参苓白术散对复发性口腔溃疡患者炎症因子和免疫功能的影响

Effect of Shenling Baizhu power on inflammatory factors and immune function for recurrent aphthous ulcer

目的探讨参苓白术散对复发性口腔溃疡炎症因子和免疫功能的影响。方法选择武警浙江省总队嘉兴医院口腔科收治的90例复发性口腔溃疡患者,按照随机数字表法分为对照组和研究组,每组45例。对照组给予口服维生素B2片、左旋咪唑和西吡氯铵漱口常规治疗,研究组在对照组基础上口服参苓白术散。1 w后观察临床疗效,Elisa法测定血清炎症因子肿瘤坏死因子α（tumor necrosis factor alpha,TNF-α）、白介素2（interleukin 2,IL-2）和白介素6（IL-6）水平,流式细胞仪测定外周血T细胞亚群CD3^＋、CD4^＋、CD8^＋和自然杀伤细胞（NKT）水平,随访1年观察复发情况。结果治疗1 w后,研究组患者总有效率91.30%显著高于对照组69.57%,差异有统计学意义（χ^2=5.874,P=0.015）。研究组患者的血清炎症因子TNF-α、IL-2和IL-6水平显著低于对照组,差异有统计学意义（P〈0.05）。研究组患者的T细胞亚群CD3^＋、CD4^＋、CD8^＋和NKT水平显著高于对照组,差异有统计学意义（P〈0.05）。随访1年,研究组患者的复发率17.78%（8/45）显著低于对照组46.67%（21/45）,差异有统计学意义（χ^2=8.598,P=0.003）。结论参苓白术散治疗复发性口腔溃疡具有较好的临床疗效,可降低炎症因子水平,提高免疫功能,降低复发率。

Objective To explore the effect of Shenling Baizhu power on inflammatory factors and immune function for recurrent aphthous ulcer.Methods Ninety patients with recurrent aphthous ulcer in our hospital were divided into control group and study group according to random number table method,with 45 cases each group. The control group were given oral vitamin B2,levamisole and cetyl pyridinium chloride gargle solution therapy,and the study group were given Shenling Baizhu power on the basis of control group. After one week treatment,the clinical curative effect were observed,the serum inflammatory factors levels of tumor necrosis factor alpha（TNF-α）,interleukin 2（IL-2） and interleukin 6（IL-6） were determined by Elisa method,the levels of peripheral blood T cell subsets CD3^＋,CD4^＋,CD8^＋ and natural killer cells（NKT） were determined by flow cytometry instrument,and the recurrence rate were observed after one year follow-up. Results After one week treatment,the total effective rate 91. 30% in study group was significantly higher than the control group 69. 57%,the difference was statistically significant（χ^2= 5. 874,P = 0. 015）. The serum levels of TNF-α,IL-2 and IL-6 in study group were significantly lower than the control group,the difference was statistically significant（P〈0. 05）. The levels of CD3^＋,CD4^＋,CD8^＋ and NKT in study group were significantly higher than the control group,the difference was statistically significant（P〈0. 05）. Followed up for 1 year,the recurrence rate 17. 78%（8/45） in study group was significantly lower than the control group 46. 67%（21/45）,the difference was statistically significant（χ^2= 8. 598,P = 0. 003）. Conclusion The Shenling Baizhu power treatment of recurrent aphthous ulcer has better clinical curative effect,can reduce levels of inflammatory factor,improve immune function,and reduce the recurrence rate.