牙周病的中医临床治疗研究
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摘要
牙周病是人類最古老最普遍的疾病之一,也是導致成年人牙齒脫落的主要原因之一。中医没有牙周病的病名,根据其临床表现,可归属于中医之“牙宣”、“齿衄”、“齿动”等病范围。根據統計,40歲以上的人拔除牙齒的原因有75%是因為牙周病所造成。牙周病常見的自覺性症狀有牙齦紅、腫、疼痛、出血及牙齿松动等。
现代医学认为牙周病的病發主因是口腔局部不良刺激和機體抵抗力下降,造成鏈球菌等微生物感染牙齒組織而引發此病。常用於治療牙周病的藥物為化學抗生素與消炎止痛劑,雖然抗生素與消炎止痛劑能緩解牙周病急性發炎期的部分症狀,但其效果常因致病菌的抗藥性而有所差異,且長期使用抗生素有可能改變口腔正常菌種的生長,消炎止痛劑所隱藏的細菌耐藥性與不良副作用現象卻是不容忽視的一大隱憂。因此抗生素与消炎止痛剂的使用在牙周病的治療上还是有所限制的。近年來由於人們逐漸有崇尚回歸自然的想法,所以這些年來許多以天然植物配方的產品也廣為大眾所接受。在我國,中醫藥治疗牙周病有着丰富的治疗经验和良好的临床疗效。历代医家不仅对牙齿疾病如牙痈、牙宣等有比较明确的认识,而且还发明了许多治疗牙齿疾病的器械如熏牙器等,也不乏手术疗法。中医对于牙周病病因的认识,不是单单强调外邪和局部因素,而是把牙周局部的病变看成全身疾病的反应,从外邪和内在体质因素,局部和全身整体两个方面认识,具有獨特的優勢,其治療方法具有較好的臨床療效,许多治疗法方法为中医所独有。所以深入研究中医药治疗牙周病的理论和临床实践经验与尋求更理想的牙周病治療藥物有一定的必要性和紧迫性。
中医对口齿类疾病的治疗有着悠久的历史和丰富的经验。早在唐代的医科中,即设有耳目口齿分科。宋代分成耳目科和口齿兼咽喉科,后来又分化为耳科、口齿科、咽喉科。中医理论将耳、咽喉、口齿均与体内脏器相联系,其有关解剖、生理的基本论述早已见于《内经》,后来在历代许多医书中,均载了相关的治疗方法。中医理论认为正气不足,外邪侵袭是牙周病的主要病因,其中肝肾亏耗,气血匮乏是牙周病的内在原因。正气代表了人体的疾病康复能力和抵御外邪入侵的能力。中醫认為腎主骨,齒為骨之餘,腎虛精虧髓少,腎精不得上達,齒失養,引起骨質的萎軟。老年腎精本已亏虛,或再因房事不節,或其他臟腑病變(糖尿病或其他血液疾病)累及於腎,更容易导致精虧髓少,齒失其养而引起牙周病。當然齒病不單與腎有密切關係,由於手足陽明經均進入齒中,因此牙齒的某些病變也與腸、胃的生理功能失調有關。脾胃乃后天之本,气血生化之源。脾胃虚损,则生化乏源,气血不足,脉络空虚,不能上输精微于齿龈,龈失养,则易为外邪所侵,牙齿消缩退腐而发生牙周病。肾阳虚损或脾阳不足,运化水液功能减退,导致水液停滞于阳明胃络,而齿龈为阳明经脉循行之地,则会出现牙龈肿痛。
牙齿疾病祖国医学多称之为齿疾,是口腔疾病中常见病之一。中医在分析该病的病因时,不仅注重肾气亏虚,气血不足,牙周失养,而且认为外感风火,局部损伤是牙周病的激发因素。不仅认识到虚可以导致牙周病,而且也十分注重对于实邪的认识。对于实邪病因,论述也是很多的,但认为主要认为是由于风、火引起。总之,牙周病的发生多具有正气亏虚,肾精耗损,虚火上炎的病理基础,同时又感受风寒、火热之邪,郁于局部而不能宣散,热壅血聚而形成的局部损伤原因。中医学对于牙周病病机多从火热、瘀滞、虚损三个方面认识。三者不仅可单独存在,而且在许多情况下可同时存在,牙周病常见病机为火热内蕴,血败肉腐、瘀血阻络,气血凝滞和精亏气弱,荣养失职。内火又称“内热”,是指阳盛或阴虚阳亢或气血郁滞、病邪郁结,而产生的火热内扰,机能亢奋的病理状态。导致牙周病发作的火热多可分为实火和虚火两大类,主要有阳盛化火、邪郁化火、五志过激化火、阴虚火旺以及各脏腑之火。实火多因胃肠积热、感受外邪等引起。中医多认为牙痛实火与胃肠郁热有关,胃肠之热多郁于阳明经而化火,火循经上炎颌面故牙痛。总之,不论内火还是外邪郁火,均可循经上炎牙齿局部,导致血败肉腐,而发生牙周病,由于火热内蕴而引发的牙周病临床表现多见牙痛较剧、牙龈红肿、出血、口臭、口渴、喜冷饮、便干、尿赤、舌质红、苔黄厚、脉滑数等症状。
瘀血阻络,气血凝滞也是牙周病的一个重要病机,瘀血是指停滞于体内的血液,包括离经之血或血运不畅,阻滞于经脉及脏腑内的血液。同时瘀血的存在可进一步造成血行不畅而凝滞,即可出现牙痛龈肿等症状。气血凝滞,瘀血阻络在牙周病的发病中,可互为因果,相互作用。总之,中医学火热、瘀滞、虚损三个方面是牙周疾病的主要病机,在临床宜详细辨别三者的主次与兼夹,辨证治疗。牙周病是全身疾病在局部的反映,因此治疗牙周病既要注意全身的状态,还要治疗局部病变,首先要处理好治标与治本的关系,中医认为治病求本,应该寻找出疾病的根本原因,并针对根本原因进行治疗。当标病甚急,如不及时解决将危及生命时则“急则治其标”;如病情缓和或慢性病或急性病恢复期则“缓则治其本”;当标本均急或标本均不太急则“标本兼治”。
在牙周病的治疗中还应该处理好扶正与祛邪的相互关系,牙周病常见气血损伤,肝肾亏虚,阴虚火旺,又感受外邪。这时就需要权衡相互关系,达到“扶正不留邪、祛邪不伤正”,扶助正气,增强体质,提高机体抗邪能力;祛除病邪,使邪去正安。正虚邪不盛情况下可单独使用扶正法,邪实而正气未明显衰可单独使用祛邪法。如果正气损伤与外邪均较轻时,可祛邪与扶正先后使用或祛邪的同时兼以扶正。对于虚实错杂的病证可合并使用。
祛除外邪,培补正气是牙周病的基本治法,由于风邪是引起牙周病的主要原因,风又为百病之长,诸邪多以风为先导而侵犯人体,因此。祛除风邪是牙周病的重要治法,临床由于感受邪气的不同,常用祛风散寒止痛、祛除风热、除湿清热,祛风散邪、清热泻火,解毒凉血、活血化淤,理气通络、滋养肝肾,补益气血等几种。辅以外治法,局部用药是提高疗效的必要措施,从古到今中医中药有许多治疗牙周病的疗法,内服汤剂、丸剂、散剂,外用擦药、涂药、贴敷、含漱、揩牙、刷牙等。由于外治疗法可以避免内服药物可能造成的耐药性和菌群失调及毒副作用,它在治疗牙宣中起着重要的作用。另外辨明特点,随证变法是牙周病治疗的关键环节,牙宣以牙肉(龈)萎缩,牙根宣露,浮动而疼,经常渗血或渗脓为其特徵。牙衄以血液自牙缝或牙龈渗出的症状。牙漏以牙根反复发作肿胀化脓,溢出不愈为特点。牙痈以牙龈疼痛、肿胀、溢脓为特徵,表现为牙龈处肿起而胀硬,焮红疼痛,甚则肿连腮颊等。齿齼以牙齿接触酸味引起的酸楚感觉为主。由于临床表现特点的不同,相应的病因病机也有一定的差异,临床应该充分认识相互间的不同点,辨证施治,随证变法,才能取得较好疗效。
临床研究随机抽取60位病患进行实验测试,其中男性26人(43.3%),女性34人(56.7%);平均年龄为47.03岁(31～40岁者11人、41～50岁者28人、51～60岁者21人)。经由随机抽样将患者分为二组,实验组男性13人、女性17人,平均年龄45.47岁(31～40岁者8人、41～50岁者15人、51～60岁者7人);對照組男性13人、女性17人,平均年龄48.6歲(31-40歲者3人、41-50歲者13人、51-60歲者14人)。實驗組由固定的中醫師根據中醫辨證論治與辨病論治相結合的原則給予每位患者以補腎清火為主的中藥治療,而對照組不服中藥,給予一般療法。检测牙周探測深度(PD)、牙齒動搖度(MO)、菌斑指數(PI)、牙齦指數(GI)等几项指标。研究結果顯示中藥之介入對於牙周探測深度(PD)、牙齒動搖度(MO)、牙菌斑指數(PI)有統計上之意義;由統計數字顯示,無論是否有中藥介入經過治療後病患之各指數皆有減少之趨勢,但是牙周炎在中藥介入治療後病患發炎情形,施用中藥組所測得數值顯著地比未施用中藥組改善,在統計上呈現顯著差異,有統計上之意義,第六週之後可能由於邊際效益遞減,使得中藥介入治療之成效沒有顯著的影響,部分地阐明了中医药治疗牙周病的机理。
Periodontitis is the most common and ancient diseases of humanity. It is one of main reasons of adult's tooth loss. Chinese Name no periodontal disease, according to clinical manifestations, Chinese medicine can be attributed to the "teeth propaganda", "moving teeth" of the disease. According to statistics, people over the age of 40 extracted teeth due to a 75% because of periodontal disease caused by. Common symptoms of periodontal disease is the consciousness of red gums, swelling, pain, bleeding and loose teeth, etc..
