肿痛安胶囊联合甲硝唑片治疗慢性牙周炎40例
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摘要
目的:观察肿痛安胶囊联合甲硝唑片治疗慢性牙周炎的临床疗效。方法:将120例慢性牙周炎患者按照随机数字表法分为对照组A、对照组B和治疗组,每组各40例,同时选择30名健康受试者为健康对照组。所有患者均予以基础治疗,对照组A口服甲硝唑片,对照组B口服肿痛安胶囊,治疗组口服肿痛安胶囊联合甲硝唑片。比较三组患者的临床疗效,检测各组患者治疗前后牙周指标、血清和龈沟液炎性因子[白细胞介素-17(interleukin-17,IL-17)、白细胞介素-23(interleukin-23,IL-23)、白细胞介素-10(interleukin-10,IL-10)和转化生长因子-β(transforming growth factor-β,TGF-β)]。结果:对照组A与对照组B有效率比较,差异无统计学意义(P> 0. 05),治疗组有效率高于对照组A和对照组B,差异具有统计学意义(P <0. 05)。各组患者治疗后牙周指标均有改善,治疗组各项指标最接近健康对照组。各组患者治疗后血清及龈沟液IL-17和IL-23水平低于治疗前,差异具有统计学意义(P <0. 05),但对照组A和对照组B治疗后血清及龈沟液IL-17和IL-23水平仍显著高于健康对照组(P <0. 05),治疗组治疗后血清及龈沟液IL-17和IL-23水平与健康对照组比较,差异无统计学意义(P> 0. 05)。三组患者治疗前后血清及龈沟液IL-10和TGF-β水平比较,差异无统计学意义(P> 0. 05)。结论:肿痛安胶囊联合甲硝唑片治疗慢性牙周炎可改善患者临床症状。
Objective: To observe the clinical curative effect of Zhongtongan Capsules( ZTAC) on chronic periodontitis. Methods: A total of 120 patients with moderate to severe chronic periodontitis were divided into the control group A,the control group B and the treatment group according to random number table method,with 40 cases in each group. At the same time,30 healthy subjects were selected as the healthy control group. All the patients were given basic treatment. The control group A was additionally given Metronidazole Tablets. The control group B was additionally given ZTAC. The treatment group was additionally given ZTAC and Metronidazole Tablets together. The clinical effects of three groups were compared,and the periodontal indexes,serum and gingival crevicular fluid inflammatory factors,including interleukin-17( IL-17),interleukin-23( IL-23) interleukin-10( IL-10) and transforming growth factor-β( TGF-β) were measured before and after the treatment. Results: There was no significant difference in the effective rate between the control group A and the control group B( P > 0. 05). The effective rate of treatment group was higher than that of control group A and that of the control group B,and the difference was statistically significant( P < 0. 05). After the treatment,the periodontal indexes of each group were improved,and those of the treatment group were closest to those of the healthy control group. Compared with before the treatment,the levels of IL-17 and IL-23 in serum and gingival crevicular fluid of each group after the treatment were lower than those before the treatment,and all the differences were statistically significant( P <0. 05). But the levels of IL-17 and IL-23 in serum and gingival crevicular fluid of the control group A and the control group B after the treatment were still significantly higher than those of the healthy control group( P < 0. 05).-There was no significant difference in the levels of 17 and IL-23 between the treatment group and the healthy control group( P > 0. 05). There was no significant difference in the levels of IL-10 and TGF-β in serum and gingival crevicular fluid between the three groups before and after the treatment( P > 0. 05). Conclusion: ZTAC can be used as an adjunct to the treatment of chronic periodontitis,which can improve the clinical symptoms of patients.
Objective: To observe the clinical curative effect of Zhongtongan Capsules( ZTAC) on chronic periodontitis. Methods: A total of 120 patients with moderate to severe chronic periodontitis were divided into the control group A,the control group B and the treatment group according to random number table method,with 40 cases in each group. At the same time,30 healthy subjects were selected as the healthy control group. All the patients were given basic treatment. The control group A was additionally given Metronidazole Tablets. The control group B was additionally given ZTAC. The treatment group was additionally given ZTAC and Metronidazole Tablets together. The clinical effects of three groups were compared,and the periodontal indexes,serum and gingival crevicular fluid inflammatory factors,including interleukin-17( IL-17),interleukin-23( IL-23) interleukin-10( IL-10) and transforming growth factor-β( TGF-β) were measured before and after the treatment. Results: There was no significant difference in the effective rate between the control group A and the control group B( P > 0. 05). The effective rate of treatment group was higher than that of control group A and that of the control group B,and the difference was statistically significant( P < 0. 05). After the treatment,the periodontal indexes of each group were improved,and those of the treatment group were closest to those of the healthy control group. Compared with before the treatment,the levels of IL-17 and IL-23 in serum and gingival crevicular fluid of each group after the treatment were lower than those before the treatment,and all the differences were statistically significant( P <0. 05). But the levels of IL-17 and IL-23 in serum and gingival crevicular fluid of the control group A and the control group B after the treatment were still significantly higher than those of the healthy control group( P < 0. 05).-There was no significant difference in the levels of 17 and IL-23 between the treatment group and the healthy control group( P > 0. 05). There was no significant difference in the levels of IL-10 and TGF-β in serum and gingival crevicular fluid between the three groups before and after the treatment( P > 0. 05). Conclusion: ZTAC can be used as an adjunct to the treatment of chronic periodontitis,which can improve the clinical symptoms of patients.
引文
[1]李吉海,李春晖,曹正国,等.替硝唑局部用药治疗牙周炎的临床疗效及安全性评价[J].临床和实验医学杂志,2014,13(4):276-279.
