固齿散联合人工牛黄甲硝唑治疗慢性牙周炎的临床研究

Clinical study on Guchi Powder combined with galculus bovis and metronidazole in treatment of chronic periodontitis

目的探讨固齿散联合人工牛黄甲硝唑胶囊治疗慢性牙周炎的临床疗效。方法选择2018年6月—2021年6月在西安交通大学口腔医院治疗的61例慢性牙周炎患者为研究对象,根据药物使用的差别分为对照组(30例)和治疗组(31例)。对照组口服人工牛黄甲硝唑胶囊,2粒/次,3次/d;治疗组在对照组基础上牙龈处涂抹固齿散,0.5 g/次,2次/d,每次涂擦2 min。两组患者均经2周治疗。观察两组患者临床疗效,比较治疗前后两组患者症状改善时间,一般自我效能感量表(GSES)、口腔健康影响程度量表(OHIP-14)、菌斑指数(PLI)、后龈沟出血指数(BI)和牙龈指数(GI)评分,及血清C反应蛋白(CRP)、降钙素基因相关肽(CGRP)、高迁移率族蛋白-1(HMGB-1)、白细胞介素-6(IL-6)和可溶性细胞间黏附分子-1(sICAM-1)水平。结果治疗后,治疗组临床有效率为96.77%,显著高于对照组(80.00%,P<0.05)。治疗后,治疗组患者症状改善时间均早于对照组(P<0.05)。治疗后,两组GSES评分明显升高,而OHIP-14、PLI、BI和GI评分明显降低(P<0.05),并以治疗组评分改善最为显著(P<0.05)。治疗后,两组患者血清CRP、HMGB-1、IL-6和sICAM-1水平均明显降低,而CGRP水平明显升高(P<0.05),且治疗组上述细胞因子水平明显好于对照组(P<0.05)。结论固齿散联合人工牛黄甲硝唑胶囊治疗慢性牙周炎可有效改善患者口腔症状和牙周状态,有利于降低机体炎症因子水平,促进口腔健康和自我效能感,降低患者不良心里感受。

Objective To investigate the clinical efficacy of Guchi Powder combined with Galculus Bovis and Metronidazole Capsules in treatment of chronic periodontitis.Methods Patients(61 cases)with chronic periodontitis in Hospital of Stomatological of Xi’an Jiaotong University from June 2018 to June 2021 were divided into control(30 cases)and treatment(31 cases)group based on different treatments.Patients in the control group was po administered with Galculus Bovis and Metronidazole Capsules,2 grains/time,three times daily.Patients in the treatment group were po administered with Guchi Powder on the basis of the control group,0.5 g/time,twice daily,applying for 2 min each time.Patients in two groups were treated for 2 weeks.After treatment,the clinical evaluation was evaluated,and the improvement time of symptom,the scores of GSES,OHIP-14,PLI,BI and GI,the levels of serum CRP,HMGB-1,IL-6,sICAM-1,and CGRP in two groups before and after treatment were compared.Results After treatment,the clinical effective rate of the treatment group was 96.77%,which was significantly higher than that of the control group(80.00%,P<0.05).After treatment,the time of symptom improvement in the treatment group was earlier than that in the control group(P<0.05).After treatment,the GSES scores in two groups were significantly increased,while the scores of OHIP-14,PLI,BI and GI were significantly decreased(P<0.05),especially in the treatment group(P<0.05).After treatment,the serum levels of CRP,HMGB-1,IL-6 and sICAM-1 in the two groups were significantly decreased,while the level of CGRP were significantly increased(P<0.05),and the level of above-mentioned cytokines in the treatment group was significantly better than that in the control group(P<0.05).Conclusion Guchi Powder combined with galculus bovis and metronidazole in treatment of chronic periodontitis can effectively improve patients’oral symptoms and periodontal state,reduce the level of inflammatory factors,promote oral health and self-efficacy,and reduce patients’bad feelings.