Crohn’s and colitis in children and adolescents

Crohn＇s disease and ulcerative colitis can be grouped as the inflammatory bowel diseases （IBD）. These conditions have become increasingly common in recent years, including in children and young people. Although much is known about aspects of the pathogenesis of these diseases, the precise aetiology is not yet understood, and there remains no cure. Recent data has illustrated the importance of a number of genes-several of these are important in the onset of IBD in early life, including in infancy. Pain, diarrhoea and weight loss are typical symptoms of paediatric Crohn＇s disease whereas bloody diarrhoea is more typical of colitis in children. However, atypical symptoms may occur in both conditions： these include isolated impairment of linear growth or presentation with extra-intestinal manifestations such as erythma nodosum. Growth and nutrition are commonly compromised at diagnosis in both Crohn＇s disease and colitis. Consideration of possible IBD and completion of appropriate investigations are essential to ensure prompt diagnosis, the- reby avoiding the consequences of diagnostic delay. Patterns of disease including location and progression of IBD in childhood differ substantially from adult- onset disease. Various treatment options are available for children and adolescents with IBD. Exclusive enteral nutrition plays a central role in the induction of remission of active Crohn＇s disease. Medical and surgical therapies need to considered within the context of a growing and developing child. The overall management of these chronic conditions in children should include multi-disciplinary expertise, with focus upon maintaining control of gut inflammation, optimising nutrition, growth and quality of life, whilst preventing disease or treatment-related complications.

Disease impact on the quality of life of children with inflammatory bowel disease

To assess the impact of disease characteristics on the quality of life (QOL) in children with inflammatory bowel diseases (IBD).METHODSThis was a cross-sectional study conducted at the First Department of Pediatrics of the University of Athens at the “Aghia Sophia” Children’s Hospital. Children diagnosed with Crohn’s disease (CD) or ulcerative colitis (UC), who were followed as outpatients or during a hospitalization, participated, after informed consent was obtained from their legal representative. QOL was assessed by the IMPACT-III questionnaire. Demographic data and disease characteristics were also collected. Statistical analyses included parametric (Student’s t-test and Pearson’s r) and non-parametric (Mann-Whitney test, Fisher’s test and Spearman’s rho) procedures.RESULTSNinety-nine patients (UC: 37, 73.0% females, CD: 62, 51.6% females), aged 12.8 ± 2.6 years were included. Overall, as well as, sub-domain scores did not differ between UC and CD (overall score: 73.9 ± 13.3 vs 77.5 ± 11.2, respectively, P = 0.16). In the entire sample, total score was related to physician’s global assessment (PGA, patients classified as “mild/moderate” active disease had, on average, 14.8 ± 2.7 points lower total scores compared to those “in remission”, P < 0.001) and age at IMPACT completion (Pearson’s r = 0.29, P = 0.05). Disease activity assessed by the indices Pediatric Ulcerative Colitis activity index, Pediatric Crohn’s disease activity index or PGA was significantly associated with all subdomains scores. Presence of extraintestinal manifestations had a negative impact on emotional and social functioning domains.CONCLUSIONDisease activity is the main correlate of QOL in children with IBD, underlining the importance of achieving and sustaining clinical remission

Risk of venous thromboembolism in children and adolescents with inflammatory bowel disease: A systematic review and meta-analysis

