中西医结合治疗牙周炎的研究
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摘要
论文从中西医两方面总结了近年来古今医学对慢性成人牙周炎 CAP 的认识
和研究 文中对中医医学中有关其病因病机 辨证论治原则及专方专药 外治疗法
等方面的观点与现代医学关于其发生机制 病理变化 确定或预测其活动性破坏的
客观指标 治疗方法等方面进行了详细论述和对比 分别指出了中 西医治疗此病
的不足之处 提出采用中西医结合治疗此病是一种可供选择的较佳方案
文中介绍了中西医结合治疗和西医治疗的对比试验的情况 试验对符合研究条
件的 19 例病人的 190 颗牙齿采用随机双盲对照分组 对照组 88 颗牙和治疗组 102
颗牙 分别检查其牙周探诊深度 探诊出血 牙齿松动度 观察牙龈红肿 牙龈出
血 牙齿松动 口臭等主观症状 并进行口腔卫生宣教 然后对两组受试牙进行龈
上洁治后 一周后复诊 实施超声龈下刮治术 对照组 治疗中以蒸馏水进行冲洗
以后以复方硼砂漱口液含漱 每日 3 次 共做 4 周 治疗组 治疗中以中药冲洗液
反复进行牙周冲洗 以后以中药试剂含漱 每日 3 次 共做 4 周 第 4 周复诊 再
次检查上述牙周指征和临床主观症状 对比前后变化 以观察治疗疗效
通过研究显示 根据总体疗效判定标准 治疗组与对照组总有效率分别为 91.97%
和 76.14% 治疗组显效率为 31.37% 对照组为 21.59% 在探诊深度 龈炎指数
牙体动度的改善上治疗组均好于对照组 尤其在牙龈出血及动度的改善上治疗组明
显好于对照组 说明采用清热解毒 活血化瘀 补肾壮骨中药在抑制炎症反应 改
善局部血循环 促进骨组织再生有很好的疗效
通过中西医结合治疗牙周炎可以体现优势互补 提高治疗疗效 尤其是在治疗
慢性口腔疾病方面 具有较为可观的前景
In this paper we summarized the study and knowledge of Chronic Adult Periodontitis
(CAP) on both Traditional Chinese Medicine (TCM) and Western Medicine(WD) We
made the contrast between TCM and MD on the pathogeny, pathogenesis and therapy
Based on the weakness for both of them, We presented the combination of TCM and WD
as the better treatment of CAP
We compared the combination of TCM and WD with the effect of WD, including 190
teeth of 19 selected patients. They were divided into two teams, 102 teeth of 10 cases as
the test group and the other as the control one. The former was treated by the ultrasonic
scaling with the herb rinse and the latter was treated by distilled water after one week of
the supraginggival scaling. They both kept for 4 weeks, 3 times one week. Before and
after treatment, Probing Depth (PD), Sulcus bleeding Index (SBI), movement of tooth
were measured, the syndromes of gingival were observed for changes.
The study showed that the total validity rate of the test group was 91.97% and of the
control one was 76.14% .The significant effect rate of the former was 31.37% and the
other was 21.59%. They demonstrated the evident antiinflammation effect of TCM. The
advantage of TCM was to slow resolution, promote circulation of blood and facilitate
regeneration of bone by detoxifcation and removing blood stasis.
In a word, the combination of TCM and WD can improve each other to promote the
curative effect, will widen consideration and pioneer a new view in study in the filed of
curing the chronic oral cavity disease.
