Intestinal complications in Brazilian patients with ulcerative colitis treated with conventional therapy between 2011 and 2020

BACKGROUND This was an observational, descriptive, and retrospective study from 2011 to 2020 from the Department of Informatics of the Brazilian Healthcare System database.AIM To describe the intestinal complications(IC) of patients with ulcerative colitis(UC) who started conventional therapies in Brazil’s public Healthcare system.METHODS Patients ≥ 18 years of age who had at least one claim related to UC 10th revision of the International Statistical Classification of Diseases and Related Health Problems(ICD-10) code and at least 2 claims for conventional therapies were included. IC was defined as at least one claim of: UC-related hospitalization, procedures code for rectum or intestinal surgeries, and/or associated disease defined by ICD-10 codes(malignant neoplasia of colon, stenosis, hemorrhage, ulcer and other rectum or anus disease, megacolon, functional diarrhea volvulus, intussusception and erythema nodosum). Descriptive statistics, annual incidence, and incidence rate(IR) [per 100 patient-years(PY)] over the available follow-up period were calculated.RESULTS In total, 41229 UC patients were included(median age, 48 years;65% women) and the median(interquartile range) follow-up period was 3.3(1.8-5.3) years. Conventional therapy used during follow-up period included: mesalazine(87%), sulfasalazine(15%), azathioprine(16%) or methotrexate(1%) with a median duration of 1.9(0.8-4.0) years. Overall IR of IC was 3.2 cases per 100 PY. Among the IC claims, 54% were related to associated diseases, 20% to procedures and 26% to hospitalizations. The overall annual incidence of IC was 2.9%, 2.6% and 2.5% in the first, second and third year after the first claim for therapy(index date), respectively. Over the first 3 years, the annual IR of UC-related hospitalizations ranged from 0.8% to 1.1%;associated diseases from 0.9% to 1.2%-in which anus or rectum disease, and malignant neoplasia of colon were the most frequently reported;and procedure events from 0.6% to 0.7%, being intestinal resection and polyp removal the most frequent ones.CONCLUSION Study shows that UC patients under conventional therapy seem to present progression of disease developing some IC, which may have a negative impact on patients and the burden on the health system.

Nomogram for predicting early complications after distal gastrectomy

BACKGROUND Reducing or preventing postoperative morbidity in patients with gastric cancer(GC)is particularly important in perioperative treatment plans.AIM To identify risk factors for early postoperative complications of GC post-distal gastrectomy and to establish a nomogram prediction model.METHODS This retrospective study included 131 patients with GC who underwent distal gastrectomy at the Second Hospital of Shandong University between January 2019 and February 2023.The factors influencing the development of complications after distal gastrectomy in these patients were evaluated using univariate and multivariate logistic regression analysis.Based on the results obtained,a predictive nomogram was established.The nomogram was validated using internal and external(n=45)datasets.Its sensitivity and specificity were established by receiver operating characteristic curve analysis.Decision curve(DCA)analysis was used to determine its clinical benefit and ten-fold overfitting was used to establish its accuracy and stability.RESULTS Multivariate logistic regression analysis showed that hypertension,diabetes,history of abdominal surgery,and perioperative blood transfusion were independent predictors of postoperative complications of distal gastrectomy.The modeling and validation sets showed that the area under the curve was 0.843[95%confidence interval(CI):0.746-0.940]and 0.877(95%CI:0.719-1.000),the sensitivity was 0.762 and 0.778,respectively,and the specificity was 0.809 and 0.944,respectively,indicating that the model had good sensitivity and specificity.The C-indexes of the modeling and validation datasets were 0.843(95%CI:0.746-0.940)and 0.877(95%CI:0.719-1.000),respectively.The calibration curve(Hosmer Lemeshow test:χ^(2)=7.33)showed that the model had good consistency.The results of the DCA analysis indicated that this model offered good clinical benefits.The accuracy of 10-fold cross-validation was 0.878,indicating that the model had good accuracy and stability.CONCLUSION The nomogram prediction model based on independent risk factors related to postoperative complications of distal gastrectomy can facilitate perioperative intervention for high-risk populations and reduce the incidence of postoperative complications.

