清胃养阴汤联合正畸治疗慢性牙周炎71例

Influence of Stomach-Clearing and Yin-Nourishing Decoction Combine with Orthodonitic Therapy on Symptoms Scores and the Level of Inflammatory Cytokines in Gingival Crevicular Fluid

目的:观察清胃养阴汤联合正畸治疗慢性牙周炎的临床疗效,并探讨其对患者临床指标及龈沟液中炎性细胞因子水平的影响。方法:将本院收治的142例患者随机分为对照组和观察组各71例。对照组单纯给予牙周基础治疗、固定矫治器正畸治疗,观察组则在对照组治疗的基础上联合给予清胃养阴汤治疗,连续治疗1个月。治疗后比较两组患者临床疗效,评价中医证候积分,比较治疗前后患者临床相关指标牙周袋深度、出血指数、牙龈指数、牙齿松动度变化,检测治疗前后龈沟液中炎性细胞因子白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)水平变化情况。结果:观察组有效率为92.9%,显著优于对照组的77.5%(χ2=6.762,P<0.05);观察组患者的临床症状改善更为明显,其治疗后中医证候积分显著低于对照组(P<0.05);观察组的牙周袋深度、出血指数、牙龈指数、牙齿松动度指标均显著低于对照组(P<0.05);观察组经治疗后龈沟液中炎性细胞因子IL-6、IL-1β、TNF-α水平均显著低于对照组(P<0.05)。结论:清胃养阴汤联合正畸治疗慢性牙周炎疗效确切,利于改善患者的临床症状,提高牙龈质量,保护牙周组织,其机制与调控龈沟液中炎性细胞因子水平有一定的相关性。

Objective： To observe the clinical effects of Stomach-Clearing and Yin-Nourishing Decoction combine with orthodonitic therapy on the symptoms scores and the level of inflammatory cytokines in gingival crevicular fluid. Methods： Totally 142 patients treated in this hospital were randomly divided into control group and observation group,with 71 cases in each group. Control group were simply given periodontal non-surgical treatment and orthodonitic therapy with fixed orthodontic appliance while observation group were added with oral administration of Stomach-Clearing and Yin-Nourishing Decoction,for continuous treatment of one month. The clinical therapeutic effects in the two groups were compared; the TCM symptom scores were evaluated; such relevant clinical indicators as the depths of the periodontal pocket,hemorrhage indexes,gingival indexes and change of teeth mobility before and after the treatment were compared; and the changes of the levels of IL-6,IL-1βand TNF-αafter the treatment were determined. Results： The effective rate was 92. 9% in observation group,remarkably higher than the 77. 5% in control group（ χ2=6. 762,P 〈 0. 05）. The improvement of the clinical symptoms in observation group was much more obvious in observation group and the TCM symptom scores in this group were apparently lower than these in control group（ P 〈 0. 05）. The depth of the periodontal pocket,hemorrhage index,gingival index and index of the teeth mobility in observation group were greatly lower than these in control group（ P 〈 0. 05）. The levels of IL-6,IL-1βand TNF-αin observation group were remarkably lower than those in control group（ P 〈 0. 05）. Conclusion： Stomach-Clearing and Yin-Nourishing Decoction combine with orthodonitic therapy has definite efficacy on the chronic periodontitis,which helps to improve the clinical symptoms,enhance the quality of the gingival and protect the periodontal tissues,The mechanism may have some relevance with the regulation of the level of the inflammatory cytokines in the gingival crevicular fluid.