焦虑与小肠细菌过度生长：与复发性阿弗他溃疡的关联。

Anxiety and small intestinal bacterial overgrowth: associations with recurrent aphthous ulcers.

作者信息

Liu Zijian, Lu Mingxing, Wang Wei, Tang Jingli, Li Shufang, Guo Qianyun, Wang Yutian, Liu Xingyun, Wang Xing, Cheng Zhe, Wang Qian, Jin Jianqiu, Han Ying, Liu Hongwei, Cui Lihong

机构信息

Department of Oral Medicine, National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Peking University School and Hospital of Stomatology, No. 22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, P.R. China.

Stomatological Hospital of Xiamen Medical College & Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Xiamen, China.

出版信息

BMC Oral Health. 2025 May 7;25(1):688. doi: 10.1186/s12903-025-05998-0.

DOI:10.1186/s12903-025-05998-0

PMID:40336035

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12057264/

Abstract

BACKGROUND

Recurrent aphthous ulcer (RAU) is the most prevalent oral mucosal disease, yet its etiology remains unclear. Anxiety and depression have been linked to the onset of RAU, but research findings were contradictory. The association of intestinal diseases with RAU implies a potential role of gut microbiota in the development of this condition. This study aims to explore the correlation between the presence and severity of RAU and psychological factors, as well as gut microbiota dysbiosis.

METHODS

The Zung's self-rating anxiety scale (SAS), Zung's self-rating depression scale (SDS), and Pittsburgh sleep quality index (PSQI) were used to assess the participants' psychological status. The lactulose hydrogen-methane breath test was performed to detect the presence of small intestinal bacterial overgrowth (SIBO) in RAU patients. The long-term severity of RAU is quantified using the monthly number of ulcers. Compare the differences in outcomes between individuals with RAU and the healthy population, and explore the factors influencing the severity of RAU.

RESULTS

Forty-nine patients and 49 controls were included. The RAU group had significantly higher SAS scores (t = 2.18, p = 0.034), and SIBO positivity (χ = 75.67, p < 0.001). Factors correlated with the monthly number of ulcers included SAS score (r = 0.52, p < 0.001), symptoms of anxiety (r = 0.42, p = 0.004), SDS score (r = 0.46, p = 0.002), PSQI score (r = 0.35, p = 0.020), and SIBO positivity (r = 0.42, p = 0.005). Multiple linear regression analyses indicated that anxiety and SIBO may influence the severity of RAU. Moreover, SAS score (r = 0.38, p = 0.010) and SDS score (r = 0.38, p = 0.009) exhibited correlations with SIBO.

CONCLUSIONS

RAU patients are at a higher risk of anxiety and gut microbiota dysbiosis, which could potentially escalate the severity of RAU. The role of the brain-gut axis in the pathogenesis of RAU warrants further exploration.

摘要

背景

复发性阿弗他溃疡（RAU）是最常见的口腔黏膜疾病，但其病因仍不清楚。焦虑和抑郁与RAU的发病有关，但研究结果相互矛盾。肠道疾病与RAU的关联暗示了肠道微生物群在这种疾病发展中的潜在作用。本研究旨在探讨RAU的存在和严重程度与心理因素以及肠道微生物群失调之间的相关性。

方法

使用zung自评焦虑量表（SAS）、zung自评抑郁量表（SDS）和匹兹堡睡眠质量指数（PSQI）来评估参与者的心理状态。进行乳果糖氢-甲烷呼气试验以检测RAU患者小肠细菌过度生长（SIBO）的存在。使用每月溃疡数来量化RAU的长期严重程度。比较RAU患者和健康人群之间结果的差异，并探讨影响RAU严重程度的因素。

结果

纳入49例患者和49例对照。RAU组的SAS评分（t = 2.18，p = 0.034）和SIBO阳性率（χ = 75.67，p < 0.001）显著更高。与每月溃疡数相关的因素包括SAS评分（r = 0.52，p < 0.001）、焦虑症状（r = 0.42，p = 0.004）、SDS评分（r = 0.46，p = 0.002）、PSQI评分（r = 0.35，p = 0.020）和SIBO阳性率（r = 0.42，p = 0.005）。多元线性回归分析表明，焦虑和SIBO可能影响RAU的严重程度。此外，SAS评分（r = 0.38，p = 0.010）和SDS评分（r = 0.38，p = 0.009）与SIBO存在相关性。