摘要
目的:探讨固齿散联合人工牛黄甲硝唑治疗慢性牙周炎的效果。方法:在2022年2月~2025年2月期间,本院针对80例慢性牙周炎患者开展前瞻性随机对照单盲(评价者盲)的临床试验研究,依据区组随机化原则均衡分为研究组40例(脱落1例,最终纳入39例)、对照组40例(脱落3例,最终纳入37例)。在接受4周基础牙周治疗后,对照组予以人工牛黄甲硝唑治疗,研究组予以固齿散联合人工牛黄甲硝唑治疗,两组均治疗3个月。比较两组临床疗效、中医证候积分(主症积分、次症积分、总积分)、牙周状况[出血指数(BI)、牙龈指数(GI)、菌斑指数(PLI)、附着丧失(AL)]、牙齿松动度[牙周袋深度(PD)]、牙槽骨吸收程度[牙槽骨丢失(ABL)]、骨平衡相关因子[核因子κB受体活化因子配体(RANKL)、骨保护素(OPG)、RANKL/OPG]及不良反应发生情况。结果:研究组治疗总有效率(94.87%)高于对照组(78.38%,P<0.05)。治疗1个月后、治疗3个月后,两组主症积分、次症积分、总积分较治疗前均降低,且研究组低于对照组(P<0.05)。治疗3个月后,两组BI、GI、PLI、AL、PD、ABL较基础牙周治疗后均降低,且研究组低于对照组(P<0.05)。治疗1个月后、治疗3个月后,两组RANKL、RANKL/OPG较治疗前均降低,且研究组低于对照组(P<0.05);OPG较治疗前均升高,且研究组高于对照组(P<0.05)。治疗期间,两组不良反应总发生率比较无统计学差异(P>0.05)。结论:固齿散联合人工牛黄甲硝唑治疗慢性牙周炎安全有效,可显著改善患者牙周状况,减少牙齿松动及牙槽骨吸收,并调节龈沟液RANKL/OPG平衡。
Objective:To investigate the efficacy of Guchi powder combined with Calculus Bovis and metronidazole in treating chronic periodontitis.Methods:A prospective,randomized,controlled,single-blind(evaluator-blinded)clinical trial was conducted on 80 patients with chronic periodontitis at our hospital between February 2022 and February 2025.Using block randomization,the patients were equally assigned to either the study group(40 patients;1 dropout,39 finally analyzed)or the control group(40 patients;3 dropouts,37 finally analyzed).After 4 weeks of baseline periodontal therapy,the control group was treated with Calculus Bovis and metronidazole,while the study group was treated with Guchi powder combined with Calculus Bovis and metronidazolee.Both groups were treated for 3 months.The following parameters were compared between the two groups:clinical efficacy,TCM syndrome scores(primary symptom score,secondary symptom score,and total score),periodontal status[bleeding index(BI),gingival index(GI),plaque index(PLI),and attachment loss(AL)],tooth mobility[periodontal pocket depth(PD)],degree of alveolar bone resorption[alveolar bone loss(ABL)],bone metabolism-related factors[receptor activator of nuclear factor-κB ligand(RANKL),osteoprotegerin(OPG),RANKL/OPG],and adverse reactions.Results:The overall response rate in the study group(94.87%)was higher than that in the control group(78.38%,P<0.05).After 1 and 3 months of treatment,the primary symptom scores,secondary symptom scores and total scores in both groups decreased compared to pre-treatment scores,with the study group showing lower scores than the control group(P<0.05).After 3 months of treatment,BI,GI,PLI,AL,PD and ABL in both groups decreased compared to baseline periodontal therapy,with the study group showing lower values than the control group(P<0.05).After 1 and 3 months of treatment,RANKL and RANKL/OPG levels in both groups decreased compared to pre-treatment levels,with the study group showing lower levels than the control group(P<0.05).OPG levels increased compared to pre-treatment levels,with the study group showing higher levels than the control group(P<0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups during the treatment(P>0.05).Conclusion:Guchi powder combined with Calculus Bovis and metronidazole is safe and effective in treating chronic periodontitis,significantly improving periodontal status,reducing tooth mobility and alveolar bone resorption,and regulating the RANKL/OPG balance in gingival crevicular fluid.
作者
张丽芸
柳桂萍
耿百韬
ZHANG Li-yun;LIU Gui-ping;GENG Bai-tao(Department of Stomatology,the Fourth People's Hospital of Xinxiang,Xinxiang 453000,China;Department of Stomatology,Zhengzhou Daqiao Hospital,Zhengzhou 450053,China)
出处
《中国合理用药探索》
2025年第11期124-130,共7页
Chinese Journal of Rational Drug Use
关键词
慢性牙周炎
固齿散
人工牛黄甲硝唑
骨保护素
牙槽骨吸收
chronic periodontitis
Guchi powder
Calculus Bovis and metronidazole
osteoprotegerin
alveolar bone resorption