Modern medicine that periodontal disease is the main cause of poor oral stimulate local resistance and decreased body, causing Streptococcus organizations such as microbial infection caused by dental disease. Commonly used in the treatment of periodontal disease with antibiotic drugs is a chemical anti-inflammatory analgesics, although anti-inflammatory analgesics and antibiotics can alleviate acute inflammation of the periodontal some symptoms, but their effectiveness due to the drug-resistant bacteria and differences and the long-term use of oral antibiotics may change the normal bacteria growth, anti-inflammatory analgesics hidden by bacterial resistance and adverse side-effects of the phenomenon should not be overlooked is a major concern. Therefore antibiotics and anti-inflammatory analgesic agents used in the treatment of periodontal disease or have restrictions. In recent years as people gradually return to nature advocating the idea, so these many years to the natural plant product formulations are also widely accepted by the public. In China, in the medical treatment of periodontal disease has a wealth of experience and good clinical effect. Doctors not only for the previous dental diseases, such as dental carbuncle, dental, and so declared a relatively clear understanding, but also invented a lot of dental diseases such as smoked dental equipment, etc., there are surgical therapy. Chinese awareness of the causes of periodontal disease is not simply that External pathogens and local factors, but the periodontal disease as a partial response to systemic disease, from External pathogens and the inherent physical factors, both local and systemic aspects of the overall understanding of unique advantages, the treatment method has a good clinical effect, many treatment methods for the unique Chinese medicine. Therefore, in-depth study of Chinese medicine treatment of periodontal disease theory and clinical practice experience and seek better treatment of periodontal disease drugs to a certain extent and urgency of the need.
Oral type of traditional Chinese medicine to the treatment of diseases have a long history and rich experience. As early as the Tang Dynasty in medicine, that is, with eyes and ears ,Oral Polyclinic. Song Branch and the Oral into eyes and ears and throat Branch, and later differentiate into ear, Oral Branch, Division throat. Chinese medicine theory ear, throat, Oral are associated with the body organ, its anatomy, physiology has been found on the basic "Classic", but many of Medical Books in the past, contained the relevant treatment. Chinese medicine theory is that upright deficiency feel External pathogens is periodontal disease pathogenesis, liver and kidney deficiency, upright periodontal disease is the main reason for inadequate. Upright on behalf of human diseases rehabilitation External pathogens invasion capacity and the ability to resist. Chinese think that the main renal bone, tooth for bone while kidney deficiency fine pulp less money, Kidney qi not reach, tooth loss support, and the weakness cause osteoporosis. This deficiency has been Kidney qi elderly, or not because of sexually section, or other viscera disease (diabetes or other blood diseases) involved in the kidney, leading to more easily fine pulp losses fewer teeth missing from custody and periodontal disease. Of course Tooth disease and renal not closely related, as the hand-foot-Yangming channels entered teeth, teeth with certain intestinal diseases, stomach disorders related to the physiological function. The spleen and stomach is acquired, the source of blood biochemistry. Wasting the spleen and stomach, the lack of biological sources, inadequate blood, thread emptiness, and not on micro-loser in gingival, gingival lost support, and easy to catch External pathogens, teeth rot and the retreat of elimination in periodontal disease. Spleen-yang deficiency damaged or inadequate, and transport of liquid water dysfunction, leading to stagnation of water in the stomach, and gingival for Yangming passages through the trip, while a gum swelling.
