甘草泻心汤加减辅助治疗儿童复发性口腔溃疡寒热错杂证50例临床观察

Clinical observation on 50 cases of recurrent oral ulcer in children with cold and heat complex syndrome adjuvantly treated by modified Gancao Xiexin Tang(甘草泻心汤)

目的观察甘草泻心汤加减辅助治疗儿童复发性口腔溃疡寒热错杂证的临床疗效。方法选取2018年1月至2020年1月在浙江大学医学院附属第一医院北仑分院口腔科和儿科就诊的复发性口腔溃疡寒热错杂证患儿100例,采用随机数字表法分为对照组和治疗组,各50例。对照组予地喹氯铵含片含服,维生素B_(12)片口服;治疗组在对照组治疗方法的基础上给予甘草泻心汤加减治疗。2组均以7 d为1个疗程,2个疗程后统计临床疗效。结果对照组总有效率为86.0%(43/50),治疗组为98.0%(49/50),2组比较,差异有统计学意义(P<0.05)。治疗组溃疡面愈合时间、疼痛缓解时间明显短于对照组,2组比较,差异有统计学意义(P<0.05)。治疗前,2组CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)水平比较,差异无统计学意义,具有可比性(P>0.05);治疗后,2组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平明显升高,CD8^(+)水平明显下降,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组升高或下降更显著(P<0.05)。治疗后随访3个月,对照组复发率为23.3%(10/43),治疗组为6.1%(3/49),2组比较,差异有统计学意义(P<0.05)。结论甘草泻心汤加减辅助治疗儿童复发性口腔溃疡寒热错杂证,能有效促进溃疡面愈合和疼痛缓解,提高患儿机体免疫力,降低复发率,疗效确切,值得临床推广应用。

Objective To observe the clinical efficacy of modified Gancao Xiexin Tang(甘草泻心汤)in adjuvant treatment of recurrent oral ulcer(ROU)in children with cold and heat complex syndrome.Methods From January 2018 to January 2020,100 cases of ROU in children with cold and heat complex syndrome consulted in stomatology department and pediatrics department of the First Hospital Beilun Branch Affiliated to Medicine School of Zhejiang University were divided into control group and treatment group according to random number table method,with 50 cases in each group.The control group was given degualinium chloride buccal tablets buccally and vitamin B12 tablets orally,on this basis,the treatment group was given modified Gancao Xiexin Tang.Seven days constituted 1 course of treatment for both groups,and we kept statistics about the clinical efficacy after 2 courses of treatment.Results The total effective rate of the control group was 86.0%(43/50),that of the treatment group was 98.0%(49/50),and the difference was statistically significant between the 2 groups(P<0.05).The healing time of ulcer areas and pain relief time in the treatment group was significantly shorter than that in the control group,and the difference was statistically significant between the 2 groups(P<0.05).Before treatment,the difference was not statistically significant in the levels of CD3^(+),CD4^(+),CD8^(+) and CD4^(+)/CD8^(+) between the 2 groups,indicating comparability(P>0.05).After treatment,the levels of CD3^(+),CD4^(+) and CD4^(+)/CD8^(+) significantly increased,whereas the level of CD8^(+)significantly decreased in the 2 groups,and the differences were statistically significant than those in the same group before treatment(P<0.05),moreover,the increase or decrease was more significant in the treatment group(P<0.05).A 3-month follow-up was conducted after treatment,the recurrence rate was 23.3%(10/43)in the control group and 6.1%(3/49)in the treatment group,and the difference was statistically significant between the 2 groups(P<0.05).Conclusion It can effectively promote the healing time of ulcer areas and pain relief time,improve the body immunity of children,reduce the recurrence rate with definite efficacy to use modified Gancao Xiexin Tang in adjuvant treatment of ROU in children with cold and heat complex syndrome,which deserves clinical promotion and application.