BACKGROUND A two-to three-fold increased risk of venous thrombotic events(VTE) has been demonstrated in patients with inflammatory bowel disease(IBD) compared to the general population, but less is known about the risk of VTE in child-and pediatric-onset IBD. In recent years, several studies have reported the rising incidence rate of VTE in juvenile patients with IBD, and the related risk factors have been explored.AIM To evaluate the risk of VTE in children and adolescents with IBD.METHODS Articles published up to April 2021 were retrieved from Pub Med, Embase, Cochrane Library, Web of Science, Sino Med, CNKI, and WANFANG. Data from observational studies and clinical work were extracted. The outcome was the occurrence of VTE according to the type of IBD. The available odds ratio(OR) and the corresponding 95% confidence interval(CI) were extracted to compare the outcomes. Effect size(P), odds ratio(OR), and 95%CI were used to assess the association between VTE risk and IBD disease. Subgroup analyses stratified by subtypes of VTE and IBD were performed.RESULTS Twelve studies(7450272 IBD patients) were included in the meta-analysis. Child and adolescent IBD patients showed increased VTE risk(P = 0.02, 95%CI: 0.01-0.03). Subgroup analyses stratified by IBD(ulcerative colitis(UC): P = 0.05, 95%CI: 0.03-0.06;Crohn’s disease(CD): P = 0.02, 95%CI: 0.00-0.04) and VTE subtypes(portal vein thrombosis: P = 0.04, 95%CI: 0.02-0.06;deep vein thrombosis: P = 0.03, 95%CI: 0.01-0.05;central venous catheter-related thrombosis: P = 0.23, 95%CI: 0.00-0.46;thromboembolic events: P = 0.02, 95%CI: 0.01-0.03) revealed a significant correlation between VTE risk and IBD. Patients with IBD were more susceptible to VTE risk than those without IBD(OR = 2.99, 95%CI: 1.45-6.18). The funnel plot was asymmetric, suggesting the presence of significant publication bias. Pediatric and adolescent IBD patients have an increased VTE risk. UC and CD patients exhibited a high risk of VTE. The risk of VTE subtypes was increased in IBD patients.CONCLUSION The current meta-analysis showed that the incidence and risk of VTE are significantly increased in pediatric and adolescent IBD patients. Thus, IBD might be a risk factor for VTE in children and young adults. High-quality prospective cohort studies are necessary to confirm these findings.

Magnetic resonance imaging in children and adolescents with chronic inflammatory bowel disease

Inflammatory bowel diseases(IBD) represent challenges, both from a diagnostic, and therapeutic point of view. Deep-seated anatomic structures are difficult to assess by ultrasound technique alone. As radiation-free alternative cross-sectional imaging method, magnetic resonance imaging of the intestinal structures is costly and time-consuming. Examination of pediatric patients imply additional considerations: reduction of body motions in younger children and consideration of the most appropriate preparation, and examination technique. The demanding Sellink technique is the only means for appropriately distending the lesser intestine in order to detect small bowel strictures. Oral intake of contrast medium(CM) alone shows its limitations regarding distensibility. The need for intravenous contrast media application needs to be considered, too. Active inflammation of both intestinal wall, and mesentery can be demonstrated accurately. Nevertheless, viable alternatives to CM application is desirable, considering non-negligible adverse reactions. Recent data suggest diffusion weighted imaging might fill this diagnostic gap. Irrespective of sequence technique chosen, bowel movement remains a major obstacle. Antispasmolytics in their function as smooth muscle relaxants help in improving image quality, however, their use in children might be off-label. Optimal preparation for the examination and appropriate imaging technique allow for diagnosing typical patterns of changes in IBD, such as bowel wall thickening, ulcers, mural stratification, strictures, creeping fat, and comb sign, and lymphadenopathy. The article gives a detailed overview of current significance of magnetic resonance imaging pediatric patients suffering from IBD, considering indications, limitations, and safety aspects.

Oral manifestation in inflammatory bowel disease:A review

Inflammatory bowel diseases (IBDs), including Crohn&#x02019;s disease (CD) and ulcerative colitis, not only affect the intestinal tract but also have an extraintestinal involvement within the oral cavity. These oral manifestations may assist in the diagnosis and the monitoring of disease activity, whilst ignoring them may lead to an inaccurate diagnosis and useless and expensive workups. Indurated tag-like lesions, cobblestoning, and mucogingivitis are the most common specific oral findings encountered in CD cases. Aphthous stomatitis and pyostomatitis vegetans are among non-specific oral manifestations of IBD. In differential diagnosis, side effects of drugs, infections, nutritional deficiencies, and other inflammatory conditions should also be considered. Treatment usually involves managing the underlying intestinal disease. In severe cases with local symptoms, topical and/or systemic steroids and immunosuppressive drugs might be used.