Complications after ileal pouch-anal anastomosis in Korean patients with ulcerative colitis

AIM: To investigate the outcomes of treatments for complications after ileal pouch-anal anastomosis (IPAA) in Korean patients with ulcerative colitis.

Metabolomics characterization of Qingwei San on oral ulcer in db/db mice with stomach heat pattern

Objective:To characterize the effects of Qingwei San(QWS)on diabetic oral ulcer(OU)mice with stomach heat pattern through metabolomic analysis.Methods:A stomach heat pattern mouse model was established by treating C57BLKS/J Leprdb/db(db/db)mice with dried Zingiber officinale Rosc.rhizome(Z.officinale,Gan Jiang)decoction by gavage.All model mice had blood glucose levels of≥11.1 m M.Subsequently,OU was induced by Na OH cauterization.After 1 week of administration of QWS,non-targeted metabolomic analysis of serum was conducted using ultra high performance liquid chromatography coupled with mass spectrometry(UHPLC-MS/MS).Results:The non-targeted metabolomics results indicated that tryptophan metabolism,2-oxocarboxylic acid metabolism,serotonergic synapses,amino sugar and nucleotide sugar metabolism,and amino acid biosynthesis were involved in the therapeutic effects of QWS,with tryptophan metabolism playing a predominant role.Conclusion:QWS treatment can significantly improve the pathological status of diabetic OU mice with stomach heat pattern.QWS may regulate the release of inflammatory factors through the tryptophan metabolism pathway.

The Evolutionary Profile of Patients Operated for Peptic Ulcer Perforation in Bujumbura

Background: The evolutionary profile of patients operated for peptic ulcer perforation in Bujumbura. Perforated peptic ulcer is a serious complication of peptic ulcer with potential risk of grave complications. Aim: To study the early morbidity and mortality of surgery for peptic ulcer perforation in Bujumbura City Hall hospitals: Kamenge University Hospital Center (CHUK), Kamenge Military Hospital (HMK) and Prince Louis Rwagasore Clinic (CPLR). Patients and methods: This is a retrospective, descriptive and analytical study carried out in the three hospitals of Bujumbura over a period of three years from January 1, 2020 to December 31, 2022. It involved 57 cases (n = 57) of peptic ulcer perforation. Results: The frequency of surgery for peptic ulcer perforation was 2.7% with a mean age of 43.6 years +/- 15.3 years and a male predominance with a sex ratio of 3.7. Eight percent of patients presented with shock, 24.5% were smokers, and 67.9% had taken non steroidal anti-inflammatory drugs. The mean hospital stay was 15.2 days with a standard deviation of 12.1. The morbidity rate was 30.2%, 32% were classified in grade IIIb of the Clavien-Dindo Surgical Complications Scale. There were 9 deaths (17%). Seven patients who underwent surgery and received late consultations died. Conclusion: Surgery for peptic ulcer perforation remains an intervention associated with a high rate of morbidity and mortality in Bujumbura. Surgery for peptic ulcer perforation remains a procedure associated with a high morbidity and mortality rate in Bujumbura. The time before consultation was the only factor associated with early morbidity and mortality of Surgery for peptic ulcer’s perforations.

Extraintestinal manifestations and complications in inflammatory bowel diseases

Crohn＇s disease （CD） and ulcerative colitis （UC） are chronic inflammatory bowel diseases （IBD） that often involve organs other than those of the gastrointestinal tract. These nonintestinal affections are termed extraintestinal symptoms. Differentiating the true extraintestinal manifestations of inflammatory bowel diseases from secondary extraintestinal complications, caused by malnutrition, chronic inflammation or side effects of therapy, may be difficult. This review concentrates on frequency, clinical presentation and therapeutic implications of extraintestinal symptoms in inflammatory bowel diseases. If possible, extraintestinal manifestations are differentiated from extraintestinal complications. Special attention is given to the more recently described sites of involvement; i.e. thromboembolic events, osteoporosis, pulmonary involvement and affection of the central nervous system.

