葛根芩连汤联合正畸治疗对重度牙周炎患者的疗效及安全性分析
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摘要
目的:探究葛根芩连汤联合正畸治疗对重度牙周炎患者的疗效及安全性。方法:选取2017年3月至2018年5月北京武警总医院口腔科收治的重度牙周炎患者107例,按照随机数字表法随机分为对照组(n=53)和观察组(n=54),所有患者均给予牙周基础治疗,对照组在牙周基础治疗的基础上联合正畸治疗,观察组在对照组的基础上联合葛根芩连汤治疗,2组均连续治疗3个月。治疗后统计2组临床疗效,比较2组治疗前后主要中医症状改善情况、牙周指标改善情况,检测龈沟液中炎性因子水平变化;记录并比较2组患者治疗期间相关不良反应发生情况。结果:治疗后观察组临床总有效率高达96. 30%,较对照组的75. 47%升高(P <0. 01);与治疗前比较,治疗后2组口臭、牙龈红肿、牙龈出血、牙齿松动、牙周溢脓、尿黄主要中医证侯积分及SBI、GI、PLI均降低(P <0. 01),且观察组低于对照组(P <0. 01); 2组PD缩短,且观察组短于对照组(P <0. 01);与治疗前比较,观察组龈沟液中IL-6、IL-1β、TNF-α、PGE2水平降低(P <0. 01),且低于对照组(P <0. 01);治疗期间2组患者均未见严重不良反应。结论:葛根芩连汤联合正畸治疗可显著改善重度牙周炎患者临床症状、牙周指标,且可有效降低机体炎性因子水平,抑制牙周炎性反应,疗效显著优于单独正畸治疗,且具有较高的安全性。
Objective: To explore the efficacy and safety of Gegen Qinlian Decoction combined with orthodontic treatment for severe periodontitis patients. Methods: A total of 107 cases of patients with severe periodontitis patients that admitted in our hospital stomatology department from March 2017 to May 2018 were selected and divided into control group( n = 53) and observation group( n = 54) according to random number table method. All patients were treated with basic periodontal therapy,control group was treated with orthodontic treatment on the basis of basic periodontal therapy,observation group was treated with Gegen Qinlian Decoction on the basis of control group,2 groups were treated for 3 months continuously. The clinical efficacy in 2 groups were detected after treatment,the improvement circumstance of major Traditional Chinese Medicine( TCM) syndromes,periodontal indicators and the changes of inflammatory factors levels in gingival crevicular fluid in 2 groups before and after treatment were detected and compared; the occurrence of related untoward reaction during the treatment in 2 groups were recorded and compared. Results: The total clinical effective rate of observation group increased to 96. 30%,which was higher than 75. 47% of control group( P < 0. 01);compared with before treatment data,the major Traditional Chinese Medicine( TCM) points of bad breath,swollen gums,bleeding gums,loose teeth,periodontal overflow pus,urine yellow and SBI,GI,PLI decreased in 2 groups after treatment,and observation group was lower than control group( P < 0. 01); the PD shortened in 2 groups,and observation group was shorter than control group( P < 0. 01); compared with before treatment data,the IL-6,IL-1β,TNF-α,PGE2 levels in gingival crevicular fluid of observation group decreased after treatment,which were lower than those of control group( P < 0. 01); there was no severe adverse reactions of patients in 2 groups during the treatment. Conclusion: Gegen Qinlian Decoction combined with orthodontic treatment can improve the clinical symptoms,periodontal indicators of severe periodontitis patients effectively,and reduce the body's inflammatory factors levels remarkably,inhibit the periodontal inflammatory response,the clinical efficacy is better than orthodontic treatment alone,and which has higher security.
