西吡氯铵含片治疗口腔念珠菌病临床疗效观察

Clinical effect of cetylpyridinium chloride buccal tablets on oral candidosis

目的探讨西吡氯铵含片单独或联用碳酸氢钠含漱液治疗口腔念珠菌病的临床疗效。方法选取经临床及实验室检查确诊为红斑型或伪膜型口腔念珠菌病的患者,采用单中心、平行对照随机分为3组:(1)实验1组为西吡氯铵含片组;(2)实验2组为西吡氯铵含片+2.5%碳酸氢钠含漱组;(3)对照组为2.5%碳酸氢钠含漱组。分别于初诊与治疗2周后复诊时记录患者口干、疼痛、红斑或伪膜的程度以及念珠菌培养数量。采用SPSS 20.0统计软件对计量资料进行配对样本t检验、配对样本秩和检验,对计数资料进行卡方检验,检验水准α=0.05。结果本研究共纳入73例口腔念珠菌病患者,其中实验1组25例、实验2组24例、对照组24例。经治疗3组均能改善口腔念珠菌病的临床表现及减少念珠菌培养数量;3组对口干改善的总有效率分别为85%、80%、84.2%,各组间差异无统计学意义(P=0.711);3组对疼痛改善的总有效率分别为90.9%、95.2%、95.2%,各组间差异无统计学意义(P=0.880);3组对红斑或伪膜改善的总有效率分别为88%、95.8%、50%,2个实验组对红斑或伪膜的改善效果均优于对照组(χ_(1组)~2=10.091,P_(1组)=0.001;χ_(2组)~2=13.819,P_(2组)<0.001),且2个实验组对红斑或伪膜的改善效果差异无统计学意义(P=0.546);3组对念珠菌清除的总有效率分别为80%、91.7%、79.2%,实验2组对念珠菌的清除效果分别优于实验1组与对照组(χ_(1组)~2=6.026,P_(1组)=0.014;χ_(对照组)~2=5.147,P_(对照组)=0.023),实验1组与对照组对念珠菌清除效果差异无统计学意义(P=0.992)。结论西吡氯铵含片能够有效治疗红斑或伪膜型口腔念珠菌病,西吡氯铵含片联合碳酸氢钠含漱液对口腔念珠菌病的抗念珠菌效果更优。

Objective This study is aimed to investigate the effect of treatment of oral candidosis with cetylpyridinium chloride buccal tablets and cetylpyridinium chloride buccal tablets combined sodium bicarbonate. Methods Patients with erythema or pseudomonas oral candidosis were randomly divided into experimental group 1（cetylpyridinium chloride buccal tablets）,experimental group 2（cetylpyridinium chloride buccal tablets combined 2.5% sodium bicarbonate） and control group（2.5% sodium bicarbonate）. Improvement rate of each symptom including dry,pain,erythema or pseudomembrane and candida clearance rate were analysed among three groups. SPSS 20.0 statistical software was used to conduct matching sample t test,paired sample rank and test of measurement data. We used Chi-square test for counting data and the significance level was 0.05. Results The 73 cases were randomly divided into three groups and each group contained 25,24 and 24 cases. The three groups all can show improved symptoms of oral candidosis and reduced number of fungal. The total effective efficiency of the three groupson the improvement of dry was 85%,80% and 84.2% respectively with no statistically significant（P =0.711）difference between the three groups. The total effective rate of pain improvement in the three groups was 90.9%,95.2% and 95.2% respectively and there was no statistically significant difference between the three groups（P = 0.880）. The total effective rate of improvement of erythema or pseudomonas was 88%,95.8% and 50% respectively. There was no statistically significant difference between the experimental group 1 and the experimental group 2（P = 0.546）and such effect on both of the two groups were better than the control group（χ（1 group）^2= 10.091,P（1 group） = 0.001;χ（2 group）^2= 13.819,P（2 group）0.001）. The total rate of removal effect of the fungus in the three groups was 80%,91.7%,79.2% respectively. The effect of experimental group 2 was better than that of the experiment group 1 and the control group（χ（1 group）^2= 6.026,P（1 group）= 0.014;χ（control group）^2= 5.147,P（control group） = 0.023）. There was no statistical difference between the experimental group 1 and the control group on removal effect of the fungus（P = 0.992）. Conclusions Cetylpyridinium chloride buccal tablets can treat erythema/pseudomonas oral candidiasis. The antifungal effect of cetylpyridinium chloride buccal tablets combined sodium bicarbonate on oral candidiasis was more superior.