中药方剂联合西药口服治疗慢性牙周炎的效果及对牙龈组织中ICAM-1表达的影响
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摘要
目的:探讨中药方剂联合西药口服治疗慢性牙周炎的效果及对牙龈组织中细胞间黏附分子-1(ICAM-1)表达的影响。方法:选择2017年1月-2018年1月东莞市石碣医院口腔门诊收治的慢性牙周炎患者80例为研究对象,按照随机数字表法分成观察A组和观察B组,每组40例;另选择同期性别年龄相匹配的健康牙龈患者40例为对照组。观察B组采用常规牙周基础及西药口服治疗,观察A组在此基础上,根据患者的中医辨证分型自拟方剂辅助治疗,观察比较两组慢性牙周炎患者的临床疗效,采用免疫组化Elivsion法检测比较三组患者牙龈组织中ICAM-1表达水平。结果:观察A组的治疗总有效率(92.50%)明显高于观察B组(72.50%),差异有统计学意义(P<0.05)。观察A组和观察B组患者的牙龈组织中ICAM-1表达均显著高于对照组(P<0.05),而观察A组和观察B组患者治疗前牙龈组织中ICAM-1阳性表达率比较,差异无统计学意义(P>0.05)。治疗后,观察A组患者牙龈组织中ICAM-1阳性表达率明显较治疗前下降(P<0.05),而观察B组患者牙龈组织中ICAM-1阳性表达率变化不明显,观察A组牙龈组织中ICAM-1阳性表达率明显低于观察B组(P<0.05)。结论:中药方剂联合西药口服治疗能有效提高慢性牙周炎的治疗效果;慢性牙周炎患者的牙龈组织中存在ICAM-1过表达,中药方剂能抑制ICAM-1的表达,进而减少炎症反应和组织破坏。
Objective:To explore the curative effect of traditional Chinese medicine prescription combined with western medicine on chronic periodontitis and the expression of ICAM-1 in gingival tissue.Method:A total of 80 patients with chronic periodontitis of Shijie Hospital of Dongguan City from January 2017 to January 2018 were selected as study objects,and they were randomly divided into observation group A and observation group B,40 cases in each group.Another 40 healthy gingival patients with matching gender and age at the same time were selected as the control group.Observation group B was treated with conventional periodontal and oral administration of western medicine.On the basis of observation group B,observation group A was treated with traditional Chinese medicine prescription.The clinical efficacy of two groups was observed and the ICAM-1 expression level in the gingival tissue of three groups were detected by Elivsion method.Result:The treatment efficiency of the observation group A(92.50%)was significantly higher than that of the observation group B(72.50%),there was statistical significance(P<0.05).ICAM-1 expression in the gingival tissues of both observation group A and B were significantly higher than that of the control group(P<0.05),while the positive expression rate of ICAM-1 in the gingival tissues of observation group A and B before treatment showed no significant difference(P>0.05).After treatment,the positive expression of ICAM-1 rate of the observation group A reduced significantly than that of before treatment(P<0.05),while the positive expression of ICAM-1 rate of the observation group B changed a little,and the positive expression rate of ICAM-1 of the observation group A was significantly lower than that of the observation group B(P<0.05).Conclusion:The combination of traditional Chinese medicine prescription and western medicine periodontal can effectively improve the therapeutic effect of chronic periodontitis.ICAM-1 overexpression exists in gingival tissue of patients with chronic periodontitis.Traditional Chinese medicine prescription can inhibit the expression of ICAM-1 and thus reduce the inflammatory reaction and tissue destruction.