Objective: To explore the efficacy and safety of Gegen Qinlian Decoction combined with orthodontic treatment for severe periodontitis patients. Methods: A total of 107 cases of patients with severe periodontitis patients that admitted in our hospital stomatology department from March 2017 to May 2018 were selected and divided into control group( n = 53) and observation group( n = 54) according to random number table method. All patients were treated with basic periodontal therapy,control group was treated with orthodontic treatment on the basis of basic periodontal therapy,observation group was treated with Gegen Qinlian Decoction on the basis of control group,2 groups were treated for 3 months continuously. The clinical efficacy in 2 groups were detected after treatment,the improvement circumstance of major Traditional Chinese Medicine( TCM) syndromes,periodontal indicators and the changes of inflammatory factors levels in gingival crevicular fluid in 2 groups before and after treatment were detected and compared; the occurrence of related untoward reaction during the treatment in 2 groups were recorded and compared. Results: The total clinical effective rate of observation group increased to 96. 30%,which was higher than 75. 47% of control group( P < 0. 01);compared with before treatment data,the major Traditional Chinese Medicine( TCM) points of bad breath,swollen gums,bleeding gums,loose teeth,periodontal overflow pus,urine yellow and SBI,GI,PLI decreased in 2 groups after treatment,and observation group was lower than control group( P < 0. 01); the PD shortened in 2 groups,and observation group was shorter than control group( P < 0. 01); compared with before treatment data,the IL-6,IL-1β,TNF-α,PGE2 levels in gingival crevicular fluid of observation group decreased after treatment,which were lower than those of control group( P < 0. 01); there was no severe adverse reactions of patients in 2 groups during the treatment. Conclusion: Gegen Qinlian Decoction combined with orthodontic treatment can improve the clinical symptoms,periodontal indicators of severe periodontitis patients effectively,and reduce the body's inflammatory factors levels remarkably,inhibit the periodontal inflammatory response,the clinical efficacy is better than orthodontic treatment alone,and which has higher security.
引文
[1]魏欣欣,刘帮国,李明春,等.牙周局部缓释药物治疗牙周炎的研究进展[J].中国医院药学杂志,2016,36(17):1524-1529.
[2]王亚玲,曹直.应用种植体修复后慢性牙周炎老年患者的IL-2、IL-8水平变化及疗效分析[J].贵州医药,2016,40(11):1184-1185.
[3]姚霜,刘晓君,周治,等.咬合调整对牙周炎正畸治疗患者牙周状况的影响[J].国际口腔医学杂志,2017,44(1):50-54.
[4]李海燕,林洋洋,徐丹,等.干黄茶乳剂对慢性牙周炎患者龈沟液中TNF-α、IL-6和IL-10水平的影响及疗效观察[J].世界中医药,2016,11(2):259-261.
[5]罗欣.葛根芩连汤对慢性牙周炎合并动脉粥样硬化大鼠超敏C-反应蛋白的影响[D].唐山:华北理工大学,2015.
[6]陈殿廉.实用牙周病学[M].乌鲁木齐:新疆人民出版社,1990:208-209.
[7]国家技术监督局.中医临床诊疗术语--疾病部分(续)[J].成都中医药大学学报,2003,26(1):62-63.
[8]国家食品药品监督管理局.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:85-86.
[9]赵建礼,李云合,谭金亮.中西医结合治疗慢性牙周炎疗效观察[J].实用中医药杂志,2016,32(10):981-982.
[10]李金华.中医辨证治疗糖尿病合并牙周炎的疗效观察[J].全科口腔医学电子杂志,2017,4(7):27-27.
[11]张景岳.景岳全书[M].太原:山西科学技术出版社,2006:900.
[12]刁俊鹏,赵清桐,谢明花.补肾汤治疗糖尿病牙周炎的临床观察[J].中国医药科学,2017,7(9):42-44.
[13]孟宪瑞,李素红,周斌,等.清胃养阴汤联合正畸治疗慢性牙周炎71例[J].河南中医,2016,36(5):893-895.
[14]赵兵,王丹,魏润生,等.葛根芩连汤治疗慢性牙周炎合并动脉粥样硬化的疗效及机制分析[J].检验医学与临床,2017,14(19):2845-2847.
[15]赵兵,和明春,蔡春江,等.葛根芩连汤在牙周疾病治疗中的应用[J].中国中西医结合耳鼻咽喉科杂志,2016,24(3):238-239.
[16]赵兵,王丹,魏润生,等.葛根芩连汤治疗慢性牙周炎的临床疗效观察[J].湖南师范大学学报:医学版,2017,14(3):7-10.
