几种药物联合治疗复发性口腔溃疡患者的疗效及对炎性因子与疼痛程度的影响

The Effect of Multiple Drug Combined Therapy on Inflammatory Factor and Pain Degree of Patients with Recurrent Oral Ulcer

目的探讨几种药物(维生素B2片、维生素E软胶囊、甲钴胺片、叶酸片、FE复合酶漱口液)联合治疗复发性口腔溃疡的临床效果及对炎性因子与疼痛程度的影响。方法选取2011年10月至2014年10月衡水市第二人民医院诊治的复发性口腔溃疡患者129例,采用随机数字表法分为三组,各43例。A组患者采用FE复合酶漱口液治疗,每次含漱10 m L,每日5次。B组患者采用维生素B2片(口服5 mg/次,每日3次)、维生素E软胶囊(口服200 mg/次,每日3次)、甲钴胺片(口服0.5 mg/次,每日3次)、叶酸片(口服5 mg/次,每日3次)治疗。C组患者采用维生素B2片、维生素E软胶囊、甲钴胺片、叶酸片、FE复合酶漱口液治疗,药物用法同A组和B组。比较三组患者的治疗效果。结果 B组和C组溃疡总个数显著少于A组[(16±6)个、(10±3)个比(22±8)个],平均溃疡期显著短于A组[(4.5±1.2)d、(3.2±0.7)d比(7.8±3.1)d],总间歇期显著长于A组[(35±6)d、(50±8)d比(25±8)d]。C组总有效率明显高于A组和B组[97.67%(42/43)比60.74%(26/43)、81.40%(35/43)],B组总有效率显著高于A组,差异有统计学意义(P<0.05)。治疗后,C组疼痛程度显著轻于A组和B组(P<0.05),B组疼痛程度显著轻于A组(P<0.05),差异均有统计学意义(P<0.05)。治疗后,B组白细胞介素(IL)-2显著高于A组[(2.73±0.38)μg/L比(2.34±0.29)μg/L],而IL-8、肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP)均显著低于A组[(56.87±21.09)ng/L比(71.34±20.87)ng/L,(19.28±6.09)μg/L比(26.75±10.38)μg/L,(5.08±1.15)mg/L比(5.94±1.28)mg/L],C组IL-2[(3.18±0.36)μg/L]显著高于A组和B组,而IL-8、TNF-α、CRP[(48.27±13.94)ng/L,(14.36±5.17)μg/L,(4.30±1.07)mg/L]均显著低于A组和B组,差异有统计学意义(P<0.05)。结论几种药物(维生素B2片、维生素E软胶囊、甲钴胺片、叶酸片、FE复合酶漱口液)联合治疗复发性口腔溃疡的效果显著,可明显改善炎症水平,延长间歇期,减轻疼痛,具有较高的安全性,值得临床推广使用。

Objective To investigate effect of multiple drug （vitamin B2 tablets, vitamin E soft capsules, mecobalamin tablets, folic acid tablets; FE compound enzyme gargle ） combination therapy on the inflammatory factor and pain degree of patients with recurrent oral ulcer. Methods Total of 129 patients with recurrent Oral ulcer in Hengshui Second Hospital from Oct. 2011 to Oct. 2014 were included in the study, and were divided into three groups according to the random number table method, 43 eases each. Group A received FE enzyme mouthwash treatment, 10 mL each gargle,5 times/d. Group B was treated with vitamin B2 tablets（oral 5 mg/time,3 times/d） ,vitamin E soft capsules（oral 200 mg/time,3 times/d） ,methylcobal- amin tablets （ oral 0. 5 mg/time, 3 times/d ）, folic acid tablets （ oral 5 mg/time, 3 times/d ）. Group C was treated with vitamin B2 tablets, vitamin E soft capsule, methyleobalamin tablets, folic acid tablets, FE composite enzyme mouthwash treatment,drug usage same as group A and group B. The therapeutic effect was compared between the three groups. Results The total number of ulcers of group B and C were significantly less than group A [ （ 16±6） counts, （ 10±3 ） counts vs （ 22±8 ） counts ] , and the average ulcer period were significantly shorter than group A [（4.5± 1.2） d, （3.2±0. 7 ） d vs （7.8± 3.1 ） d ], and the total interval were significantly longer than group A [ （35 ± 6 ） d, （50±8 ） d vs （25± 8 ） d ]. The total efficacy of group C wias significantly higher than group A and group B [ 97.67 % （42/43）vs 60. 74% （26/43）, 81.40% （35/ 43 ） ], group B was significantly higher than group A, the differences were statistically significant （ P 〈 0. 05 ）. After treatment, the degree of pain in group C was significantly lighter than group A and group B （P 〈 0. 05 ）, and group B was significantly lighter than group A（ P 〈 0.05 ）, the differences were statistically sig- nificant（ P 〈 0. 05 ）. After treatment, the interleukin （IL）-2 of group B was significantly higher than group A [ （ 2. 73 ± 0.38 ） μg/L vs （ 2.34 ± 0. 29 ） μg/L ], and IL-8, tumor necrosis factoret （ TNF-ct ）, C-reactive protein（CRP） were significantly lower than group A [ （ 56. 87±21.09） ng/L vs （71.34±20. 87） ng/L, （ 19. 28±6. 09） μg,/L vs （ 26. 75±10. 38 ） μg/L, （5.08 ± 1.15 ） mg/L vs （5.94 ± 1.28 ） mg/L ], group C IL-2 [ （3.18±0.36） μg/L] was significantly higher than group A and group B,and IL-8,TNF-α,CRP [ （48.27 ± 13.94 ） ng/L, （ 14. 36 ± 5. 17 ） αg/L, （ 4. 30 ± 1.07 ） mg/L ] were significantly lower than group A and group B, the differences were statistically significant （ P 〈 0. 05 ）. Conclusion Multiple drugs （vitamin B2 tablets, vitamin E soft capsules, mecobalamin tablets, folic acid tablets; FE compound enzyme gargle） combined therapy has significant effect for recurrent oral ulcer, which can significantly improve inflammation level, prolong intermittent period, and alleviate pain with high safety, thus is worthy of the clini- cal application and promotion.