摘要
目的探讨老年慢性牙周炎患者应用清胃固齿方结合替硝唑治疗的临床效果及对患者炎症水平、牙周菌斑分布影响。方法纳入101例老年慢性牙周炎患者,采取随机数字表法分为两组,分别为对照组50例和观察组51例,对照组患者进行牙周基础治疗,并给予替硝唑治疗,观察组患者在对照组治疗基础上结合清胃固齿方治疗,研究过程中对照组脱落1例,观察组患者脱落1例。观察各组数据:临床疗效、患者症状改善时间(牙龈肿痛、口臭、牙齿松动)、治疗前后患者中医证候积分(牙龈作痛、出血、口气热臭、渴喜冷饮、大便干结等)变化、菌斑指数(plaque index,PLI)与牙周袋探诊深度(probing depth,PD)、龈沟出血指数(sulcus bleeding index,SBI)、牙周附着丧失(attach-ment loss,AL)等牙周相关指标变化、龈沟液白细胞介素-6(interleukin-6,IL-6)与肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)、口腔健康影响程度量表(oral health impact profile,OHIP-14)评分变化、治疗不良反应情况。结果观察组患者临床疗效(94.00%,47/50)优于对照组(79.59%,39/49),差异有统计学意义(P<0.05);与对照组比较,观察组患者症状改善时间(牙龈肿痛、口臭、牙齿松动)均更短,差异有统计学意义(P<0.05);治疗前各组患者中医证候积分、牙周相关指标(PLI、PD、SBI及AL)、IL-6及TNF-α水平、OHIP-14量表评分比较,差异无统计学意义(P>0.05),治疗后各组患者中医证候积分、牙周相关指标(PLI、PD、SBI及AL)、IL-6及TNF-α水平、OHIP-14量表评分均改善,而观察组患者治疗后中医证候积分(牙龈作痛、出血、口气热臭、渴喜冷饮、大便干结等)、牙周相关指标(PLI、PD、SBI及AL)、IL-6及TNF-α水平、OHIP-14量表评分均优于对照组患者,差异有统计学意义(P<0.05);观察组患者总不良反应率低于对照组,差异有统计学意义(P<0.05)。结论老年慢性牙周炎患者应用清胃固齿方结合替硝唑治疗的临床效果良好,可较好降低机体炎症反应,改善患者牙周菌斑分布情况,以改善患者病情及生活质量,且治疗不良反少,安全可靠。
Objective To investigate the clinical effect of Qingwei Guchi Prescription(清胃固齿方)combined with tinidazole on inflammation and the distribution of periodontal plaque in elderly patients with chronic periodontitis.Methods A total of 101 elderly patients with chronic periodontitis admitted from January 2021 to February 2023 were divided into two groups by random number table method,namely control group(50 cases)and observation group(51 cases).The control group received periodontal basic treatment and tinidazole and the observation group was combined with Qingwei Guchi Prescription on the basis of the control group.During the study,1 patient fell off in the control group and 1 fell off in the observation group.The clinical efficacy,symptom improvement time(swollen gums,bad breath,loose teeth),changes of TCM syndrome scores(gum pain,bleeding,hot breath,thirst for cold drinks,dry stool,etc.)before and after treatment,plaque index(PLI)and probing depth(PD)of periodontal pockets,sulcus bleeding index(SBI),attach loss(AL)and other periodontal related indicators,the levels of interleukin-6(interleukin-6)and tumor necrosis factor-α(TNF-α)in gingival crevicular fluid,changes in the score of Oral Health Impact Profile(OHIP-14)and adverse reactions were compared.Results The clinical effect of the observation group(94.00%,47/50)was better than that of control group(79.59%,39/49)(P<0.05).Compared with that in the control group,the improvement time of symptoms(swollen gums,bad breath,loose teeth)in the observation group was shorter(P<0.05).Before treatment,TCM syndrome scores(gingival pain,bleeding,hot breath,thirst for cold drinks,dry stool,etc.),periodontal related indexes(PLI,PD,SBI and AL),the levels of IL-6 and TNF-αand OHIP-14 scale scores were not significant between two groups(P>0.05).After treatment,TCM syndrome scores(gum pain,bleeding,hot breath,thirst for cold drinks,dry stool,etc.),periodontal related indexes(PLI,PD,SBI and AL),the levels of IL-6 and TNF-αand OHIP-14 scale scores were improved in both groups.After treatment,TCM syndrome scores(gingival pain,bleeding,hot breath,thirst for cold drinks,dry stool,etc.),periodontal related indexes(PLI,PD,SBI and AL),the levels of IL-6 and TNF-αand OHIP-14 scale scores in the observation group were superior to those in the control group(P<0.05).The total adverse reaction rate of the observation group was lower than that of the control group(P<0.05).Conclusion In elderly patients with chronic periodontitis,Qingwei Guchi Prescription combined with tinidazole has good clinical effect,which can effectively reduce the inflammatory response of the body and improve the distribution of periodontal plaque in patients,so as to improve the condition and quality of life of patients.The treatment is safe and reliable and less adverse reaction.
作者
马海冰
杨鹏强
胡永寿
祝静莉
赵弼洲
田佳灵
赵瑮
MA Haibing;YANG Pengqiang;HU Yongshou;ZHU Jingli;ZHAO Bizhou;TIAN Jialing;ZHAO Li(Gansu Provincial Hospital of Traditional Chinese Medicine,Lanzhou730050,Gansu,China)
出处
《中华中医药学刊》
北大核心
2025年第5期218-221,共4页
Chinese Archives of Traditional Chinese Medicine
基金
甘肃省科学技术厅项目(1606RJYA278)。
关键词
老年慢性牙周炎
替硝唑
清胃固齿方
炎症水平
牙周菌斑分布
疗效
不良反应
senile chronic periodontitis
tinidazole
Qingwei Guchi Prescription(清胃固齿方)
inflammation levels
periodontal plaque distribution
curative efect
adverse reaction
作者简介
马海冰(1983-),女(回族),甘肃兰州人,副主任医师,硕士,研究方向:口腔临床(全科);通讯作者:赵瑮(1973-),女,甘肃兰州人,副主任医师,学士,研究方向:牙体牙髓病及颞颌关节病。E-mail:zhaolizyy@126.com。