[17]Min K N,Min J,Kim S H,et al.Assessment of IL-6,IL-8 and TNF-αlevels in the gingival tissue of patients with periodontitis[J].Experimental&Therapeutic Medicine,2013,6(3):847-851.
[18]黄连膏对全层皮肤缺损小鼠创面愈合的影响及相关机制[J].中华烧伤杂志,2016,32(12):714-720.
[19]范淑红,罗夏.黄芩不同萃取物对痤疮致病菌抑菌及抗炎作用的影响[J].世界中西医结合杂志,2016,11(10):1361-1364.
[20]刘元华,关景丽,孙静,等.蒙古黄芪中的异黄酮类成分对成骨细胞增殖、分化的影响[J].社区医学杂志,2014,12(24):24-26.
[21]刘伟,王雷,陈守奎.黄芩苷联合柚皮苷对人牙周膜细胞活性的影响[J].河南中医,2017,37(1):172-174.
[2]王亚玲,曹直.应用种植体修复后慢性牙周炎老年患者的IL-2、IL-8水平变化及疗效分析[J].贵州医药,2016,40(11):1184-1185.
[3]姚霜,刘晓君,周治,等.咬合调整对牙周炎正畸治疗患者牙周状况的影响[J].国际口腔医学杂志,2017,44(1):50-54.
[4]李海燕,林洋洋,徐丹,等.干黄茶乳剂对慢性牙周炎患者龈沟液中TNF-α、IL-6和IL-10水平的影响及疗效观察[J].世界中医药,2016,11(2):259-261.
[5]罗欣.葛根芩连汤对慢性牙周炎合并动脉粥样硬化大鼠超敏C-反应蛋白的影响[D].唐山:华北理工大学,2015.
[6]陈殿廉.实用牙周病学[M].乌鲁木齐:新疆人民出版社,1990:208-209.
[7]国家技术监督局.中医临床诊疗术语--疾病部分(续)[J].成都中医药大学学报,2003,26(1):62-63.
[8]国家食品药品监督管理局.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:85-86.
[9]赵建礼,李云合,谭金亮.中西医结合治疗慢性牙周炎疗效观察[J].实用中医药杂志,2016,32(10):981-982.
[10]李金华.中医辨证治疗糖尿病合并牙周炎的疗效观察[J].全科口腔医学电子杂志,2017,4(7):27-27.
[11]张景岳.景岳全书[M].太原:山西科学技术出版社,2006:900.
[12]刁俊鹏,赵清桐,谢明花.补肾汤治疗糖尿病牙周炎的临床观察[J].中国医药科学,2017,7(9):42-44.
[13]孟宪瑞,李素红,周斌,等.清胃养阴汤联合正畸治疗慢性牙周炎71例[J].河南中医,2016,36(5):893-895.
[14]赵兵,王丹,魏润生,等.葛根芩连汤治疗慢性牙周炎合并动脉粥样硬化的疗效及机制分析[J].检验医学与临床,2017,14(19):2845-2847.
[15]赵兵,和明春,蔡春江,等.葛根芩连汤在牙周疾病治疗中的应用[J].中国中西医结合耳鼻咽喉科杂志,2016,24(3):238-239.
[16]赵兵,王丹,魏润生,等.葛根芩连汤治疗慢性牙周炎的临床疗效观察[J].湖南师范大学学报:医学版,2017,14(3):7-10.
[17]Min K N,Min J,Kim S H,et al.Assessment of IL-6,IL-8 and TNF-αlevels in the gingival tissue of patients with periodontitis[J].Experimental&Therapeutic Medicine,2013,6(3):847-851.
[18]黄连膏对全层皮肤缺损小鼠创面愈合的影响及相关机制[J].中华烧伤杂志,2016,32(12):714-720.
[19]范淑红,罗夏.黄芩不同萃取物对痤疮致病菌抑菌及抗炎作用的影响[J].世界中西医结合杂志,2016,11(10):1361-1364.
[20]刘元华,关景丽,孙静,等.蒙古黄芪中的异黄酮类成分对成骨细胞增殖、分化的影响[J].社区医学杂志,2014,12(24):24-26.
[21]刘伟,王雷,陈守奎.黄芩苷联合柚皮苷对人牙周膜细胞活性的影响[J].河南中医,2017,37(1):172-174.