Inflammatory bowel disease incidence in Czech children:A regional prospective study,2000-2015

AIM To examine the incidence and trends in pediatric inflammatory bowel diseases(IBDs) over 2000-2015 and project the incidence to 2018. METHODS A 16-year prospective study of IBD patients < 19 years of age was conducted in the Czech Republic(the Pilsen region). All incident IBD cases within a well-defined geographical area were retrieved from a prospectively collected computerized clinical database. Historical Czech data were used for comparison(1990-2001). Our catchment population was determined from the census data. We calculated the incidence by relating the number of newly diagnosed cases to the size of thepediatric population-at-risk in each calendar year. Age/sex, disease type, place of residence, and race/ethnicity were identified. RESULTS In total, 170 new IBD cases [105 Crohn's disease(CD), 48 ulcerative colitis(UC), and 17 IBD-unclassified(IBD-U)] were identified. The median age at IBD diagnosis was 14.2 years, 59.4% were males, and 97.1% were Caucasians. A male preponderance of IBD(P = 0.026) and CD(P = 0.016) was observed. With 109209 person-years in the catchment area, the average incidence of IBD per 100000 person-years was 10.0(6.2 for CD, 2.8 for UC, and 1.0 for IBD-U) for children aged 0 to 19 years; for those aged 0 to 15 years, the incidence rate was 7.3(4.6 for CD, 2.0 for UC, and 0.7 for IBD-U). An increase in incidence with age was observed(P = 0.0003). Over the 16-year period, the incidence increased for IBD patients(P = 0.01) and CD in particular(P < 0.0001), whereas the incidence for UC(P = 0.09) and IBD-U(P = 0.339) remained unchanged. IBD-projected data from 2016 to 2018 were 12.1, 12.3 and 12.6 per 100000 personyears, respectively.CONCLUSION Pediatric-onset IBD incidence is around its highest point. The increase, which is particularly pronounced for CD, may be challenging to relate to causes of pediatric disease.

基于“阴火理论”探析干燥综合征口腔溃疡辨治思路

口腔溃疡是干燥综合征患者常见的口腔黏膜病变,易反复发作,令人痛苦不堪。干燥综合征患者口腔溃疡多是由于脾胃虚弱、阴津不足、火热上炎、瘀毒蕴结而导致与阴火的发病机制以及临床表现有相通之处,可从阴火理论治口腔溃疡,故而提出“调补脾胃、兼顾先天”“滋阴润燥、养血生津”“降泻阴火、升提清阳”“行气活、化瘀解毒”的治疗方法,以便临床应用,促进疾病向愈。

儿童苔藓样肉芽肿性口炎1例报道及文献回顾

目的探讨口腔苔藓样损害的分类、临床表现、诊断、鉴别诊断及治疗,为临床提供参考。方法获得医院伦理审批及患者知情同意,报道1例儿童口腔苔藓样损害病例,结合文献对口腔苔藓样损害的诊疗进行回顾分析。结果患儿舌背反复破溃伴疼痛3年余,舌背大面积糜烂面,形状不规则,糜烂周围见珠光白色纹,左侧糜烂区伴组织增生,约1.5 cm×2.0 cm,质地韧,宽蒂。舌背白色网纹组织切取活检病理诊断为苔藓样损害;舌背增生物切除活检病理诊断为苔藓样损害伴肉芽肿性炎。根据患者口内损害特征、系统病史、用药史、组织病理学检查结果,最终诊断为苔藓样肉芽肿性口炎。文献回顾表明,口腔苔藓样损害病因不明,临床上需与口腔扁平苔藓、口腔苔藓样药物反应、口腔苔藓样接触性损害、慢性溃疡性口炎等疾病鉴别。临床上治疗口腔苔藓样损害以糖皮质激素的局部和/或全身使用为主。结论目前口腔苔藓样损害的分类和诊断仍无统一标准,主要依靠病史询问、临床表现和组织病理学检查结果,治疗方法主要为糖皮质激素的局部和/或全身使用。

西瓜霜联合维生素B12溶液在小儿口腔溃疡中的应用效果

目的探讨西瓜霜联合维生素B12溶液在小儿口腔溃疡中的应用效果。方法选取2019年1月至2020年1月滨州市沾化区下洼镇卫生院收治的66例口腔溃疡患儿,按照随机数字表法分为对照组和研究组,每组各33例。对照组采用维生素B12溶液治疗,研究组在对照组基础上联合西瓜霜治疗。比较两组免疫功能、疼痛程度及复发率。结果治疗后,研究组CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)水平均优于对照组(P<0.05)。治疗后1、2、3d,研究组疼痛评分均低于对照组(P<0.05)。研究组复发率低于对照组(P<0.05)。结论西瓜霜联合维生素B12溶液在小儿口腔溃疡中应用可提高患儿免疫功能,减轻疼痛程度,降低复发率。

