Sharquie Khalifa E, Al-Tammimy Sami M, Al-Mashhadani Sabeeh, Hayani Raafa K, Al-Nuaimy Adil A
Scientific Council of Dermatology and Venereology, Iraqi Board for Medical Specializations.
Dermatol Online J. 2006 Dec 10;12(7):2.
Recurrent aphthous ulcerations (RAU) are the most common oral mucosal disease among the general population including in Iraq. There is no uniformly effective therapy for this disease.
To evaluate the therapeutic efficacy and safety of 5-percent lactic acid mouthwash in the treatment of patients with recurrent aphthous ulcerations.
This is a single-blind controlled therapeutic study. We recruited 80 subjects with early-onset oral aphthosis from patients who attended Baghdad Teaching Hospital Department of Dermatology and Venereology in the period between April 2004 and April 2005. Of those subjects, 10 defaulted; the remaining 70 patients were divided into two groups, A and B. Subjects in group A (36 patients) were instructed to use 5-percent lactic acid mouthwash, one teaspoonful three times daily before meals. Subjects in group B (34 patients) were instructed to use placebo (distilled water mouthwash) in a similar way. Assessment of each patient of both groups was done by using oral clinical manifestation index (OCMI) before, after 3 days and after 7 days of therapy.
The mean of OCMI in group A started to decline after 3 days of therapy and attained statistically significant lower level after 7 days of therapy (p <0.05). The change in the mean OCMI of group B after 3 and 7 days of therapy was also statistically significant (p <0.05). However, the response rate (percentage of change in the mean) after 3 days of therapy in group A was 63.6 percent and in group B was 8.8 percent, and the response rate after 7 days of therapy in group A was 90.8 percent and in group B was 35.7 percent. The difference in the response rates after 3 and 7 days between groups A and B was statistically significant (p <0.05). No significant side effects were noticed apart from mild irritation in two patients using lactic acid.
Lactic acid 5 percent mouthwash is a new effective mode of therapy for patients with RAU and had significantly reduced the signs and symptoms of the disease, especially when compared with placebo. The mechanism of action may be related to increasing spontaneous secretion of endothelial growth factor from keratinocytes.
复发性阿弗他溃疡（RAU）是包括伊拉克在内的普通人群中最常见的口腔黏膜疾病。目前尚无针对该疾病的统一有效治疗方法。
评估5%乳酸漱口水治疗复发性阿弗他溃疡患者的疗效和安全性。
这是一项单盲对照治疗研究。我们从2004年4月至2005年4月期间前往巴格达教学医院皮肤科和性病科就诊的患者中招募了80例早发性口腔口疮患者。其中10例失访；其余70例患者分为A、B两组。A组（36例患者）被指示使用5%乳酸漱口水，每天饭前1茶匙，每日3次。B组（34例患者）被指示以类似方式使用安慰剂（蒸馏水漱口水）。在治疗前、治疗3天后和7天后，通过使用口腔临床表现指数（OCMI）对两组的每位患者进行评估。
A组的OCMI平均值在治疗3天后开始下降，在治疗7天后达到统计学显著更低水平（p<0.05）。B组在治疗3天和7天后的OCMI平均值变化也具有统计学意义（p<0.05）。然而，A组治疗3天后的反应率（平均值变化百分比）为63.6%，B组为8.8%，A组治疗7天后的反应率为90.8%，B组为35.7%。A组和B组在治疗3天和7天后的反应率差异具有统计学意义（p<0.05）。除了两名使用乳酸的患者出现轻度刺激外，未观察到明显的副作用。
5%乳酸漱口水是治疗RAU患者的一种新的有效治疗方式，并且显著减轻了该疾病的体征和症状，尤其是与安慰剂相比时。其作用机制可能与增加角质形成细胞中内皮生长因子的自发分泌有关。
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