The efficacy of topical hyaluronic acid in the management of oral lichen planus

Background:  The aim of this study was to evaluate the efficacy of a topical hyaluronic acid (HA) gel preparation (0.2%) in the management of oral lichen planus (OLP).
Methods:  A total of 124 patients with erosive OLP participated in a randomized, placebo-controlled, double-blind trial to evaluate the efficacy of a topical HA preparation. Outcome measures included soreness relief following immediate application, oral function and size of erosive/ulcerative area. Patients were medicated for 28 days and completed a log diary recording oral function and soreness scores.
Results:  Application of topical HA produced a significant reduction ( P  < 0.05) in soreness scores when compared with placebo for up to 4 h post-application. There was no difference between treatment groups ( P  > 0.05) with respect to oral function. Patients treated with 0.2% HA showed a significant reduction ( P  < 0.05) in the size of the erosive/ulcerated area after 28 days of treatment when compared with baseline. There was no significant difference in changes in ulcerative areas between treatment groups.
Conclusions:  Topical HA (0.2%) does appear to be of some benefit in the management of erosive lichen planus providing efficacy for up to 4 h after administration. Very frequent applications should be considered to obtain a more significant clinical benefit. Topical HA gel may be a useful addition to the treatment option for OLP.     

A comparative study of the efficacy of AphthealTM in the management of recurrent minor aphthous ulceration

BACKGROUND: Recurrent minor aphthous ulceration (RAU) is a common condition which is multifactorial in origin. METHODS: This study, firstly, aimed to treat the prodromal stage of RAU with Aphtheal (5% amlexanox paste) to determine if ulcer development could be prevented. A second arm of the study investigated treatment of RAU with Aphtheal once ulceration had developed. Ulcer duration, ulcer size and associated pain were measured. Both groups of subjects had previously undergone a no-treatment run-in period to establish these parameters over an untreated episode of ulceration. RESULTS: By day 3, only 35% of the prodromal group had developed an ulcer compared with 97% of the ulcer group (P < 0.001). In the treated ulcer group only 66% had an ulcer present by day 3. Treatment at the onset of prodromal symptoms reduced the maximum ulcer size score by 84% (P < 0.01), extent of ulceration by 88% (P < 0.01), maximum pain score by 69% (P < 0.01) and extent of pain by 85% (P < 0.01) compared to no treatment. CONCLUSION: Treatment with Aphtheal at the onset of prodromal RAU symptoms can prevent progression to ulcer development and significantly reduced symptoms if ulcers do develop.     

枸杞多糖联合白芍总苷治疗复发性阿弗他溃疡的疗效评定

目的 评价枸杞多糖联合白芍总苷在治疗复发性阿弗他溃疡(recurrent aphthous ulcer,RAU)中的长期临床疗效及不良反应。方法 将160例RAU患者随机分为两组,治疗组80例采用宁夏枸杞提取物枸杞多糖联合白芍总苷治疗,对照组80例只采用白芍总苷治疗,两组疗程均为6个月。根据中华口腔医学会黏膜病专业委员会的“RAU疗效评价试行标准”进行疗效评价。结果 枸杞多糖联合白芍总苷组治疗RAU患者总体有效率显著优于白芍总苷组,且不良反应较轻;两组RAU患者在治疗期内的总间歇期均延长,溃疡总数目均减少,其对间歇期的影响,存在显著性差异（P＜0.01）;对溃疡数目的影响,未见明显差异（P>0.05）。结论 枸杞多糖联合白芍总苷治疗RAU长期疗效显著,不良反应轻微。     

“养阴生肌散”治疗口腔溃疡疗效观察

目的：观察“养阴生肌散”应用于复发性口腔溃疡的治疗疗效。方法：80名口腔溃疡患者随机分成两组,对照组病人行传统治疗,而治疗组病人在溃疡局部应用“养阴生肌散”,每天四次,并记录用药至溃疡愈合的时间,疼痛程度的变化。结果“养阴生肌散”可明显减轻口腔溃疡的疼痛,并可使溃疡愈合加快,治疗组和对照组疗效有显著性差异。结论：“养阴生肌散”是一种安全、有效、副作用小,使用方便的口腔粘膜用药。     