Chinese Medicine and more dental disease called Tooth disease, oral diseases is one of the common diseases. Chinese medicine practitioners in the etiology of the disease, not only on kidney qi deficiency, the lack of blood, lost periodontal support, and that Exogenous introduced this year. These partial damage occurred and also lead to periodontal one of the reasons why. Recognizing that not only can the virtual to periodontal disease, but also pay attention to the very real understanding of evil. In fact, the cause of evil, many also discussed, but that is mainly because of the wind, the fire caused. In short, the occurrence of periodontal disease is more upright deficiency, Kidney qi depletion, virtual fire on the basis of the pathological inflammation, but also feeling cold fiery evil, stasis declared in the local and not casual, thermal Obstructing blood-formed local Injury . Periodontal disease in the medical machines more from the fire, stasis, virtual three awareness. Three can not only stand alone, and in many cases can co-exist, periodontal disease pathogenesis of common diseases for the fiery intrinsic, meat rot lost blood, blood stasis, and liver-kidney yin deficiency stasis blood, blood two losses. The fire also known as the "heat" refers to excessiveYang, or Yin deficiency and yang excess blood and the fiery disturbance in the function of the extreme pathological state. The strength of a fire at its main plane of the Super-fire, the fire of evil stasis, a fire of mental depression. Lead the attack with fire periodontal disease can be divided into multiple excess fire and deficient fire two categories. It is more a result of the fire gastrointestinal plot fever, caused by feelings External pathogens. Chinese medicine practitioners believe that toothache fire and heat-related gastrointestinal stasis, stasis gastrointestinal more in the heat and stomach of the fire, the fire on the inflammation and maxillofacial it toothache. In short, regardless of the fire or External pathogens stasis, are to follow through on the teeth local inflammation, leading to blood lost meat rot, and in periodontal disease, caused by the fiery intrinsic periodontal clinical manifestations, toothache more drama , gums, swelling, bleeding, bad breath, thirsty, cold-hi, they stem, urine red tongue red, yellow thick moss, pulse Waterloo few symptoms.
Blood stasis is stagnation of blood in the body, including blood from the blood supply or poor, block the channels and viscera. Congestion at the same time the existence of a blood can be further impeded and stasis of a toothache and swollen subgingival symptoms. stasis qi and blood, blood stasis in the pathogenesis of periodontal disease can be casual, interaction. In short, the medical fire, stasis, dificiency are the main periodontal disease pathogenesis, in clinical detail to identify the primary and secondary with three and folders, Differential Treatment. Periodontal disease in the body is a reflection of local, we should pay attention to treatment of periodontal disease state of the body, but also the treatment of local lesions, first tackling the symptoms and to properly handle the relationship between the Chinese medicine for the treatment that should be finding diseases the root causes and address root causes of treatment. When the disease has very superscript, if not resolved in a timely manner will be life-threatening when "radical, treat the symptoms" such as illness or chronic or acute ease recovery, "the government ease its own" When specimens were not urgent or specimen urgent, "once."
In the treatment of periodontal disease we should also properly handle the telation between replenishing root and purging Pathogens, periodontal disease common blood injury, liver and kidney deficiency, invasion of External pathogens. If upright injury and External pathogens are lighter, it may have to reinstate Eliminating Pathogens with the use or Eliminating Pathogens at the same time and to reinstate. Cuza the strength of the card can be combined.
Wipe out External pathogens, assisting upright is the primary treatment of periodontal disease due to periodontal disease caused wind is the main reason for the problem in the wind and the length of all evil in the wind pathogen for more than the violation of human pilot, so. Wipe out wind important is the treatment of periodontal disease, clinical evil influences due to the different feelings, Wipe out wind cold-dispelling commonly used painkillers, wipe out hot wind, detoxification, kidney yin,purging stomach heat, promoting blood circulating to remove blood stasis , smoothing the liver to regulate the flow of qi and nourish liver and kidney. Adequately supported by external treatment is to improve the effect of the basis of Chinese medicine since ancient times many treated teeth declared the therapy, Oral decoction, pills, powders, paste spreads, mouthwash, losers teeth, brush such as tooth. As can be avoided, Oral drug therapy may cause drug resistance and dysbacteriosis and toxicity, in the treatment of dental declared it plays an important role. In addition to fully understand the characteristics, with the permit is modified live periodontal therapy, dental vent to Yaru (GCF) shrink root declared open, floating and pain, bleeding or recurrent seepage septic its characteristics. En blood to the teeth or gums Yafeng exudative symptoms. Dental root leakage to recurrent swelling suppuration, overflow Fuyu characterized. Carbuncle teeth to gum pain, swelling, excess pus features for the performance of the gums and bulging hard Zhongqi,is very swollen cheek, and so even the gills. Bitterness of tooth is that tooth contact caused bitterness sour feeling. The clinical features of different etiology and pathogenesis of the corresponding also have some differences, should be fully aware of each other's differences, Differential Treatment, can be achieved good effect.
Clinical study were randomly selected to conduct experiments on 60 patients tested, 26 were males (43.3%), 34 were women (56.7%), and the average age was 47.03 years old (31 to 40 years old, 11 were 41 to 50 years old were 28 , 51 to 60 years of age 21). Through random sampling will be divided into two patient groups, the experimental group were 13 males and 17 females, with an average age of 45.47 years (31～40 years of age 8, 41 to 50 years old, 15, 51 -60 years of age 7) the control group 13 were males and 17 females, with an average age of 48.6 years (31-40 years of age 3 ,41-50-year-old, 13 ,51-60-14). Fixed by the experimental group under TCM practitioners and Differential Treatment debate on the Treatment of the principle of combining to give each patient to fire Bushen-based Chinese medicine treatment and control group against Chinese medicine, to the general therapy. Detection of probing depth (PD), teeth shaken degrees (MO), plaque index (PI), gingival index (GI), a few indicators. The results showed that the intervention of Chinese medicine for probing depth (PD), teeth shaken degrees (MO), plaque index (PI) of the statistical significance of the statistics show that, irrespective of whether the Chinese intervention patients after treatment The index both reduce the trend, but the Chinese intervention in the treatment of periodontitis patients with inflammatory situation after the application of traditional Chinese medicine constituencies measured values than not significantly improve the application of traditional Chinese medicine group, a statistically significant difference was, Statistics on the significance of the sixth week after the marginal benefits may be reduced, making the effectiveness of Chinese medicine interventional treatment had no significant effect.
