康复新液和重组牛碱性成纤维细胞生长因子外用溶液治疗顽固性轻型复发性阿弗他溃疡的疗效比较
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摘要
目的复发性阿弗他溃疡(RAU)病因及发病机制尚不完全明确,至今仍缺乏有效的根治方法。文中旨在比较康复新液和重组牛碱性成纤维细胞生长因子外用溶液治疗顽固性轻型复发性阿弗他溃疡(Mi RAU)的短期疗效。方法选择2016年3月至2018年6月南京大学医学院附属口腔医院口腔黏膜病科门诊诊断为顽固性Mi RAU的150例患者进行前瞻性研究。随机分为5组:康复新液组(康复新液)、生长因子组(重组牛碱性成纤维细胞生长因子外用溶液)、吞服盐水组(吞服等渗盐水)、喷涂盐水组(喷涂等渗盐水)、空白对照组(不接受治疗),每组30例。记录第1、3、5、7天溃疡面积、疼痛指数及首次用药后的止痛起效时间、止痛维持时间、平均溃疡期等。结果第3、5、7天,康复新液组溃疡面积明显小于吞服盐水组、空白对照组(P<0.05);生长因子组明显小于喷涂盐水组、空白对照组(P<0.05)。第3、5天,生长因子组疼痛指数[(3.35±1.23)、(2.32±1.80)]明显小于喷涂盐水组[(5.08±1.83)、(3.53±1.50)]、空白对照组[(5.50±1.69)、(3.79±1.34)],康复新液组[(4.21±1.47)、(2.97±1.69)]明显小于吞服盐水组[(5.29±1.73)、(3.74±1.42)]、空白对照组(P<0.05);第3天,生长因子组明显小于康复新液组(P<0.05)。康复新液组平均溃疡期较生长因子组改善更加明显(P<0.05)。康复新液组止痛起效时间较生长因子组明显延长,止痛维持时间明显缩短(P<0.05)。结论康复新液和重组牛碱性成纤维细胞生长因子外用溶液治疗RAU均有较好的短期临床疗效,康复新液患者的平均溃疡期改善更加明显,而重组牛碱性成纤维细胞生长因子外用溶液止痛起效快,维持时间长。
Objective The etiology and pathogenesis of recurrent aphtha ulcer(RAU) are not yet sufficiently clear and there has been no cure for it hitherto. This study aimed to compare the short-term effect of Kangfuxin Liquid(KFX) versus that of Beifuji Solution(BFJ,a topical solution of the recombinant bovine alkaline fibroblast growth factor) on refractory minor RAU(RMi RAU).Methods This prospective study included 150 cases of RMi RAU treated in Nanjing Hospital of Stomatology between March 2016 and June 2018. The patients were randomized into five groups of equal number: KFX,BFJ,oral control(oral isotonic saline),topical control(topical isotonic saline),and blank control(not treated). We measured the ulcer area and obtained the pain index at 1,3,5 and 7 days of treatment. We also recorded the onset time and duration of analgesia as well as the course of ulcer after initial medication. Results At 3,5,and 7 days after treatment,the ulcer areas in the KFX group,significantly smaller than in the oral control and blank control groups,and also smaller in the BFJ than in the topical control and blank control groups(P<0.05). At 3 and 5 days,the pain indexes were(3.35±1.23) and(2.32±1.80) in the BFJ group,significantly lower than(5.08±1.83) and(3.53±1.50) in the topical control and(5.50±1.69) and(3.79± 1.34) in the blank control group(P< 0.05),and lower in the KFX than in the oral control([5. 29 ±1.73] and [3.74±1.42]) and blank control groups(P< 0.05); On day 3,the pain index of the BFJ group is much smaller than the KFX liquid group(P<0.05). The course of ulcer after initial medication was remarkably shorter,the onset of analgesia significantly later,and duration of analgesia markedly shorter in the KFX than in the BFJ group(all P<0.05). Conclusion Both KFX and BFJ have a good short clinical effect on RAU. KFX has advantage in decreasingulcer duration; BFJ has fast onset time and long maintenance time.
