银花解毒汤加减治疗慢性牙周炎疗效及对龈沟液Th17细胞相关细胞因子的影响

Therapeutic Effect of Using Yinhua Jiedu Decoction in the Treatment of Chronic Periodontitis and Its Influnce on Th17 Cell Related Cytokines in Gingival Crevicular Fluid

目的:探讨银花解毒汤加减治疗慢性牙周炎(CP)的疗效及对患者龈沟液辅助性T细胞17(Th17)细胞相关细胞因子的影响。方法:选取2019年4月~2021年6月本院收治的85例CP患者为研究对象,将其简单随机分为对照组(n=42)和观察组(n=43),对照组给予常规治疗,观察组在上述基础采用银花解毒汤加减治疗,连续治疗1周,比较两组患者临床疗效、中医症候积分、龈沟液Th17细胞相关细胞因子水平、牙周状况、不良反应。结果:观察组临床有效率(90.70%)较对照组(71.43%)显著高,且差异有统计学意义(P<0.05);治疗前,两组患者中医症候积分(牙龈肿痛、口干、口臭、便秘)、龈沟液Th17细胞相关细胞因子水平[白介素-17(IL-17)、白介素-23(IL-23)]、牙周指标[牙周附着水平(PAL)、牙周袋深度(PPD)、牙菌斑指数(PLI)、牙龈指数(GI)]比较无明显差异(P>0.05),治疗后,两组患者上述中医症状积分、龈沟液Th17细胞相关细胞因子水平、牙周指标均下降,且观察组较对照组更低(P<0.05);两组不良反应发生率对比无显著差异(χ^(2)=0.322,P>0.05)。结论:银花解毒汤加减治疗CP疗效确切,可有效缓解患者临床症状,降低龈沟液Th17细胞相关细胞因子水平,改善牙周状况,且安全性较高。

Objective:To explore the curative effect of Modified Yinhua Jiedu Decoction in treating chronic periodontitis(CP)and its influences on helper T cell 17(Th17)-related cytokines in gingival crevicular fluid.Methods:A total of 85 patients with CP admitted to the hospital were enrolled as the research objects between April 2019 and June 2021.They were randomly divided into a controlled group(n=42)and an observation group(n=43).The controlled group was given routine treatment,while the observation group was additionally treated with Modified Yinhua Jiedu Decoction.All were continuously treated for 1 week.The clinical curative effect,scores of TCM symptoms,levels of Th17-related cytokines in gingival crevicular fluid,periodontal status and adverse reactions were compared between the two groups.Results:The clinical response rate of the observation group was significantly higher than that of the controlled group(90.70%vs 71.43%)(P<0.05).Before treatment,there was no significant difference in scores of TCM symptoms(gingival pain and swellings,dry mouth,ozostomia,constipation),levels of Th17-related cytokines in gingival crevicular fluid[interleukin-17(IL-17),interleukin-23(IL-23)]or periodontal indexes[periodontal attachment level(PAL),periodontal pocket depth(PPD),plaque index(PLI),gingival index(GI)]between the two groups(P>0.05).After treatment,the above-mentioned indexes in both groups were decreased,which were lower in the observation group than the controlled group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(χ^(2)=0.322,P>0.05).Conclusion:The curative effect of Modified Yinhua Jiedu Decoction is significant on CP,which can effectively relieve clinical symptoms of patients,reduce levels of Th17-related cytokines in gingival crevicular fluid and improve periodontal condition,with high safety.