关键词: 灼口综合征, 低能量激光, 维生素, 唾液分泌, 淀粉酶, 基质金属蛋白酶-9, 分泌型免疫球蛋白A, 疼痛

Abstract:

Objective To analyze the impact of low-energy laser in combination with vitamin therapy on burning mouth syndrome and its effects on the levels of salivary amylase （AMS）， matrix metalloproteinase-9 （MMP-9）， and secretory immunoglobulin A （SIgA）. Methods A total of 174 patients diagnosed with burning mouth syndrome who were admitted to our hospital between November 2023 and April 2025 were randomly assigned to three groups-the vitamin group （n = 58）， the low-energy laser group （n = 58）， and the combined group （n = 58） using a random number table. In the vitamin group， patients were treated with oral administration of 100 mg of vitamin E， 10 mg of oryvertin， and 10 mg of vitamin B₂. The low-energy laser group received low-energy laser treatment， while the combined group was treated with oral vitamins in combination with low-energy laser. Each treatment course spanned 10 days， and all three groups underwent two treatment courses. The efficacy after two treatment courses， salivary flow， pain level， salivary α-AMS， MMP-9， SIgA， serum brain-derived neurotrophic factor （BDNF）， interleukin-6 （IL-6）， tumor necrosis factor-α （TNF-α）， anxiety， depression， and sleep quality were compared between the three groups both before and after two treatment courses. Additionally， the safety during the treatment period was also compared. Results The overall effective rate of the combined group reached 94.83%， which was significantly higher than the 75.86% in the vitamin group and 79.31% in the low-energy laser group （P < 0.05）. When compared with the baseline values， the unstimulated and stimulated salivary flow， salivary AMS and SIgA levels， as well as serum BDNF levels， all showed an increase after two treatment courses in the three groups. Among them， the combined group exhibited the most substantial increments （P < 0.05）. Similarly， the visual analogue scale （VAS） pain scores， salivary MMP-9 levels， serum IL-6 and TNF-α levels， scores of the Generalized Anxiety Disorder-7 （GAD-7）， Patient Health Questionnaire-9 （PHQ-9）， and Pittsburgh Sleep Quality Index （PSQI） all decreased in all three groups. The combined group had the most significant reductions （P < 0.05）. Throughout the treatment period， no serious adverse reactions were reported in either group， and all patients successfully completed the full course of treatment. Conclusions Supplementation with oral vitamins combined with low - level laser therapy can enhance saliva secretion， relieve pain， alleviate anxiety and depression， and improve sleep quality in patients with burning mouth syndrome. This regimen modulates salivary AMS， MMP-9， and SIgA， as well as serum BDNF， IL-6， and TNF-α. Consequently， it improves oral function and reduces neuro- inflammation while ensuring good safety.

Key words: burning mouth syndrome, low-energy laser therapy, vitamins, saliva secretion, amylase, matrix metalloproteinase-9, secretory immunoglobulin A, pain