雷尼替丁治疗老年复发性口腔溃疡的疗效及对细胞免疫、炎性因子的影响

Efficacy of ranitidine in the treatment of recurrent oral ulcers in elderly patients and its effect on cell/tissue factor

目的观察雷尼替丁治疗老年复发性口腔溃疡(ROU)的疗效及对患者免疫功能与炎性因子的影响。方法选取2015年9月—2017年4月新疆生产建设兵团机关门诊部口腔科、乌鲁木齐市口腔医院、新疆医科大学第一附属医院口腔科共收治的老年复发性口腔溃疡患者94例作为研究对象,按照随机数字表法分为对照组和观察组各47例。对照组给予冰硼散+维生素C常规治疗,观察组在此基础上辅以雷尼替丁口服,比较2组临床疗效,IFN-γ、TNF-α、IL-2水平、T细胞亚群水平变化及不良反应。结果 (1)临床总有效率观察组(91.49%)高于对照组(76.59%)(X^2=3.887,P=0.049);(2)治疗后2组患者IFN-γ、TNF-α、IL-2水平较治疗前明显改善,且观察组TNF-α、IL-2水平低于对照组(t=13.539、23.235,P=0.000、0.000),IFN-γ水平高于对照组(t=4.695,P=0.000);(3)治疗后2组T细胞亚群水平均改善,且观察组CD3^+、CD4^+、CD4^+/CD8^+水平高于对照组(t=9.881、9.762、4.303.P=0.000、0.000、0.000),CD8^+水平低于对照组(t=7.432,P=0.000);(4)观察组不良反应发生率(10.64%)高于对照组(8.51%),但差异无统计学意义(X^2=0.561,P=0.372)。结论雷尼替丁辅助治疗老年复发性口腔溃疡疗效显著,对患者免疫功能、炎性反应改善良好,值得临床推广。

Objective To observe the effect of ranitidine on senile recurrent oral ulcer （ROU） and its effect on immune function and related serum. Methods From September 2015 to April 2017, 94 cases of recurrent oral ulcer in the elderly from Outpatient Department of Xinjiang Production and Construction Corps and The First Affiliated Hospital of Xinjiang Medical University were selected, the patients were divided into two groups according to the random number table method. The control group was given routine treatment with ice boron powder and vitamin C; the observation group was treated with oral administration of ranitidine on the basis of the treatment of the control group. The clinical efficacy, levels of IFN-γ, TNF-α, IL-2, the T cell subsets change and adverse effects were compared between the two groups. Results The total effective rate of the observation group was higher than that of the control group （χ^2 = 3. 887, P = 0. 049 ） ; After treatment, The levels of IFN-＇,/, TNF-c~ and IL-2 in the 2 groups were significantly improved compared with those before treatment, The level of TNF-α and IL 2 in the observation group were lower than those in the control group （ t = 13. 539, t = 23. 235, P = 0. 000, P = 0.000）. The level of IFN-γ was higher than that of control group （t =4. 695, P =0. 000）. After treatment, the levels of CD3^＋ , CD4^＋ , CD4^＋ and/CD8^＋ in the observation group were higher than those in the control group （ t = 9. 881, t = 9. 762, t = 4. 303, P = 0. 000, P = 0,000, P = 0. 000）. The level of CD8^＋ was higher than that of the control group （t = 7. 432, P = 0.000）. The incidence of adverse reactions in the observation group was lower than that in the control group （10.64% vs. 8.51% χ^2 =0. 561, P = 372）. Conclusion Ranitidine is effective in the treatment of recurrent oral ulcer in the elderly, and the immune function of the patients is improved and worthy of clinical promotion.