和研究 文中对中医医学中有关其病因病机 辨证论治原则及专方专药 外治疗法
等方面的观点与现代医学关于其发生机制 病理变化 确定或预测其活动性破坏的
客观指标 治疗方法等方面进行了详细论述和对比 分别指出了中 西医治疗此病
的不足之处 提出采用中西医结合治疗此病是一种可供选择的较佳方案
文中介绍了中西医结合治疗和西医治疗的对比试验的情况 试验对符合研究条
件的 19 例病人的 190 颗牙齿采用随机双盲对照分组 对照组 88 颗牙和治疗组 102
颗牙 分别检查其牙周探诊深度 探诊出血 牙齿松动度 观察牙龈红肿 牙龈出
血 牙齿松动 口臭等主观症状 并进行口腔卫生宣教 然后对两组受试牙进行龈
上洁治后 一周后复诊 实施超声龈下刮治术 对照组 治疗中以蒸馏水进行冲洗
以后以复方硼砂漱口液含漱 每日 3 次 共做 4 周 治疗组 治疗中以中药冲洗液
反复进行牙周冲洗 以后以中药试剂含漱 每日 3 次 共做 4 周 第 4 周复诊 再
次检查上述牙周指征和临床主观症状 对比前后变化 以观察治疗疗效
通过研究显示 根据总体疗效判定标准 治疗组与对照组总有效率分别为 91.97%
和 76.14% 治疗组显效率为 31.37% 对照组为 21.59% 在探诊深度 龈炎指数
牙体动度的改善上治疗组均好于对照组 尤其在牙龈出血及动度的改善上治疗组明
显好于对照组 说明采用清热解毒 活血化瘀 补肾壮骨中药在抑制炎症反应 改
善局部血循环 促进骨组织再生有很好的疗效
通过中西医结合治疗牙周炎可以体现优势互补 提高治疗疗效 尤其是在治疗
慢性口腔疾病方面 具有较为可观的前景
In this paper we summarized the study and knowledge of Chronic Adult Periodontitis
(CAP) on both Traditional Chinese Medicine (TCM) and Western Medicine(WD) We
made the contrast between TCM and MD on the pathogeny, pathogenesis and therapy
Based on the weakness for both of them, We presented the combination of TCM and WD
as the better treatment of CAP
We compared the combination of TCM and WD with the effect of WD, including 190
teeth of 19 selected patients. They were divided into two teams, 102 teeth of 10 cases as
the test group and the other as the control one. The former was treated by the ultrasonic
scaling with the herb rinse and the latter was treated by distilled water after one week of
the supraginggival scaling. They both kept for 4 weeks, 3 times one week. Before and
after treatment, Probing Depth (PD), Sulcus bleeding Index (SBI), movement of tooth
were measured, the syndromes of gingival were observed for changes.
The study showed that the total validity rate of the test group was 91.97% and of the
control one was 76.14% .The significant effect rate of the former was 31.37% and the
other was 21.59%. They demonstrated the evident antiinflammation effect of TCM. The
advantage of TCM was to slow resolution, promote circulation of blood and facilitate
regeneration of bone by detoxifcation and removing blood stasis.
In a word, the combination of TCM and WD can improve each other to promote the
curative effect, will widen consideration and pioneer a new view in study in the filed of
curing the chronic oral cavity disease.
引文
25
参 考 文 献
1.曹采方等.牙周病学.人民卫生出版社,2000 年:29 65
2.和璐.不同取样方法对龈沟液中的酶水平影响以及牙周炎时龈沟液中弹性蛋白酶水
平的研究.北医博士论文,1997,4:14-25,70-80
3.闫福华.龈沟液中酶活性在牙周炎活动性诊断中的意义.北医学位研究生论文
1993,4:6-16
4.周爽英.牙周炎治疗后临床 X 线片及龈沟液中的酶水平纵向观察.北京医科大学博士
学位论文,1996,5:17-20,52-65
5.闫福华,曹采方,李晓新.龈沟液中酶稳定性的研究.牙体牙髓牙周病学杂志 1993 2
89
6.刘荣坤.中性多形核白细胞与快速进展性牙周炎.北医学位博士论文,1998,5:26-61
7.尹丽媛.IL-1 和 TNF- 及其基因多态与成人牙周炎的相关性研究.中国医科大
学,2001
8.Michel JF, Gagnot G, Mongnet P, et al, Chimiotaxy of PMN ceus from patients with
early-onet periodontitis, Journal of Dental Research 1992, 72: 712, Abstr, NO 1574
9.Katsuragi Y, Mastuda N, Nakamura M, et al, Nentrophil functions in patients with
severe periodontal disease. Advances in Dental Research. 1988 2: 359-363
10.Page Rc, Host response test for diagnoring periodontal disease. J Periodontal, 1992, 63:
356-366
11. Silness J and Loe H. periodontal disease in pregnancy .correlation between hygiene
and periodontal condition. Acta Odontal Scand 1964; 22: 121-135
12. Becker W, Becker B, Ochsenbein C, et al. A Longitudinal study comparing scaling,
osseons surgery and modified Widman Procedures-results after one after. J Peniodontel,
1988;59:351-365
13. Kinane DF,Chllen CF, Joinston F, et al. Neutrophil chemotactic behaviour in patients
with early-onset forms of periodontitis( ). Assessment using the under agarose technique.
