or P < 0.01). The healing time and time for paindisappearance in the observation group were significantly shorter than those in the control group(P < 0.05). Aftertreatment,The serum levels of TNF-α and IL-2 were significantly decreased and the serum levels of IL-6,C3,C4 were significantly increased in the two groups(P < 0.05). The serum levels of TNF-α and IL-2 weresignificantly lower and the serum levels of IL-6,C3,C4 were significantly higher in the observation group thanthose in the control group(P < 0.05). There was no significant difference in the occurrence rate of adverse effectsbetween the two groups(P > 0.05). Conclusion Acupuncture exerts certain clinical efficacy for the treatment ofROU with damp-heat accumulation type by decreasing the recurrence rate and shortening the healing time and timefor pain disappearance,and its therapeutic mechanism may be related with the up-regulation of complement levelsand inhibition of inflammatory response.
Objective To observe the clinical efficacy of acupuncture in treating recurrent oral ulceration(ROU)patients with damp-heat accumulation type,and to explore its therapeutic mechanism. Methods A total of 160 cases of ROU patients were randomly divided into control group and observation group,80 cases in each group.The patients in the control group received Total Glucosides of Paeony Capsules(0.6 g per time,3 times per day),and the patients in the observation group received acupuncture on bilateral acupoints of Hegu(LI4), Zusanli(ST36),Tianshu(ST25),and Fenglong(ST40)based on the treatment for the control group. The treatmentcovered one continuous month and the follow-up lasted for one year in both groups. After treatment,the clinicalefficacy and recurrence rate were evaluated,and the healing time and time for pain disappearance were observedin the two groups. Before and after treatment, and the serum levels of tumor necrosis factor α(TNF-α),interleukin 2(IL-2),interleukin 6(IL-6),and complement C3,C4 in the two groups were examined. And theadverse effects in the two gruops were also observed. Results The total effective rate and recurrence rate were88.75% and 28.75% in the observation group and were 77.50% and 57.50% in the control group,respectively,and the observation group had stronger effect and lower recurrence rate than the control group,the differencesbeing statistically significant between the two groups(P < 0.05 or P < 0.01). The healing time and time for paindisappearance in the observation group were significantly shorter than those in the control group(P < 0.05). Aftertreatment,The serum levels of TNF-α and IL-2 were significantly decreased and the serum levels of IL-6,C3,C4 were significantly increased in the two groups(P < 0.05). The serum levels of TNF-α and IL-2 weresignificantly lower and the serum levels of IL-6,C3,C4 were significantly higher in the observation group thanthose in the control group(P < 0.05). There was no significant difference in the occurrence rate of adverse effectsbetween the two groups(P > 0.05). Conclusion Acupuncture exerts certain clinical efficacy for the treatment ofROU with damp-heat accumulation type by decreasing the recurrence rate and shortening the healing time and timefor pain disappearance,and its therapeutic mechanism may be related with the up-regulation of complement levelsand inhibition of inflammatory response.
引文
[1]张存宝,孙莉,张雄,等.康复新液治疗复发性口腔溃疡的作用机制研究[J].浙江医学,2016,38(11):818.
[2]杨金晖,李崴嵬,崔秋平,等.雷尼替丁辅助治疗老年复发性口腔溃疡的临床研究[J].中国临床药理学杂志,2016,32(19):1745.
[3]冯亮.利多卡因凝胶联合氧疗治疗复发性口腔溃疡的疗效及对血清T淋巴细胞亚群水平的影响[J].中国药物经济学,2015,(1):1.
[4]张智慧,张有年.中西医结合治疗复发性口腔溃疡临床观察[J].湖北中医药大学学报,2016,18(1):84.
[5]谢佳颖,王冰.中西医结合治疗复发性口腔溃疡的临床观察[J].中国中医急症,2016,25(1):174.
[6]中华口腔医学会口腔黏膜病专业委员会.复发性阿弗他溃疡疗效评价试行标准[J].中华口腔医学杂志,2002,37(3):92.
[7]徐治鸿.中西医结合口腔黏膜病学[M].北京:人民卫生出版社,2008:235-237.
[8]王涛,赵永兴,林建能,等.康复新液联合利多卡因辅助氧疗对复发性口腔溃疡患者疗效及相关指标的影响[J].中国药房,2016,27(33):4654.
[9]苑玉良.利多卡因凝胶联合氧疗治疗复发性口腔溃疡的疗效及对血清T细胞亚群水平的影响[J].中国药业,2015,24(1):39.
