黄芪多糖在正畸骨改建中的作用

Effect of astragalus polysaccharides on orthodontic bone remodeling

背景:黄芪是一种常用的中药材,黄芪多糖是由黄芪茎部或干根提取的中心活性成分,具备抗肿瘤、改善记忆力、抗骨质疏松、调节血糖、调节免疫等功能。研究显示,黄芪多糖可以通过影响牙周组织重建来调整牙齿矫正的移动速度,并且在矫正过程中可能会抑制牙根的吸收,减少牙齿矫正复发的概率,局部西药治疗加用黄芪注射液静滴可促进口腔溃疡患者的溃疡愈合并延缓复发。目的:结合国内外文献对黄芪多糖在正畸过程中对牙移动、牙根吸收、正畸术后复发以及联合西药治疗口腔溃疡的作用机制做一综述,为其更好地应用于正畸治疗提供参考。方法:文章第一作者使用计算机检索万方、中国知网、PubMed等数据库查找近15年有关黄芪多糖在正畸过程中对牙移动、牙周组织改建、牙根吸收、正畸性口腔溃疡以及正畸术后复发等影响的文献。中文检索词为“黄芪、正畸牙移动、牙周组织改建、成骨细胞、破骨细胞、正畸诱导性炎性牙根吸收、正畸术后复发、正畸性口腔溃疡”,英文检索词为“astragalus membranaceus,orthodontic tooth movement,periodontium remodeling,osteoblast,osteoclast,orthodontically induced inflammatory rootresorption,recurrence after orthodontic treatment,orthodontic mouth ulcers”,最终纳入54篇文献进行归纳总结。结果与结论:①黄芪多糖在正畸过程中对各组织结构改建有着重要的调节作用,可以在口腔正畸治疗相关领域发挥重要作用,包括加速牙齿移动、促进牙周组织改建、抑制牙根吸收以及术后复发,局部西药治疗联合黄芪注射液静滴还可通过改善T细胞亚群的失衡治疗口腔溃疡并减少其发生;②但目前大多局限于动物实验阶段,仍需更多临床研究证实,黄芪多糖作为常用中草药成分,未来有望作为正畸治疗辅助手段,提高治疗效果并维持疗效;③将中医与组织工程相结合,可以为促进再生医学的发展提供进一步策略。

BACKGROUND:Astragalus membranaceus is a commonly used traditional Chinese herb.Astragalus polysaccharide is the central active ingredient extra cted fro m the stem or root of Astragalus membranaceus.It has the functions of anti-tumor,improving memory,anti-osteoporosis,regulating blood glucose and regulating immunity.Studies have shown that astragalus polysaccharides can regulate the movement speed of orthodontic teeth by affecting pe riodontal tissue remodeling and inhibit root resorption and postope rative recurrence caused by orthodontic treatment.Local western medicine combined with astragalus injection can significantly promote ulcer healing and delay ulcer recurrence in patients with oral ulcer.OBJECTIVE:To review the effects of astragalus polysaccharides on tooth movement,root resorption,recurrence after orthodontic surgery and the treatment of oral ulcer combined with western drug therapy during orthodontic treatment,there by providing reference for its better application in orthodontic treatment.METHODS:The first author searched Wan Fang,CNKI,and PubMed for relevant lite rature about the effect of astragalus polysaccharides on orthodontic tooth movement,periodontal tissue remodeling,root resorption,orthodontic oral ulcer and postoperative recurrence published in the past 15 years.The keywords were "Astragalus membranaceus,orthodontic tooth movement,pe riodontium remodeling,osteoblast,osteoclast,orthodontically induced inflammatory root resorption,recurrence after orthodontic treatment,orthodontic mouth ulcers" in Chinese and English.Finally,54 eligible articles were included for review.RESULTS AND CONCLUSION:Astragalus polysaccharide plays an important role in the adjustment of tissue remodeling as well as in orthodontic treatment,including accele rating tooth movement,promoting periodontal tissue remodeling,inhibiting root resorption and postoperative recurrence.Local western drug therapy combined with astragalus injection can also treat oral ulcer and reduce its occurrence by improving the imbalance of T cell subsets.However,most of them are limited to the animal experimental stage and more clinical studies are needed.Astragalus polysaccharide,as a commonly used ingredient of Chinese herbal medicine,is expected to be used as an adjunct to orthodontic treatment in the future to enhance and maintain therapeutic effects.The combination of Tra ditional Chinese Medicine and tissue enginee ring can provide further strategies to promote the development of regenerative medicine.