Hemobilia and other complications caused by percutaneous ultrasound-guided liver biopsy

Hemobilia accounts for approximately 3%of all major percutaneous liver biopsy complications,and rarely results from arterioportal fistula.We report a patient who suffered from four complications over 11 d after ultrasound-guided percutaneous liver biopsy:hemobilia,acute pancreatitis,acute cholecystitis,and multiple stomach ulcers.Digital subtraction angiography was done after consultation with doctors,and showed obvious arteriovenous fistula of the right liver.The hepatic artery was selected and embolized by spring orbs.The active bleeding was stopped after embolization of the hepatic artery.The patient was discharged home on day 12 after embolization and remained well.

Healing property of the Piper betel phenol, allylpyrocatechol against indomethacin-induced stomach ulceration and mechanism of action

AIM：To evaluate the protective activity of allylpyrocatechol （APC）, the major antioxidant constituent of Piper betel, against the indomethacin-induced stomach ulceration in the rat model and correlates with its antioxidative and mucin protecting properties.METHODS： Male Sprague-Dawley rats were divided into five groups. Normal control rats （group Ⅰ ） were given the vehicle oral dose of gum acacia in distilled water （1 mL per rat）; ulcerated control and treated rats （groups Ⅱ-V） were given a single dose of indomethacin （30 mg/kg body wt.）; group Ⅱ rats were sacrificed 4 h after indomethacin administration; groups Ⅲ-Ⅴ rats were given the vehicle （1 mL per rat） or APC （2 mg/kg body wt.） or misoprostol （1.43 μg/kg body wt.） once daily by oral intubation for 7 d starting from 4 h after the indomethacin administration. After 7 d, the stomach tissues were excised for histological examination and biochemical analysis. RESULTS： Treatment with APC （2 mg/kg body wt per day） and misoprostol （1.43 μg/kg body wt per day） for 7 d could effectively heal the stomach ulceration as revealed from the ulcer index and histopathological studies. Compared to the zero day ulcerated group, treatment with APC and misoprostol reduced the ulcer index by 93.4% and 85.4% respectively （P 〈 0.05）. Both APC and misoprostol accelerated ulcer healing observed in natural recovery （P 〈 0.05）, their respective healing capacities not being significantly different. The healing capacities of APC and misoprostol could be attributed to their antioxidant activity as well as the ability to enhance the rnucin content of the gastric tissues. Compared to the ulcerated untreated rats, those treated with APC and rnisoprostol showed near normal MDA levels, while the protein levels were 86% and 78% of the normal value respectively （P 〈 0.05）. Likewise, both APC and rnisoprostol increased the SOD, catalase, and rnucin levels significantly （P 〈 0.05）, the effect of APC being better. CONCLUSION： APC can protect indomethacin-induced gastric ulceration due to its antioxidative and mucin protecting properties.

Diabetic foot ulcers: A devastating complication of diabetes mellitus continues non-stop in spite of new medical treatment modalities

Diabetic foot ulcer is a devastating complication of diabetes mellitus and significant cause of mortality and morbidity all over the world and can be complex and costly.The development of foot ulcer in a diabetic patient has been estimated to be 19%-34%through their lifetime.The pathophysiology of diabetic foot ulcer consist of neuropathy,trauma and,in many patients,additional peripheral arterial disease.In particular,diabetic neuropathy leads to foot deformity,callus formation,and insensitivity to trauma or pressure.The standard algorithms in diabetic foot ulcer management include assessing the ulcer grade classification,surgical debridement,dressing to facilitate wound healing,offloading,vascular assessment(status and presence of a chance for interventional vascular correction),and infection and glycemic control.Although especially surgical procedures are sometimes inevitable,they are poor predictive factors for the prognosis of diabetic foot ulcer.Different novel treatment modalities such as nonsurgical debridement agents,oxygen therapies,and negative pressure wound therapy,topical drugs,cellular bioproducts,human growth factors,energy-based therapies,and systematic therapies have been available for patients with diabetic foot ulcer.However,it is uncertain whether they are effective in terms of promoting wound healing related with a limited number of randomized controlled trials.This review aims at evaluating diabetic foot ulcer with regard to all aspects.We will also focus on conventional and novel adjunctive therapy in diabetic foot management.

