益气升阳固齿汤与放血疗法、针刺疗法联合常规疗法治疗慢性牙周炎临床研究

Clinical Study on Yiqi Shengyang Guchi Tang,Bloodletting Therapy and Acupuncture Therapy Combined with Routine Therapy for Chronic Periodontitis

目的:观察在现代医学常规疗法基础上加用益气升阳固齿汤与放血疗法、针刺疗法治疗慢性牙周炎患者的疗效。方法:将125例脾肾阳虚兼阳气下陷、热毒炽盛型慢性牙周炎患者随机分为2组,对照组62例患者予常规疗法治疗,包括根面平整术、洁治术、龈下刮治术,术后口服阿莫西林胶囊、甲硝唑片等,观察组63例患者在对照组治疗基础上联合益气升阳固齿汤及放血疗法、针刺疗法治疗,2组均治疗7 d。于治疗前及治疗7 d后测定龈沟出血指数(SBI)、牙齿松动度(TM)、牙周袋探诊深度(PD)、菌斑指数(PLI)、炎症因子[C-反应蛋白(CRP)、白细胞介素-17(IL-17)及白细胞介素-21(IL-21)]及骨保护素水平,评价中医症状评分(牙龈肿痛、口臭口干、齿衄溲黄、便秘)。比较2组的临床疗效,观察不良反应发生情况。结果:治疗7 d后,观察组临床疗效总有效率高于对照组(P<0.05)。2组TM、PLI、SBI与PD值均较治疗前下降(P<0.05),观察组4项指标值低于对照组(P<0.05)。2组牙龈肿痛、口臭口干、齿衄溲黄、便秘评分与CRP、IL-17、IL-21水平均较治疗前降低(P<0.05),观察组以上4项中医症状评分与3项炎症因子水平均低于对照组(P<0.05)。2组骨保护素水平均较治疗前升高(P<0.01),观察组骨保护素水平高于对照组(P<0.01)。结论:在现代医学常规疗法基础上加用益气升阳固齿汤与放血疗法、针刺疗法治疗脾肾阳虚兼阳气下陷、热毒炽盛型慢性牙周炎可提高疗效,有效缓解临床症状,改善牙周炎症情况,安全性较好。

Objective:To observe the curative effect of Yiqi Shengyang Guchi tang,bloodletting therapy and acupuncture therapy for patients with chronic periodontitis based on routine modern medical therapy.Methods:A total of 125 cases of patients with chronic periodontitis of spleen-kidney yang deficiency with sunken middle qi and intense heat toxin type were randomly divided into two groups.The control group(62 cases)was treated with routine therapy,including root planning,scaling,subgingival scaling,and postoperative oral administration of amoxicillin capsules and metronidazole tablets.The observation group(63 cases)was additionally treated with Yiqi Shengyang Guchi tang,bloodletting therapy and acupuncture therapy based on the treatment of the control group.Both groups were treated for seven days.Before treatment and after seven-day treatment,gingival sulcus bleeding index(SBI),tooth mobility(TM),periodontal probing depth(PD),plaque index(PLI),inflammatory factors[C-reactive protein(CRP),interleukin-17(IL-17)and interleukin-21(IL-21)]and osteoprotegerin levels were measured;Chinese medicine symptom scores(swelling and aching of gum,fetid mouth odor and dry mouth,gum bleeding and yellow urine,constipation)were evaluated.Clinical effects and incidence of adverse reactions were compared between the two groups.Results:After seven-day treatment,total clinical effective rate in the observation group was higher than that in the control group(P<0.05).Values of TM,PLI,SBI and PD in the two groups were decreased when compared with those before treatment(P<0.05),and the four indexes in the observation group were lower than those in the control group(P<0.05).Scores of swelling and aching of gum,fetid mouth odor and dry mouth,gum bleeding and yellow urine,and constipation,as well as levels of CRP,IL-17 and IL-21 in the two groups were decreased when compared with those before treatment(P<0.05),and the four Chinese medicine symptom scores and levels of three inflammatory factors above in the observation group were lower than those in the control group(P<0.05).Levels of osteoprotegerin in the two groups were increased when compared with those before treatment(P<0.01),and the osteoprotegerin in the observation group was higher than that in the control group(P<0.01).Conclusion:Based on routine modern medical therapy,the therapy of Yiqi Shengyang Guchi tang,bloodletting therapy and acupuncture therapy in the treatment of chronic periodontitis of spleen-kidney yang deficiency with sunken middle qi and intense heat toxin type can enhance curative effect,effectively relieve clinical symptoms,and improve periodontitis symptoms,with good safety.