目的 比較口服與外敷六神膠囊藥粉治療口腔潰瘍的臨床效果。方法 選取2023年1～8月蘇州大學(xué)附屬第四醫(yī)院收治的40名口腔潰瘍患者，按照入院順序?qū)⒀芯繉?duì)象分為口服組和外敷組，每組20例?？诜M患者口服六神膠囊，1粒/次，2次/d。外敷組患者用無(wú)菌棉簽蘸取六神膠囊藥粉末涂抹在潰瘍創(chuàng)面上，每次蘸取綠豆大小，以薄層均勻覆蓋創(chuàng)面為準(zhǔn)，用藥后30 min內(nèi)不漱口、喝水或進(jìn)食，每天早晚各1次。兩組治療7 d。觀察兩組的臨床療效，比較兩組VAS評(píng)分、好轉(zhuǎn)天數(shù)、血清炎癥因子水平、最大潰瘍直徑。結(jié)果 治療后，外敷組患者總有效率90.0%，顯著高于口服組的85.0%（P＜0.05）。治療第1天兩組患者潰瘍導(dǎo)致的燒灼樣疼痛比較劇烈，用藥治療后隨時(shí)間推移兩組患者VAS評(píng)分在第5天明顯降低（P＜0.05），外敷組評(píng)分顯著低于口服組（P＜0.05）；治療第7天患者VAS評(píng)分較同組治療第一天降低（P＜0.05），但兩組比較無(wú)統(tǒng)計(jì)學(xué)差異。外敷組疼痛好轉(zhuǎn)天數(shù)是（5.7±0.3）d，口服組是（7.0±1.4）d，兩組比較差異無(wú)統(tǒng)計(jì)學(xué)意義。治療后，兩組C反應(yīng)蛋白（CRP）、白細(xì)胞介素-2（IL-2）、腫瘤壞死因子-α（TNF-α）均較同組治療前顯著降低（P＜0.05）；治療后兩組炎性因子水平比較差異無(wú)統(tǒng)計(jì)學(xué)意義?？诜M與外敷組患者治療初期的最大潰瘍直徑4.63～6.09 mm，兩組比較差異無(wú)統(tǒng)計(jì)學(xué)意義；治療后隨著藥物起效，兩組患者的最大潰瘍直徑在治療第5天左右開(kāi)始下降，第7天潰瘍直徑顯著縮?。?i>P＜0.05），但兩組比較無(wú)統(tǒng)計(jì)學(xué)差異。結(jié)論 口服與外敷六神膠囊治療都能有效促進(jìn)口腔潰瘍創(chuàng)面愈合，外敷組總有效率高于對(duì)照組。

Objective To compare the clinical effect of oral and external application of Liushen Capsules powder in treatment of oral ulcer. Methods Forty patients with oral ulcer admitted to the Fourth Affiliated Hospital of Soochow University from January to August 2023 were selected, and the subjects were divided into oral group and external application group according to the admission order, with 20 cases in each group. Patients in oral group were po administered with Liushen Capsules, 1 grain/time, twice daily. Patients in external application group dipped a sterile cotton swab into Liushen Capsules drug powder and smeared it on the ulcer wound. Each time, the size of mung bean was dipped and the wound was evenly covered with a thin layer. No gargling, drinking water or eating was done within 30 minutes after medication, once in the morning and once in the evening. Both groups were treated for 7 d. The clinical effects of the two groups were observed, and VAS scores, days of improvement, serum inflammatory factor levels and maximum ulcer diameter were compared between two groups. Results After treatment, the total effective rate of external application group was 90.0%, which was significantly higher than that of oral group 85.0% (P < 0.05). The burning pain caused by ulcers in two groups was more severe on the first day of treatment, and the VAS score of the two groups was significantly decreased on the fifth day after medication treatment (P < 0.05), and the score of the external application group was significantly lower than that of the oral group (P < 0.05). VAS scores of patients on the 7th day of treatment were lower than those on the 1st day of treatment (P < 0.05), but there was no statistical difference between the two groups. The number of days for pain improvement was (5.7 ± 0.3) d in external application group and (7.0 ± 1.4) d in oral group, with no significant difference between the two groups. After treatment, C-reactive protein (CRP), interleukin-2 (IL-2) and tumor necrosis factor-α (TNF-α) in two groups were significantly decreased compared with before treatment (P < 0.05). There was no significant difference in the levels of inflammatory factors between two groups after treatment. The maximum ulcer diameter between oral group and external group was 4.63 — 6.09 mm at the beginning of treatment, and there was no statistical significance between two groups. After treatment, as the drug took effect, the maximum ulcer diameter of the two groups began to decline around the 5th day of treatment, and the ulcer diameter was significantly reduced on the 7th day (P < 0.05), but there was no statistical difference between two groups. Conclusion Both oral and external application of Liushen Capsules can effectively promote the healing of oral ulcer wound, and the total effective rate of external application group is higher than that of control group.

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