玉女煎联合米诺环素治疗慢性牙周炎临床研究

Clinical Study on Yunv Jian Combined with Minocycline for Chronic Periodontitis

目的:观察玉女煎联合米诺环素治疗对慢性牙周炎患者牙周指标的影响。方法:将慢性牙周炎患者82例(98颗患牙),随机分为对照组41例(48颗)和观察组41例(50颗);2组患者均进行常规牙周基础治疗,对照组加用盐酸米诺环素软膏治疗,观察组在对照组的基础上加用玉女煎治疗;比较2组患者治疗前后中医症状积分(牙龈肿痛、口臭)、牙周指标龈沟出血指数(SBI)、探诊深度(PD)和菌斑指数(PLI)变化情况,检测2组治疗前后龈沟液中C-反应蛋白(CRP)、白细胞介素-8(IL-8)、白细胞介素-10(IL-10)变化,统计2组总体临床治疗效果。结果:总有效率观察组为96.00%,对照组为81.25%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组患者牙龈肿痛、口臭积分均较治疗前明显降低(P<0.05),且观察组两项积分均明显低于对照组(P<0.05)。治疗后,2组患者SBI、PD、PLI等指标均较治疗前明显下降(P<0.05),但观察组上述指标改善较对照组更显著(P<0.05)。治疗后,2组龈沟液CRP、IL-8水平均较治疗前降低(P<0.05),IL-10水平较治疗前升高(P<0.05);且观察组上述指标改善较对照组更显著(P<0.05)。结论:米诺环素联合玉女煎口服治疗慢性牙周炎,可更好地改善患者临床症状,降低炎症因子水平,疗效优于单纯西药治疗。

Objective:To observe the effect of Yunv jian combined with minocycline on the periodontal indexes of patients with chronic periodontitis.Methods:A total of 82 cases of patients with chronic periodontitis(98 diseased teeth)were divided randomly into the control group and the observation group,with 41 cases(48 diseased teeth)and 41 cases(50 diseased teeth)in each group respectively.Both groups were given routine initial periodontal therapy;the control group was additionally given minocycline hydrochloride ointment;the observation group was additionally given Yunv jian based on the treatment of the control group.The changes in Chinese medicine symptom scores including swelling and aching of gum and halitosis,and the periodontal indexes including sulcus bleeding index(SBI),probing depth(PD)and plague index(PLI)before and after treatment in the two groups were compared.The changes in the levels of C-reactive protein(CRP),interleukin-8(IL-8)and interleukin-10(IL-10)in gingival crevicular fluid before and after treatment in the two groups were evaluated.The total clinical effect in the two groups was counted.Results:The total effective rate was 96.00%in the observation group and 81.25%in the control group,the difference being significant(P<0.05).After treatment,the scores of swelling and aching of gum and halitosis in both groups were significantly lower than those before treatment(P<0.05),and the two scores in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the indexes of SBI,PD and PLI in both groups were significantly decreased when compared with those before treatment(P<0.05),but the improvement of the indexes above in the observation group was more significant than that in the control group(P<0.05).After treatment,the levels of CRP and IL-8 in gingival crevicular in both groups were lower than those before treatment(P<0.05),and the levels of IL-10 were higher than those before treatment(P<0.05);the improvement of the indexes above in the observation group was more significant than that in the control group(P<0.05).Conclusion:The application of minocycline combined with the oral administration of Yunv jian in treating chronic periodontitis can better improve the clinical symptoms of patients and reduce the levels of inflammatory factors,whose curative effect is better than that of simple western medicine.