High-sensitivity C-reactive protein in paediatric inflammatory bowel disease

AIM:To study whether high-sensitivity C-reactive protein(hs-CRP) measurement can aid the assessment of disease activity and glucocorticoid treatment in paediatric inflammatory bowel disease(IBD).METHODS:CRP levels were measured in 39 children with IBD undergoing colonoscopy [median age 12.8 years,Crohn's disease(CD) n=20],in 22 other children with IBD followed for acute response to glucocorticoids,and in 33 paediatric non-IBD patients.When standard CRP level was below detection limit(<5mg/L),hs-CRP was analyzed.RESULTS:Sixty-four percent(25/39) of the children with IBD undergoing colonoscopy displayed undetectable(<5mg/L) standard CRP levels.Of these,the hs-CRP measurement could not differentiate between active(median,0.2 mg/L,range,0.007-1.37,n=17) or quiescent(0.1 mg/L,0.01-1.89,n=8,P=NS) disease.Patients with ileocolonic CD had higher CRP levels(14mg/L,0.06-45,n=13) than patients with no ileal involvement(0.18 mg/L,0.01-9,n=7,P<0.01) or ulcerative colitis(UC)(0.13 mg/L,0.007-23,P<0.05).In children with active IBD treated with systemic glucocorticoids,the standard CRP was undetectable in 59% of the patients.The hs-CRP levels did not differ between patients that responded to steroid therapy and in non-responders.CONCLUSION:The measurement of hs-CRP did not prove useful in the assessment of disease activity or glucocorticoid treatment in paediatric IBD patients that had undetectable standard CRP.

Regional variation of pediatric inflammatory bowel disease in Saudi Arabia: Results from a multicenter study

BACKGROUND Incidence and severity variations of inflammatory bowel disease(IBD)have been reported from Western populations between continents and regions of the same countries.However,no data were available from other countries.AIM To investigate the regional differences in the IBD profiles of pediatric patients from the Kingdom of Saudi Arabia.METHODS Data from a national multicenter IBD study were used.The incidence,time trend,and clinical presentation of Crohn’s disease(CD)and ulcerative colitis(UC)in the Central region(CR),Western region(WR),and Eastern region(ER)were analyzed and compared.Statistical analysis included Poisson regression analysis for incidence variation and Chi-square test for demographic and clinical parameters.A P<0.05 was considered significant.RESULTS The prevalence of positive family history was lower in children with CD from the ER than the CR or the WR.Consanguinity rate was higher in children with CD and UC from the CR and the ER,respectively.The incidences and time trends of CD and UC were not significantly different between regions.In the ER,a significantly higher percentage of children with CD presented with abdominal pain(P<0.001),blood in stools(P=0.048),stricturing or penetrating disease(P=0.029),higher erythrocyte sedimentation rate(P<0.001),higher C-reactive protein(P<0.001),higher anemia(P=0.017),and lower albumin level(P=0.014).For children with UC from the ER,a significantly higher percentage presented with anemia(P=0.006)and a lower percentage with pancolitis(P<0.001).CONCLUSION The most important finding is the identification of significantly more severe presentation of CD in the ER of the Kingdom of Saudi Arabia.Prospective studies are needed to explain such variations.

重组人碱性成纤维细胞生长因子治疗手足口病口腔溃疡患儿的效果

目的:观察重组人碱性成纤维细胞生长因子治疗手足口病口腔溃疡患儿的效果。方法:回顾性分析2021年9月至2022年10月该院收治的85例手足口病口腔溃疡患儿的临床资料,根据不同治疗方式将其分为对照组(n=43)和研究组(n=42)。对照组给予常规治疗,研究组在对照组基础上增加重组人碱性成纤维细胞生长因子治疗,比较两组临床疗效、治疗前后疼痛程度[修订版WongBaker面部表情疼痛评估法(FPS-R)]评分、口腔溃疡愈合时间、平均止痛时间、住院时间、治疗前后血常规指标水平(白细胞计数、中性粒细胞百分比、淋巴细胞百分比)和治疗1周内不良反应发生率。结果:研究组治疗总有效率为95.24%(40/42),高于对照组的79.07%(34/43),差异有统计学意义(P<0.05);治疗2 h、1 d、3 d、5 d及1周后,两组FPS-R评分均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);研究组愈合时间、平均止痛时间和住院时间均短于对照组,差异有统计学意义(P<0.05);两组治疗前后白细胞计数、中性粒细胞百分比、淋巴细胞百分比比较,差异均无统计学意义(P>0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:在常规治疗基础上采用重组人碱性成纤维细胞生长因子治疗手足口病口腔溃疡患儿可提高治疗总有效率,缩短愈合时间、平均止痛时间和住院时间,降低疼痛程度评分,效果优于单纯常规治疗。