Journal of cunical Periodontology, 1989, 16: 247-251
14.张一民,等.牙周炎的药物治疗进展与回顾.现代口腔医学杂志,2000,14(6):417-418
15.白碧荣,镡旭民.牙周炎的药物治疗进展.护理学杂志,2003,7,16(7):557-558
16.鲁红.不同牙周缓释药膜对成人牙周炎疗效的对比评价.第四军医大学硕士学位论
文,1989,5:18-20,25-31
17.董立武.牙周基础治疗结合 Cervitec 凝胶局部应用对牙周炎龈下菌群的影响.四川
大学硕士论文,2002,4:15-18,30-31
26 中西医结合治疗牙周炎的研究
18. 北京中医学院.中医口腔文献学,1985,10
19.汪明星等.甲硝唑与中药联合应用治疗牙周炎 46 例疗效观察.西北药学杂志,1993
年,3,8(1)
20.王立飞,岳峰.重度牙周炎非手术治疗的临床及微生物学评价.南京医科大学学报
中文版 ,1996,11,16(6):561-562
21.魏永群,等.中西医结合治疗牙周炎 65 例分析.华夏医学,1999,2:12
22.李爱芹,等.中医辨证施治牙周炎临床疗效分析.天津中医 2000,4,17(2):51
23.王国芳,张杰.近 10 年中医药治疗牙周炎概况.河南中医,2003,2,23(2):68-69
24.陶伟.中药与甲硝唑治疗牙周炎的对比研究.天津中医,2002,12,17(6):15-16
25.温杨智.温阳利水法治疗中老年牙周炎的经验与体会.江西中医,1993,24(6)期,22-23
26.Lente VF, et al. Alakine and acid phosphatase determinations in bone disease or
thopedic clinies of Morth. America, 1979;10-437
27.胡壮,等.中医辨证分型治疗牙周炎 78 例.上海中医药杂志,3(3):37-38
28. Lente VF, et al. Alakine and acid phosphatase determinations in bone disease or
thopedic clinies of Morth. America, 1979;10-437
29.刘树生,等.中西医结合治疗成人牙周炎的临床研究.北京口腔医学,2002,10(1):27-29
30.李佳瑜,黄颐玉.牙周抑菌方治疗慢性牙周炎 30 例.北京中医药大学学报
2002,25(6):70-72
31.张延琳,等.固齿散治疗牙周炎的二期临床试验总结.牙体牙髓牙周病学杂
志,2002,4,12(4):213-214
32.王咏芳.中西医结合治疗牙周炎 80 例.中国民间疗法,2003,7,11(7)
33.张德景,等.中西医结合治疗牙周炎72例.2000年全国中西医结合诊治疑难病学术研
讨会论文集,150-151
34.Nakashima K,Roehrich N and Cimasoni. Osteocalcin prostaglandin Ez and alkaline
phosphatase in gingival creviculan fluid: their relation to periodontal status. J Clin
periodintol, 1994;21:327-333
35.Page RC,Schroeder HE,Features in man and animals. In: periodontitis in man and other
amines Zurick: Kangen 1982: 233
36. 吴克强.中药古今应用指南.广东科技出版社,1998:74-202
参 考 文 献
1.曹采方等.牙周病学.人民卫生出版社,2000 年:29 65
2.和璐.不同取样方法对龈沟液中的酶水平影响以及牙周炎时龈沟液中弹性蛋白酶水
平的研究.北医博士论文,1997,4:14-25,70-80
3.闫福华.龈沟液中酶活性在牙周炎活动性诊断中的意义.北医学位研究生论文
1993,4:6-16
4.周爽英.牙周炎治疗后临床 X 线片及龈沟液中的酶水平纵向观察.北京医科大学博士
学位论文,1996,5:17-20,52-65
5.闫福华,曹采方,李晓新.龈沟液中酶稳定性的研究.牙体牙髓牙周病学杂志 1993 2
89
6.刘荣坤.中性多形核白细胞与快速进展性牙周炎.北医学位博士论文,1998,5:26-61
7.尹丽媛.IL-1 和 TNF- 及其基因多态与成人牙周炎的相关性研究.中国医科大
学,2001
8.Michel JF, Gagnot G, Mongnet P, et al, Chimiotaxy of PMN ceus from patients with
early-onet periodontitis, Journal of Dental Research 1992, 72: 712, Abstr, NO 1574
9.Katsuragi Y, Mastuda N, Nakamura M, et al, Nentrophil functions in patients with
severe periodontal disease. Advances in Dental Research. 1988 2: 359-363
10.Page Rc, Host response test for diagnoring periodontal disease. J Periodontal, 1992, 63:
356-366
11. Silness J and Loe H. periodontal disease in pregnancy .correlation between hygiene
and periodontal condition. Acta Odontal Scand 1964; 22: 121-135
12. Becker W, Becker B, Ochsenbein C, et al. A Longitudinal study comparing scaling,
osseons surgery and modified Widman Procedures-results after one after. J Peniodontel,
1988;59:351-365
13. Kinane DF,Chllen CF, Joinston F, et al. Neutrophil chemotactic behaviour in patients
with early-onset forms of periodontitis( ). Assessment using the under agarose technique.
