使用Ranitidine在復發性口腔潰瘍的療效評估

復發性口腔潰瘍（recurrent aphthous stomatitis）在臨床上是很常見到的問題，目前的治療共識是利用局部性類固醇來降低發炎反應以控制潰瘍所造成的不舒服，並促進潰瘍癒合。但是在治療疾病復發性方面的成效仍沒有令人滿意的結果。本次先導性試驗的目的就是要探討 Ranitidine 應用在復發性口腔潰瘍患者的治療成效，期望能降低復發性口腔潰瘍對患者生活的影響。本試驗收納15位復發性口腔潰瘍的患者，所有患者都沒有全身性系統疾病。所有病患都接受口服 Ranitidine(150mg) 每天兩次的治療90天，如果需要的話也會搭配局部類固醇的使用，並利用 visual analogue scale(VAS) 來評估疾病改善狀況。結果顯示，復發性口腔潰瘍的患者，在治療前 VAS 平均分數為7. 35，但在治療後 VAS 平均分數降為2.21 。以 paired t-test 分析每一位患者的結果，治療前後的 VAS 分數有統計學上顯著差異性的降低（P<0.001）。初步結果證實 Ranitidine 應用於復發性口腔潰瘍的治療上有顯著的改善效果，但仍需進行雙盲隨機臨床試驗以及增加樣本數以獲得更多的佐證。

關鍵字

復發性口腔潰瘍；疼痛評估

並列摘要

Recurrent aphthous stomatitis(RAS) is a common problem in clinic. There is no curative treatment for RAS. The best that can be achieved is to avoid local traumatic precipitants, lessen the pain and duration of ulceration by suppressing the local immune response, and prevent secondary infection. Topical steroids become the mainstay of the treatment of RAS but the recurrent conditions still affect life quality of patients. The aim of this pilot study was to evaluate the role of Ranitidine in the management of patients with RAS. Fifteen patients without any systemic disease participate in this study. They took Ranitidine 150mg twice daily for 90 days and used topical steroid over ulcer if need. Evaluate the improvement of the disease by visual analogue scale(VAS). The results show the average VAS before treatment is 7.35 and becomes 2.21 after treatment. There are statistically significant differences between the VAS of before treatment and the VAS of after treatment(P < 0.001). This pilot study shows Ranitidine as a potential therapy in the management of RAS but we still need more exact evidence by double-blind randomized controlled trial and more sample size and long-term follow-up data.

並列關鍵字

Ranitidine ； PFAPA ； aphthous ； VAS

參考文獻

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2. Scully C, Gorsky M, Lozada-Nur F. The diagnosis and management of recurrent aphthous stomatitis: A consensus approach. J Am Dent Assoc 2003;134:200-7.

3. Eguia A, Martinez-Conde R, Lopez J, Uribarri A, Aguirre JM. Salivary levels of Tumour Necrosis Factor-alpha in patients with recurrent aphthous stomatitis. Med Oral Patol Oral Cir Bucal 2010.

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使用Ranitidine在復發性口腔潰瘍的療效評估

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