Diseases of digestive system (15%):
Patients with systemic diseases are prone to oral ulcers, mainly by affecting the immune system. Oral ulcer is related to gastric ulcer, duodenal ulcer, ulcerative colitis, localized enteritis and hepatitis. Studies have shown that 30%-48% of patients with oral ulcers suffer from digestive tract diseases, such as abdominal distension, diarrhea or constipation. More than 9% of them have digestive tract ulcers.
Nutritional factors (25%):
Deficiency and malnutrition of trace elements such as zinc, iron, folic acid and vitamin B 12 can reduce immune function and increase the possibility of recurrent oral ulcer.
Infection factors (13%):
Streptococcus and several viruses have been proposed to play a pathogenic role in the pathogenesis of recurrent oral ulcer.
Genetic factors (10%):
If both parents suffer from recurrent oral ulcers, about 80-90% of children will get sick, and if one parent suffers from this disease, about 50-60% of children will get sick.
Symptoms of oral ulcer
1. Mild aphtha: It usually occurs in the parts with poor oral mucosa keratinization. Ulcers are round or oval, with different sizes and numbers, scattered distribution, neat edges, redness and pain around them, self-limiting and recurrence history, and no scars are left after healing.
2. Herpes-like aphthae: The number of ulcers is small, up to more than 20, and it is widely distributed without aggregation and fusion. The patient developed systemic symptoms such as pain, headache, low fever, etc., and left no scars after being cured.
3. Periglandular aphtha: It usually occurs in the mucous membrane of the inner lip and mouth corner. Ulcers are mostly single, large and deep, with a "crater" shape, protruding edges, uneven bottom and a long course of disease, which can leave scars after healing.
4. Behcet's syndrome: If the mouth, eyes, genitals and skin are damaged, the diagnosis should be combined with other system damages.
Examination of oral ulcer
Simple oral ulcer can be diagnosed by oral examination; If the course of oral ulcer is long or accompanied by other diseases, the primary disease should also be checked. If it is nonspecific inflammation, serious vascular and inflammatory reactions will appear in the early stage. After the ulcer is formed, its surface is covered with cellulose pseudomembrane, and there is a small amount of necrotic tissue under it. There are a large number of inflammatory cells infiltrating in the lamina propria, and collagen fibers can be edematous, glassy or broken and disappear. The pathological changes of periapical aphtha are the same as the above-mentioned basic changes, but the scope is large and deep, with salivary gland destruction, glandular duct dilatation and epithelial hyperplasia.
According to relevant statistics, the incidence of this disease is not less than 65,438+00%, and it mostly occurs in areas with no keratinization or poor keratinization of oral mucosa, such as inner lip, tongue tip, tongue edge, tongue abdomen, cheek, soft palate and vestibular groove.
Diagnosis of oral ulcer
First of all, according to the healing time of ulcer, benign oral ulcer can heal within a few days to weeks, while malignant oral ulcer develops gradually and does not heal for months or even years.
Secondly, it can be distinguished by morphology. Benign oral ulcers are generally regular in shape, round, oval or linear, with neat and clear edges and clear boundaries with surrounding tissues. The base of the depression is smooth, soft to the touch, and the pain is obvious, while the shape of malignant oral ulcer is irregular, the boundary is unclear, and the edge is scraggy, which is granular and difficult to touch, which is obviously different from normal mucosa, but the pain of ulcer is not obvious.
Third, it can be distinguished by the course of disease. Benign oral ulcers often occur repeatedly and are self-limited, while malignant oral ulcers have no recurrence history. Once it happens, it won't heal.
Fourth, we can distinguish the general situation. Benign oral ulcers generally have fewer symptoms, but the cervical lymph nodes are not swollen but not hard or adherent, while malignant oral ulcers are the opposite, and some even have cachexia. Finally, it can be judged according to the sensitivity to drugs. Benign oral ulcers generally have obvious effects after using anti-inflammatory and bactericidal drugs, and the healing is accelerated, while malignant oral ulcers often ignore drugs and have no obvious curative effect.
treat cordially
Treatment of oral ulcer
Western medicine treatment:
(1) Local treatment: The main purpose is to diminish inflammation, relieve pain and promote ulcer healing. There are many kinds of treatment methods, according to the condition of choice:
Gargle: 0.25% chlortetracycline solution, 1: 5000 chlorhexidine solution, 1: 5000 potassium permanganate solution, 1: 5000 nitrofurazone solution, etc.
