清热解毒中药合剂治疗牙周炎的临床疗效及对患牙龈沟液和血清中TNF-α及IL-1β的影响

Clinical Effect of Using Traditional Chinese Medicine Mixture for Clearing Away Heat and Toxin in the Treatment of Paradentitis and the Effect of Attacked Gingival Sulcus Fluid and TNF-α and IL-1β Levels in Serum

目的：分析清热解毒中药合剂在牙周基础治疗对TNF-α及IL-1β的影响及其意义。方法：选取我科2012年6月至2014年6月就诊的慢性牙周炎患者共80例（102颗观察牙）,随机分为实验组和对照组。对照组予以牙周基础治疗,实验组在对照组基础上,加用清热解毒中药合剂。对比两组患者治疗前和治疗4周后的探诊深度（probing depth,PD）、附着水平（attachment level,AL）、出血指数（bleeding index,BI）、临床附着丧失（clinical attachment level,CAL）、BOP阳性位点数和菌斑指数（plaque index,PLI）、咬合指标、患牙龈沟液和血清中肿瘤坏死因子-α（TNF-α）及白细胞介素~1β（IL-1β）水平。结果：两组患者治疗4周后的PD、AL、BI、CAL、BOP阳性位点数和PLI显著低于治疗前（P〈0.05）;实验组治疗4周后的PD、AL、BI、CAL、BOP阳性位点数和PLI显著低于对照组（P〈0.05）。两组患者治疗4周后的咬合时间和咬合受力百分比均显著低于治疗前,P〈0.05;实验组治疗4周后的咬合时间和咬合受力百分比均显著低于对照组（P〈0.05）。两组患者治疗4周后的患牙龈沟液和血清中TNF-α及IL-1β显著低于治疗前（P〈0.05）;实验组治疗4周后的患牙龈沟液和血清中TNF-α及IL-1β显著低于对照组（P〈0.05）。结论：清热解毒中药合剂联合牙周基础治疗可有效改善牙周状况,同时降低炎症反应。

Objective： To analyze the effect of traditional Chinese medicine mixture for clearing away heat and toxin in the basic treatment of periodontal disease and its significance on TNF-α and IL-1β. Methods： 80cases（ 102 observed teeth） with chronic periodontitis in our department from June 2012 to June 2014 for treatment were randomly divided into experimental and controlled groups. The controlled group was received periodontal treatment; the experimental group was received traditional Chinese medicine treatment on the basis of detoxification agent. The probing depth（ PD）,attachment level（ AL）,bleeding index（ bleeding index,BI）,clinical attachment level（ CAL）,BOP positive loci and plaque index（ plaque index,PLI）,bite indicators,gingival sulcus fluid and serum tumor necrosis factor-α（ TNF-α） and interleukin-1β（ IL-1β） levels were comparedbetween the two groups before treatment and after 4weeks of treatment. Results： PD,AL,BI,CAL,BOP and PLI of 4weeks after treatment were significantly lower than before treatment,P〈0. 05. PD,AL,BI,CAL,BOP and PLI in the experimental group of 4weeks after treatment were significantly lower than the controlled group,P〈0. 05. Occlusion time and occlusal force percentages in the two groups of patients after four weeks of treatment were significantly lower than before treatment,P〈0. 05.Occlusion time and occlusal force percentages in the experimental group after four weeks of treatment were significantly lower than the controlled group,P〈0. 05. TNF-α and IL-1β in the gingival sulcus fluid and serum in the two groups of patients four weeks after treatment was significantly lower than before treatment,P〈0. 05. TNF-α and IL-1β in the gingival sulcus fluid and serum in the experimental group after 4weeks of treatment was significantly lower than the controlled group,P〈0. 05. Conclusion： Traditional Chinese medicine mixture for clearing away heat and toxin combined with basic treatment of periodontal disease can effectively improve the periodontal status while reducing inflammation.