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Dtsch Arztebl Int:口腔溃疡发病机制尚不明确

来源:生物谷 2014-10-27 11:35

2014年10月27日 讯 /生物谷BIOON/ --口腔黏膜上伤口发生炎症病变是非常痛苦的,人们经常感觉到伤口周围似乎在燃烧,每两个人中就有一个发生这种病变——口腔溃疡。通常在短期内口疮就会愈合。而2%至10%的患者口疮会复发然后就需要治疗。糟糕的是Andreas Altenberg和他的同事们指出当前口腔溃疡的病变机制尚不清楚,因此口腔溃疡只能根据表现的症状来进行治疗。

即使我们不知道口腔溃疡是如何发展的,但是一些诱发因素已被确定,如铁、叶酸和维生素B12缺乏症以及粘膜损伤会导致口腔溃疡。建议患者采取一些预防措施以避免此病的发生,如减少酸和咸的食物的食用,减少酒精和碳酸饮料等食物的饮用。根据作者介绍,大多数情况下只处理发病部位就可以,通常只需一个药膏就能搞定。只有在严重的病情情况下使用系统性药物的才是必要的。(生物谷 Bioon.com)

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The treatment of chronic recurrent oral aphthous ulcers.

1.Altenburg A, El-Haj N, Micheli C, Puttkammer M, Abdel-Naser MB, Zouboulis CC.

Background: Chronic recurrent oral aphthous ulcers are the most common type of inflammatory efflorescence of the oral mucosa, with a prevalence of 2% to 10% in Caucasian populations. To treat them properly, physicians should know their clinical appearance and course, conditioning factors, underlying causes, and differential diagnosis. Method: This review is based on pertinent articles that were retrieved by a selective search in PubMed and in the Cochrane Central Register of Controlled Trials. Results: Hard, acidic, and salty foods and toothpastes containing sodium lauryl sulfate should be avoided, along with alcohol and carbonated drinks. In Germany, the only drugs that have been approved to treat oral aphthous ulcers are corticosteroids, topical antiseptic/anti-inflammatory agents such as triclosan and diclofenac, and local anesthetics such as lidocaine. Antiseptic agents and local anesthetics should be tried first; if these are ineffective, topical corticosteroids should be used. In severe cases, local measures can be combined with systemic drugs, e.g., colchicine, pentoxifylline, or prednisolone. The efficacy of systemic treatment is debated. Other immunosuppressive agents should be given systemically only for refractory or particularly severe oral aphthous ulcers due to Adamantiades-Behçet disease. Conclusion: The treatment of chronic recurrent oral aphthous ulcers is symptomatic, mainly with topically applied agents. It is tailored to the severity of the problem in the individual case, i.e., the frequency of ulcers, the intensity of pain, and the responsiveness of the lesions to treatment. Effective treatment relieves pain, lessens functional impairment, and lowers the frequency and severity of recurrences.

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