现代医学认为牙周病的病發主因是口腔局部不良刺激和機體抵抗力下降,造成鏈球菌等微生物感染牙齒組織而引發此病。常用於治療牙周病的藥物為化學抗生素與消炎止痛劑,雖然抗生素與消炎止痛劑能緩解牙周病急性發炎期的部分症狀,但其效果常因致病菌的抗藥性而有所差異,且長期使用抗生素有可能改變口腔正常菌種的生長,消炎止痛劑所隱藏的細菌耐藥性與不良副作用現象卻是不容忽視的一大隱憂。因此抗生素与消炎止痛剂的使用在牙周病的治療上还是有所限制的。近年來由於人們逐漸有崇尚回歸自然的想法,所以這些年來許多以天然植物配方的產品也廣為大眾所接受。在我國,中醫藥治疗牙周病有着丰富的治疗经验和良好的临床疗效。历代医家不仅对牙齿疾病如牙痈、牙宣等有比较明确的认识,而且还发明了许多治疗牙齿疾病的器械如熏牙器等,也不乏手术疗法。中医对于牙周病病因的认识,不是单单强调外邪和局部因素,而是把牙周局部的病变看成全身疾病的反应,从外邪和内在体质因素,局部和全身整体两个方面认识,具有獨特的優勢,其治療方法具有較好的臨床療效,许多治疗法方法为中医所独有。所以深入研究中医药治疗牙周病的理论和临床实践经验与尋求更理想的牙周病治療藥物有一定的必要性和紧迫性。
中医对口齿类疾病的治疗有着悠久的历史和丰富的经验。早在唐代的医科中,即设有耳目口齿分科。宋代分成耳目科和口齿兼咽喉科,后来又分化为耳科、口齿科、咽喉科。中医理论将耳、咽喉、口齿均与体内脏器相联系,其有关解剖、生理的基本论述早已见于《内经》,后来在历代许多医书中,均载了相关的治疗方法。中医理论认为正气不足,外邪侵袭是牙周病的主要病因,其中肝肾亏耗,气血匮乏是牙周病的内在原因。正气代表了人体的疾病康复能力和抵御外邪入侵的能力。中醫认為腎主骨,齒為骨之餘,腎虛精虧髓少,腎精不得上達,齒失養,引起骨質的萎軟。老年腎精本已亏虛,或再因房事不節,或其他臟腑病變(糖尿病或其他血液疾病)累及於腎,更容易导致精虧髓少,齒失其养而引起牙周病。當然齒病不單與腎有密切關係,由於手足陽明經均進入齒中,因此牙齒的某些病變也與腸、胃的生理功能失調有關。脾胃乃后天之本,气血生化之源。脾胃虚损,则生化乏源,气血不足,脉络空虚,不能上输精微于齿龈,龈失养,则易为外邪所侵,牙齿消缩退腐而发生牙周病。肾阳虚损或脾阳不足,运化水液功能减退,导致水液停滞于阳明胃络,而齿龈为阳明经脉循行之地,则会出现牙龈肿痛。
牙齿疾病祖国医学多称之为齿疾,是口腔疾病中常见病之一。中医在分析该病的病因时,不仅注重肾气亏虚,气血不足,牙周失养,而且认为外感风火,局部损伤是牙周病的激发因素。不仅认识到虚可以导致牙周病,而且也十分注重对于实邪的认识。对于实邪病因,论述也是很多的,但认为主要认为是由于风、火引起。总之,牙周病的发生多具有正气亏虚,肾精耗损,虚火上炎的病理基础,同时又感受风寒、火热之邪,郁于局部而不能宣散,热壅血聚而形成的局部损伤原因。中医学对于牙周病病机多从火热、瘀滞、虚损三个方面认识。三者不仅可单独存在,而且在许多情况下可同时存在,牙周病常见病机为火热内蕴,血败肉腐、瘀血阻络,气血凝滞和精亏气弱,荣养失职。内火又称“内热”,是指阳盛或阴虚阳亢或气血郁滞、病邪郁结,而产生的火热内扰,机能亢奋的病理状态。导致牙周病发作的火热多可分为实火和虚火两大类,主要有阳盛化火、邪郁化火、五志过激化火、阴虚火旺以及各脏腑之火。实火多因胃肠积热、感受外邪等引起。中医多认为牙痛实火与胃肠郁热有关,胃肠之热多郁于阳明经而化火,火循经上炎颌面故牙痛。总之,不论内火还是外邪郁火,均可循经上炎牙齿局部,导致血败肉腐,而发生牙周病,由于火热内蕴而引发的牙周病临床表现多见牙痛较剧、牙龈红肿、出血、口臭、口渴、喜冷饮、便干、尿赤、舌质红、苔黄厚、脉滑数等症状。
瘀血阻络,气血凝滞也是牙周病的一个重要病机,瘀血是指停滞于体内的血液,包括离经之血或血运不畅,阻滞于经脉及脏腑内的血液。同时瘀血的存在可进一步造成血行不畅而凝滞,即可出现牙痛龈肿等症状。气血凝滞,瘀血阻络在牙周病的发病中,可互为因果,相互作用。总之,中医学火热、瘀滞、虚损三个方面是牙周疾病的主要病机,在临床宜详细辨别三者的主次与兼夹,辨证治疗。牙周病是全身疾病在局部的反映,因此治疗牙周病既要注意全身的状态,还要治疗局部病变,首先要处理好治标与治本的关系,中医认为治病求本,应该寻找出疾病的根本原因,并针对根本原因进行治疗。当标病甚急,如不及时解决将危及生命时则“急则治其标”;如病情缓和或慢性病或急性病恢复期则“缓则治其本”;当标本均急或标本均不太急则“标本兼治”。
在牙周病的治疗中还应该处理好扶正与祛邪的相互关系,牙周病常见气血损伤,肝肾亏虚,阴虚火旺,又感受外邪。这时就需要权衡相互关系,达到“扶正不留邪、祛邪不伤正”,扶助正气,增强体质,提高机体抗邪能力;祛除病邪,使邪去正安。正虚邪不盛情况下可单独使用扶正法,邪实而正气未明显衰可单独使用祛邪法。如果正气损伤与外邪均较轻时,可祛邪与扶正先后使用或祛邪的同时兼以扶正。对于虚实错杂的病证可合并使用。
祛除外邪,培补正气是牙周病的基本治法,由于风邪是引起牙周病的主要原因,风又为百病之长,诸邪多以风为先导而侵犯人体,因此。祛除风邪是牙周病的重要治法,临床由于感受邪气的不同,常用祛风散寒止痛、祛除风热、除湿清热,祛风散邪、清热泻火,解毒凉血、活血化淤,理气通络、滋养肝肾,补益气血等几种。辅以外治法,局部用药是提高疗效的必要措施,从古到今中医中药有许多治疗牙周病的疗法,内服汤剂、丸剂、散剂,外用擦药、涂药、贴敷、含漱、揩牙、刷牙等。由于外治疗法可以避免内服药物可能造成的耐药性和菌群失调及毒副作用,它在治疗牙宣中起着重要的作用。另外辨明特点,随证变法是牙周病治疗的关键环节,牙宣以牙肉(龈)萎缩,牙根宣露,浮动而疼,经常渗血或渗脓为其特徵。牙衄以血液自牙缝或牙龈渗出的症状。牙漏以牙根反复发作肿胀化脓,溢出不愈为特点。牙痈以牙龈疼痛、肿胀、溢脓为特徵,表现为牙龈处肿起而胀硬,焮红疼痛,甚则肿连腮颊等。齿齼以牙齿接触酸味引起的酸楚感觉为主。由于临床表现特点的不同,相应的病因病机也有一定的差异,临床应该充分认识相互间的不同点,辨证施治,随证变法,才能取得较好疗效。
临床研究随机抽取60位病患进行实验测试,其中男性26人(43.3%),女性34人(56.7%);平均年龄为47.03岁(31～40岁者11人、41～50岁者28人、51～60岁者21人)。经由随机抽样将患者分为二组,实验组男性13人、女性17人,平均年龄45.47岁(31～40岁者8人、41～50岁者15人、51～60岁者7人);對照組男性13人、女性17人,平均年龄48.6歲(31-40歲者3人、41-50歲者13人、51-60歲者14人)。實驗組由固定的中醫師根據中醫辨證論治與辨病論治相結合的原則給予每位患者以補腎清火為主的中藥治療,而對照組不服中藥,給予一般療法。检测牙周探測深度(PD)、牙齒動搖度(MO)、菌斑指數(PI)、牙齦指數(GI)等几项指标。研究結果顯示中藥之介入對於牙周探測深度(PD)、牙齒動搖度(MO)、牙菌斑指數(PI)有統計上之意義;由統計數字顯示,無論是否有中藥介入經過治療後病患之各指數皆有減少之趨勢,但是牙周炎在中藥介入治療後病患發炎情形,施用中藥組所測得數值顯著地比未施用中藥組改善,在統計上呈現顯著差異,有統計上之意義,第六週之後可能由於邊際效益遞減,使得中藥介入治療之成效沒有顯著的影響,部分地阐明了中医药治疗牙周病的机理。
Periodontitis is the most common and ancient diseases of humanity. It is one of main reasons of adult's tooth loss. Chinese Name no periodontal disease, according to clinical manifestations, Chinese medicine can be attributed to the "teeth propaganda", "moving teeth" of the disease. According to statistics, people over the age of 40 extracted teeth due to a 75% because of periodontal disease caused by. Common symptoms of periodontal disease is the consciousness of red gums, swelling, pain, bleeding and loose teeth, etc..
Modern medicine that periodontal disease is the main cause of poor oral stimulate local resistance and decreased body, causing Streptococcus organizations such as microbial infection caused by dental disease. Commonly used in the treatment of periodontal disease with antibiotic drugs is a chemical anti-inflammatory analgesics, although anti-inflammatory analgesics and antibiotics can alleviate acute inflammation of the periodontal some symptoms, but their effectiveness due to the drug-resistant bacteria and differences and the long-term use of oral antibiotics may change the normal bacteria growth, anti-inflammatory analgesics hidden by bacterial resistance and adverse side-effects of the phenomenon should not be overlooked is a major concern. Therefore antibiotics and anti-inflammatory analgesic agents used in the treatment of periodontal disease or have restrictions. In recent years as people gradually return to nature advocating the idea, so these many years to the natural plant product formulations are also widely accepted by the public. In China, in the medical treatment of periodontal disease has a wealth of experience and good clinical effect. Doctors not only for the previous dental diseases, such as dental carbuncle, dental, and so declared a relatively clear understanding, but also invented a lot of dental diseases such as smoked dental equipment, etc., there are surgical therapy. Chinese awareness of the causes of periodontal disease is not simply that External pathogens and local factors, but the periodontal disease as a partial response to systemic disease, from External pathogens and the inherent physical factors, both local and systemic aspects of the overall understanding of unique advantages, the treatment method has a good clinical effect, many treatment methods for the unique Chinese medicine. Therefore, in-depth study of Chinese medicine treatment of periodontal disease theory and clinical practice experience and seek better treatment of periodontal disease drugs to a certain extent and urgency of the need.
