局部用药在口腔黏膜疾病中的应用现状及展望  

Application status and prospects of topical drug therapy in oral mucosal diseases

作　　者：倪广成 但红霞[1] 赵行 陈谦明[1] NI Guangcheng;DAN Hongxia;ZHAO hang;CHEN Qianming(State Key Laboratory of Oral Diseases&National Clinical Research Cen-ter for Oral Diseases&Department of Oral Mucosa,West China Hospital of Stomatology,Sichuan University,Chengdu 610041,China;State Key Laboratory of Oral Diseases&National Clinical Research Center for Oral Diseases&West China Hospital of Stomatology,Sichuan University,Chengdu 610041,China)

机构地区：[1]口腔疾病研究国家重点实验室,国家口腔疾病临床医学研究中心,四川大学华西口腔医院黏膜科,四川成都610041 [2]口腔疾病研究国家重点实验室,国家口腔疾病临床医学研究中心,四川大学华西口腔医院,四川成都610041

出　　处：《口腔疾病防治》2022年第9期663-669,共7页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：国家自然科学基金项目(81922020,81970950);四川省科技计划项目(20ZDYF2890)。

摘　　要：口腔黏膜病是主要累及口腔黏膜及周围软组织的一类疾病总称。在口腔黏膜疾病治疗中,因解剖位置的特殊性,局部给药操作简便;药物易于在病损局部富集;同时还可以避免因全身用药而引起的不良反应。局部用药目前已成为口腔黏膜疾病治疗的重要甚至首选方案。临床常用的口腔黏膜局部用药种类多样,包括糖皮质激素如曲安奈德、免疫调节药物如他克莫司、消毒防腐药物如氯己定、止痛药物如利多卡因,中成药如芦荟凝胶等。这些局部药物中,以含漱液、喷雾剂等液体剂型应用最为广泛,这类制剂使用简便,但因口腔环境与功能的特殊性,并不利于药物局部停留。为解决这一问题,学者们对药物的剂型进行了不断改良,开发了一系列凝胶、软膏等半固体药物制剂,部分已在临床工作中发挥良好的疗效;此外,贴膜、贴片等固体药物制剂虽在口腔黏膜疾病临床治疗中鲜有应用,也已有大量基础研究被报道,并有望成为今后的主流剂型。总体而言,随着剂型的改良,局部给药在口腔黏膜疾病的治疗中发挥着越来越重要的作用。笔者将结合基础研究与临床报道,对局部用药在口腔黏膜疾病治疗中的应用现状进行综述。Oral mucosal disease is a general term for a type of disease that mainly affects the oral mucosa and surrounding soft tissues.In the treatment of oral mucosal diseases,due to the particularity of the anatomical location,the use of topical administration is relatively simple and convenient;drugs can easily accumulate in the lesions,and at the same time,they can also avoid adverse reactions caused by systemic drug delivery.Topical administration has become an important and even preferred option for the treatment of oral mucosal diseases.There are various types of topically used drugs for oral mucosal diseases,such as glucocorticoids(triamcinolone acetonide),immunomodulatory drugs(tacrolimus),antiseptic drugs(chlorhexidine),pain relievers(lidocaine) and proprietary Chinese medicines(aloe vera gel).Among these drugs,although the most widely used liquid formulations such as gargles and sprays are easy to use,they are not conducive to local retention of drugs due to the particularity of the oral environment and function.Based on this,researchers have continuously improved the dosage form of the drug,and developed a series of semi-solid pharmaceutical preparations such as gels and ointments,some of which have exerted good curative effects in clinical work.In addition,although films,patches and other solid oral mucosal topical pharmaceutical preparations have few clinical applications,they have also been widely researched and described and are expected to become the mainstream dosage form in the future.In general,with the improvement of dosage forms,topical administration is playing an increasingly important role in the treatment of oral mucosal diseases.Therefore,combined with basic research and clinical reports,this article reviews the application of topical drug delivery in the treatment of oral mucosal diseases.

关 键 词：口腔黏膜病 局部给药 药物剂型 含漱液 喷雾剂 凝胶 软膏 曲安奈德 他克莫司 氯己定 利多卡因 芦荟凝胶 

分 类 号：R78[医药卫生—口腔医学]