转移因子治疗复发性阿弗他溃疡的短期疗效观察

目的：观察转移因子口服液治疗轻型复发性阿弗它溃疡的短期疗效。方法：复发性阿弗它溃疡患者62例，随机分组，服药3个月，随访6个月，记录总间歇时间及总溃疡数目。结果：转移因子组治疗后总间歇时间较治疗前延长，总溃疡数减少，差异均有显著性（P＜0．01）。TF组总有效率为76．47％，高于对照组32．14％，差异有显著性（P＜0．01）。结论：TF治疗轻型RAU具有较好的短期疗效。     

复发性阿弗他溃疡患者唾液中表皮生长因子和病损区表皮生长因子受体的定量研究

目的探讨复发性阿弗他溃疡（RAU）患者溃疡期和间隙期唾液表皮生长因子（EGF）质量浓度的变化以及病损区表皮生长因子受体（EGFR）的表达有无缺陷。方法选择27例在溃疡期和间隙期均成功获取唾液样本的轻型RAU患者作为RAU1组,采集33例正常人的唾液样本作为对照1组,采用酶联免疫吸附法检测两组唾液样本中EGF质量浓度。另外选择31例轻型RAU溃疡期患者在溃疡基底部剪取小块组织样本作为RAU2组,采集35例无RAU者的正常黏膜组织作为对照2组,采用荧光定量逆转录聚合酶链反应检测两组组织样本内EGFR的RNA表达情况。结果RAU1组溃疡期患者唾液EGF质量浓度高于RAU1组间隙期和对照1组,而间隙期EGF质量浓度低于对照1组（P<0.05）。RAU1组和对照1组唾液EGF质量浓度在不同性别间差别不大,与年龄也没有相关性（P>0.05）。RAU2组EGFR的RNA表达强度高于对照2组,两组间有统计学差异（P<0.05）。结论RAU患者口腔溃疡的复发性可能与间隙期唾液EGF质量浓度减少有关;口腔溃疡的自愈性可能与溃疡期唾液EGF质量浓度增加和溃疡区EGFR表达增加有关。     

沙利度胺对复发性阿弗他溃疡患者外周血淋巴细胞亚群的影响

目的：观察沙利度胺对复发性阿弗他溃疡（ RAU）患者外周血淋巴细胞亚群的影响及治疗疗效。方法：选择轻型RAU患者（轻型RAU组）85例,健康对照组80例,随访观察服用沙利度胺25 mg／d治疗轻型RAU的疗效;同时比较健康对照组,轻型RAU组治疗前后外周血淋巴细胞亚群检测结果。结果：和健康对照组相比,轻型RAU患者CD4＋T淋巴细胞数目减少,CD8＋T淋巴细胞增多,淋巴细胞亚群比例失调;经沙利度胺治疗后,轻型RAU患者淋巴细胞亚群比例异常改善,同时患者溃疡间歇期明显延长,溃疡数目明显减少,差异均具有统计学意义（P＜0．05）。结论：轻型RAU患者存在外周血T淋巴细胞亚群比例异常,沙利度胺可有效调节CD4＋、CD8＋T淋巴细胞亚群比例,延长溃疡间歇期,减少溃疡发作,临床疗效满意。     

Effect of a toothpaste containing amyloglucosidase and glucose oxidase on recurrent aphthous ulcers

The aim of this study was to assess whether a toothpaste containing amyloglucosidase and glucose oxidase (Z) provoked any effect on minor recurrent aphthous ulcers, (RAU) as compared with a placebo toothpaste (P). Twenty patients (11 females), suffering from minor RAU, participated in this study during a period of 15 weeks. The patients brushed their teeth twice a day with the toothpaste. They were examined once a week to monitor the number and size of ulcers. The mean number of ulcers in both groups was about 40% lower than that found before treatment. Ulcer mean diameter had also decreased in both the placebo (about 32%) and experimental groups (about 66%). There were no statistically significant differences between the two groups in number of weeks with ulcers, in total number of ulcers per patient, and in mean diameter of the ulcers. In conclusion, no significant differences in therapeutic effects could be shown between treatments with Z and P.     