Oral type of traditional Chinese medicine to the treatment of diseases have a long history and rich experience. As early as the Tang Dynasty in medicine, that is, with eyes and ears ,Oral Polyclinic. Song Branch and the Oral into eyes and ears and throat Branch, and later differentiate into ear, Oral Branch, Division throat. Chinese medicine theory ear, throat, Oral are associated with the body organ, its anatomy, physiology has been found on the basic "Classic", but many of Medical Books in the past, contained the relevant treatment. Chinese medicine theory is that upright deficiency feel External pathogens is periodontal disease pathogenesis, liver and kidney deficiency, upright periodontal disease is the main reason for inadequate. Upright on behalf of human diseases rehabilitation External pathogens invasion capacity and the ability to resist. Chinese think that the main renal bone, tooth for bone while kidney deficiency fine pulp less money, Kidney qi not reach, tooth loss support, and the weakness cause osteoporosis. This deficiency has been Kidney qi elderly, or not because of sexually section, or other viscera disease (diabetes or other blood diseases) involved in the kidney, leading to more easily fine pulp losses fewer teeth missing from custody and periodontal disease. Of course Tooth disease and renal not closely related, as the hand-foot-Yangming channels entered teeth, teeth with certain intestinal diseases, stomach disorders related to the physiological function. The spleen and stomach is acquired, the source of blood biochemistry. Wasting the spleen and stomach, the lack of biological sources, inadequate blood, thread emptiness, and not on micro-loser in gingival, gingival lost support, and easy to catch External pathogens, teeth rot and the retreat of elimination in periodontal disease. Spleen-yang deficiency damaged or inadequate, and transport of liquid water dysfunction, leading to stagnation of water in the stomach, and gingival for Yangming passages through the trip, while a gum swelling.
Chinese Medicine and more dental disease called Tooth disease, oral diseases is one of the common diseases. Chinese medicine practitioners in the etiology of the disease, not only on kidney qi deficiency, the lack of blood, lost periodontal support, and that Exogenous introduced this year. These partial damage occurred and also lead to periodontal one of the reasons why. Recognizing that not only can the virtual to periodontal disease, but also pay attention to the very real understanding of evil. In fact, the cause of evil, many also discussed, but that is mainly because of the wind, the fire caused. In short, the occurrence of periodontal disease is more upright deficiency, Kidney qi depletion, virtual fire on the basis of the pathological inflammation, but also feeling cold fiery evil, stasis declared in the local and not casual, thermal Obstructing blood-formed local Injury . Periodontal disease in the medical machines more from the fire, stasis, virtual three awareness. Three can not only stand alone, and in many cases can co-exist, periodontal disease pathogenesis of common diseases for the fiery intrinsic, meat rot lost blood, blood stasis, and liver-kidney yin deficiency stasis blood, blood two losses. The fire also known as the "heat" refers to excessiveYang, or Yin deficiency and yang excess blood and the fiery disturbance in the function of the extreme pathological state. The strength of a fire at its main plane of the Super-fire, the fire of evil stasis, a fire of mental depression. Lead the attack with fire periodontal disease can be divided into multiple excess fire and deficient fire two categories. It is more a result of the fire gastrointestinal plot fever, caused by feelings External pathogens. Chinese medicine practitioners believe that toothache fire and heat-related gastrointestinal stasis, stasis gastrointestinal more in the heat and stomach of the fire, the fire on the inflammation and maxillofacial it toothache. In short, regardless of the fire or External pathogens stasis, are to follow through on the teeth local inflammation, leading to blood lost meat rot, and in periodontal disease, caused by the fiery intrinsic periodontal clinical manifestations, toothache more drama , gums, swelling, bleeding, bad breath, thirsty, cold-hi, they stem, urine red tongue red, yellow thick moss, pulse Waterloo few symptoms.
