How does TCM treat recurrent canker sores?

Recurrent oral ulcers are one of the most common oral mucosal diseases in clinical practice, which tend to occur in parts with low keratinization of the oral mucosa, such as the tongue, lips, cheeks, soft palate and other mucosal parts, and the ulcers are round or oval.

The most troubling thing is that the disease recurs more frequently, which seriously interferes with people's daily life and mental state. At present, the cause of recurrent oral ulcers cannot be fully determined, but it is speculated that the pathological mechanism may be related to the lack of trace elements in the human body, the disorder of some bacteria in the oral cavity, immune system diseases, and microcirculation disorders.

According to the summary of clinical experience, it has also been found that the predisposing factors of recurrent oral ulcers include anxiety state, craving for spicy food, etc., and there is a certain genetic predisposition. Investigations have found that patients with a history of recurrent canker sores have significantly higher levels of depression and anxiety, and psychological stress is considered to be the main cause of ulcer recurrence.

In the clinical diagnosis of recurrent oral ulcers, special laboratory tests are often not required, and the diagnosis is mainly based on the clinical manifestations of local ulcer lesions such as red, yellow, painful, and pitted, as well as its self-limited, recurrent, and periodic historical characteristics.

There are three types of recurrent canker sores: mild, severe and herpetic, with mild recurrent canker sores being the most common. Diseases that need to be distinguished from recurrent oral ulcers in clinical practice include acute herpetic gingivostomatitis, traumatic ulcers, cancerous ulcers, tuberculous ulcers, etc. At present, there is no ideal method for radically curing recurrent oral ulcers at home and abroad.

Western medicine advocates symptomatic treatment for recurrent oral ulcers, and topical drugs are the main ones in the onset period, but topical drugs are often more irritating to the ulcer mucosa, and the long-term effect is not good, which cannot solve the problem of recurrent oral ulcers.

For patients with severe ulcer lesions, ulcers that are difficult to heal and frequent attacks, Western medicine advocates the use of oral hormones or immunomodulatory drugs for treatment, but due to the unknown cause of recurrent oral ulcers, the efficacy varies greatly in individuality, and these drugs often have side effects that cannot be ignored, and some patients are still prone to recurrence after stopping the drugs.

The holistic concept of TCM gives it a unique advantage in its understanding and treatment of the disease. There is a saying in the "Neijing": "All pains, itching and sores belong to fire", so when traditional Chinese medicine treats aphthous sores in clinical practice, it is often treated from the heat, but the "fire" needs to distinguish between real fire and virtual fire.

Patients with recurrent oral ulcers in clinical practice often have the most lingering and difficult to heal with cold and heat disorders, and most of these patients have a certain degree of anxiety.

Gypsum and cimicifuga are paired with lifting, gypsum is led by cimicifuga, up to the mouth, and the fire of the Qingyang Ming Meridian is used to treat the sores of the mouth and tongue. Cimicifuga penetrates evil and detoxifies, and with the help of gypsum, the power of clarity is significantly enhanced.

Honeysuckle and peony skin clear away heat, detoxify and cool blood to eliminate mouth sores. The whole side is used in combination with cold and heat, and the three cokes are taken care of, one is to adjust the cold and heat of the viscera, and the second is to adjust the air conditioner, vertical and horizontal, strong and soft, and there is a supplement in the line, so as to achieve the dual effect of promoting ulcer healing and reducing recurrence.

1. The understanding of the disease in traditional Chinese medicine

Traditional Chinese medicine recognized the disease of "recurrent mouth ulcers" as early as 2,000 years ago and named them "mouth ulcers", "mouth ulcers", etc. The causes of aphthous ulcers can be divided into external causes and internal causes, and the external causes are mostly related to weather changes, so that people are exposed to fire poison, damp poison, wind heat, etc., and the internal causes are generally spicy food, emotional internal injury, overwork or congenital endowment abnormalities.

Aphthous ulcers are manifested in the mouth and tongue, but they are closely related to multiple viscera. "The Yellow Emperor's Neijing" has a saying: "All pains, itches and sores belong to the heart", the tongue is the seedling of the heart, so the mouth sores are closely related to the heart;

According to the "Extracts of Medicine", if the spleen and soil are damp, they are prone to heat, causing dampness and heat fumigation, and the spleen opens in the mouth, causing aphthous ulcers, and the stomach meridians, liver meridians, and kidney meridians all pass through the lips, so they can all lead to the occurrence of aphthous ulcers.