The efficacy and safety of 50 mg penicillin G potassium troches for recurrent aphthous ulcers

PURPOSE: To determine both the efficacy and safety of the topical application of 50 mg penicillin G potassium troches (Cankercillin) in the treatment of minor recurrent aphthous stomatitis (RAS). STUDY DESIGN: The investigation used a phase 2 double-blind, randomized placebo-controlled trial with a no-treatment arm. Subjects with minor aphthous ulcers of duration <48 hours were followed for 1 week. The primary endpoint for efficacy was time (days) to complete ulcer resolution, and the secondary endpoint was time (days) to complete pain relief. RESULTS: Thirty-one, 33, and 36 subjects were randomized to the active treatment, placebo, and no-treatment arms, respectively. Baseline findings were heterogeneous across arms. Subjects who received penicillin G treatment had complete ulcer healing and pain relief significantly earlier than those in the placebo and no-treatment arms. No allergic reactions were observed. CONCLUSIONS: Topical penicillin G, by mechanisms which remain unclear, reduces the time of healing and pain relief of minor aphthous ulcers with minimal safety concerns. Larger phase 3 studies are necessary to confirm these findings.     

心理社会因素对复发性口腔溃疡的影响

目的 :探讨心理社会因素对复发性口腔溃疡的影响。方法 :选择门诊复发性口腔溃疡患者 10 5例为实验组和健康正常人 10 0例为对照组 ,采用艾森克人格问卷 ,社会支持评定量表及症状自评量表的方法进行调查分析。结果 :艾森克个性问卷结果显示N量表分实验组明显高于对照组 ,差异有显著性 (P <0 0 1) ;SCL 90结果显示强迫、人际敏感、抑郁、敌对等因子实验组与对照组差异有显著性 (P <0 0 1) ;社会支持评定结果显示实验组与对照组在主观支持和对社会支持利用度两个程度上差异有显著性 (P <0 0 1)。结论 :心理社会因素对复发性口腔溃疡有一定影响。     

A controlled trial of a dissolving oral patch concerning glycyrrhiza (licorice) herbal extract for the treatment of aphthous ulcers.

Recurrent aphthous ulcers (RAU) are a common and painful condition. This article describes a randomized, double-blind clinical trial of an over-the-counter medicated intraoral adhesive patch for treatment of RAU. Subjects were randomly assigned to either an active drug (patch with extract of glycyrrhiza root) or placebo patch treatment group (both n=23) at onset of a lesion. Lesion size and pain report (unstimulated and stimulated) were assessed at intervals. A no-treatment group (n=23) also was recruited and assessed similarly. By the eighth day, the ulcer size for the active treatment group was significantly lower (p < 0.05), while the By the fourth day, the active treatment group lesions in the no-treatment group increased 13% from baseline.reported significantly less pre-stimulus pain (p < 0.01); at this point, 81% of this group reported no pre-stimulus pain, comp ared with 63% of the placebo patch group and 40% of the no-treatment group     

蒲地蓝可炎宁牙膏治疗复发性阿弗他溃疡的临床研究

目的研究蒲地蓝可炎宁牙膏治疗复发性阿弗他溃疡的有效性和安全性。方法将轻型复发性阿弗他患者引用随机、双盲、平行对照的临床试验方法,分为试验组(40例)和对照组(入组40例,实际完成39例),分别应用蒲地蓝可炎宁牙膏和空白对照牙膏,2次/d,治疗6 d。比较2组溃疡愈合时间、靶溃疡的愈合率、疼痛指数变化、靶溃疡的面积和渗出、充血程度评分,并记录不良事件。结果用药6 d后,试验组和对照组的靶溃疡愈合率分别为95.00%、51.28%(P<0.05)。50%受试者溃疡愈合在试验组为5 d,对照组为6 d(P<0.05)。两组治疗第6天的疼痛指数评分、靶溃疡的面积、渗出和充血程度评分的比较均有统计学意义(P<0.05)。2组均未发生与牙膏有关的不良事件。结论蒲地蓝可炎宁牙膏治疗复发性阿弗他溃疡是安全有效的。     

A clinical trial of Azelastine in recurrent aphthous ulceration, with an analysis of its actions on leukocytes

