Lee Yi-Chiao, Wang Ting-Hao, Chen Shih-Yu, Lin Hsiang-Ling, Tsai Ming-Yen
Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Department of Pediatrics, E-DA Hospital and I-Shou University, Kaohsiung, Taiwan.
Complement Ther Med. 2017 Jun;32:61-65. doi: 10.1016/j.ctim.2017.04.001. Epub 2017 Apr 12.
Viral oral ulcers are common presentations in pediatric clinics. Although self-limiting, painful ulcerative lesions and inflamed mucosa can decrease oral intake and lead to dehydration. Despite the widespread use of Chinese herbal medicine (CHM) for pediatric upper respiratory disease in Taiwan, there is little evidence for its effectiveness as an antipyretic or in aiding ulcer healing for children with viral oral ulcers. We report two cases of children who presented with viral oral ulcers to illustrate the potential efficacy of CHM treatment in recovery from herpangina (HA) and herpetic gingivostomatitis (HGS).
A 10-year-old girl with HA presented with an acute febrile illness associated with small vesicular or ulcerative lesions on the posterior oropharyngeal structures. The family refused western medicine due to a prior anaphylactic skin rash when she had taken sulfa drugs. The other patient was a 4-year-old boy with complaints of painful ulcers and hemorrhagic crusts on the lips. He was diagnosed with HGS and had received ibuprofen and supportive treatments such as hydration and local anesthesia spray for days, characterized by fever, anorexia, and nausea to no effect. Because the patients were suffering from the damp-heat syndrome according to Traditional Chinese Medicine (TCM) differentiation, both were treated using the same herbal formulas powder prescription, named Liang Ge San (LGS) and Gan Lu Xiao Du Dan (GLXDD). After several days of CHM treatment, the oral ulcers were in regression. Follow-up of the frontal view in both patients showed satisfactory disappearance of the sick furred tongue.
The results of these case reports show that the early prescription of CHM is an effective modality of alternative treatment for viral oral ulcers. To our knowledge, this is the first report of CHM treatment hastening the recovery from febrile disease with viral oral ulcers in Taiwan. Future experimental studies to determine the definitive mechanism and clinical trials are warranted.
病毒性口腔溃疡是儿科门诊的常见病症。尽管具有自限性，但疼痛性溃疡性病变和黏膜炎症会减少经口摄入量并导致脱水。尽管台湾广泛使用中药治疗小儿上呼吸道疾病，但几乎没有证据表明其对病毒性口腔溃疡患儿具有退热或促进溃疡愈合的功效。我们报告两例患有病毒性口腔溃疡的儿童病例，以说明中药治疗在疱疹性咽峡炎（HA）和疱疹性龈口炎（HGS）康复中的潜在疗效。
一名10岁患HA的女孩出现急性发热性疾病，伴有口咽后部结构的小水疱或溃疡性病变。该家庭因她之前服用磺胺类药物时出现过敏性皮疹而拒绝西药治疗。另一名患者是一名4岁男孩，主诉嘴唇有疼痛性溃疡和出血性痂皮。他被诊断为HGS，已接受布洛芬以及补液和局部麻醉喷雾等支持性治疗数天，症状表现为发热、厌食和恶心，但均无效果。根据中医辨证，两名患者均属湿热证，均使用相同的中药配方散剂处方治疗，名为凉膈散（LGS）和甘露消毒丹（GLXDD）。经过几天的中药治疗，口腔溃疡逐渐消退。对两名患者的正面视图随访显示，病苔均令人满意地消失。
这些病例报告结果表明中药早期处方是治疗病毒性口腔溃疡的一种有效替代疗法。据我们所知，这是台湾首例关于中药治疗加速病毒性口腔溃疡发热性疾病康复的报告。未来有必要开展实验研究以确定确切机制并进行临床试验。