2. The experience of syndrome differentiation and treatment of modern doctors

The severity of aphthous ulcer lesions can reflect its development status, and when treating aphthous ulcers, we should not only pay attention to the color of the local wound, but also pay attention to the clinical manifestations of the whole body, distinguish the false and the real in detail, and examine the causes and treatments, so as to achieve an overall grasp.

The pathogenesis of aphthous ulcers is mainly based on fire evil, and damp heat and poisonous stasis, so the treatment should distinguish the deficiency and reality of fire to treat it, and at the same time pay attention to harmonizing the spleen and stomach, regulating qi and blood, and then combining it with astringent muscle-building products for external use. There are four reasons why mouth ulcers are lingering and difficult to heal: phlegm and dampness, inflammation on the void fire, qi and blood depletion, and internal cessation of congestion.

The first is that the diet is not controlled, and the craving for spicy, fatty, sweet and thick flavor will cause phlegm dampness in the middle burn, and heat will be generated when it is wet, and the heat will cause aphthous sores when it occurs outside, and the phlegm and dampness will be trapped in the middle of the scorch, so it will recur;

The third is that the old age and the body are weak, the yin fire is high, and the qi and blood are exhausted, so it is difficult for the aphthous sores to heal; the fourth is that the sores are long, the blood stops in the veins, and the carrion is difficult to remove, so it is difficult to heal. The treatment should pay attention to phlegm, blood circulation, yin nourishment, and fire clearing, and then according to the actual situation, it should be supplemented with drugs such as clearing heat and detoxifying, dispelling dampness, and replenishing qi.

For recurrent oral ulcers, the treatment should be divided into stages, the "acute stage" should mainly be to clear the upper scorched heart and spleen, and the "remission stage" should be attacked and replenished, paying attention to the tonic spleen and stomach in the middle to achieve the effect of replenishing the soil and subduing the fire;

Most patients with recurrent aphthous ulcers do not see signs of real fire, but are often accompanied by typical spleen deficiency, so he believes that the local lesions of ulcers are only visible to the naked eye, and the syndrome should be carefully differentiated to determine whether the essence is medium-scorched spleen and soil deficiency.

The treatment of such patients should be based on tonifying the spleen and soil, and according to the situation, it should be supplemented with dampness and heat clearing. In addition, Professor Li commonly uses "wind medicine" in clinical practice, such as Qianghuo, Angelica dahurica, cimicifuga, etc., because the ulcer lesion is located in the oral cavity, the light and clear nature of wind medicine should be used to induce the medicine to go up, and relieve depression.

3. Basis for modern pharmacological research

1. Anti-inflammatory effect

Recurrent oral ulcers are a kind of chronic inflammation of the oral mucosa, and there are many active ingredients in the prescription that have anti-inflammatory activity, such as baicalin in skullcap, berberine in Coptis chinensis, aconitine and norwusine in aconite, methyl eugenol and safrole in asaroxin, saikosaponin and volatile oil in Bupleurum chinensis, etc.

Studies have found that these active ingredients can often act on multiple targets, and play a good anti-inflammatory role in vivo and in vitro by inhibiting inflammatory pathways, blocking the expression of pro-inflammatory cytokines, and reducing the release of inflammatory factors.

At the same time, some studies have found that the extract of Pseudostellaria stellariae has the effect of scavenging NO, can protect DNA, and is believed to reduce the inflammatory response induced by stress damage, and has the effect of repairing inflammatory damage.

1. Antimicrobial action

Many of the drugs in the prescription are rich in active ingredients with antimicrobial activity, which have an antibacterial effect on the ulcer lesions when rinsing. A number of pharmacological studies have shown that most of these ingredients have relatively strong and broad-spectrum antibacterial activity, which can inhibit a variety of bacteria and even fungi.