2. Buccal tablets: Dumifen Buccal Tablets, Lysozyme Buccal Tablets and Chlorhexidine Buccal Tablets.
3. Powder: Bingpeng Powder, Xilei Powder, Qingdai Powder, Yangyin Shengji Powder, Huanglian Powder, etc. It is the main medicine for treating oral ulcer in traditional Chinese medicine. In addition, compound betamethasone has anti-inflammatory, analgesic and ulcer healing effects.
4. Drug film: Its matrix contains antibiotics, cortisone and other drugs. When in use, dry the ulcer, cut off the medicinal film similar to the lesion and stick it on the ulcer, which has the functions of relieving pain, protecting the ulcer surface and promoting healing.
5. Analgesics: There are 0.5% ~ 1% procaine solution, 0.5% ~ 1% dyclonine solution and 0.5% ~ 1% dicaine solution, which are applied to the ulcer surface twice in a row to temporarily relieve pain before eating.
6. Cauterization: It is suitable for the elderly with few ulcers, small area and intermittent period. The method is to anesthetize the ulcer surface with 2% dicaine, wet and dry the ulcer surface, dip a cotton ball smaller than the ulcer surface with 10% silver nitrate solution or 50% glyceryl triacetate tincture or iodophenol solution, and put it on the ulcer surface until the surface turns white. These drugs can precipitate protein on the ulcer surface, form a film, protect the ulcer surface and promote healing. It should be noted that the liquid medicine should not be soaked too much, and the adjacent healthy tissues should not be burnt.
7. Local sealing is suitable for periglandular aphtha. Add 0.5 ~ 1 ml of 2.5% prednisolone acetate suspension into 1% procaine solution 1 ml and inject it into the tissue under the ulcer, 1 ~ 2 times, 2 ~ 4 times a week. Has that effect of accelerate ulcer healing.
8. He-Ne laser irradiation laser therapy can make the process of mucosal regeneration active, reduce inflammatory reaction and promote healing. During the treatment, the irradiation time is 30 seconds to 5 minutes. One irradiation should not exceed 5 lesions.
(2) Systemic treatment: Because the cause is not clear, the treatment effect is not ideal.
1. Immunosuppressant: At present, it is considered that this disease is related to autoimmune diseases. Immunosuppressants have been tried in recent years, and some cases have a certain effect. If the autoimmune disease can be diagnosed by examination, immunosuppressants have obvious curative effect. Commonly used drugs are adrenocortical hormones: prednisone (5mg/ tablet) and dexamethasone (0.75mg/ tablet), 3 ~ 4 times a day, each time 1 tablet. After 5 days, the disease was controlled and reduced by 5 ~ 10 mg per day. The total course of treatment was 7 ~ 10 days. If the course of treatment is long, antibiotics should be added to prevent the spread of infection. For severe Behcet's disease, hydrocortisone 100mg or dexamethasone 5mg and tetracycline 1g can be added to the 5% ~ 10% glucose solution after hospitalization, and the amount will be gradually reduced after the condition improves. Patients with gastric ulcer, diabetes and active pulmonary tuberculosis are prohibited or used with caution.
2. Immunomodulators and enhancers
(1) Levamisole: used for those who need to enhance cellular immunity. Adults should take 50mg three times a day for 2 days, and stop taking drugs for 5 days, with February to March as a course of treatment. Common side effects include headache, head error, fatigue and joint pain. In a few cases, neutropenia may occur, and routine blood tests should be carried out regularly during treatment.
(2) Gamma globulin: It is suitable for patients with decreased humoral immune function. Intramuscular injection of 1 branch (3ml) in the acute stage of ulcer, and another 3ml after 1 week if necessary. It is not suitable for long-term use, and the inhibition of human immune response by excessive use is called feedback inhibition.
(3) Transfer factor: it can transfer immune function to non-immune body and restore its immune function. It is suitable for patients with decreased or defective cellular immune function. 1 ml contains 5× 109 leukocyte extract. Inject under the skin with abundant lymphatic reflux, such as armpit or groin. Each time 1ml, once a week 1 ~ 2 times, 10 times is a course of treatment, generally a course of treatment is enough.