Blood stasis is stagnation of blood in the body, including blood from the blood supply or poor, block the channels and viscera. Congestion at the same time the existence of a blood can be further impeded and stasis of a toothache and swollen subgingival symptoms. stasis qi and blood, blood stasis in the pathogenesis of periodontal disease can be casual, interaction. In short, the medical fire, stasis, dificiency are the main periodontal disease pathogenesis, in clinical detail to identify the primary and secondary with three and folders, Differential Treatment. Periodontal disease in the body is a reflection of local, we should pay attention to treatment of periodontal disease state of the body, but also the treatment of local lesions, first tackling the symptoms and to properly handle the relationship between the Chinese medicine for the treatment that should be finding diseases the root causes and address root causes of treatment. When the disease has very superscript, if not resolved in a timely manner will be life-threatening when "radical, treat the symptoms" such as illness or chronic or acute ease recovery, "the government ease its own" When specimens were not urgent or specimen urgent, "once."
In the treatment of periodontal disease we should also properly handle the telation between replenishing root and purging Pathogens, periodontal disease common blood injury, liver and kidney deficiency, invasion of External pathogens. If upright injury and External pathogens are lighter, it may have to reinstate Eliminating Pathogens with the use or Eliminating Pathogens at the same time and to reinstate. Cuza the strength of the card can be combined.
Wipe out External pathogens, assisting upright is the primary treatment of periodontal disease due to periodontal disease caused wind is the main reason for the problem in the wind and the length of all evil in the wind pathogen for more than the violation of human pilot, so. Wipe out wind important is the treatment of periodontal disease, clinical evil influences due to the different feelings, Wipe out wind cold-dispelling commonly used painkillers, wipe out hot wind, detoxification, kidney yin,purging stomach heat, promoting blood circulating to remove blood stasis , smoothing the liver to regulate the flow of qi and nourish liver and kidney. Adequately supported by external treatment is to improve the effect of the basis of Chinese medicine since ancient times many treated teeth declared the therapy, Oral decoction, pills, powders, paste spreads, mouthwash, losers teeth, brush such as tooth. As can be avoided, Oral drug therapy may cause drug resistance and dysbacteriosis and toxicity, in the treatment of dental declared it plays an important role. In addition to fully understand the characteristics, with the permit is modified live periodontal therapy, dental vent to Yaru (GCF) shrink root declared open, floating and pain, bleeding or recurrent seepage septic its characteristics. En blood to the teeth or gums Yafeng exudative symptoms. Dental root leakage to recurrent swelling suppuration, overflow Fuyu characterized. Carbuncle teeth to gum pain, swelling, excess pus features for the performance of the gums and bulging hard Zhongqi,is very swollen cheek, and so even the gills. Bitterness of tooth is that tooth contact caused bitterness sour feeling. The clinical features of different etiology and pathogenesis of the corresponding also have some differences, should be fully aware of each other's differences, Differential Treatment, can be achieved good effect.
Clinical study were randomly selected to conduct experiments on 60 patients tested, 26 were males (43.3%), 34 were women (56.7%), and the average age was 47.03 years old (31 to 40 years old, 11 were 41 to 50 years old were 28 , 51 to 60 years of age 21). Through random sampling will be divided into two patient groups, the experimental group were 13 males and 17 females, with an average age of 45.47 years (31～40 years of age 8, 41 to 50 years old, 15, 51 -60 years of age 7) the control group 13 were males and 17 females, with an average age of 48.6 years (31-40 years of age 3 ,41-50-year-old, 13 ,51-60-14). Fixed by the experimental group under TCM practitioners and Differential Treatment debate on the Treatment of the principle of combining to give each patient to fire Bushen-based Chinese medicine treatment and control group against Chinese medicine, to the general therapy. Detection of probing depth (PD), teeth shaken degrees (MO), plaque index (PI), gingival index (GI), a few indicators. The results showed that the intervention of Chinese medicine for probing depth (PD), teeth shaken degrees (MO), plaque index (PI) of the statistical significance of the statistics show that, irrespective of whether the Chinese intervention patients after treatment The index both reduce the trend, but the Chinese intervention in the treatment of periodontitis patients with inflammatory situation after the application of traditional Chinese medicine constituencies measured values than not significantly improve the application of traditional Chinese medicine group, a statistically significant difference was, Statistics on the significance of the sixth week after the marginal benefits may be reduced, making the effectiveness of Chinese medicine interventional treatment had no significant effect.
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13.于莉英.育阴煎治疗急性牙眼感染40例.陕西中医,2001,22(3):173
14.孙培华.清胃散治疗急性牙周炎.1995年3月号
15.陈晓生,肖雪芬等.清胃散治疗牙周炎30例临床疗效观察.甘肃中医,2007,20(8)
16.郝瑞雪,郝瑞梅等.玉女煎加味治疗慢性牙周炎32例.井冈山医专学报,2007,9(4):61-62。
17.吴丽霞.玉女煎治疗牙周炎.中国民间疗法,2005,13(4):61
18.刘美蓉,高瑞平.中药治疗肾虚胃热型牙周炎60例.中医药信息,1999,6:35
19.李莹,张玮.王育群辨证治肝病齿衄举隅.中国煤炭工业医学杂志,2003,6(12)
20.耿晓江.桃核承气汤治疗牙跟肿痛.山西中医,1996,12(3):33-34
21.程门雪医案:120
22.成爱武,王梅.知柏地黄汤治疗肾虚火旺型牙周炎18例.中医研究,2005,18(9):46
23.刘萍.引火归原法的临床运用.湖北中医杂志,2002,24(12):22
24.彭运生.引火归源法的临床运用.衡阳医学院学报1995,23(4):286-287
25.开雁.补肾固齿汤治疗慢性牙周炎54例.四川中医,1999,17(12):48
26.罗冬青,吕霞.牙宣的中医药外治疗法.河南中医,1998,18(3):186
27.杨达邦,王金诚.“清胃散火汤”治疗牙周炎52例.江苏中医,1994,16(2):21
28.王琳,张平.加减玉女煎治牙周炎16例.中国民间疗法,1998,2:36
29.孙韬.齿衄的辫证论治韦云.中国农村医学,1997,25,5:18,
30.王丽萍.养阴凉血法治疗肝硬化齿衄10例.时珍国医国药,2002,13(12):744
[1]孫金泉,馬偉民等.清胃散加味治療82例中老年牙周病臨床分析.青海醫藥雜誌,2003,33(7):57
[2]裴霞.中医药在牙周疾病的临床应用.现代口腔医学杂志,2001,15(2):151-152.