Azelastine (azelastine hydrochloride) was orally administered to 43 patients with recurrent aphthous ulcers (RAU). and its clinical effects and in vitro influence on leukocytes were examined. During at least 6 months after drug treatment, no oral ulcers occurred in 7 patients, and an improvement of the oral condition was exhibited in all except 4 of the remaining patients. The frequency of occurrence of RAU was significantly reduced, from 1.7 ± 0.9 to 0.9 ± 0.5 times month. and ulcer duration and oral irritation were also significantly reduced from 12.5 ± 2.5 and 7.5 ± 2.4 days to 9.8 ± 2.6 and 5.3 ± 2.4 days, respectively. Neutrophils from patients treated with Azelastine generated a suppressed volume of superoxide (O₂). Suppression of O₂ generation and chemiluminescence by in vitro Azelasline was also confirmed to occur in a dose-dependent manner. Furthermore, the production of TNF-α and GM-CSK in lymphocytes was suppressed in the presence of Azelastine, and the drug protected sheep red blood cells and epithelial tumor cell lines against hydrogen peroxide impairment and hypotonic shock. These clinical and experimental results lead to the conclusion that improvement of RAU by Azelastine depends on the protection of cell membranes and the suppression of leukocyte-function, including reactive oxygen generation.     

霍香正气散治疗复发性阿弗他溃疡的临床观察

目的 观察藿香正气散加减治疗复发性阿弗他溃疡（RAU）的疗效。方法 120例RAU随机分成2组，对照组以维生素类、锌剂等治疗，实验组应用藿香正气散加减煎服，每天一剂，4周为一疗程，观察用药期间溃疡愈合时间及复发时间、溃疡个数。结果 藿香正气散加减可以减轻RAU溃疡的疼痛，加快愈合，明显延长复发时间，减少溃疡个数。结论 藿香正气散加减治疗RAU有一定的应用价值。     

Subantimicrobial dose doxycycline in the treatment of recurrent oral aphthous ulceration: a pilot study

BACKGROUND: Recurrent oral aphthous ulceration (ROAU) is a common problem that can result in considerable pain and distress for patients. The aim of this pilot study was to evaluate the role of subantimicrobial dose doxycycline (SDD - 20 mg doxycycline twice daily) in the management of patients with ROAU. METHODS: 50 patients with ROAU were randomly allocated to treatment with SDD or placebo for 90 days. Daily ulcer diaries were completed by the participants to record the number of new ulcers and the pain associated with the ulcers. RESULTS: There were significantly more days with no new ulcers in the SDD group (80.4 +/- 5.9) than the placebo group (69.8 +/- 18.7; P=0.04). Strong trends were observed towards fewer new ulcers per day, fewer new ulcers over the 90-day period, and more days with no pain in the SDD group compared with the placebo group (P=0.06-0.08). CONCLUSION: SDD shows promise as potential therapy in the management of ROAU, though this needs to be confirmed in further studies.     

Pain and pain-related interference associated with recurrent aphthous ulcers

AIMS: (1) To use psychometrically sound measures to characterize the pain levels and pain-related interference associated with recurrent aphthous ulcers (RAU); (2) to determine whether subjects with RAU report clinically significant psychologic symptoms; and (3) to examine the relationships between physical characteristics and self-reported psychologic symptoms, pain, and pain-related interference. METHODS: Forty-seven subjects with RAU and an active ulcer completed the Graded Chronic Pain Scale and the Symptom Checklist-90R (SCL-90R). Ulcers were photographed for measurement, and subjects rated pain levels on a 0-to-l0 scale before and after swabbing of the ulcer with a saturated solution of sodium chloride and distilled water. RESULTS: Mean characteristic pain intensity was 4.76, with a pain-related interference score of 1.21. None of the average SCL-90R subscale scores were considered elevated. In the model predicting pain intensity after swabbing, pain intensity before swabbing explained 43.6% of the variance (P = .000). Neither the addition of physical characteristics (R2 change = .04; P = .28) nor psychologic characteristics (R2 change = .09; P = .83) contributed significantly to the model. In contrast, only psychologic characteristics contributed to the variance explained in the model predicting pain-related interference (R2 change = .505; P = .007). CONCLUSIONS: RAU is a moderately painful condition causing some impairment in functioning. Self-reported pain intensity of a sore does not appear to be influenced by psychologic characteristics. However, pain-related interference appears to be related to psychologic and not physical characteristics.     