(4) Vitamins: Vitamins can maintain normal metabolic function and promote the healing of lesions. Vitamin C 0. 1 ~ 0.2g was given at the time of ulcer attack, and vitamin B 1 tablet was given three times a day.
(5) Female hormones: When the onset of female diseases is related to the menstrual cycle, estrogen can be used with caution. Diethylstilbestrol 0. 1mg, taken every night 1 time, starting from the fifth day after menstruation, for 20 consecutive days.
(6) Trace elements: patients with decreased serum zinc content have improved after zinc supplementation, and can use 1% zinc sulfate syrup, once 10ml, three times a day; Or zinc sulfate tablets, each time 0. 1g, each time 1 tablet, three times a day. Vitamins are riboflavin derivatives, which contain many vitamins, amino acids, trace elements and some coenzymes necessary for human body. Vitamins have a certain curative effect on patients with gastrointestinal diseases, and can promote ulcer healing. Each time 1g, three times a day has no side effects and can be taken for a long time.
Chinese medicine treatment:
Recurrent aphtha, also known as aphthous stomatitis, is a small and painful ulcer on the oral mucosa, which is recurrent. This disease is mostly related to mental stress, endocrine disorders, nutritional deficiency, infection, heredity, abnormal immune function, digestive system diseases and other factors. Traditional Chinese medicine believes that the external cause of this disease is mainly heat toxin; The internal causes are mostly emotional internal injuries, improper diet and atrioventricular fatigue. This disease is more common in middle-aged women, and ulcers are mostly scattered in areas where mucous membranes are easy to move, and the pain is often unbearable, which makes patients insomnia. In clinical practice, we often divide syndrome differentiation into six treatment methods.
A, exogenous toxic aphtha:
The main symptoms are 1 ~ 2 days after exogenous diseases, accompanied by exogenous symptoms. At first, the oral mucosa was congested, red and slightly painful. Chestnut-like little red dot or herpes appeared on the tip of the tongue or lips. Herpes ulcerated within 12 hours, showing superficial ulcers with clear boundaries.
The principle of treatment is to clear away heat and toxic materials, strengthen the spleen and eliminate dampness.
Prescription Flos Lonicerae, Fructus Forsythiae, Herba Agastaches, Radix Aucklandiae, Herba Eupatorii, Poria, Massa Medicata Fermentata, Fructus Aurantii, Radix Puerariae, Atractylodis Macrocephalae, Ochre and Inula (decoction), 65438 0 doses per day.
Second, spleen and stomach heat accumulation type:
The main symptoms are multiple erosions and sores on the tongue and mouth, swelling and burning pain on the sore surface, even halitosis with swollen gums, thirst and excessive drinking, constipation in urine, red tongue with yellow fur and slippery pulse.
The rule of law requires clearing away heat and purging fire, and cleaning stomach heat.
Prescription drugs are Gardenia 12g, Scutellaria baicalensis Georgi 12g, Fructus Forsythiae 12g, Radix et Rhizoma Rhei, Natrii Sulfas, Herba Menthae, Rhizoma Coptidis, Folium Bambusae and Glycyrrhrizae Radix, decocted in water, daily 1 dose.
Three, spleen and kidney yang deficiency type:
The main symptoms are sores on the mouth and tongue, white ulcer surface, less redness and swelling around it, which can not be cured for a long time, accompanied by tepid limbs, dry mouth and hot drinks, backache, frequent urination, thin stool, pale tongue with white greasy fur and weak pulse. Treatment should be warming and invigorating the kidney and spleen, and fire should be triggered to seek the source.
The prescription is prepared by decocting Radix Aconiti Lateralis Preparata tablets (decocted for 30 minutes), Cortex Cinnamomi, Radix Rehmanniae Preparata, Fructus Corni, Rhizoma Dioscoreae, Cortex Moutan, Poria, Rhizoma Alismatis and Rhizoma Atractylodis in water, with 65,438 0 doses per day.
Four, spleen and stomach weakness type:
The main symptoms are sores on the mouth and tongue, pale and sunken face, fatigue, shortness of breath, loss of appetite, tepid limbs, thin stool, pale tongue with white fur and thready pulse.
The treatment should be to replenish the middle energizer, strengthen the spleen and eliminate dampness.