1. Immunomodulatory effects

Frequent episodes of recurrent canker sores may be related to an imbalance in the body's immune regulation. Drugs such as atractylodes, magnolia officinalis, and honeysuckle can carry out different degrees of immune regulation on the body, helping the human body to restore normal immune function, thereby reducing recurrence.

Studies have found that the polysaccharides in Atractylodes macrocephalus have the effect of increasing the weight of animal immune organs, accelerating the proliferation of immune cells, and protecting the immune system of intestinal mucosa.

In addition, animal studies have found that honeysuckle polysaccharides in honeysuckle and paeonol in peony skin have good immunomodulatory functions, which can significantly enhance the body's cellular immunity and humoral immunity, promote lymphocyte proliferation, enhance immune factor activity, and enhance antioxidant effect.

1. Analgesic effect

When recurrent oral ulcers occur, the lesion is often accompanied by a burning sensation that cannot be ignored, which affects the patient's diet and mood. The fine puncture, aconite, magnolia bark, etc. in the ulcer clearing formula can exert a good analgesic effect through different ways.

Pharmacological studies have shown that asaroxin has a good analgesic effect, and the active ingredient in it is methyleugenol, which can be used as a local anesthetic. Magnokiol in Magnolia officinalis has the effect of reducing inflammatory pain, and the pharmacological mechanism is related to its regulatory effect on the excitability of dorsal root ganglion cells.

1. Antidepressant anxiety effect

Patients with recurrent oral ulcers tend to have high levels of depression and anxiety, and mental stress is one of the main triggers for ulcer recurrence. The clear formula contains many active ingredients, which can alleviate anxiety and depression and reduce the mental sensitivity of patients.

Paeonia also has antidepressant effects, the main active ingredients of which are paeoniflorin and paeonioniolide. A number of experimental studies have shown that Magnolia officinalis has anti-depressant effects against a variety of neurological diseases, such as honokiol, and the active ingredients are honokiol and honokiol.

1. Regulates gastrointestinal function

Patients with recurrent oral ulcers with cold and heat syndrome have abnormal function of the spleen and stomach, often accompanied by digestive symptoms such as gastric discomfort, acid reflux, heartburn, and loss of appetite, which shows that there is a certain association between gastrointestinal dysfunction and recurrent oral ulcers.

Ulcer clearing prescription can play a role in regulating gastrointestinal function, improving the quality of life of patients and reducing recurrence. Paeonol contained in peony peel has the effect of protecting the gastric mucosa and has a certain therapeutic effect on gastric ulcers.

1. Supplement with trace elements

Deficiency of trace elements is also associated with the onset of recurrent canker sores. A number of pharmacological studies have shown that the prince ginseng and citrus aurantium husk in the Qingul formula are rich in a variety of trace elements, such as: potassium, calcium, iron, zinc, phosphorus, boron and so on.

IV. Conclusion

Recurrent oral ulcers are one of the most common oral mucosal diseases in clinical practice, and the pain and burning sensation of ulcer lesions are strong, which has a certain impact on the patient's diet, speech, and even spirit. The most troubling thing is that the disease recurs more frequently, which seriously interferes with people's daily life and mental state.

At present, the cause of recurrent oral ulcers cannot be fully determined, but it is speculated that the pathological mechanism may be related to the lack of trace elements in the human body, the disorder of some bacteria in the oral cavity, immune system diseases, and microcirculation disorders.

At present, there is no specific method to cure recurrent oral ulcers, Western medicine has certain limitations in the treatment of recurrent oral ulcers, it advocates symptomatic treatment, the attack period is mainly topical medication, but the long-term effect is not good, for patients with severe ulcer lesions, ulcers are difficult to heal and frequent attacks, the use of hormones or immune-modulating drugs is advocated, but there are many side effects, and it is still easy to recur after discontinuation.

The unique holistic concept and syndrome differentiation and treatment concept of TCM make it unique in its understanding and treatment of this disease. Ulcer clearing prescription can effectively shorten the ulceration period of recurrent oral ulcers, relieve the symptoms of local lesions, and reduce pain.

Ulcer clearing can effectively improve the TCM symptoms of patients with cold and heat syndrome, improve the anxiety and depression of patients, and reduce the frequency of recurrent oral ulcers.

That's all for this article, if you have any questions, you can let me know in the comments section and we'll discuss them together.