清胃泻火汤联合活性银离子抗菌液对口腔正畸所致牙龈炎牙周指标、龈沟液TNF-α、sICAM-1、NO水平的影响

Effect of Qingwei Xiehuo Decoction(清胃泻火汤)Combined with Active Silver Ion Antibacterial Liquid on Periodontal Indexes and Levels of TNF-α,sICAM-1 and NO in Gingival Crevicular Fluid of Patients with Gingivitis Caused by Orthodontics

目的研究清胃泻火汤联合活性银离子抗菌液对口腔正畸所致牙龈炎患者牙周指标、龈沟液肿瘤坏死因子-α(tumour necrosis factor-α,TNF-α)、可溶性细胞间黏附因子-1(soluble intercellular adhesion molecule-1,sICAM-1)、一氧化氮(nitric oxide,NO)水平的影响。方法选择医院2018年10月—2020年10月口腔正畸所致牙龈炎患者116例,随机数字表法分为联合组、抗菌液组各58例。抗菌液组予以活性银离子抗菌液治疗,联合组采取清胃泻火汤联合活性银离子抗菌液治疗,均治疗1个月。以疗效、牙龈肿痛程度、牙周指标、龈沟液TNF-α、sICAM-1、NO水平、不良反应、1年复发率为观察指标比较两组治疗效果及安全性。结果联合组治疗1个月后总有效率(91.38%,53/58)高于抗菌液组(74.14%,43/58)(P<0.05),联合组治疗期间不良反应发生率(5.17%,3/58)与抗菌液组(1.72%,1/58)相比,差异无统计学意义(P>0.05);联合组治疗1个月后牙龈肿胀、疼痛程度较抗菌液组低(P<0.05);联合组治疗1个月后SBI、PLI、GI评分、龈沟液TNF-α、sICAM-1、NO水平均低于抗菌液组(P<0.05);联合组治疗后6个月复发率(1.75%,1/57)与抗菌液组(12.50%,7/56)相比,差异无统计学意义(P>0.05),联合组治疗后1年复发率(5.26%,3/57)低于抗菌液组(23.21%,13/56)(P<0.05)。结论清胃泻火汤联合活性银离子抗菌液治疗口腔正畸所致牙龈炎可明显降低龈沟液TNF-α、sICAM-1、NO水平,减轻牙龈肿痛程度,加速牙龈健康状态恢复,降低复发率,安全有效。

Objective To study the effects of Qingwei Xiehuo Decoction(清胃泻火汤)combined with active silver ion anti⁃bacterial solution on periodontal indexes and the levels of tumor necrosis factor-α(TNF-α),soluble intercellular adhesion fac⁃tor-1(sICAM-1)and nitric oxide(NO)in gingival crevicular fluid of patients with gingivitis caused by orthodontics.Methods From October 2018 to October 2020,116 patients with gingivitis caused by orthodontics were selected from the hospital,and they were divided into a combination group and an antibacterial liquid group,58 cases in each group,by a random number table.The antibacterial liquid group was treated with active silver ion antibacterial liquid,and the combination group was treated with Qing⁃wei Xiehuo Decoction combined with active silver ion antibacterial liquid for 1 month.The efficacy,gingival swelling and pain,periodontal indicators,levels of TNF-α,sICAM-1 and NO in gingival crevicular fluid,adverse reactions,and 1-year recur⁃rence rate were used to compare the therapeutic effects and safety of the two groups.Results The total effective rate(91.38%,53/58)of the combination group after 1 month of treatment was higher than that of the antibacterial solution group(74.14%,43/58)(P<0.05),and the incidence of adverse reactions during the treatment of the combination group(5.17%,3/58)was not statistically significant compared with that of the antibacterial solution group(1.72%,1/58)(P>0.05).After 1 month of treat⁃ment in the combination group,the gingival swelling and pain were lower than those of the antibacterial solution group(P<0.05).Sulcus bleeding index(SBI),plaque index(PLI)and gingival index(GI)scores,levels of TNF-α,sICAM-1 and NO in gingival crevicular fluid in the combination group were lower than those of the antibacterial solution group after 1 month of treat⁃ment(P<0.05).The recurrence rate of the combination group 6 months after treatment was 1.75%(1/57)and that of the anti⁃bacterial solution group was 12.50%(7/56),and the difference was not statistically significant(P>0.05),and the recurrence rate in the combination group one year after treatment(5.26%,3/57)was lower than that of the antibacterial solution group(23.21%,13/56)(P<0.05).Conclusion Qingwei Xiehuo Decoction combined with active silver ion antibacterial liquid in the treatment of gingivitis caused by orthodontics can significantly reduce the levels of TNF-α,sICAM-1 and NO in gingival crevic⁃ular fluid,reduce swelling and pain of the gums,accelerate the recovery of gum health,and reduce the recurrence rate.It is safe and effective.