Objective:To explore the curative effect of traditional Chinese medicine prescription combined with western medicine on chronic periodontitis and the expression of ICAM-1 in gingival tissue.Method:A total of 80 patients with chronic periodontitis of Shijie Hospital of Dongguan City from January 2017 to January 2018 were selected as study objects,and they were randomly divided into observation group A and observation group B,40 cases in each group.Another 40 healthy gingival patients with matching gender and age at the same time were selected as the control group.Observation group B was treated with conventional periodontal and oral administration of western medicine.On the basis of observation group B,observation group A was treated with traditional Chinese medicine prescription.The clinical efficacy of two groups was observed and the ICAM-1 expression level in the gingival tissue of three groups were detected by Elivsion method.Result:The treatment efficiency of the observation group A(92.50%)was significantly higher than that of the observation group B(72.50%),there was statistical significance(P<0.05).ICAM-1 expression in the gingival tissues of both observation group A and B were significantly higher than that of the control group(P<0.05),while the positive expression rate of ICAM-1 in the gingival tissues of observation group A and B before treatment showed no significant difference(P>0.05).After treatment,the positive expression of ICAM-1 rate of the observation group A reduced significantly than that of before treatment(P<0.05),while the positive expression of ICAM-1 rate of the observation group B changed a little,and the positive expression rate of ICAM-1 of the observation group A was significantly lower than that of the observation group B(P<0.05).Conclusion:The combination of traditional Chinese medicine prescription and western medicine periodontal can effectively improve the therapeutic effect of chronic periodontitis.ICAM-1 overexpression exists in gingival tissue of patients with chronic periodontitis.Traditional Chinese medicine prescription can inhibit the expression of ICAM-1 and thus reduce the inflammatory reaction and tissue destruction.
引文
[1]董允允,宋立婷,朱东望,等.慢性牙周炎患者和健康人牙龈成纤维细胞细胞活性和凋亡的比较研究[J].口腔医学研究,2016,32(5):474-477.
[2]王欣欣.中药辨证联合替硝唑注射液在牙周炎治疗中疗效分析[J].内蒙古中医药,2017,8(17):31-32.
[3]王焕文.中药口腔含漱液对慢性牙周炎抗菌斑作用及其对牙周指数影响研究[J].福建中医药,2017,48(4):12-14.
[4]林宵辉,蔡剑林,梁景星,等.滋阴降火中药治疗中重度慢性牙周炎疗效及对龈沟液中炎性因子、病原菌的影响[J].现代中西医结合杂志,2017,5(7):3378-3380.
[5]孟焕新.牙周病学[M].3版.北京:人民卫生出版社,2011:118-124,202-205.
[6]郭立华,高维诺,路丽,等.中药方剂对牙周炎大鼠牙周组织影响研究[J].中华中医药杂志,2015,12(8):3001-3003.
[7]陈飞,焦鹏,车鸿泽,等.中药双黄补联合西帕依固龈液对种植体周围炎患者牙周炎症的改善作用及其临床意义[J].吉林大学学报(医学版),2017,10(6):1226-1230.
[8]刘迪.研究中药银黄牙周冲洗液在早期牙周病治疗中的应用[J].中国继续医学教育,2016,9(7):185-186.
[9]李春,董福生,李淑娟,等.大鼠实验性牙周炎局部治疗后牙周组织及血清中CRP、ICAM-1、E-selectin变化的研究[J].牙体牙髓牙周病学杂志,2015,25(2):95-99.
[10]李春年,武明轩,陈瑞雪,等.CRP、ICAM-1、E-selectins在实验性牙周炎大鼠牙周组织中的表达及意义[J].口腔医学研究,2015,31(2):109-112.
[11]李炜.清热解毒中药合剂治疗牙周炎的临床疗效及对患牙龈沟液和血清中TNF-α及IL-1β的影响[J].四川中医,2016,34(9):142-145.
[12]李晋凤,魏秀玲,曾惠玲,等.龈上洁治术与牙周非手术治疗对单纯中重度牙周炎患者肱踝脉搏波传导速度、踝臂指数和sICAM-1的影响比较[J].临床和实验医学杂志,2018,14(8):876-879.
[13]刘奕,王峰,鄂玲玲,等.牙龈卟啉单胞菌脂多糖在高糖条件下对人脐静脉内皮细胞表达ICAM-1的影响[J].中华老年口腔医学杂志,2016,2(2):83-86.
[14]张冬梅,常春荣,潘亚萍,等.NF-κB/IκB信号通路对牙龈卟啉单胞菌感染诱导血管内皮细胞ICAM-1表达调控研究[J].中国实用口腔科杂志,2013,10(7):417-420.
[15]侯萌,王苹,魏玲玲,等.细胞间黏附分子-1与牙周炎的关系[J].牙体牙髓牙周病学杂志,2014,24(8):491-494.
[16]胡馨元,毕良佳,王梦溪,等.大鼠咬合创伤牙周膜中MCP-1、ICAM-1的表达变化[J].现代生物医学进展,2015,4(32):6234-6237.
