摘要
目的:研究野菊花骨碎补复合中药制剂联合奥硝唑对慢性牙周炎的治疗作用,探讨该方法治疗慢性牙周炎的疗效并阐明其作用机制。方法:将112例慢性牙周炎患者按照就诊时间顺序分为对照组、奥硝唑组、中药组和中药联合奥硝唑组(联合组),每组28例。对患牙进行基本牙周治疗(龈上洁治和龈下刮治)后,对照组患者采用3%H2O2和0.9%NaCl注射液交替冲洗牙周袋,每周1次;奥硝唑组患者口服奥硝唑,每次1片,每日2次;中药组患者在牙周袋内注射野菊花骨碎补复合中药制剂,使药物溢出至牙龈边缘,每周1次;联合组患者在牙周袋内注射复合中药制剂,同时口服奥硝唑。各组患者均以4周为1个疗程。观察各组患者治疗前后的牙周指数,包括改良菌斑指数(mPLI)、改良龈沟出血指数(mSBI)、牙周探诊深度(PD)和附着丧失(AL);检测治疗1个疗程后各组患者龈沟液(PISF)中肿瘤坏死因子α(TNF-α)和前列腺素E2(PGE2)水平。结果:治疗前各组患者牙周指数、PISF中TNF-α和PGE2水平比较差异无统计学意义(P>0.05)。与对照组比较,中药组患者PISF中PGE2水平降低(P<0.05);奥硝唑组患者PD和PISF中PGE2水平明显降低(P<0.05);联合组患者mPLI、mSBI、PD和AL,PISF中TNF-α和PGE2水平均明显降低(P<0.05)。与奥硝唑组比较,中药组患者上述各指标差异无统计学意义(P>0.05),联合组患者mPLI、mSBI、PD和AL,PISF中TNF-α水平明显降低(P<0.05)。与中药组比较,联合组患者mPLI、mSBI、PD和AL,PISF中TNF-α和PGE2 水平均明显降低(P<0.05)。结论:传统野菊花骨碎补复合中药制剂联合奥硝唑对于慢性牙周炎的治疗效果最佳,可改善患者牙周指数,降低患者PISF中的TNF-α和PGE2水平。
Objective : To study the therapeutic effect of compound Chinese medicine preparation of wild chrysanthemum and rhizoma drynariae combined with ornidazole in the treatment of chronic periodontitis,to explore the curative effect of this method in the treatment of chronic periodontitis,and to calarify its mechanism. Methods : A total of 112 patients with chronic periodontitis were divided into control gro up, ornidazole group, Chinese medicine group, Chinese medicine combined with ornidazole group (combination group) according the order of clinic time;there were 28 cases in each group. After basic periodontal treatment of the affected tooth (supragingival scaling and subgingival scaling), the periodontal pockets of the patients in control group were washed with 3%H 2O 2 and 0.9%NaCl injection by turns,once a week;the patients in ornidazole group were orally administered with ornidazole one piece at a time, twice a day;the patients in Chinese medicine group were injected with compound Chinese medicine preparation of wild ch rysanthemum and rhizoma drynariae into the pocket to make the medicine overflow to the edge of the gingival margin,once a week;the patients in combination group were in jected with compound Chinese medicine preparation into the periodontal pocket while orally administered with ornidazole. All patients in various groups were treated for 4 weeks .The periodontal indexes including modified plaque index(mPLI), modified sulcus bleeding index (mSBI),probing depth(PD), and attachment loss (AL) of the patients in various groups were observed before and after treatment;and the levels of tumor necrosis factor-α(TNF-α) and prostaglandin E 2 (PGE 2) in the gingival crevicular fluid (PISF) of the patients in various groups were detected after one course of treatment. Results : There were no significant differences in the periodontal indexes and the levels of TNF-αand PGE 2 in PISF of the patients before treatment between various groups( P >0.05). Compared with control group,the level of PGE 2 in PISF in Chinese medicine group was reduced( P <0.05);the PD and the PGE 2 level in PISF of the patients in ornidazole group were significantly reduced ( P <0.05);the mPLI,mSBI,PD and AL, the levels of TNF-α and PGE 2 in PISF of the patients in combination group were significantly reduced ( P <0.05).Compared with ornidazole group, there were no significant differences in the above indicators of the patients in Chinese medicine group ( P >0.05);the mPLI, mSBI, PD and AL,the TNF-α level in PISF of the patients in combination group were significantly reduced ( P <0.05).Compared with Chinese medicine group,the mPLI, mSBI, PD and AL,the levels of TNF-α and PGE 2 in PISF of the patients in combination group were significantly reduced( P <0.05). Conclusion : The traditional compound Chinese medicine preparation of wild chrysanthemum and rhizoma drynariae combined with ornidazole has the best therapeutic effect in the chronic periodontitis,which can improve the periodontal index and reduce the levels of TNF-α and PGE 2 in PISF of the patients.
作者
许立硕
黄玉
金权
刘晨光
陈飞
张莉
马宁
XU Lishuo;HUANG Yu;JIN Quan;LIU Chenguang;CHEN Fei;ZHANG Li;MA Ning(Department of Periodontics,Stomatology Hospital,Jilin University,Changchun 130021,China;Department of Stomatology,Jilin Provincial People’s Hospital,Changchun 130021,China;Department of Emergency,Stomatology Hospital,Jilin University,Changchun 130021,China)
出处
《吉林大学学报（医学版）》
CAS
CSCD
北大核心
2019年第5期1128-1133,共6页
Journal of Jilin University：Medicine Edition
基金
吉林省中医药管理局科研项目资助课题(2017097)
关键词
慢性牙周炎
野菊花
骨碎补
奥硝唑
chronic periodontitis
wild chrysanthemum
rhizome drynariae
ornidazole
