目的 比较口服与外敷六神胶囊药粉治疗口腔溃疡的临床效果。方法 选取2023年1～8月苏州大学附属第四医院收治的40名口腔溃疡患者，按照入院顺序将研究对象分为口服组和外敷组，每组20例。口服组患者口服六神胶囊，1粒/次，2次/d。外敷组患者用无菌棉签蘸取六神胶囊药粉末涂抹在溃疡创面上，每次蘸取绿豆大小，以薄层均匀覆盖创面为准，用药后30 min内不漱口、喝水或进食，每天早晚各1次。两组治疗7 d。观察两组的临床疗效，比较两组VAS评分、好转天数、血清炎症因子水平、最大溃疡直径。结果 治疗后，外敷组患者总有效率90.0%，显著高于口服组的85.0%（P＜0.05）。治疗第1天两组患者溃疡导致的烧灼样疼痛比较剧烈，用药治疗后随时间推移两组患者VAS评分在第5天明显降低（P＜0.05），外敷组评分显著低于口服组（P＜0.05）；治疗第7天患者VAS评分较同组治疗第一天降低（P＜0.05），但两组比较无统计学差异。外敷组疼痛好转天数是（5.7±0.3）d，口服组是（7.0±1.4）d，两组比较差异无统计学意义。治疗后，两组C反应蛋白（CRP）、白细胞介素-2（IL-2）、肿瘤坏死因子-α（TNF-α）均较同组治疗前显著降低（P＜0.05）；治疗后两组炎性因子水平比较差异无统计学意义。口服组与外敷组患者治疗初期的最大溃疡直径4.63～6.09 mm，两组比较差异无统计学意义；治疗后随着药物起效，两组患者的最大溃疡直径在治疗第5天左右开始下降，第7天溃疡直径显著缩小（P＜0.05），但两组比较无统计学差异。结论 口服与外敷六神胶囊治疗都能有效促进口腔溃疡创面愈合，外敷组总有效率高于对照组。

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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