中药汤剂联合西药治疗儿童复发性口腔溃疡脾胃积热证临床研究

目的:观察中药汤剂联合西药治疗儿童复发性口腔溃疡(ROU)脾胃积热证的临床疗效。方法:将124例ROU脾胃积热证患儿按随机数字表法分为治疗组64例与对照组60例,对照组给予常规西药治疗,治疗组在对照组基础上给予中药汤剂治疗。评估2组临床疗效、症状改善时间、复发率及治疗前后中医证候积分、免疫功能指标。结果:治疗组治疗总有效率96.88%,高于对照组85.00%(P<0.05)。治疗前,2组中医证候积分比较,差异无统计学意义(P>0.05);治疗后,2组中医证候积分低于治疗前(P<0.05),且治疗组低于对照组(P<0.05)。治疗组治疗后疼痛消失时间、溃疡愈合时间均短于对照组(P<0.05)。治疗前,2组CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)比较,差异无统计学意义(P>0.05);治疗后,2组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均升高(P<0.05),CD8^(+)水平均降低(P<0.05),且治疗组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平高于对照组(P<0.05),CD8^(+)水平低于对照组(P<0.05)。治疗组复发率6.45%,低于对照组23.53%(P<0.05)。结论:中药汤剂联合西药治疗儿童ROU脾胃积热证疗效确切,可减轻患儿临床症状,促进溃疡愈合,提高患儿机体免疫力,减少复发率。

EB病毒与儿童复发性口腔溃疡前口腔病变的关联机制

目的探究EB病毒与儿童复发性口腔溃疡前口腔病变的关联机制。方法选择90例复发性口腔溃疡前口腔病变的患儿作为本研究的观察组,根据EB病毒DNA是否检出分为检出组(n=66)和未检出组(n=24),同时选择同期的健康儿童50例作为对照组。对比分析观察组和对照组EB病毒DNA检出率、EB病毒DNA检出组与未检出组血清炎症因子水平和免疫功能指标水平。采用Person法分析EB病毒与血清炎症因子和免疫功能指标水平的相关性。结果观察组患儿中EB病毒DNA检出率为73.33%,对照组EB病毒DNA检出率仅为2.00%,差异有统计学意义(P<0.05);检出组患儿血清中TNF-α、CRP、IL-6、IL-8水平以及IgA、IgG和IgM水平均显著高于对照组,差异有统计学意义(P<0.05)。Person相关性分析结果显示,EB病毒DNA检出组与血清炎症因子和免疫功能指标水平之间存在显著的正相关系(P<0.05);而EB病毒DNA未检出组与血清炎症因子和免疫功能指标水平之间的相关性不显著(P>0.05)。结论EB病毒的存在会导致机体血清炎症因子和免疫功能指标水平升高,进而促进复发性口腔溃疡前口腔病变的发生。

重症婴幼儿龋对儿童口腔健康相关生活质量的影响

目的:探讨重症婴幼儿龋(S-ECC)对儿童口腔健康相关生活质量(OHRQL)的影响。方法:随机选取来我院就诊的S-ECC及无龋儿童各95名,进行口腔健康状况检查,并采用学龄前儿童口腔健康影响量表(Early Childhood Oral Health Impact Scale,ECOHIS)调查儿童的OHRQL。比较S-ECC及无龋儿童的ECOHIS得分情况,分析ECOHIS得分与患龋状况的相关性。结果:S-ECC儿童的ECOHIS总分以及在各领域的得分均明显高于无龋儿童(P<0.05)。ECOHIS总分及各领域得分均与儿童的龋齿数和患龋牙面数呈正相关。S-ECC对儿童OHRQL的影响主要体现在儿童的口腔症状、口腔功能及家长内疚感3个领域。结论:S-ECC儿童的OHRQL低下,应引起广泛关注,并对其采取积极的治疗措施。