Objective The etiology and pathogenesis of recurrent aphtha ulcer(RAU) are not yet sufficiently clear and there has been no cure for it hitherto. This study aimed to compare the short-term effect of Kangfuxin Liquid(KFX) versus that of Beifuji Solution(BFJ,a topical solution of the recombinant bovine alkaline fibroblast growth factor) on refractory minor RAU(RMi RAU).Methods This prospective study included 150 cases of RMi RAU treated in Nanjing Hospital of Stomatology between March 2016 and June 2018. The patients were randomized into five groups of equal number: KFX,BFJ,oral control(oral isotonic saline),topical control(topical isotonic saline),and blank control(not treated). We measured the ulcer area and obtained the pain index at 1,3,5 and 7 days of treatment. We also recorded the onset time and duration of analgesia as well as the course of ulcer after initial medication. Results At 3,5,and 7 days after treatment,the ulcer areas in the KFX group,significantly smaller than in the oral control and blank control groups,and also smaller in the BFJ than in the topical control and blank control groups(P<0.05). At 3 and 5 days,the pain indexes were(3.35±1.23) and(2.32±1.80) in the BFJ group,significantly lower than(5.08±1.83) and(3.53±1.50) in the topical control and(5.50±1.69) and(3.79± 1.34) in the blank control group(P< 0.05),and lower in the KFX than in the oral control([5. 29 ±1.73] and [3.74±1.42]) and blank control groups(P< 0.05); On day 3,the pain index of the BFJ group is much smaller than the KFX liquid group(P<0.05). The course of ulcer after initial medication was remarkably shorter,the onset of analgesia significantly later,and duration of analgesia markedly shorter in the KFX than in the BFJ group(all P<0.05). Conclusion Both KFX and BFJ have a good short clinical effect on RAU. KFX has advantage in decreasingulcer duration; BFJ has fast onset time and long maintenance time.
引文
[1]陈谦明.口腔黏膜病学[M].第4版.北京:人民卫生出版社,2012:64-69.
[2]李秉琦,唐国瑶.复发性阿弗他溃疡疗效评价的试行标准[J].中华口腔医学杂志,2002,37(3):234.
[3]Belenguer-Guallar I,Jiménez-Soriano Y,Claramunt-Lozano A.Treatment of recurrent aphthous stomatitis.A literature review[J].J Clin Exp Dent,2014,6(2):e168-74.
[4]Scully C.Clinical practice:Aphthous ulceration[J].N Eng J Med,2006,322(2):165-172.
[5]Tarakji B,Gazal G,Al-Maweri SA,et al.Guideline for the Diagnosis and Treatment of Recurrent Aphthous Stomatitis for Dental Practitioners[J].J Int Oral Health,2015,7(5):74-80.
[6]郑际烈.复发性口疮的分类[J].临床口腔医学杂志,2000,16(1):62-63.
[7]中华口腔医学会口腔黏膜病专业委员会,中华口腔医学会中西医结合专业委员会.复发性阿弗他溃疡的诊疗指南(试行)[J].中华口腔医学杂志,2012,47(7):402-404.
[8]Cui RZ,Bruce AJ,Rogers RS.Recurrent aphthous stomatitis[J].Clin Dermatol,2016,34(4):475-481.
[9]Baccaglini L,Lalla RV,Bruce AJ,et al.Urban legends:recurrent aphthous stomatitis[J].Oral Dis,2011,17(8):755-770.
[10]樊瑞斌,崔君霞,张虹.复发性阿弗它溃疡的局部药物治疗现况[J].北京口腔医学,2011,19(2):118-120.
[11]周海文,吴岚,周曾同.复发性阿弗他口腔溃疡的诊断与治疗[J].中华口腔医学杂志,2007,42(1):57.
[12]张圣林,钟大仓,张冠男,等.重组人表皮生长因子凝胶防治放射性口腔黏膜炎的临床疗效观察[J].医学研究生学报,2018,31(1):56-59.