Does testosterone prevent early postoperative complications after gastrointestinal surgery?

AIM:To investigate the role of sex hormones in the early postoperative complications of gastrointestinal diseases. METHODS:A total of 65 patients who underwent operations for gastric and colorectal diseases(mainly malignant diseases)were included in the study. Peripheral venous blood samples were collected at different times for analysis of estradiol,testosterone and progesterone.The only study endpoint was analysis of postoperative complications. RESULTS:Patients of both sexes were uniform but postoperative complication rate was significantly higher in female patients(P=0.027).There was no significant association of estradiol and progesterone with postoperative complications.Testosterone levels in complicated patients were significantly lower than in uncomplicated patients(P<0.05).Area under the receiver operating characteristic curve showed that a lower value of testosterone was a predictor for higher complication rate(P<0.05),and a lower value oftestosterone at later times after surgery was a better predictor of complications. CONCLUSION:Patients with low testosterone level were prone to higher postoperative complications,which was evident in both sexes.However,further studies are necessary to support this result.

Risk of post-operative complications associated with anti-TNF therapy in inflammatory bowel disease

There have been increasing concerns regarding the safety of perioperative anti-tumour necrosis factor (anti-TNF) α agents. We performed a literature review to evaluate the post-operative complications associated with perioperative anti-TNF use in patients with inflammatory bowel disease. A comprehensive review was performed with a literature search utilizing Pub Med, Cochrane, OVID and EMBASE databases according to published guidelines. To date, there are only data for infliximab. There are three published studies which have assessed post-operative complications with perioperative infliximab use in patients with Crohn' s disease (CD), four studies in ulcerative colitis (UC) patients, and one study on both CD and UC patients. Two out of the three studies in CD patients showed no increased post-operative complications associated with perioperative infliximab. Two out of four studies in UC patients also did not show an increase in post-operative complications, and the combined study with CD and UC patients did not show an increased risk as well. Studyresults could not be combined secondary to significant differences in study designs, patient population and definition of their endpoints. There appears to be a risk of post-operative complications associated with TNF therapy in some patients. Based on these data, careful patient selection and prospective data collection should be performed.

Feed Form Affects Growth and Stomach Ulcers in Yearling Horses

Fourteen yearling standardbred horses were used to test the hypothesis that hay and grain fed as a complete total mixed ration （TMR） cube diet （C） would result in greater average daily gain （ADG）, feed efficiency （gain to feed ratio, G/F） and apparent digestibility in horses on the TMR diet compared to horses fed the same weight and proportion of hay cubes and grain fed separately （diet HG）. Both diets consisted of 75% forage and 25% ground oats. The forage in both the plain hay cubes and the complete cubes was 80% alfalfa and 20% endophyte-free tall rescue. An additional hypothesis that stomach ulceration would not differ between horses fed either of the two diet treatments was also tested by comparing upper gastric endoscopies before and after 70 days of feeding the experimental diets. Horses fed diet C had greater ADG （P 〈 0.046） while G/F between the two treatments was not significantly different （P 〉 0.065） but showed a trend to be higher in the horses consuming diet C. Apparent digestibility of dry matter and crude protein was not different between the diet treatments, and no major gastric ulceration was found in horses consuming either diet treatment. The results of this study found that a complete cubed diet of 75% hay and 25% oats did not cause stomach ulceration while achieving an acceptable growth rate in yearling horses.

