双花清胃汤配合替硝唑治疗对慢性牙周炎患者牙周状态及龈沟液中EA-S、EA-P水平的影响

Effect of Shuanghua Qingwei Decoction Combined with Tinidazole on Periodontal Status and Levels of EA-S and EA-P in Gingival Crevicular Fluid for Patients with Chronic Periodontitis

目的:观察双花清胃汤配合替硝唑治疗对慢性牙周炎患者牙周状态及龈沟液中细胞外弹性蛋白酶(EA-S)、细胞内弹性蛋白酶(EA-P)水平的影响。方法:收集2017年1月~2017年12月我科收治的慢性牙周炎患者150例,按照随机数字表,把选入患者分成研究组75例与对照组75例,两组均给予控制牙菌斑等基础处置,对照组在基础处置上,口服替硝唑片,研究组在对照组之上,加服双花清胃汤,治疗2周后观察两组中医症候积分及疗效、牙周状态、龈沟液EA-S、EA-P水平及致病菌检出率,并监测不良反应。结果:治疗2周后,两组中医症候积分均显著低于治疗前(P<0.05),且研究组改善程度优于对照组(P<0.05);研究组治疗总有效率92.00%,显著高于对照组的78.67%(P<0.05);两组牙周探诊深度(PD)、牙龈指数(GI)、菌斑指数(PLI)、牙松动指数(TM)评分均显著低于治疗前(P<0.05),两组龈沟液EA-S、EA-P水平均显著低于治疗前(P<0.05),且研究组上述指标改善优于对照组(P<0.05);两组Pg、Aa、Tf检测率均显著低于治疗前(P<0.05),且研究组Pg、Aa、Tf检出率显著低于对照组(P<0.05);治疗期间,研究组不良反应发生率4.00%,与对照组的2.67%比较差异无统计学意义(P>0.05);半年内,研究组复发率6.67%,显著低于对照组的17.33%(P<0.05)。结论:采用双花清胃汤配合替硝唑治疗慢性牙周炎患者,可以更好减轻患者中医症候,改善患者牙周状况,降低龈沟液EA-S、EA-P水平及致病菌水平,减少复发率,且安全性好。

Objective:To observe the effect of Shuanghua Qingwei Decoction combined with Tinidazole on periodontal status and levels of elastase in the supernatant(EA-S)and elastase in the pellet(EA-P)in gingival crevicular fluid for patients with chronic periodontitis.Methods:150cases of patients with chronic periodontitis treated in our department from January 2017to December 2017were collected and divided into study group(n=75)and controlled group(71=75)according to the random number table method.The two groups were given the basic treatment of dental plaque control,and the controlled group was given orally Tinidazole Tablets based on basic treatment,and the study group was additionally given Shuanghua Qingwei Decoction on the basis of the controlled group.After 2weeks of treatment,the TCM syndromes scores and efficacy,periodontal status,the levels of EAS and EA-P in gingival crevicular fluid,and the detection rate of pathogenic bacteria were observed in the two groups,and the adverse reactions were monitored.Results:After 2weeks of treatment,the scores of TCM symptoms in the two groups were significantly lower than those before treatment(P<0.05),and the improvement in the study group was better than that in the controlled group(PvO.05).The total effective rate of treatment in the study group was significantly higher than that in the controlled group(92.00%vs 78.67%)(P<0.05).The periodontal probing depth(PD),gingival index(GI),plaque index(PLI)and tooth loosening index(TM)in the two groups were significantly lower than those before treatment(P<0.05),and the levels of EA-S and EA-P were significantly lower than those before treatment(P<0.05),and the improvement of above indexes in the study group was better than that in the controlled group(P<0.05).The detection rates of Pg,Aa and Tf in the two groups were significantly lower than those before treatment(PvO.05),and the three detection rates in the study group were significantly lower than those in the controlled group(P<0.05).During treatment,there was no statistical difference in the incidence rate of adverse reactions between the study group and the controlled group(4.00%vs.2.67%)(P〉0.05).Within 6months,the recurrence rate in the study group was significantly lower than that in the controlled group(6.67%vs.17.33%)(P<0.05).Conclusion:Shuanghua Qingwei Decoction combined with Tinidazole for patients with chronic periodontitis can better relieve the TCM symptoms,improve the periodontal status,and reduce the levels of EA-S,EA-P and pathogenic bacteria in gingival crevicular fluid,and reduce recurrence rate,and it has good safety.