清胃固齿方辅助治疗慢性牙周炎的疗效以及对龈沟液MMPs/TIMP表达的影响

Effi cacy of Qingwei Guding Prescription in Treating Chronic Periodontitis and Its Effect on Gingival Crevicular Fluid Levels of MMPs/TIMP

目的:探讨清胃固齿方辅助治疗慢性牙周炎胃火炽盛证的疗效以及对龈沟基质金属蛋白酶-2(MMP-2)、MMP-9及金属蛋白酶组织抑制因子(TIMP)-2水平的影响。方法:将2016年1月-2018年10月笔者医院收治90例的慢性牙周炎患者按数字表法随机分为对照组和观察组,每组45例。两组均给予常规干预措施。对照组给予口服罗红霉素胶囊,0.15g/次,2次/d。口服替硝唑片,1g/次,1次/d;观察组在对照组基础上给予清胃固齿方治疗,1剂/d,2次/d。两组连续治疗4周。比较两组菌斑指数、牙龈指数、探针深度、龈沟出血指数,主要症状改善时间、临床疗效、龈沟液MMP-2、MMP-9及TIMP-2水平。结果:治疗4周后,观察组患者的菌斑指数、牙龈指数、探诊深度及龈沟出血指数评分明显低于对照组(P<0.01);牙齿松动、口臭、牙龈肿痛的改善时间显著短于对照组(P<0.01);观察组总有效率为93.33%,明显高于对照组的77.78%(P<0.05);治疗4周后,观察组龈沟液MMP-2、MMP-9水平显著低于对照组,TIMP-2水平明显高于对照组(P<0.01)。结论:在常规治疗基础上,联合清胃固齿方治疗慢性牙周炎胃火炽盛证的疗效确切,调节MMP-2、MMP-9及TIMP-2水平可能是其疗效途径之一。

Objective To investigate the efficacy of Qingwei Guding prescription in the treatment of chronic periodontitis with syndrome of exuberance of stomach fire and its effect on gingival crevicular matrix levels of matrix metalloproteinase-2(MMP-2),MMP-9,and metalloproteinase tissue inhibitor(TIMP-2).Methods Ninety chronic periodontitis cases were selected from Jan of 2016 to Oct of 2018 and randomly divided into the control group and the observation group with 45 cases in each group.Both groups were given with routine therapy.Cases in the control group were orally treated with roxithromycin capsules(0.15g/time,2 times/d)and Tinidazole tablets(1g/time,1 time/d).On basis of the control group,the observation group was treated with Qingwei Guding prescription(1 dose/d and bid).The course was for 4 weeks in both groups.Scores of plaque index,gingival index,probe depth,gingival bleeding index,the improvement time of main symptoms,the efficacy and gingival crevicular matrix levels of MMP-2,MMP-9,and TIMP-2 were compared in two groups.Results After 4 weeks’treatment,scores of plaque index,gingival index,probe depth,and gingival bleeding index in the observation group were obviously lower than those of the control group(P<0.01).Improvement time of teeth loose,bad breath,and swollen gums in the observation group was shorter than the control group(P<0.01).Total efficacy rate of treatment group was 93.33%superior to control group(77.78%)(P<0.01).Gingival crevicular matrix levels of MMP-2 and MMP-9 in the observation group were obviously lower,while TIMP-2 was higher,than control group(P<0.01).Conclusion The efficacy of Qingwei Guding prescription in the treatment of chronic periodontitis with syndrome of exuberance of stomach fire is signifi cant,and regulation of gingival crevicular matrix levels of MMP-2,MMP-9,and TIMP-2 may be one of effective ways.