免疫方法建立复发性口腔溃疡动物模型

目的 :利用试验家兔口腔黏膜蛋白注射方法 ,建立复发性口腔溃疡动物模型 ,为研究人类RAU的发病机制及治疗提供理论基础。方法 :应用从试验家兔提取的口腔黏膜蛋白及沉淀物 ,分别作为抗原免疫家兔。将上述抗原注入家兔脊柱二侧皮内 ,2周注射一次 ,观察家兔口腔溃疡的发病情况及愈合情况。检测试验家兔血清中抗口腔黏膜抗体并做溃疡的组织病理学检查。结果 :以口腔黏膜蛋白作为抗原的实验家兔都发生了RAU ,血清中抗口腔黏膜抗体阳性。以口腔黏膜蛋白作为抗原组与以沉淀物作为抗原组引发实验家兔RAU有显著统计学差异(p <0 .0 1)。结论 :利用兔口腔黏膜蛋白作为抗原 ,可引起实验家兔发生RAU ,其临床表现及组织学检查均与人类RAU相似 ,表明此动物模型可作为研究人类RAU的模型。也提示了人类RAU的发生可能与自身免疫有关。     

温清饮对复发性口疮患者疗效及免疫功能的影响

目的 研究温清饮对复发性口疮患者疗效及免疫功能的影响。方法 用放射免疫分析(RIA)和酶联免疫吸附试验(ELISA)检测温清饮治疗前后复发性口疮患者血清白介素2 (IL-2)、可溶性白介素2受体(sIL-2R)及肿瘤坏死因子α(TNF-α)水平的变化。结果 温清饮治疗后显效者31例(64.6％),有效者13例(27.1％),无效者4例(8.3％)。治疗后复发性口疮患者血清IL-2水平升高(P<0.01),接近于对照组(P>0.05);sIL-2R、TNF-α水平下降(P<0.05,P<0.01),但仍高于对照组(P<0.05)。结论 温清饮可以调节复发性口疮患者失常的细胞免疫功能,治疗复发性口疮。     

Clinical, historic, and therapeutic features of aphthous stomatitis. Literature review and open clinical trial employing steroids.

The clinical and historic features of 50 patients with diagnosed aphthous stomatitis and treated with topical triamcinolone acetonide, 0.1% or 0.2% aqueous suspension; alone or in combination with initial burst therapy of 40 to 60 mg of prednisone, are reviewed. The mean age of our patients was 36.6 years (range 6 to 80 years). The duration of the chief complaint, usually oral pain, or more specifically, recurrent oral ulcers, was 11.1 years (range 4 weeks to 40 years). All patients showed a wide range of ulcer sizes when examined initially or at follow-up. Forty were followed up for an average of 22.9 months. Thirty-four reported prompt healing of ulcers identified at the time of initial evaluation, and no or markedly fewer ulcers subsequently if maintenance therapy of prophylactic topical triamcinolone, 0.1% or 0.2% aqueous rinse, was used. Five patients reported partial relief. No systemic side effects were noted even after long-term topical therapy. Local candidosis was a complication encountered in five patients.     

Recurrent aphthous ulcers in association with HIV infection. Description of ulcer types and analysis of T-lymphocyte subsets.

This study was conducted to characterize the recurrent aphthous ulcers (RAU) found in association with human immunodeficiency virus (HIV) infection, to examine evidence for increased severity of the ulcers with HIV disease, and to determine whether increased severity is associated with abnormalities of peripheral blood lymphocyte subsets. Seventy-five HIV-seropositive patients with RAU were followed for up to 2 years, and lymphocyte subsets were analyzed in 42. Minor, herpetiform, and major ulcer types were seen, but unexpectedly, 66% of the patients had the usually uncommon herpetiform and major types. These types were temporally associated with symptomatic HIV disease. Patients with major RAU were significantly more immunosuppressed than those with minor or herpetiform RAU in that they had fewer CD4 and CD8 lymphocytes (p less than 0.05). The lesion of RAU is considered to represent a local breakdown in immunoregulation. The systemic immune imbalance seen with HIV disease may amplify the local defect and lead to more severe ulcers.