清肺口服液治疗小儿病毒性肺炎58例疗效观察

目的 :评价清肺口服液 (南京中医药大学附属医院院内制剂 )治疗小儿病毒性肺炎痰热闭肺证的有效性。方法 :选择 87例符合小儿病毒性肺炎痰热闭肺证诊断标准的患儿 ,按随机化原则分为试验组 (5 8例 )和对照组 (2 9例 ) ,分别给予清肺口服液、利巴韦林注射液治疗 ,观察疗程为 1 0天。 结果 :试验组患儿痊愈 5 0例 (86 .2 1 % ) ,显效 5例 (8.6 2 % ) ;对照组患儿痊愈 1 5例 (5 1 .72 % ) ,显效 1 4例 (4 8.2 8% ) ,经秩和检验P <0 .0 0 0 1 ,试验组疗效显著优于对照组。咳嗽、肺部湿啰音、Ｘ线全胸片等指标好转情况 ,试验组优于对照组。发热、气促等指标好转情况 ,两组疗效无显著性差异。 结论

康复新液治疗儿童口腔溃疡疗效分析

目的:评价康复新液治疗儿童口腔溃疡的临床疗效。方法:选取2009～2010年在湖南省儿童医院口腔科就诊符合条件的患儿60例,随机分成两组各30例,试验组采用康复新液治疗,对照组采用碘甘油治疗,疗程7 d,观察两组的疗效并进行分析。结果:在治疗3 d和7 d后,试验组的总有效率分别为73.3%、86.7%,对照组的总有效率分别为46.7%、63.3%,试验组总有效率高于对照组,差异均具有统计学意义(P<0.05)。结论:康复新液治疗儿童口腔溃疡具有良好的临床疗效,值得临床推广使用。

MRC肌功能矫治器矫治儿童口腔不良习惯的临床研究

目的探讨应用MRC肌功能矫治器治疗口腔不良习惯并伴有错牙合畸形患儿的矫治效果。方法将2011-03~2014-03到该院就诊的患儿按就诊单双日随机分为试验组(13例)和对照组(12例),试验组选择合适的软质MRC肌功能矫治器(以Infant型为主)对患儿进行矫治;对照组采用传统的功能性矫治器进行矫治。比较两组矫治口腔不良习惯效果,同时比较两组家长对矫治器佩戴的舒适度、矫治效果的主观评价。结果试验组矫治口腔不良习惯效果的成功率高于对照组,但差异无统计学意义(P>0.05)。试验组第1周、1个月、3个月佩戴顺利率高于对照组,差异有统计学意义(P<0.05)。结论 MRC肌功能矫治器能较好地矫治儿童口腔不良习惯,且具有轻便、无损坏、造价低、技术敏感度低等优点,值得临床推广应用。

康复新液治疗儿童白血病化疗后口腔溃疡25例临床观察

目的观察康复新液防治急性白血病患儿化疗后口腔溃疡的效果。方法 45例同期拟行化疗的急性白血病患儿随机分为观察组25例和对照组20例,两组化疗方案相同,化疗过程中观察组予康复新液口服和局部涂抹;对照组给予口泰含漱,观察两组口腔黏膜反应程度及有无不良反应。结果观察组口腔溃疡愈合有效率明显高于对照组。结论康复新液治疗急性白血病患儿化疗所致口腔溃疡效果确切,且耐受性好。

中药泻心天泽方治疗儿童复发性口腔溃疡30例临床观察

目的:研究中药泻心天泽方用于临床治疗儿童复发性阿弗他溃疡的疗效。方法:将60例心火上炎型儿童复发性口腔溃疡病例随机分为观察组与对照组,观察组给予口服中药泻心天泽方,对照组单纯给予碘甘油局部外涂治疗。观察两组的溃疡愈合时间,疼痛评分,治疗有效情况及对患儿免疫功能的改善情况与治疗期间的不良反应。结果:观察组30例总有效率93.33%,对照组30例,总有效率66.67%。观察组疗效明显优于对照组,两者有显著性差异(P<0.05)。结论:中药泻心天泽方治疗儿童复发性阿弗他溃疡临床疗效显著,能够缩短疗程,使用方便,优于对照组。