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[10]CHEN X T,CHEN L L,TAN J Y,et al.Th17 and Th1 lymphocytes are correlated with chronic periodontitis[J].Immunol Invest,2016,45(3):243-254.
[11]WANG L Y,WANG J Y,JIN Y,et al.Oral administration of alltrans retinoic acid suppresses experimental periodontitis by modulating the Th17/Treg imbalance[J].J Periodontol,2014,85(5):740-750.
[12]袁琴,刘朝奇,袁丁.Th17细胞和调节性T细胞在炎症性疾病中的研究进展[J].细胞与分子免疫学杂志,2016,32(4):564-567.
[13]ZHANG Q Y,LIU S,GE D X,et al.Targeting Th17-IL-17pathway in prevention of micro-invasive prostate cancer in a mouse model[J].Prostate,2017,77(8):888-899.
[14]LEE H S,PARK H W,SONG W J,et al.TNF-αenhance Th2and Th17 immune responses regulating by IL23 during sensitization in asthma model[J].Cytokine,2016,79(3):23-30.
[15]鲍文华,梁建合,李树民,等.Th17细胞和IL-23/IL-17轴在肺纤维化大鼠肺组织动态表达的意义[J].医学研究生学报,2014,27(3):240-244.
[16]WATANABE N,KAMINUMA O,KITAMURA N,et al.Induced treg cells augment the Th17-mediated intestinal inflammatory response in a CTLA4-dependent manner[J].PLo S One,2016,11(3):e0150244.
[17]DAI W,LIU F,LI C,et al.Blockade of wnt/β-catenin pathway aggravated silica-induced lung inflammation through tregs regulation on th immune responses[J].Mediators of Inflammation,2016,47(4):1-14.
[18]GüRKAN A,EMINGIL G,CINARCIK S,et al.Gingival crevicular fluid transforming growth factor-beta1 in several forms of periodontal disease[J].Arch Oral Biol,2006,51(10):906-912.
[19]赵华兵.慢性牙周炎不同临床阶段龈沟液及血清中Th17和Treg的相关细胞因子的检测[D].石家庄:河北医科大学,2016.
[2]孟焕新.牙周病学[M].3版.北京:人民卫生出版社,2008:4.
[3]BUENO A C,FERREIRA R C,COTA L O,et al.Comparison of different criteria for periodontitis case definition in head and neck cancer individuals[J].Support Care Cancer,2015,23(9):2599-2604.
[4]赵娜,方慧,唐亚平,等.MAPK信号转导通路与慢性牙周炎的相关研究进展[J].口腔医学研究,2017,33(9):1012-1015.
[5]KNIGHT E T,LIU J,SEYMOUR G J,et al.Risk factors that may modify the innate and adaptive immune responses in periodontal diseases[J].Periodontol,2000,2016,71(1):22-51.
[6]ANDRUKHOV O,HONG J S,ANDRUKHOVA O,et al.Response of human periodontal ligament stem cells to IFN-γand TLR-agonists[J].Sci Rep,2017,7(1):12856.
[7]GEMMELL E,YAMAZAKI K,SEYMOUR G J.Destructive periodontitis lesions are determined by the nature of the lymphocytic response[J].Crit Rev Oral Biol Med,2002,13(1):17-34.
[8]BERGLUNDH T,DONATI M.Aspects of adaptive host response in periodontitis[J].J Clin Periodontol,2005,32(Suppl 6):87-107.
[9]SOUTO G R,QUEIROZ-JUNIOR C M,DE ABREU M H,et al.Pro-inflammatory,Th1,Th2,Th17 cytokines and dendritic cells:A cross-sectional study in chronic periodontitis[J].PLo S One,2014,9(3):e91636.
[10]CHEN X T,CHEN L L,TAN J Y,et al.Th17 and Th1 lymphocytes are correlated with chronic periodontitis[J].Immunol Invest,2016,45(3):243-254.
[11]WANG L Y,WANG J Y,JIN Y,et al.Oral administration of alltrans retinoic acid suppresses experimental periodontitis by modulating the Th17/Treg imbalance[J].J Periodontol,2014,85(5):740-750.
[12]袁琴,刘朝奇,袁丁.Th17细胞和调节性T细胞在炎症性疾病中的研究进展[J].细胞与分子免疫学杂志,2016,32(4):564-567.
[13]ZHANG Q Y,LIU S,GE D X,et al.Targeting Th17-IL-17pathway in prevention of micro-invasive prostate cancer in a mouse model[J].Prostate,2017,77(8):888-899.
[14]LEE H S,PARK H W,SONG W J,et al.TNF-αenhance Th2and Th17 immune responses regulating by IL23 during sensitization in asthma model[J].Cytokine,2016,79(3):23-30.
[15]鲍文华,梁建合,李树民,等.Th17细胞和IL-23/IL-17轴在肺纤维化大鼠肺组织动态表达的意义[J].医学研究生学报,2014,27(3):240-244.
[16]WATANABE N,KAMINUMA O,KITAMURA N,et al.Induced treg cells augment the Th17-mediated intestinal inflammatory response in a CTLA4-dependent manner[J].PLo S One,2016,11(3):e0150244.
[17]DAI W,LIU F,LI C,et al.Blockade of wnt/β-catenin pathway aggravated silica-induced lung inflammation through tregs regulation on th immune responses[J].Mediators of Inflammation,2016,47(4):1-14.
[18]GüRKAN A,EMINGIL G,CINARCIK S,et al.Gingival crevicular fluid transforming growth factor-beta1 in several forms of periodontal disease[J].Arch Oral Biol,2006,51(10):906-912.
[19]赵华兵.慢性牙周炎不同临床阶段龈沟液及血清中Th17和Treg的相关细胞因子的检测[D].石家庄:河北医科大学,2016.