[10]许景川,陈作良.沙利度胺联合白芍总苷治疗复发性口腔溃疡的疗效观察[J].海峡药学,2017,29(6):108.
[11]魏强,王乐.维生素联合云南白药治疗复发性口腔溃疡的临床研究[J].中国医刊,2016,51(8):93.
[12]李明伟,路军章,杜岩,等.复方竹叶石膏颗粒治疗复发性口腔溃疡49例疗效观察[J].中医杂志,2016,57(22):1939.
[13]褚群峰.自拟中药汤剂辅助治疗77例复发性口腔溃疡的疗效分析[J].中华全科医学,2016,14(1):128.
[14]麦熙,王新红,何霞.温阳健脾汤结合艾灸治疗脾胃虚寒型复发性口腔溃疡疗效及对患者血清炎性因子,补体C3,C4水平的影响[J].中国实验方剂学杂志,2018,24(8):189.
[15]温庆春,罗毅,李生柏,等.康复新液对复发性口腔溃疡患者血清炎性因子表达的影响[J].中医药导报,2016,22(19):83.
[16]李文东,孙秀荣.中药白苇饮联合康复新液对复发性口腔溃疡患者唾液EGF及血清TNF-α水平的影响[J].中国临床研究,2016,29(4):533.
[17]刘好好,许子悦,谢春雨,等.复发性口腔溃疡与T细胞免疫研究进展[J].现代免疫学,2016,36(1):72.
[18]林智勇,刘新迎,李其玉,等.复发性口腔溃疡中医证型与免疫状态研究[J].实用中医药杂志,2016,32(6):519.
[2]杨金晖,李崴嵬,崔秋平,等.雷尼替丁辅助治疗老年复发性口腔溃疡的临床研究[J].中国临床药理学杂志,2016,32(19):1745.
[3]冯亮.利多卡因凝胶联合氧疗治疗复发性口腔溃疡的疗效及对血清T淋巴细胞亚群水平的影响[J].中国药物经济学,2015,(1):1.
[4]张智慧,张有年.中西医结合治疗复发性口腔溃疡临床观察[J].湖北中医药大学学报,2016,18(1):84.
[5]谢佳颖,王冰.中西医结合治疗复发性口腔溃疡的临床观察[J].中国中医急症,2016,25(1):174.
[6]中华口腔医学会口腔黏膜病专业委员会.复发性阿弗他溃疡疗效评价试行标准[J].中华口腔医学杂志,2002,37(3):92.
[7]徐治鸿.中西医结合口腔黏膜病学[M].北京:人民卫生出版社,2008:235-237.
[8]王涛,赵永兴,林建能,等.康复新液联合利多卡因辅助氧疗对复发性口腔溃疡患者疗效及相关指标的影响[J].中国药房,2016,27(33):4654.
[9]苑玉良.利多卡因凝胶联合氧疗治疗复发性口腔溃疡的疗效及对血清T细胞亚群水平的影响[J].中国药业,2015,24(1):39.
[10]许景川,陈作良.沙利度胺联合白芍总苷治疗复发性口腔溃疡的疗效观察[J].海峡药学,2017,29(6):108.
[11]魏强,王乐.维生素联合云南白药治疗复发性口腔溃疡的临床研究[J].中国医刊,2016,51(8):93.
[12]李明伟,路军章,杜岩,等.复方竹叶石膏颗粒治疗复发性口腔溃疡49例疗效观察[J].中医杂志,2016,57(22):1939.
[13]褚群峰.自拟中药汤剂辅助治疗77例复发性口腔溃疡的疗效分析[J].中华全科医学,2016,14(1):128.
[14]麦熙,王新红,何霞.温阳健脾汤结合艾灸治疗脾胃虚寒型复发性口腔溃疡疗效及对患者血清炎性因子,补体C3,C4水平的影响[J].中国实验方剂学杂志,2018,24(8):189.
[15]温庆春,罗毅,李生柏,等.康复新液对复发性口腔溃疡患者血清炎性因子表达的影响[J].中医药导报,2016,22(19):83.
[16]李文东,孙秀荣.中药白苇饮联合康复新液对复发性口腔溃疡患者唾液EGF及血清TNF-α水平的影响[J].中国临床研究,2016,29(4):533.
[17]刘好好,许子悦,谢春雨,等.复发性口腔溃疡与T细胞免疫研究进展[J].现代免疫学,2016,36(1):72.
[18]林智勇,刘新迎,李其玉,等.复发性口腔溃疡中医证型与免疫状态研究[J].实用中医药杂志,2016,32(6):519.