补肾固齿丸联合松牙固定对重症牙周炎疗效及机制研究

Bushenguchiwan combined with ceramic restoration splinting in treatment of severe periodontitis

目的探讨补肾固齿丸对重症牙周炎松动牙夹板固定的疗效和机制。方法选38例重症牙周炎患者作为研究对象,随机分为治疗组和对照组,治疗组20例患者在松动牙夹板固定联合用固齿丸治疗,对照组18例行松动牙固定,所有患者固定前行牙周基础治疗。测定龈沟出血指数(sulcus bleeding index,SBI)、牙周袋深度(pocketdeep,PD)、牙龈血流量(gingival blood flow,GBF)、碱性磷酸酶(alkaline phosphatase,ALP)和牙槽骨吸收程度变化。随访2年。结果治疗组在治疗后SBI和PD明显降低,GBF和ALP明显增加,牙槽骨吸收程度明显改善,与对照组有显著性差异。2年后随访SBI和PD比对照组明显好转,GBF和ALP明显增加,牙槽骨吸收程度改善。结论补肾固齿丸联合牙周夹板可通过改善牙龈微循环,调节骨代谢和减少合创伤对牙槽骨再生有一定调节作用。

Objective To evaluate the efficacy of Traditional Chinese medicinal Bushenguchiwan combined with ceramic restoration splinting for severe periodontitis. Methods Thirty-eight patients with severe periodontitis were enrolled in the study. They were randomly divided into two groups： patients in combination group （n = 20） received 4 g Bushenguchiwan orally twice a day for 3 months after ceramic restoration splinting; patients in control group （n = 18 ） received ceramic restoration splinting only. In addition all patients received initial periodontal therapy. Sulcus bleeding index （SBI）, pocket deep （PD）, gingival blood flow （GBF）, alkaline phosphatase （ALP）, and degree of alveolar bone absorption were measured before and after treatment. All patients were followed-up for 2 years. Results The SBI score and PD value were significantly lower and the GBF, ALP and degree of alveolar bone after treatment in combination group were higher than those in control group （P 〈 0.01 ）. After 2 years the SBI score and PD were lower and the GBF was higher in combination group than those in control group. The degree of alveolar bone absorption after 2 years in combination group was improved than that of baseline. Conclusion Bushenguchiwan combined with ceramic restoration splinting can improve the gingival microcirculation and bone metabolism and decrease occlusive trauma to promote new bone formation for severe periodontitis.