摘要
目的观察扶脾益肾方结合手工根面平整术治疗重度慢性牙周炎(脾肾阳虚型)临床效果及对患者炎性因子影响。方法共计纳入102例重度慢性牙周炎(脾肾阳虚型)患者(2020年1月—2024年1月收治)进行分组研究,以随机数字表法将患者分为单纯手术组与结合中药组,各组51例,单纯手术组患者均行手工根面平整术治疗,结合中药组患者采取手工根面平整术治疗同时结合扶脾益肾方治疗,治疗及研究过程中单纯手术组患者脱落1例,结合中药组患者脱落2例,各组患者数据观察:临床疗效、治疗前后中医证候(主症、次症与舌脉)积分变化、牙周指数变化及龈沟液内炎症因子浓度变化、咀嚼功能(咬合力和咀嚼效率)变化、治疗不良反应。结果结合中药组患者治疗总有效率比单纯手术组更高,P<0.05;各组患者治疗前中医症候(主症、次症与舌脉)积分、牙龈出血指数(Gingival bleeding index,BI)、菌斑指数(plaque index,PLI)及附着丧失(Attachment loss,AL)、牙周探诊深度(probing depth,PD)等牙周指数、龈沟液内肿瘤坏死因子-α(Tumor Necrosis Factor-α,TNF-α)与白细胞介素-1β(Interleukin-1β,IL-1β)等炎症因子浓度、咀嚼功能(咬合力和咀嚼效率)等指标比较,均P>0.05,各组患者治疗后以上指标均显著改善,而结合中药组患者治疗后以上指标改善程度均优于单纯手术组患者,均P<0.05;结合中药组与单纯手术组均未见严重不良反应发生,P>0.05。结论扶脾益肾方结合手工根面平整术治疗重度慢性牙周炎(脾肾阳虚型)临床效果显著,可较好降低患者龈沟液内炎症因子浓度,改善患者临床症状及牙周指数、咀嚼功能,促进患者恢复,治疗较为安全可靠。
Objective To observe the clinical effect of Fupi Yishen Recipe(扶脾益肾方)combined with manual root surface leveling in the treatment of severe chronic periodontitis(spleen-kidney Yang deficiency type)and its effect on inflammatory factors.Methods A total of 102 patients with severe chronic periodontitis(spleen-kidney-yang deficiency type)admitted from January 2020 to January 2024 were included in the group study.The patients were divided into the simple operation group and the combined Chinese medicine group by random number table method,with 51 cases in each group.All patients in the simple operation group received manual root planarization treatment.Those in the combined Chinese medicine group were treated with manual root surface leveling and Fupi Yishen Recipe.During the treatment and study,1 patient in the simple operation group fell off,and 2 patients in the combined Chinese medicine group fell off.The clinical efficacy,integral changes of TCM symptoms(main symptoms,secondary symptoms and tongue and pulse)before and after treatment,the changes of periodontal index and concentration of inflammatory factors in gingival crevicular fluid,the changes of masticatory function(bite force and masticatory efficiency)and the adverse reactions of treatment of two groups were observed.Results The total effective rate of the combined Chinese medicine group was higher than that of the operation group(P<0.05).Before treatment,the scores of TCM symptoms(main symptoms,secondary symptoms and tongue and pulse),periodontal indices such as gingival bleeding index(BI),plaque index(PLI)and loss of attachment(AL),depth of periodontal probe(PD),concentration of inflammatory factors such as tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β)in gingival crevicular fluid,and chewing function(biting force)of patients in both groups had no significance(all P>0.05).After treatment,the above indexes were all improved and those in the combined Chinese medicine group were better than those in the simple operation group(all P<0.05).No serious adverse reactions were observed in the combined Chinese medicine group and the simple operation group(P>0.05).Conclusion Fupi Yishen Recipe combined with manual root surface leveling has significant clinical effect in the treatment of severe chronic periodontitis(spleen-kidney Yang deficiency type),which can effectively reduce the concentration of inflammatory factors in gingival crevicular fluid,improve the clinical symptoms,periodontal index and masticatory function of patients and promote the recovery of patients.The treatment is relatively safe and reliable.
作者
蒋文卉
曹峥
李寅
JIANG Wenhui;CAO Zheng;LI Yin(Department of Stomatology,Huzhou Central Hospital,The Fifth School of Clinical Medicine of Zhejiang Chinese Medical University,Huzhou 313000,Zhejiang,China)
出处
《中华中医药学刊》
北大核心
2025年第9期202-205,共4页
Chinese Archives of Traditional Chinese Medicine
基金
浙江省中医药科技计划项目(2024ZL1025)。
关键词
重度慢性牙周炎
脾肾阳虚型
扶脾益肾方
手工根面平整术
疗效
龈沟液内炎症因子浓度
牙周指数
severe chronic periodontitis
spleen-kidney Yang deficiency type
Fupi Yishen Recipe(扶脾益肾方)
manual root surface leveling
curative effect
concentration of inflammatory factors in gingival crevicular fluid
periodontal index
