超声龈下刮治联合黄连解毒汤加味含漱治疗慢性牙周炎临床研究

目的：观察超声龈下刮治联合黄连解毒汤加味含漱治疗慢性牙周炎热毒炽盛证的临床疗效。方法：选取104例慢性牙周炎热毒炽盛证患者,按随机数字表法分成对照组和观察组各52例。对照组剔除2例,最终纳入研究观察组52例、对照组50例。2组均进行龈上洁治、抛光,7 d后进行超声龈下刮治。对照组给予0.9%氯化钠溶液含漱,观察组给予黄连解毒汤加味含漱。比较2组临床疗效、牙周指数[牙周探诊深度（PD）、牙龈指数（GI）、牙龈出血指数（BI）、菌斑指数（PLI） ]、龈沟液中炎症因子[白细胞介素-1β（IL-1β）、肿瘤坏死因子-α（TNF-α） ]水平及龈沟液中氧化应激指标[丙二醛（MDA）、超氧化物歧化酶（SOD）、谷胱甘肽过氧化物酶（GSH-Px）、一氧化氮（NO） ]水平。结果：治疗1个月后,观察组临床疗效总有效率98.08%,高于对照组84.00%（P＜0.05）。2组PD、GI、BI、PLI均较治疗前降低（P＜0.05）,观察组上述4项牙周指数均低于对照组（P＜0.05）。2 组龈沟液中IL-1β、TNF-α 水平均较治疗前降低（P＜0.05）,观察组龈沟液中IL-1β、TNF-α 水平均低于对照组（P＜0.05）。2组龈沟液中MDA、NO 水平均较治疗前降低（P＜0.05）,龈沟液中SOD、GSH-Px水平均较治疗前升高（P＜0.05）;观察组龈沟液中MDA、NO水平均低于对照组（P＜0.05）,龈沟液中SOD、GSH-Px水平均高于对照组（P＜0.05）。结论：超声龈下刮治联合黄连解毒汤加味含漱治疗慢性牙周炎热毒炽盛证,可有效改善牙周症状,作用机制可能与抑制牙周组织炎症及改善牙周组织氧化应激反应有关。

Clinical Study on Ultrasonic Subgingival Scaling and Gargle with Modified HuanglianJiedu Decoction for Chronic Periodontitis

Abstract：Objective：To observe the clinical effect of the therapy of ultrasonic subgingival scaling andgargle with modified Huanglian Jiedu Decoction on chronic periodontitis with intense heat toxin syndrome.Methods：A total of 104 cases of patients with chronic periodontitis with intense heat toxin syndrome wereselected and divided into the control group and the observation group according to the random number tablemethod, with 52 cases in each group. With two cases being culled in the control group, finally 52 and50 cases were included into the observation group and the control group respectively. The two groupswere given supragingival scaling and polishing , and ultrasonic subgingival scaling after seven days. Thecontrol group was given gardling with 0.9% Sodium Chloride Solution,and the observation group was givengardling with modified Huanglian Jiedu Decoction. The clinical effects, levels of periodontal indexes[periodontal probing depth (PD), gingival index (GI), periodontal bleeding index (BI), and plaque index(PLI)],and inflammatory factors [interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α)] and oxidativestress indexes [malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px)and nitric oxide (NO)] in gingival crevicular fluid were compared between the two groups. Results：After onemonth of treatment,the total clinical effective rate was 98.08% in the observation group,higher than thatof 84.00% in the control group (P＜0.05). The levels of PD, GI, BI, and PLI in the two groups weredecreased when compared with those before treatment,and the above four levels in the observation groupwere lower than those in the control group (P＜0.05). The levels of IL-1β and TNF- α in gingival crevicularfluid in the two groups were decreased when compared with those before treatment (P＜0.05), and theabove two levels in the observation group were lower than those in the control group (P＜0.05). The levels ofMDA and NO in gingival crevicular fluid in the two groups were decreased when compared with thosebefore treatment (P＜0.05),and the levels of SOD and GSH-Px in gingival crevicular fluid were increasedwhen compared with those before treatment (P＜0.05); the levels of MDA and NO in gingival crevicularfluid in the observation group were lower than those in the control group (P＜0.05),and the levels of SODand GSH-Px in gingival crevicular fluid in the observation group were higher than those in the control group(P＜0.05). Conclusion： Ultrasonic subgingival scaling and gargle with modified Huanglian Jiedu Decoctioncan effectively improve the periodontal symptoms of patients with chronic periodontitis with intense heattoxin syndrome. The action mechanism may be related to inhibiting periodontal tissue inflammation andimproving oxidative stress responses in periodontal tissue.