本文選題：RAU + 沙利度胺��； 參考：《山東大學》2014年碩士論文

【摘要】：目的： 復發(fā)性口腔潰瘍(Recurrent oral ulcers,RAU)是最常見的口腔黏膜病,是一種周期性反復發(fā)作的自限性黏膜病,其發(fā)病機制尚不明確。研究表明免疫因素、精神因素、激素水平均可誘發(fā)RAU,局部刺激因素可加重RAU的癥狀。有研究證實RAU患者血清中IL-8、IL-12、IL-4、IL-10等因子的分泌異常,腫瘤壞死因子-α(TNF-α)的水平高于健康人,而白細胞介素-2(interleukin-2,IL-2)水平低于正常人,TNF-α、IL-2在RAU的發(fā)生發(fā)展中可能起到一定作用。沙利度胺(Thalidomide)是一種人工合成的谷氨酸衍生物,對神經中樞具有抑制作用。近年來發(fā)現沙利度胺是一種免疫抑制劑,具有雙向免疫調節(jié)、抗炎、抗血管生成及干擾細胞粘附等作用。本研究觀察沙利度胺聯合白芍總苷膠囊治療RAU患者的臨床效果,并檢測治療前、后患者血清中TNF-α、IL-2的水平,初步探討沙利度胺治療RAU的可能機制。 方法： 1.2013年7月-2014年2月于山東省口腔醫(yī)院黏膜�？崎T診就診的60例RAU患者隨機分為兩組,應用沙利度胺加白芍總苷膠囊治療的做為實驗組,昆明山海棠片加白芍總苷膠囊治療的做為對照組,觀察、記錄臨床指標并比較其療效。 2.獲取實驗組和對照組患者治療前、后的血清,應用ELISA方法檢測其血清中TNF-α、IL-2的含量并進行統(tǒng)計學檢驗。 結果： 1、實驗組和對照組RAU患者治療后在延長總間歇期、減少總潰瘍數、減輕潰瘍疼痛指數和縮短平均潰瘍期臨床效果均較顯著(P0.05),與對照組相比,實驗組效果更顯著(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水平重型輕型健康人(P0.05),IL-2水平重型輕型健康人(P0.05)； 3、實驗組和對照組RAU患者血清中TNF-α水平均顯著降低(P0.05),IL-2水平增高(P0.05)；且與對照組相比,實驗組改變更明顯(P0.05)。 結論： 沙利度胺加白芍總苷膠囊與昆明山海棠片加白芍總苷膠囊相比能更好的治療RAU患者,減輕RAU患者臨床癥狀,這種作用可能是通過降低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水平來實現的。
[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- 偽 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- 偽 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- 偽 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- 偽 was lower than that of healthy persons (P 0.05). 3. The levels of TNF- 偽 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- 偽 or / and increasing the IL-2 level in the serum of RAU patients.
【學位授予單位】：山東大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R781.5

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