Journal of cunical Periodontology, 1989, 16: 247-251
14.张一民,等.牙周炎的药物治疗进展与回顾.现代口腔医学杂志,2000,14(6):417-418
15.白碧荣,镡旭民.牙周炎的药物治疗进展.护理学杂志,2003,7,16(7):557-558
16.鲁红.不同牙周缓释药膜对成人牙周炎疗效的对比评价.第四军医大学硕士学位论
文,1989,5:18-20,25-31
17.董立武.牙周基础治疗结合 Cervitec 凝胶局部应用对牙周炎龈下菌群的影响.四川
大学硕士论文,2002,4:15-18,30-31
26 中西医结合治疗牙周炎的研究
18. 北京中医学院.中医口腔文献学,1985,10
19.汪明星等.甲硝唑与中药联合应用治疗牙周炎 46 例疗效观察.西北药学杂志,1993
年,3,8(1)
20.王立飞,岳峰.重度牙周炎非手术治疗的临床及微生物学评价.南京医科大学学报
中文版 ,1996,11,16(6):561-562
21.魏永群,等.中西医结合治疗牙周炎 65 例分析.华夏医学,1999,2:12
22.李爱芹,等.中医辨证施治牙周炎临床疗效分析.天津中医 2000,4,17(2):51
23.王国芳,张杰.近 10 年中医药治疗牙周炎概况.河南中医,2003,2,23(2):68-69
24.陶伟.中药与甲硝唑治疗牙周炎的对比研究.天津中医,2002,12,17(6):15-16
25.温杨智.温阳利水法治疗中老年牙周炎的经验与体会.江西中医,1993,24(6)期,22-23
26.Lente VF, et al. Alakine and acid phosphatase determinations in bone disease or
thopedic clinies of Morth. America, 1979;10-437
27.胡壮,等.中医辨证分型治疗牙周炎 78 例.上海中医药杂志,3(3):37-38
28. Lente VF, et al. Alakine and acid phosphatase determinations in bone disease or
thopedic clinies of Morth. America, 1979;10-437
29.刘树生,等.中西医结合治疗成人牙周炎的临床研究.北京口腔医学,2002,10(1):27-29
30.李佳瑜,黄颐玉.牙周抑菌方治疗慢性牙周炎 30 例.北京中医药大学学报
2002,25(6):70-72
31.张延琳,等.固齿散治疗牙周炎的二期临床试验总结.牙体牙髓牙周病学杂
志,2002,4,12(4):213-214
32.王咏芳.中西医结合治疗牙周炎 80 例.中国民间疗法,2003,7,11(7)
33.张德景,等.中西医结合治疗牙周炎72例.2000年全国中西医结合诊治疑难病学术研
讨会论文集,150-151
34.Nakashima K,Roehrich N and Cimasoni. Osteocalcin prostaglandin Ez and alkaline
phosphatase in gingival creviculan fluid: their relation to periodontal status. J Clin
periodintol, 1994;21:327-333
35.Page RC,Schroeder HE,Features in man and animals. In: periodontitis in man and other
amines Zurick: Kangen 1982: 233
36. 吴克强.中药古今应用指南.广东科技出版社,1998:74-202