[13]姚杨,李蓉,苏杰,等.迷迭香酸对口腔溃疡大鼠炎症因子和免疫功能的影响[J].医学研究生学报,2018,31(1):29-32.
[14]陈筠,李志艳.康复新液治疗复发性阿弗他溃疡的临床疗效观察[J].中华中医药杂,2013,28(9):2800-2801.
[15]邹金伟,朱宇锋.贝复济治疗复发性口腔溃疡的临床观察[J].临床口腔医学杂志,2012,28(4):228-229.
[16]周刚,陈汉正,李辉.碱性成纤维细胞生长因子治疗复发性口腔溃疡的临床观察[J].临床口腔医学杂志,1998,14(2):103-104.
[17]贺飞.碱性成纤维细胞生长因子治疗复发性口腔溃疡83例[J].口腔医学研究,2013(5):476-477.
[18]Fujisawa K,Miyamoto Y,Nagayama M.Basic fibroblast growth factorand epidermal growth factor reverlse impairedillcer healing of therabbit oral mucosa[J].Oral Pathol Med,2003,32(6):358-366.
[2]李秉琦,唐国瑶.复发性阿弗他溃疡疗效评价的试行标准[J].中华口腔医学杂志,2002,37(3):234.
[3]Belenguer-Guallar I,Jiménez-Soriano Y,Claramunt-Lozano A.Treatment of recurrent aphthous stomatitis.A literature review[J].J Clin Exp Dent,2014,6(2):e168-74.
[4]Scully C.Clinical practice:Aphthous ulceration[J].N Eng J Med,2006,322(2):165-172.
[5]Tarakji B,Gazal G,Al-Maweri SA,et al.Guideline for the Diagnosis and Treatment of Recurrent Aphthous Stomatitis for Dental Practitioners[J].J Int Oral Health,2015,7(5):74-80.
[6]郑际烈.复发性口疮的分类[J].临床口腔医学杂志,2000,16(1):62-63.
[7]中华口腔医学会口腔黏膜病专业委员会,中华口腔医学会中西医结合专业委员会.复发性阿弗他溃疡的诊疗指南(试行)[J].中华口腔医学杂志,2012,47(7):402-404.
[8]Cui RZ,Bruce AJ,Rogers RS.Recurrent aphthous stomatitis[J].Clin Dermatol,2016,34(4):475-481.
[9]Baccaglini L,Lalla RV,Bruce AJ,et al.Urban legends:recurrent aphthous stomatitis[J].Oral Dis,2011,17(8):755-770.
[10]樊瑞斌,崔君霞,张虹.复发性阿弗它溃疡的局部药物治疗现况[J].北京口腔医学,2011,19(2):118-120.
[11]周海文,吴岚,周曾同.复发性阿弗他口腔溃疡的诊断与治疗[J].中华口腔医学杂志,2007,42(1):57.
[12]张圣林,钟大仓,张冠男,等.重组人表皮生长因子凝胶防治放射性口腔黏膜炎的临床疗效观察[J].医学研究生学报,2018,31(1):56-59.
[13]姚杨,李蓉,苏杰,等.迷迭香酸对口腔溃疡大鼠炎症因子和免疫功能的影响[J].医学研究生学报,2018,31(1):29-32.
[14]陈筠,李志艳.康复新液治疗复发性阿弗他溃疡的临床疗效观察[J].中华中医药杂,2013,28(9):2800-2801.
[15]邹金伟,朱宇锋.贝复济治疗复发性口腔溃疡的临床观察[J].临床口腔医学杂志,2012,28(4):228-229.
[16]周刚,陈汉正,李辉.碱性成纤维细胞生长因子治疗复发性口腔溃疡的临床观察[J].临床口腔医学杂志,1998,14(2):103-104.
[17]贺飞.碱性成纤维细胞生长因子治疗复发性口腔溃疡83例[J].口腔医学研究,2013(5):476-477.
[18]Fujisawa K,Miyamoto Y,Nagayama M.Basic fibroblast growth factorand epidermal growth factor reverlse impairedillcer healing of therabbit oral mucosa[J].Oral Pathol Med,2003,32(6):358-366.