探讨口腔洁含漱液对脾胃伏火型复发性口腔溃疡患者口腔菌群、血清炎症因子和T 细胞亚群水 平的影响。方法 选取2022 年4 月至2023 年3 月成都中医药大学附属医院口腔科和四川大学华西口腔医院口 腔黏膜科收治的脾胃伏火型复发性口腔溃疡患者64 例为研究对象，按照随机数字表法分为试验组（32 例）和对 照组（32 例），对照组患者给予醋酸曲安奈德乳膏治疗，试验组在对照组基础上联合口腔洁含漱液含漱、吞 服，每日3 次，持续治疗7 d。观察两组患者临床疗效，评价两组治疗前后，以及治疗后组间的中医证候积 分、疼痛指数、疼痛持续时间和溃疡愈合时间；实时荧光定量PCR 法分析口腔菌群（链球菌、韦荣氏菌、奈瑟 氏菌）DNA 浓度；ELISA 法检测血清炎症因子［肿瘤坏死因子α（TNF-α）、白细胞介素（IL）-6、IL-8］含量；流 式细胞术测定血清T 细胞亚群水平［T 淋巴细胞（CD3+）、辅助性T 淋巴细胞（CD4+）、CD4+/细胞毒性T 淋巴细胞 （CD8+）］。同时记录治疗期间不良反应，比较6 个月后复发情况。结果 试验组临床疗效、疼痛抑制效果和溃 疡愈合速率均优于对照组（P＜0.05）；两组患者治疗后口腔内链球菌和韦荣氏菌DNA 浓度明显高于治疗前，且 试验组高于对照组，差异均有统计学意义（P＜0.05）；两组患者治疗后血清炎症因子TNF-α、IL-6、IL-8 含量 相较治疗前降低，CD3+、CD4+、CD4+/CD8+相较治疗前升高，且试验组改善程度优于对照组，差异均有统计学 意义（P＜0.05）。试验组复发率显著低于对照组（P＜0.05）。结论 口腔洁含漱液治疗脾胃伏火型复发性口腔溃 疡患者，可显著提高临床疗效，改善口腔菌群构成，抑制血清炎性反应水平，提高细胞免疫功能，降低复发 率，值得临床推广应用。

To explore the effects of Kouqiangjie （KQJ） Gargle on the oral microflora，serum inflammatory factors and T cell subgroup levels in patients with recurrent oral ulcer （ROU） caused by fire hidden in the spleen and stomach. Methods From April 2022 to March 2023，64 patients with ROU caused by fire hidden in the spleen and stomach，who were treated in the Department of Stomatology，the Hospital of Chengdu University of Traditional Chinese Medicine （TCM） and Department of Oral Mucosa， West China Hospital of Stomatology， Sichuan University， were enrolled as the research object. All patients were randomly divided into trial group （n=32） and control group （n=32） according to random number table method. Patients in the control group were treated with Triamcinolone Acetonide Acetate Cream，while patients in the trial group received the same treatment of the control group combined with KQJ Gargle rinsing and swallowing， 3 times daily for 1 week. Clinical efficacy of the two groups were compared. The traditional Chinese medicine （TCM） syndrome scores， pain index， pain duration and ulcer healing time were recorded. The DNA concentrations of oral microflora （Streptococcus， Veillonella and Neisseria） were detected by real-time quantitative polymerase chain reaction （RT-qPCR）， enzyme-linked immunosorbent assay （ELISA） was used to determine the levels of serum inflammatory factors [tumor necrosis factor-α （TNF-α），interleukin-6 （IL-6） and IL-8] ，and flow cytometry was applied to examine the level of T cell subsets ［T lymphocytes （CD3+），helper T lymphocytes （CD4+），CD4+/cytotoxic T lymphocytes （CD8+）］. The adverse reactions during treatment were observed and recorded， and the recurrence rate after 6 months were also compared. Results The clinical efficacy，pain inhibitory effect and ulcer healing rate of trial group were higher than those in control group （P＜0.05）. After treatment，the DNA concentrations of Streptococcus，and Veillonella were significantly higher than those before treatment in both groups. Moreover，the trial group was higher than the control group，with statistical significance （P＜0.05）. The levels of serum inflammatory factors （TNF-α，IL-6 and IL-8） in two groups after treatment were diminished when compared to prior-treatment， while the levels of CD3+， CD4+ and CD4+/CD8+ were raised， and the improvement degree was greater in the trial group than in the control group. The difference was statistically significant （P＜0.05）. The recurrence rate in the trial group was significantly lower than that in the control group （P＜0.05）. Conclusion KQJ Gargle can significantly improve the therapeutic effect， ameliorate the compositions of oral microflora， inhibit serum inflammatory response levels， enhance the cellular immune functions， and reduce recurrence rate in the treatment of patients with ROU caused by fire hidden in the spleen and stomach，so it is worthy of clinical application.

R285.6

国家自然科学基金项目（81973684）；四川省自然科学基金项目（23NSFSC2574）。