[3]楊達邦,王金誠,“清胃散火湯”治療牙周炎52例.江蘇中醫,1994,16(2)
[4]賴正均.中醫治療牙周病.2005,1版:07-143
[5]徐治鸿,孙小平等.固齿健周煎剂对老年小鼠的抗氧化作用.中华口腔医学杂志,1998,33(4):219.
[6]樊明文,凌均,程祥荣等.固齿增骨散的研制和初步临床应用,口腔医学纵横杂志,1994,10(4):195.
[7]伍利君.西医结合治瘵口腔急性炎症80例.实用中医杂志.1999,15(4)
[8]乔守正.中医对牙周病的一些认识[J].北京口腔医学,1998,6(1):20-23.
[9]王永兰,邹朝辉等.中医药在口腔疾病治疗中的应用[J].天津中医药,2003,20(5):87-88.
[10]罗礼君.牙周病的中医药治疗概况和展望[J].牙体牙髓牙周病学杂志,2003,13(9):514-513.
[11]李宏丽.中医辨治牙周炎213例.河南中医药学刊2000,15(5)91-94.
[12]徐治鸿.实用中医口腔病学[M].天津:天津科技翻译出版公司,1991:91.
[13]张灵芝,韩双平等.中西医结合治疗牙周炎58例.河北中医,2003,25(6):52-453.
[14]胡壮.中医辨证分型治疗牙周炎78例.上海中医药杂志,2003,(3):33-34.
[15]毕天军.中医药结合治疗牙周炎120例.中西医结合杂志,2001,21(3):230
[16]陶伟.中药与甲硝唑治疗牙周炎的对比研究[J].天津中医,2000,17(6):15.
[17]葛琳华,束蓉等.中医辅助治疗牙周病的临床观察.口腔材料器械杂志.2006,15(1):51-52
[18]张举之.固齿丸治疗牙周病机理探讨.华西口腔医学杂志,1990,8(3):198-200
[19]张举之,杨新雪等.固齿丸合螺旋霉素治疗牙周病的临床研究.中国中西医结合杂志,1992,12(2):83-85
1.牛東平.口腔内科學.人民衛生出版社1990;p.121-136
2.曹采方.牙周病學.人民衛生出版社2000;p.29-65,66-80
3.孫金泉,馬偉民等.“清胃散加味”治療82例中老年牙周病臨床分析.青海醫藥雜 誌,2003,33(7):57
4.裴霞.中醫藥在牙周疾病的臨床應用.現代口腔醫學雜誌2001,15(2):151-152。
5.樊明文,浚均等.固齒增骨散的研製和初步臨床.應用口腔醫學縱橫雜誌,1994,10(4):195.
6.楊達邦,王金誠.“清胃散火湯”治療牙周炎52例.江蘇中醫,1994,16(2):81-83
7.張靈芝,韓雙平等.中西醫結合治療牙周炎58例.河北中醫,2003,25(6):52-53.
8.胡壯.中醫辨證分型治療牙周炎78例.上海中醫藥雜誌,2003,(3):33-34.
9.畢天軍.中醫藥結合治療牙周炎120例.中西醫結合雜誌,2001,21(3):230
10.張舉之.固齒丸治療牙周病機理探討.華西口腔醫學雜誌,1990,8(3),198-200.
11.張舉之 楊新雪等.固齒丸合螺旋黴素治療牙周病的臨床研究.中國中西醫結合雜誌,1992,12(2):83-85.
12.葛琳華,束蓉等.中醫輔助治療牙周病的臨床觀察.口腔材料器械雜誌,2006,15(1):51-52.
13.羅禮君.牙周病的中醫藥治療概況和展望[J].牙體牙髓牙周病學雜誌,2003,13(9):514-513.
14.Hausmann E.Potential pathways for bone rsorption in human periodontal disease.J.Periodontol,1974;45,338
15.Larto D.,Stahl S.S.,Brown R.J.The effect of prescribed method of toothbrushing on the fluctuaeion of marginal gingivivtis.J.Periodontol,1969;40,142.
16.Lenox J.A.,Kopczyk R.A..A clinical scoring a patient's oral hygene performance.J.Am.Dent.Assoc 1973;86,849.