Prescription drugs are Radix Astragali, Radix Codonopsis, Radix Angelicae Sinensis, Pericarpium Citri Tangerinae, Radix Bupleuri, Cimicifugae Rhizoma, Herba Pogostemonis, Poria, Atractylodis Macrocephalae, and Glycyrrhrizae Radix, which are decocted in water, with 65438 0 doses per day.
Five, heart and kidney yin deficiency type:
The main symptoms are bright red color, numerous shapes and sizes, mild pain during the day, severe pain at night, accompanied by palpitation, insomnia, dreaminess, forgetfulness, dizziness, tinnitus, pain in the waist and knees, dry throat and dry mouth, short and yellow urine, red tongue with thin coating and rapid pulse.
To govern the rule of law, we should nourish yin and clear fire, nourish the heart and soothe the nerves.
Radix Rehmanniae, Cortex Lycii, Rhizoma Dioscoreae, Alismatis Rhizoma, Corni Fructus, Flos Chrysanthemi Indici, Fructus Forsythiae, Cimicifuga Rhizoma, Fructus Amomi, and Herba Taxilli are decocted with water, with 65438 0 doses per day.
Six, blood deficiency and yin deficiency type:
The main symptoms are tongue and mouth ulceration, which mostly occurs around menstruation, accompanied by premenstrual excess, upset and fever, dry mouth and thirst, pale tongue with thin white fur and weak pulse.
The treatment should nourish blood and yin, and subdue deficiency fire.
Radix Angelicae Sinensis, Radix Paeoniae Alba, Radix Rehmanniae, Folium Bambusae, Poria, Cortex Moutan, Fructus Gardeniae, Radix Bupleuri, Radix Ophiopogonis, Fructus Schisandrae Chinensis, and Radix Scrophulariae, decocted in water, 65,438 0 doses per day.
Seven, common oral ulcers:
The main symptoms are ulcer surface on the mucosa of mouth, lips, tongue and cheek, swelling and pain, difficulty in eating, difficulty in speaking, red tongue and slippery pulse.
Indications: Oral ulcer.
A few grams of prescription bile alum should be applied to the ulcer surface, which should not be ground into powder to prevent overdose.
keep fit
Health care of oral ulcer
Symptom nursing
1. Under the guidance of a doctor, rinse your mouth with medicine or liquid medicine.
2. Pay attention to oral hygiene and wash food at any time after meals.
3. Avoid eating foods that are too hard or too thick in fiber, so as not to stimulate the wound and aggravate the pain.
4. Don't pick foods that taste too strong, such as foods that are too sour, too salty and too spicy, so as not to irritate mucous membranes.
5. Drink less alcohol and carbonated drinks to stimulate the wound.
6. Foods that are too hot or too cold will aggravate the pain of oral ulcers and should be avoided.
7. Under the guidance of a doctor, supplement the intake of vitamins B2, C and folic acid.
8. Regular blood and liver and kidney health checks.
ordinary care
1. Choose a healthy toothbrush and fluoride toothpaste: a healthy toothbrush can effectively clean your mouth without damaging your teeth and gums. The bristles of the health toothbrush are soft and elastic, the brush surface is flat, the brush head is small and the end is round. Fluorine in fluoride toothpaste can be combined with enamel to make teeth stronger and have good caries prevention effect.
2, regular oral examination: regular oral examination, the dentist will provide you with oral health guidance and help to ensure that your teeth and gums are healthy and beautiful.
3, pay attention to the teeth behind the mouth: the teeth behind the mouth also need attention, after cleaning all the teeth, rinse your mouth with water.
Daily health care
1, life aftercare: ensure adequate sleep and avoid fatigue, tension and excessive brain use; Keep your mouth clean, and clean your mouth 2~3 times a day. The toothbrush should not be brushed too hard, so as not to hurt the oral mucosa. Insisting on gargling with strong tea can promote the healing of oral ulcer surface.
2, mental conditioning: maintain a happy mood, cheerful personality, relaxed body and mind, correctly treat daily work and illness.
3, diet aftercare: encourage eating and drinking, do a regular diet, chew slowly. Appropriate amount of vitamins and various trace elements needed by human body, eat more fruits and vegetables, eat more foods rich in protein, avoid irritating diet, and avoid fried, baked and spicy food. Quit smoking and drinking during the onset.
