甘草泻心汤联合维生素B12对复发性口腔溃疡患儿T淋巴细胞亚群、溃疡面积及口腔菌群的影响

目的:探讨小儿复发性口腔溃疡(ROU)应用甘草泻心汤联合维生素B12治疗的临床效果。方法:选取2016年6月至2018年6月江西省儿童医院收治的116例ROU患儿,利用随机数字表法将其随机分成观察组与对照组,各58例。对照组口服维生素B_(12)治疗,观察组在此基础上内服甘草泻心汤治疗,所有患儿均治疗14 d。比较两组临床效果,治疗前后T淋巴细胞亚群(CD3~+,CD4~+,CD8~+及CD4~+/CD8~+)水平,溃疡面积及口腔菌群(韦荣氏菌、链球菌)含量变化,药物副作用发生情况。结果:观察组总有效率为96. 6%(56/58),明显高于对照组的84. 5%(49/58)(P 0. 05)。与本组治疗前比较,两组治疗后外周血CD3~+,CD4~+水平及CD4~+/CD8~+均明显升高(P 0. 05),CD8~+水平均明显降低(P 0. 05);与对照组比较,观察组T淋巴细胞亚群指标(CD3~+,CD4~+,CD8~+水平和CD4~+/CD8~+)改善更明显(P 0. 05)。治疗后,两组患儿口腔溃疡面积均逐渐缩小(P 0. 05);与对照组比较,观察组治疗7,14 d后溃疡面积较对照组同期均明显更小(P 0. 05)。与本组治疗前比较,两组治疗后口腔中韦荣氏菌、链球菌含量均明显增加(P 0. 05),且观察组上升更明显(P 0. 05)。结论:小儿ROU应用甘草泻心汤联合维生素B12治疗能有效纠正患儿血中T淋巴细胞亚群失衡,促进口腔溃疡愈合,正性调控口腔微生态环境,疗效确切,患儿耐受性良好。

Effect of Gancao Xiexintang Combined with Vitamin B12 on T Lymphocyte Subset, Ulcer Area, Oral Flora in Children with Recurrent Oral Ulcer

Objective:To investigate the clinical efficacy of Gancao Xiexintang combined with vitamin B₁₂ on recurrent oral ulcer (ROU) in children. Method:Totally 116 children with ROU admitted in Jiangxi Provincial Children''s Hospital from June 2016 to June 2018 were divided into observation group and control group on the basis of random number table,with 58 cases in each group. The control group was orally treated with vitamin B₁₂, while the observation group was orally treated with Gancao Xiexintang in addition to the therapy of the control group. All of the children were treated for 14 days. Clinical efficacy, changes of T lymphocyte subset (CD3⁺, CD4⁺, CD8⁺, CD4⁺/CD8⁺), ulcer area, content of oral flora (veillonella, streptococcus) before and after treatment, and side effect were compared between the two groups. Result:The overall effective rate of the observation group was 96.6%(56/58), which was much higher than 84.5%(49/58) of the control group (P<0.05). After treatment, both groups had much higher CD3⁺, CD4⁺, CD4⁺/CD8⁺in peripheral blood, but lower CD8⁺compared with those before treatment (P<0.05), and T lymphocyte subset (CD3⁺, CD4⁺, CD8⁺, CD4⁺/CD8⁺) indexes in observation group was improved more significantly (P<0.05). After treatment, the ulcer area of both groups shrank (P<0.05), and observation group had a much smaller ulcer area than control group after 7, 14 d of treatment (P<0.05). After treatment, both groups showed higher content of veillonella and streptococcus compared with before treatment (P<0.05), and the observation group showed a more obvious increase (P<0.05). Neither group showed severe side effect. Conclusion:In treating ROU in children, the combination of Gancao Xiexintang and vitamin B₁₂ can significantly correct imbalance of T lymphocyte subset, promote the recovery of oral ulcer, and positively regulate oral micro-ecological environment, with an exact curative effect and high patient tolerance.