目的 分析灼口综合征接受低能量激光联合维生素治疗的效果及对唾液淀粉酶（AMS）、基质金属蛋白酶-9（MMP-9）、分泌型免疫球蛋白A（SIgA）水平的影响。 方法 通过随机数字表法将2023年11月至2025年4月衡水市人民医院收治的灼口综合征患者174例分为维生素组（n = 58）、低能量激光组（n = 58）、联合组（n = 58）。维生素组口服维生素E 100 mg+谷维素10 mg+维生素B₂ 10 mg治疗，低能量激光组在接受低能量激光治疗、联合组接受口服维生素结合低能量激光治疗。10 d为1个疗程，3组患者共治疗2个疗程。比较3组治疗2个疗程后疗效，治疗前、治疗2个疗程后唾液分泌、疼痛、唾液AMS、MMP-9、SIgA水平、血清脑源性神经营养因子（BDNF）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）水平、焦虑、抑郁及睡眠评分，治疗期间安全性。 结果 联合组总有效率为94.83%，高于维生素组的75.86%、低能量激光组的79.31%（P < 0.05）。相较治疗前，治疗2个疗程后3组静息状态下唾液流量、刺激状态下唾液流量、唾液AMS、SIgA水平、血清BDNF水平升高，且联合组更高（P < 0.05）。相较治疗前，治疗2个疗程后3组视觉模拟评分（VAS）评分、唾液MMP-9水平、血清IL-6、TNF-α水平，广泛性焦虑量表（GAD-7）、健康问卷抑郁量表（PHQ-9）、匹兹堡睡眠质量指数量表（PSQI）评分降低，且联合组更低（P < 0.05）。3组治疗期间均无严重不良反应报告，均完成全程治疗。 结论 在口服维生素的基础上，应用低能量激光可促进灼口综合征患者唾液分泌，降低疼痛，改善焦虑、抑郁情况及睡眠质量，调节唾液AMS、MMP-9、SIgA及血清BDNF、IL-6、TNF-α水平，进而改善口腔功能并降低神经炎症，安全性良好。

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.