沙利度胺联合白芍总苷胶囊治疗复发性口腔溃疡的疗效及其机制的初步探讨

发布时间：2018-06-01 09:41

本文选题：RAU + 沙利度胺　；参考：《山东大学》2014年硕士论文

【摘要】：目的：复发性口腔溃疡(Recurrent oral ulcers,RAU)是最常见的口腔黏膜病,是一种周期性反复发作的自限性黏膜病,其发病机制尚不明确。研究表明免疫因素、精神因素、激素水平均可诱发RAU,局部刺激因素可加重RAU的症状。有研究证实RAU患者血清中IL-8、IL-12、IL-4、IL-10等因子的分泌异常,肿瘤坏死因子-α(TNF-α)的水平高于健康人,而白细胞介素-2(interleukin-2,IL-2)水平低于正常人,TNF-α、IL-2在RAU的发生发展中可能起到一定作用。沙利度胺(Thalidomide)是一种人工合成的谷氨酸衍生物,对神经中枢具有抑制作用。近年来发现沙利度胺是一种免疫抑制剂,具有双向免疫调节、抗炎、抗血管生成及干扰细胞粘附等作用。本研究观察沙利度胺联合白芍总苷胶囊治疗RAU患者的临床效果,并检测治疗前、后患者血清中TNF-α、IL-2的水平,初步探讨沙利度胺治疗RAU的可能机制。方法： 1.2013年7月-2014年2月于山东省口腔医院黏膜专科门诊就诊的60例RAU患者随机分为两组,应用沙利度胺加白芍总苷胶囊治疗的做为实验组,昆明山海棠片加白芍总苷胶囊治疗的做为对照组,观察、记录临床指标并比较其疗效。 2.获取实验组和对照组患者治疗前、后的血清,应用ELISA方法检测其血清中TNF-α、IL-2的含量并进行统计学检验。结果： 1、实验组和对照组RAU患者治疗后在延长总间歇期、减少总溃疡数、减轻溃疡疼痛指数和缩短平均溃疡期临床效果均较显著(P0.05),与对照组相比,实验组效果更显著(P0.05)； 2、RAU患者血清中TNF-α水平高于健康人(P0.05),而IL-2水平低于健康人(P0.05),且TNF-α水平重型轻型健康人(P0.05),IL-2水平重型轻型健康人(P0.05)； 3、实验组和对照组RAU患者血清中TNF-α水平均显著降低(P0.05),IL-2水平增高(P0.05)；且与对照组相比,实验组改变更明显(P0.05)。结论：沙利度胺加白芍总苷胶囊与昆明山海棠片加白芍总苷胶囊相比能更好的治疗RAU患者,减轻RAU患者临床症状,这种作用可能是通过降低RAU患者血清中升高的TNF-α或(和)升高RAU患者血清中降低的IL-2水平来实现的。
[Abstract]:Objective: Recurrent oral ulcer (Recurrent oral ulcersrau) is the most common oral mucosal disease. Studies have shown that immune factors, mental factors, hormone levels can induce RAU, local stimuli can aggravate the symptoms of RAU. Thalidomide (Thalidomide) is a synthetic glutamate derivative that inhibits the nerve center. In recent years, thalidomide is an immunosuppressant with bidirectional immunomodulation, anti-inflammation, anti-angiogenesis and interference with cell adhesion. The aim of this study was to observe the clinical effect of thalidomide combined with total glucoside of paeony in the treatment of RAU, and to detect the level of TNF- 伪 and IL-2 before and after treatment, and to explore the possible mechanism of thalidomide in the treatment of RAU. Methods: 1. From July 2013 to February 2014, 60 patients with RAU were randomly divided into two groups, treated with thalidomide and total glucoside of paeony. Kunming Haitang tablet and total glucoside of paeony were used as control group to observe and record the clinical indexes and compare the curative effect. 2. The serum levels of TNF- 伪 and IL-2 were measured by ELISA method before and after treatment in the experimental group and the control group. Results: 1. After treatment, the total interval period was prolonged, the total ulcer number was reduced, the pain index of ulcer and the average ulcer period were reduced significantly in the experimental group and control group, compared with the control group, the effect of the experimental group was more significant than that of the control group. 2the level of TNF- 伪 in serum of patients with Rau was higher than that of healthy persons (P 0.05), but the level of IL-2 was lower than that of healthy persons (P 0.05), and the level of TNF- 伪 was lower than that of healthy persons (P 0.05). 3. The levels of TNF- 伪 in the serum of RAU patients in the experimental group and the control group were significantly lower than those in the control group, and the level of P0.05 and IL-2 in the experimental group was significantly lower than that in the control group, and the change in the experimental group was more obvious than that in the control group. Conclusion: Compared with Kunming Shan Haitang tablet and total paeony glucoside capsule, thalidomide plus total paeony glycoside capsule can better treat RAU patients and alleviate the clinical symptoms of RAU patients. This effect may be achieved by reducing the elevated TNF- 伪 or / and increasing the IL-2 level in the serum of RAU patients.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R781.5

【参考文献】