双花清胃汤治疗慢性牙周炎60例临床研究

Shuanhua Qingwei Decoction Clinical Study on the Treatment of 60 Cases of Chronic Periodontitis

目的:观察双花清胃汤治疗慢性牙周炎(CP)的临床疗效及对牙齿沟液中炎性因子和病原菌的影响。方法:将96例CP患者随机分按数字法分为对照组和观察组各48例。两组均对患牙作基础治疗。对照组口服罗红霉素胶囊,0.15 g,bid;替硝唑片,1.0 g,qd,口服。观察组在对照组基础上加用双花清胃汤,1剂/d,含漱及口服,bid,疗程均为7 d。观察治疗前后牙周局部症状,包括牙龈指数(GI)、菌斑指数(PLI)、牙周袋深度(PD)、龈沟出血指数(SBI);检测治疗前后牙齿沟液中肿瘤坏死因子-α(TNF-α)、前列腺E2(PGE2)及白细胞介数-6(IL-6)水平,采用聚合酶链式反应(PCR)技术检测牙齿沟液中病原菌,包括伴放线放线杆菌(Aa)、牙龈卟啉单胞菌(Pg)及福赛类杆菌(Tf)。结果:观察组总有效率为91.7%优于对照组的75.0%(P<0.05);观察组SBI,PLI,GI及PD评分均低于对照组(P<0.01);观察组牙齿沟液中TNF-α,PGE2和IL-6水平低于对照组(P<0.01);观察组牙齿沟液中病原菌Aa,Pg及Tf检出率低于对照组(P<0.01)。结论:双花清胃汤口服和含漱能控制CP患者炎症水平,抑制齿沟液中牙周致病菌含量,减轻临床症状,提高疾病疗效,值得临床使用。

Objective： To discuss the clinical efficacy of Shuanghua Qingwei decoction on patients with chronic periodontitis and the effect on inflammatory factor and pathogenic bacteria. Method： Ninety-six patients were randomly divided into observation group （n=48） and control group （n=48）.Both groups were given basic treatment. Control group was given roxithromycin capsules, 0.15 g each time, 2 times each day;tinidazole tablets, 1 g each time, 1 times each day. Shuanghua Qingwei decoction were added to observation group, 1 decoction each time, 2 times each day, all for 7 days. Local symptoms of periodontal were observed, including the gingival index（GI）, plaque index（PLI）, pocket depth（PD）, sulcus bleeding index（SBI）, tumor necrosis factor-α（TNF-α）, prostaglandin E2（PGE2）, interleukin count-6（IL-6）. Polymerase chain reaction was used to test pathogenic bacteria, including actinobacillus actinomycetemcomitans（Aa）,porphyromonas gingivalis aeromonas（Pg）, bacteroides forsythus（Tf）. Result： The total effective rate of observation group （91.7%） was superior to control group （75.0%） （P〈0.01）;the scores of SBI, PLI, GI in observation group were lower than control group （P〈0.01）;the level of TNF-α, PGE2, IL-6 in observation group were lower than those in control group （P〈0.01）;the relevance ratio of Aa, Pg, Tf in observation group were lower than those in control group （P〈0.01）. Conclusion： Shuanghua Qingwei decoction can control inflammation level of CP patients, inhibit the content of periodontal pathogen, relieve the clinical symptoms of disease, enhance curative effect. It is worthy of clinical use.