Meitner,W..Identification of inflamed gingival surface.J.Clin.Pedodontol.1979;(6),93
Schorder H.E.Quantitative parmeters of early human gingival inflammation.Arch.Oral Biol.1970;15,383
19.Serio F.G.,Siegel M.A.Periontal disease:A review.Curtis 1991;47(1)55-62
20.Saglie R,Newman M.G.,Carranza F.A.Scanning electron microsopy of the interaction of leukocytes and bacteria in human periodontitis.J.Periodontol.1982;53,752
2.牛束平.口腔内科学.人民卫生出版社,1990:121-136
3.Larto D.,Stahl S.S.,Brown R.J.The effect of prescribed method of toothbrushing on the fluctuaeion of marginal gingivivtis.J.Periodontol.1969;40,142
4.Lenox J.A.,Kopczyk R.A..A clinical scoring a patient's oral hygene performance.J.Am.Dent.Assoc 1973;86,849
5.Schorder H.E.Quantitative parmeters of early human gingival inflammation.Arch.Oral Bio1.1970;15,383
6.谭清武,陈春丽等.老年牙周组织疾病216例证候分析.中国中医药信息杂志,2005,12(1):13-14
7.李龙骧.李洁生治疗齿龈病经验.上海中医药杂志,1998,10:17-18
8.陈建灵.提高中医治疗牙周炎临床疗效的思路探析.时珍国医国药,2006,17(2):292
9.张日厦.叙淑占.山东中医杂志,1995,14(7):329
10.曹兴奇,轰建平.中药治疗牙周脓肿52例临床观察.西北国防医学杂志, 1996,17(3):215
11.欧阳利民.慢性弥漫性牙周炎验案.四川中医,1997,15(5)
12.胡壮,沈海滨.中医辨证分型治疗牙周炎78例.上海中医药杂志,2003,第37(3)
13.于莉英.育阴煎治疗急性牙眼感染40例.陕西中医,2001,22(3):173
14.孙培华.清胃散治疗急性牙周炎.1995年3月号
15.陈晓生,肖雪芬等.清胃散治疗牙周炎30例临床疗效观察.甘肃中医,2007,20(8)
16.郝瑞雪,郝瑞梅等.玉女煎加味治疗慢性牙周炎32例.井冈山医专学报,2007,9(4):61-62。
17.吴丽霞.玉女煎治疗牙周炎.中国民间疗法,2005,13(4):61
18.刘美蓉,高瑞平.中药治疗肾虚胃热型牙周炎60例.中医药信息,1999,6:35
19.李莹,张玮.王育群辨证治肝病齿衄举隅.中国煤炭工业医学杂志,2003,6(12)
20.耿晓江.桃核承气汤治疗牙跟肿痛.山西中医,1996,12(3):33-34
21.程门雪医案:120
22.成爱武,王梅.知柏地黄汤治疗肾虚火旺型牙周炎18例.中医研究,2005,18(9):46
23.刘萍.引火归原法的临床运用.湖北中医杂志,2002,24(12):22
24.彭运生.引火归源法的临床运用.衡阳医学院学报1995,23(4):286-287
25.开雁.补肾固齿汤治疗慢性牙周炎54例.四川中医,1999,17(12):48
26.罗冬青,吕霞.牙宣的中医药外治疗法.河南中医,1998,18(3):186
27.杨达邦,王金诚.“清胃散火汤”治疗牙周炎52例.江苏中医,1994,16(2):21
28.王琳,张平.加减玉女煎治牙周炎16例.中国民间疗法,1998,2:36
29.孙韬.齿衄的辫证论治韦云.中国农村医学,1997,25,5:18,
30.王丽萍.养阴凉血法治疗肝硬化齿衄10例.时珍国医国药,2002,13(12):744
[1]孫金泉,馬偉民等.清胃散加味治療82例中老年牙周病臨床分析.青海醫藥雜誌,2003,33(7):57
[2]裴霞.中医药在牙周疾病的临床应用.现代口腔医学杂志,2001,15(2):151-152.
[3]楊達邦,王金誠,“清胃散火湯”治療牙周炎52例.江蘇中醫,1994,16(2)
[4]賴正均.中醫治療牙周病.2005,1版:07-143
[5]徐治鸿,孙小平等.固齿健周煎剂对老年小鼠的抗氧化作用.中华口腔医学杂志,1998,33(4):219.
[6]樊明文,凌均,程祥荣等.固齿增骨散的研制和初步临床应用,口腔医学纵横杂志,1994,10(4):195.
[7]伍利君.西医结合治瘵口腔急性炎症80例.实用中医杂志.1999,15(4)
[8]乔守正.中医对牙周病的一些认识[J].北京口腔医学,1998,6(1):20-23.
[9]王永兰,邹朝辉等.中医药在口腔疾病治疗中的应用[J].天津中医药,2003,20(5):87-88.
[10]罗礼君.牙周病的中医药治疗概况和展望[J].牙体牙髓牙周病学杂志,2003,13(9):514-513.
[11]李宏丽.中医辨治牙周炎213例.河南中医药学刊2000,15(5)91-94.
[12]徐治鸿.实用中医口腔病学[M].天津:天津科技翻译出版公司,1991:91.
[13]张灵芝,韩双平等.中西医结合治疗牙周炎58例.河北中医,2003,25(6):52-453.
[14]胡壮.中医辨证分型治疗牙周炎78例.上海中医药杂志,2003,(3):33-34.
[15]毕天军.中医药结合治疗牙周炎120例.中西医结合杂志,2001,21(3):230
[16]陶伟.中药与甲硝唑治疗牙周炎的对比研究[J].天津中医,2000,17(6):15.
[17]葛琳华,束蓉等.中医辅助治疗牙周病的临床观察.口腔材料器械杂志.2006,15(1):51-52
[18]张举之.固齿丸治疗牙周病机理探讨.华西口腔医学杂志,1990,8(3):198-200
[19]张举之,杨新雪等.固齿丸合螺旋霉素治疗牙周病的临床研究.中国中西医结合杂志,1992,12(2):83-85
1.牛東平.口腔内科學.人民衛生出版社1990;p.121-136
2.曹采方.牙周病學.人民衛生出版社2000;p.29-65,66-80
3.孫金泉,馬偉民等.“清胃散加味”治療82例中老年牙周病臨床分析.青海醫藥雜 誌,2003,33(7):57
4.裴霞.中醫藥在牙周疾病的臨床應用.現代口腔醫學雜誌2001,15(2):151-152。
5.樊明文,浚均等.固齒增骨散的研製和初步臨床.應用口腔醫學縱橫雜誌,1994,10(4):195.
6.楊達邦,王金誠.“清胃散火湯”治療牙周炎52例.江蘇中醫,1994,16(2):81-83
7.張靈芝,韓雙平等.中西醫結合治療牙周炎58例.河北中醫,2003,25(6):52-53.
8.胡壯.中醫辨證分型治療牙周炎78例.上海中醫藥雜誌,2003,(3):33-34.
9.畢天軍.中醫藥結合治療牙周炎120例.中西醫結合雜誌,2001,21(3):230
10.張舉之.固齒丸治療牙周病機理探討.華西口腔醫學雜誌,1990,8(3),198-200.
11.張舉之 楊新雪等.固齒丸合螺旋黴素治療牙周病的臨床研究.中國中西醫結合雜誌,1992,12(2):83-85.
12.葛琳華,束蓉等.中醫輔助治療牙周病的臨床觀察.口腔材料器械雜誌,2006,15(1):51-52.
13.羅禮君.牙周病的中醫藥治療概況和展望[J].牙體牙髓牙周病學雜誌,2003,13(9):514-513.
14.Hausmann E.Potential pathways for bone rsorption in human periodontal disease.J.Periodontol,1974;45,338
15.Larto D.,Stahl S.S.,Brown R.J.The effect of prescribed method of toothbrushing on the fluctuaeion of marginal gingivivtis.J.Periodontol,1969;40,142.
16.Lenox J.A.,Kopczyk R.A..A clinical scoring a patient's oral hygene performance.J.Am.Dent.Assoc 1973;86,849.
Meitner,W..Identification of inflamed gingival surface.J.Clin.Pedodontol.1979;(6),93
Schorder H.E.Quantitative parmeters of early human gingival inflammation.Arch.Oral Biol.1970;15,383
19.Serio F.G.,Siegel M.A.Periontal disease:A review.Curtis 1991;47(1)55-62
20.Saglie R,Newman M.G.,Carranza F.A.Scanning electron microsopy of the interaction of leukocytes and bacteria in human periodontitis.J.Periodontol.1982;53,752