Recurrent Oral Ulcer Being Treated Under The Guidance Of Doctrine Of Insidious Pathogen

Recurrent oral ulcer is a common disease of oral mucosal disease. Every body could affected by the disease and the morbidity is at20%high. Currently the factor and pathogenesis are not confirm. Probably local trauma, mantal stress, food, medicine, level of hormone and lack of trace elements were the remote cause. Therefore systematic diseases, heredity, immune and microorganism play the important role. Because of uncertain factors, the diagnosis based on the medical history and clinical manifestation. And then there was lack of laboratory indicators to ensure the definite diagnosis. Oral ulcer indicates that the patient may have some potential systematic diseases. In theropy, hormone and Vitamin B can be selected to cure it, but it takes a long protocol and easier to recur. In TCM oral ulcer belongs to aphtha. It appears in some conditions such as fat ganhou greasy food, fondness of liquor. Then spleen and stomach were impaired, endogenous fire appeared, zang-fu function imbalance. This research tried to explore the relativity of oral ulcer and TCM syndrome and offer the theoretical and practical basis to treat recurrent oral ulcer.Part one Literature ResearchThis paper summarized the name, pathogenesis, treatment of recurrent oral ulcer in TCM and modern traditional Chinese medical physician’s achievements. It alao summed up the domestic and foreign scholars’s progress on the epidemiology, etiology, pathology, pathogenesis, diagnosis and treatment, and the research trend and direction of recurrent oral ulcer, in our country or abroad. Currently the factor and pathogenesis are not confirm. It is said that there were a lot of factors would lead to recurrent oral ulcer such as mental stress, tired, endocrine disorders. There are no certain therapy to cure once for all. Although the site of disease is the mouth, it is said that spleen opens at the mouth. Therefore the onset of it has the intimate relativity of spleen and stomach’s function. Insufficiency of the spleen and hot on inflammation were the key point.Part two clinical and experimental research1. Objective:In order to supply the theoretical and practical basis, we treated it under the doctrine of insidious pathogen and found the relativity between TCM syndrome and oral ulcer.2. Methods:46patients who comply with a standard were collected. On the basis of the syndrome classification from the Chinese Internal Medicine, they have been divided in to4groups which followed by liang ge san, huang qin plus dou chi xuan shen, huang lian e jiao tang and gan lu xiao du dan.3. Results:1)There were27male and19female. The ages were between22to68years old. The average frequency of attack is4.66±1.84months, the average amount of oral ulcer is3.24±1.58.2)Damp and hot accumulate poison is the most familiar syndrome in recurrent oral ulcer and it takes41.3%. Heat scorching chest and diaphragm is the second rate that contains32.6%. Hot stagnate the shaoyang qi.3)The symptom of Oropharyngeal dry accounted for the most of analysis of manifestation. Then bitter mouth and dry throat, anorexia and bloating were in the secongd place.4) Red tongue was the main tongue nature, occupied76.1%. Pale red tongue23.9%, yellow greasy coating34.8%, moss white be bored.5) In the analysis of relativity between TCM syndrome and course of disease, we found that fire excess from yin deficiency has the longest disease course, with the average course5.3+2.1years. Syndrome of damp-heat with exuberance of virulence was in the second place with the average course3.1+1.4years.6)We found that the frequency of attack were5.6+2.84times per year and5.6+2.84times per year in syndromes of fire excess from yin deficiency and damp-heat with exuberance of virulence. The least attack frequency is syndrome of hot stagnating shaoyang.7) In the study, we found that syndrome of hot stagnating shaoyang’s curative effect was100%. The other syndromes’effective rate were94.8%,87.5%and 75%in syndromes of damp-heat with exuberance of virulence, fire excess from yin deficiency and hot stagnating shaoyang.8)Evaluating the result after6months follow-up, we found that attack frequency were less than be treated before for3.87±1.42years but is no statistical difference.4. Conclusion:The theory of insidious pathogen adapt to the pathogenesis, clinical manifestation and treating principle. Because of the characters of disease and one’s immunity, some patients in the stage of recurrent or chronic infection. All the characters above were adapt to the point of incubative pathogen. Damp and hot accumulating poison was the most common syndrome in recurrent oral ulcer. Then the main pathogensis was Damp and hot accumulating poison and evil heat falling in. The total effective rate was90.2%under Chinese medicine. It is offer a feasible treatment of recurrent oral ulcer.