4, develop good eating habits: reduce the number of times to eat sugary food, because the edges of teeth and gums gather a lot of bacteria, bacteria use sugar to produce acid, corrode teeth and cause dental caries. This kind of oral ulcer prevention is more effective.
5. Correct brushing angle and action: tilt the toothbrush at 45 degrees and press it between the tooth surface and gums. Brush as far as possible into the gingival sulcus and between the teeth, then brush vertically along the teeth and gently rotate the brush head. Don't push too hard. Brush each tooth in turn for three minutes each time. This is also a preventive measure for oral ulcers.
6. Establish good oral hygiene habits: always keep the oral hygiene clean, master the correct method of brushing teeth, rinse your mouth after meals, brush your teeth in the morning and evening, change your toothbrush regularly, and use dental floss to completely remove food residues between your teeth. This belongs to the prevention method of oral ulcer.
Dietotherapy and health care (the following information is for reference only, please consult your doctor for details)
1, radish drink 1 white radish (sweet and crisp is better) (about 500 grams), chop up the juice, season with white sugar, rinse your mouth and swallow it slowly. The radish in the recipe is beneficial to the stomach and digestion, clearing away heat and promoting fluid production. It is suitable for patients with oral ulcer, epigastric pain, belching and anorexia.
2, bamboo heart porridge fresh bamboo leaves roll heart 15 g (dry 8 g) gypsum 30 g, glutinous rice 100 g porridge; After the porridge is dissolved with appropriate amount of rock sugar, take it. In the prescription, bamboo leaves clear the heart and relieve annoyance, gypsum clears away heat and purges fire, and japonica rice crystal sugar benefits the stomach and spleen. It is suitable for patients with oral ulcer, halitosis, thirst, upset and dryness.
3. The green crab tea contains Folium Isatidis 10g, Folium Sennae 5g, and proper amount of sugar, which is brewed and drunk. In the prescription, Folium Isatidis clears the heart and stomach, cools serum heat, and senna laxatives. Suitable for patients with oral ulcer and constipation.
4. Lotus seed soup: 30 grams of lotus seeds (without lotus seeds), 0/5 grams of gardenia/kloc (wrapped in gauze), adding appropriate amount of rock sugar, decocting in water, eating lotus seeds and drinking soup.
5. Lotus root soup: 6 grams of lotus seed core and 30 grams of lotus root, decocted once a day for 3-5 days.
6, tremella lotus seed soup: 25 grams of tremella, 50 grams of lotus seeds. Wash tremella and lotus seeds with clear water, put them in a pot, add water until the silver is cooked, add crystal sugar or distiller's grains to dissolve, and eat them in a small bowl in the morning and evening. It can clear heat and nourish yin.
7, honey water: honey 10 ml, add 80 ml of water, shake well, gargle, several times a day, or decoct.
8, radish fresh lotus root juice: a number of white radishes, 500 grams of fresh lotus root. Wash radish and lotus root with clear water, mash them in a clean vessel, wring the juice with sterile gauze to get the juice, put it in your mouth several times a day and swallow it later.
9. Use honey 25g, green tea 1g and gallnut 10g. Add 400 ml of water to gallnut, boil it for 10 minute, add green tea and honey, and drink it slowly twice after 5 minutes for 3 days. Suitable for general oral ulcers.
10, black date rose soup:
Formula: black dates and dried rose petals.
Method: Take out the black jujube pit, wash the roses, fill them in, put them in a bowl, cover them, and boil them in water. You can put some honey to taste properly, and honey also has the effect of treating aphtha.
Usage: Eat five jujubes three times a day, often.
1 1, Wu Mei Sheng Di mung bean cake:
Formula: 50g of ebony, 30g of rehmannia root, 500g of mung bean and 250g of red bean paste.
Methods: Soak the ebony in boiling water for about 3 minutes, take it out and cut it into cubes or thin slices. Slice the raw materials and mix well with dark plum. After scalding mung beans with boiling water, put them in a basket to wipe off the skin and rinse them with clear water. Put mung beans in a bowl, steam them in a steamer with clear water for 3 hours until they are crisp, take them out, take them out and drain them, and rub them into mung bean paste on a sieve. Put the special wooden frame on the chopping board, line it with a piece of white paper, first put half of the mung bean paste, spread it evenly, remove the dark plum and radix rehmanniae, spread a layer of mung bean paste in the middle, then spread the remaining mung bean paste, press it firmly, and finally sprinkle sugar on the surface. Cut the cake into cubes.