Clinical experience of Professor Xie Jingri in the deficiency-cold of spleen and stomach type of complex peptic ulcer

Objective:To summarize Professor Xie's clinical experience in treating the deficiency cold of spleen and stomach type of complex peptic ulcer.Methods:through the observation of the curative effect of the patients with the deficiency cold of spleen and stomach type of complex peptic ulcer in the outpatient department of liver,spleen and stomach department of our hospital,the dialectical application and clinical experience of Professor Xie Jingri's self-made prescription in clinical practice were summarized.Results:Professor Xie Jingri's self-made prescription can effectively improve the clinical symptoms of patients with the deficiency cold of spleen and stomach type of complex peptic ulcer,and through individual syndrome differentiation and treatment,make the self-made prescription vary from person to person,clinical addition and subtraction,so as to further improve the clinical efficacy of patients.Conclusion:Professor Xie Jingri's self-made prescription is effective in treating complex peptic ulcer of spleen stomach deficiency cold type,which is worthy of further clinical application and promotion.

Migration of the distal ventriculoperitoneal shunt catheter into the stomach with or without trans-oral extrusion:A systematic literature review and meta-analysis

BACKGROUND Intra-gastric migration of the distal ventriculoperitoneal shunt(VPS)catheter clinically presenting with or without trans-oral extrusion is one of the rare complications of VPS catheter insertion.AIM To identify the demographics,clinical presentation,clinical findings,and results of surgical therapy offered for the treatment of intra-gastric migration of the distal VPS catheter,clinically presented with or without trans-oral extrusion.METHODS An online search was performed for the extraction/retrieval of the published/available literature pertaining to the above-mentioned VPS complication.Manuscripts were searched from PubMed,PMC(PubMed Central),ResearchGate,and Google Scholar databases using various terminology relating to the VPS complications.The first case of migration of a VPS catheter into the stomach was reported in the year 1980,and the data were retrieved from 1980 to December 2022.Cases were categorized into two groups;Group A:Cases who had migration of the distal VPS catheter into the stomach and clinically presented with trans-oral extrusion of the same,and Group B:Cases who had migration of the distal VPS catheter into the stomach,but presented without trans-oral extrusion.RESULTS A total of n=46 cases(n=27;58.69%male,and n=19;41.3%females)were recruited for the systematic review.Group A included n=32,and Group B n=14 cases.Congenital hydrocephalus was the indication for the primary VPS insertion for approximately half of the(n=22)cases.Approximately sixty percent(n=27)of them were children≤5 years of age at the time of the diagnosis of the complication mentioned above.In seventy-two percent(n=33)cases,this complication was detected within 24 mo after the VPS insertion/last shunt revision.Clinical diagnosis was evident for the entire group A cases.Various diagnostic modalities were used to confirm the diagnosis for Group B cases.Various surgical procedures were offered for the management of the complication in n=43 cases of both Groups.In two instances,intra-gastric migration of the distal VPS catheter was detected during the autopsy.This review documented four deaths.CONCLUSION Intra-gastric migration of the peritoneal end of a VPS catheter is one of the rare complications of VPS catheter implantation done for the treatment of hydrocephalus across all age groups.It was more frequently reported in children,although also reported in adults and older people.A very high degree of clinical suspicion is required for the diagnosis of a case of an intra-gastric migration of the distal VPS catheter clinically presenting without transoral extrusion.