[17]刘玉三,毕良佳,林江,等.MCP-1和ICAM-1在大鼠实验性牙周炎牙周纤维中的表达[J].牙体牙髓牙周病学杂志,2013,23(9):107-110.
[18]任静,杨军英,陶军,等.牙周非手术治疗对动脉硬度和血清s ICAM-1的影响[J].中山大学学报(医学科学版),2015,11(1):66-70.
[19]范芹,管晓燕,李小娜,等.TP对脂多糖介导人牙周膜成纤维细胞细胞间黏附分子-1表达的影响[J].口腔医学研究,2018,34(10):1089-1092.
[2]王欣欣.中药辨证联合替硝唑注射液在牙周炎治疗中疗效分析[J].内蒙古中医药,2017,8(17):31-32.
[3]王焕文.中药口腔含漱液对慢性牙周炎抗菌斑作用及其对牙周指数影响研究[J].福建中医药,2017,48(4):12-14.
[4]林宵辉,蔡剑林,梁景星,等.滋阴降火中药治疗中重度慢性牙周炎疗效及对龈沟液中炎性因子、病原菌的影响[J].现代中西医结合杂志,2017,5(7):3378-3380.
[5]孟焕新.牙周病学[M].3版.北京:人民卫生出版社,2011:118-124,202-205.
[6]郭立华,高维诺,路丽,等.中药方剂对牙周炎大鼠牙周组织影响研究[J].中华中医药杂志,2015,12(8):3001-3003.
[7]陈飞,焦鹏,车鸿泽,等.中药双黄补联合西帕依固龈液对种植体周围炎患者牙周炎症的改善作用及其临床意义[J].吉林大学学报(医学版),2017,10(6):1226-1230.
[8]刘迪.研究中药银黄牙周冲洗液在早期牙周病治疗中的应用[J].中国继续医学教育,2016,9(7):185-186.
[9]李春,董福生,李淑娟,等.大鼠实验性牙周炎局部治疗后牙周组织及血清中CRP、ICAM-1、E-selectin变化的研究[J].牙体牙髓牙周病学杂志,2015,25(2):95-99.
[10]李春年,武明轩,陈瑞雪,等.CRP、ICAM-1、E-selectins在实验性牙周炎大鼠牙周组织中的表达及意义[J].口腔医学研究,2015,31(2):109-112.
[11]李炜.清热解毒中药合剂治疗牙周炎的临床疗效及对患牙龈沟液和血清中TNF-α及IL-1β的影响[J].四川中医,2016,34(9):142-145.
[12]李晋凤,魏秀玲,曾惠玲,等.龈上洁治术与牙周非手术治疗对单纯中重度牙周炎患者肱踝脉搏波传导速度、踝臂指数和sICAM-1的影响比较[J].临床和实验医学杂志,2018,14(8):876-879.
[13]刘奕,王峰,鄂玲玲,等.牙龈卟啉单胞菌脂多糖在高糖条件下对人脐静脉内皮细胞表达ICAM-1的影响[J].中华老年口腔医学杂志,2016,2(2):83-86.
[14]张冬梅,常春荣,潘亚萍,等.NF-κB/IκB信号通路对牙龈卟啉单胞菌感染诱导血管内皮细胞ICAM-1表达调控研究[J].中国实用口腔科杂志,2013,10(7):417-420.
[15]侯萌,王苹,魏玲玲,等.细胞间黏附分子-1与牙周炎的关系[J].牙体牙髓牙周病学杂志,2014,24(8):491-494.
[16]胡馨元,毕良佳,王梦溪,等.大鼠咬合创伤牙周膜中MCP-1、ICAM-1的表达变化[J].现代生物医学进展,2015,4(32):6234-6237.
[17]刘玉三,毕良佳,林江,等.MCP-1和ICAM-1在大鼠实验性牙周炎牙周纤维中的表达[J].牙体牙髓牙周病学杂志,2013,23(9):107-110.
[18]任静,杨军英,陶军,等.牙周非手术治疗对动脉硬度和血清s ICAM-1的影响[J].中山大学学报(医学科学版),2015,11(1):66-70.
[19]范芹,管晓燕,李小娜,等.TP对脂多糖介导人牙周膜成纤维细胞细胞间黏附分子-1表达的影响[J].口腔医学研究,2018,34(10):1089-1092.