Efficacy: nourishing yin and clearing heat, detoxifying and healing sores.
Usage: As a snack.
12, Sheng Di Mei Qing beverage:
Formula: Radix Rehmanniae15g, Herba Dendrobii10g, Radix Glycyrrhizae 2g and Semen Pruni 30g.
Methods: Rehmannia glutinosa, Dendrobium nobile, Glycyrrhiza uralensis Fisch and Mume Fructus were boiled for 20 minutes, and the residue was removed to get juice.
Efficacy: nourishing yin and clearing heat, reducing fire and healing sores.
Usage: daily 1 dose, 2 ~ 3 times for several days.
13, Sheng Di Lian Xin Tang:
Formula: 9 grams of Radix Rehmanniae, 6 grams of lotus plumule and 6 grams of licorice.
Methods: add water to the three herbs, decoct them together, remove residue and get juice.
Efficacy: nourishing yin and clearing heat.
Usage: 1 dose for several days every day.
14, lotus seed licorice tea:
Formula: lotus seed 15g, licorice 2g and green tea 5g.
Method: Put the above things into a teacup and soak them in boiling water.
Efficacy: clearing heat.
Usage: Always drink instead of tea.
15, bamboo leaf grass mung bean porridge:
Formula: Lophatherum gracile 10g, medulla tetrapanacis 5g, Glycyrrhiza uralensis Fisch 1.5g, mung bean 30g and japonica rice 150g.
Methods: Chop the Lophatherum gracile, Tetrapanacis tetrapanacis and Glycyrrhiza uralensis Fisch, put them into gauze bags, add mung beans and japonica rice with water for 30 minutes, and cook them with slow fire to make porridge.
Efficacy: clearing away heat and purging fire, detoxifying and healing sores.
Usage: divide food in the morning and evening.
16, fresh lotus root radish beverage:
Lotus root is effective for oral ulcer. Formula: some raw radishes and 500g fresh lotus root.
Methods: Mash them to get juice.
Efficacy: clearing away heat and vexation, promoting fluid production and quenching thirst.
Usage: rinse your mouth. Several times a day for 3 days.
17, lotus seed gardenia licorice tea:
Formula: 3 grams of lotus plumule, 9 grams of gardenia and 6 grams of licorice.
Methods: Soak the above materials in boiling water.
Efficacy: Clearing heart and purging fire.
Usage: daily 1 dose, drink frequently instead of tea, with 3 doses available.
18, enemy Qin Zhuye drink:
Formula: Radix Rehmanniae 15g, Radix Scutellariae 9g, Bamboo Leaves 15g, and proper amount of sugar.
Methods: The first three herbs were decocted with water into soup, and sugar was added.
Efficacy: Clearing heart and purging fire.
Usage: 1 dose, twice a day, or tea instead of wine.
19, gallnut dried alum sugar:
Formula: 36g gallnut, 24g dried alum and 2g sugar.
Method: First, stir-fry gallnut, add sugar and stir-fry for a while. When the sugar is completely dissolved, pour it out and dry it, then grind it with dried alum, and adjust the powder into a thin paste with sesame oil.
Efficacy: Clearing heart and purging fire.
Usage: Apply to the affected area, 2-3 times a day.
prevent
Prevention of oral ulcer
Daily prevention
Oral ulcer is largely related to personal physique, which is unlikely to be completely avoided, but if the inducing factors are avoided, the incidence rate can still be reduced.
Specific measures are:
1, pay attention to oral hygiene, avoid damaging oral mucosa, avoid spicy food and local irritation.
2. Keep a good mood, be optimistic and cheerful, and avoid being in a hurry.
3. Ensure adequate sleep time and avoid excessive fatigue.
4. Pay attention to the law of life and balanced nutrition, develop certain defecation habits and prevent constipation.
health education
1, rinse your mouth with saline or physiological saline after each meal, or rinse your mouth with drugs to prevent secondary infection caused by food residues.
It is also important to establish good eating habits. Usually eat more fruits and vegetables and supplement rich vitamins.
3, the right amount of vitamins a and B.
4. Develop good living habits. Don't smoke, drink less, and eat less spicy and overheated food.