65例胃早癌脉管侵犯的相关因素分析

目的探讨胃早癌脉管侵犯的相关因素。方法回顾性分析江苏省扬州市江都人民医院2018年1月—2023年6月收治的65例胃早癌内镜黏膜下剥离术(endoscopic submucosal dissection,ESD)患者资料。根据术后病理结果将患者分为脉管侵犯组与非侵犯组,分别为31例和34例。分析各组病例的临床特征、胃镜表现及病理特点,通过logistic回归分析探讨胃癌发生脉管浸润的独立危险因素。结果病灶>2 cm(OR=4.959,95%CI1.490~16.500)、合并溃疡(OR=3.667,95%CI 1.429~21.950)、Kit-67指数>30%(OR=9.601,95%CI2.530~36.373)、病理分化差(OR=6.440,95%CI1.822~22.760)及浸润深度T1b(tumour infiltration depth 1b,T1b)(OR=6.301,95%CI1.913~20.802)对胃早癌脉管侵犯有影响(P<0.05)。Kit-67指数>30%是脉管转移独立高危因素(P<0.05)。结论脉管侵犯与多种因素有关,Kit-67指数对评估是否合并脉管侵犯有重要临床意义。

补益脾胃溃结方对脾胃虚弱型溃疡性结肠炎患者的临床疗效

目的 探讨补益脾胃溃结方对脾胃虚弱型溃疡性结肠炎患者的临床疗效。方法 132例患者随机分为对照组和观察组,每组66例,对照组给予常规治疗,观察组在对照组基础上加用补益脾胃溃结方,疗程4周。检测临床疗效、Mayo评分、SF-36评分、中医证候评分、5-HT、IL-6、TNF-α、IL-4、CD4^(+)/CD8^(+)、LPS、TGF-β1、DAO变化。结果 观察组总有效率高于对照组(P<0.05)。治疗后,2组Mayo评分、中医证候评分、TNF-α、LPS、5-HT、IL-6、CD4^(+)/CD8^(+)、DAO降低(P<0.05),SF-36评分、TGF-β1、IL-4升高(P<0.05),以观察组更明显(P<0.05)。结论 补益脾胃溃结方可减轻脾胃虚弱型溃疡性结肠炎患者炎症反应,调节免疫功能,抑制疼痛介质分泌,促进肠黏膜修复,提高临床疗效。

抗生素骨水泥增强胫骨横向骨搬运治疗感染创面的能力

背景:糖尿病足伴创面感染的患者群体庞大,目前尚无满意的治疗方案。目的:探讨改良胫骨横向骨搬运技术联合抗生素骨水泥治疗顽固性糖尿病足溃疡的临床疗效。方法:选择2020年1月至2023年1月首都医科大学附属北京朝阳医院和北京朝阳中西医结合急诊抢救医院收治的46例糖尿病足溃疡患者,男27例,女19例,平均年龄64.37岁,均接受改良胫骨横向骨搬运手术联合抗生素骨水泥治疗。记录胫骨横向骨搬运术前及术后3个月患者的踝肱指数、伤口/缺血/足部感染分级(WIFi分级)、目测类比评分与溃疡面积。结果与结论:①46例患者溃疡平均愈合时间为(58.07±24.82)d,46例患者胫骨横向骨搬运术后3个月的踝肱指数、目测类比评分、溃疡面积、WIFi分级均较术前明显改善(P<0.05)。随访期间,2例患者出现钉道感染,未出现溃疡或感染复发。②结果显示,改良胫骨横向骨搬运术联合抗生素骨水泥可有效缓解糖尿病足溃疡患者的疼痛、改善下肢血运、控制感染并促进溃疡的愈合。

韩捷基于脏腑气化论治溃疡性结肠炎腹胀经验

韩捷教授从脏腑气化学说探讨溃疡性结肠炎腹胀,认为土虚木贼导致的腹胀与肝脾气化失常有关,食积湿热导致的腹胀与脾胃气化失常有关,清浊相混、气机郁滞所致腹胀与肠胃气化紧密联系,虚寒所致腹胀与脾肾气化相关联。其中尤以脾胃气化为主。在治疗上斡旋中焦气机,辨证选用疏肝、通调腑气、温补肾阳等法,使脏腑气化功能复常,气机通调,水谷精微吸收布散复常,则无胀满之机。韩捷教授从脏腑气化学说探讨溃疡性结肠炎腹胀之机,探寻腹胀之治,在临床取得较好疗效。

降钙素基因相关肽在胃溃疡模型小鼠穴位敏化中的作用研究

目的从分子生物学的角度,探讨降钙素基因相关肽(calcitonin gene-related peptide,CGRP)在慢性胃溃疡模型小鼠穴位敏化过程中的作用。方法将C57BL/6小鼠随机分为对照组和模型组,每组15只,将冰乙酸溶液于胃小弯近幽门处注射到胃壁肌层近黏膜下层构建慢性胃溃疡模型,随后在小鼠尾静脉上注射伊文思蓝,观察穴位敏化点的体表分布规律;HE染色法观察胃部组织在造模前后的病理形态变化;通过体表痛敏行为学实验,观察小鼠痛觉阈值的改变;蛋白质印迹法、免疫荧光染色法检测穴位敏化后脊髓、背根神经节(dorsal root ganglion,DRG)和皮肤中的CGRP表达。结果通过向小鼠胃部注射冰乙酸可诱导其形成符合胃溃疡典型病理特征的动物模型;对照组EB渗出点较少,模型组EB渗出点分散于脊髓T_(1)~T_(13)节段支配区域,其中以T_(9)~_(T11)区域最为集中,且其伊文思蓝渗出点压痛阈较造模前显著降低(P<0.01)。穴位敏化后模型组的脊髓、DRG和皮肤中的CGRP蛋白和荧光蛋白阳性表达显著高于对照组(P<0.01)。结论冰乙酸诱导小鼠形成胃溃疡后,其胃部组织病变所对应的体表敏化区、相应的脊髓T9~T11节段和DRG神经元中CGRP表达增高,可能是引起外周和中枢痛觉敏化,使体表局部出现神经源性炎性反应,介导穴位敏化的原因。

口腔洁含漱液对脾胃伏火型复发性口腔溃疡患者口腔菌群、血清炎症因子和T细胞亚群水平的影响

目的探讨口腔洁含漱液对脾胃伏火型复发性口腔溃疡患者口腔菌群、血清炎症因子和T细胞亚群水平的影响。方法选取2022年4月至2023年3月成都中医药大学附属医院口腔科和四川大学华西口腔医院口腔黏膜科收治的脾胃伏火型复发性口腔溃疡患者64例为研究对象,按照随机数字表法分为试验组(32例)和对照组(32例),对照组患者给予醋酸曲安奈德乳膏治疗,试验组在对照组基础上联合口腔洁含漱液含漱、吞服,每日3次,持续治疗7 d。观察两组患者临床疗效,评价两组治疗前后,以及治疗后组间的中医证候积分、疼痛指数、疼痛持续时间和溃疡愈合时间;实时荧光定量PCR法分析口腔菌群(链球菌、韦荣氏菌、奈瑟氏菌)DNA浓度;ELISA法检测血清炎症因子[肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-6、IL-8]含量;流式细胞术测定血清T细胞亚群水平[T淋巴细胞(CD3^(+))、辅助性T淋巴细胞(CD4^(+))、CD4^(+)/细胞毒性T淋巴细胞(CD8^(+))]。同时记录治疗期间不良反应,比较6个月后复发情况。结果试验组临床疗效、疼痛抑制效果和溃疡愈合速率均优于对照组(P<0.05);两组患者治疗后口腔内链球菌和韦荣氏菌DNA浓度明显高于治疗前,且试验组高于对照组,差异均有统计学意义(P<0.05);两组患者治疗后血清炎症因子TNF-α、IL-6、IL-8含量相较治疗前降低,CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)相较治疗前升高,且试验组改善程度优于对照组,差异均有统计学意义(P<0.05)。试验组复发率显著低于对照组(P<0.05)。结论口腔洁含漱液治疗脾胃伏火型复发性口腔溃疡患者,可显著提高临床疗效,改善口腔菌群构成,抑制血清炎性反应水平,提高细胞免疫功能,降低复发率,值得临床推广应用。