大黄五倍子含漱液治疗慢性牙周炎的临床疗效观察和体外抑菌作用的研究  

Efficacy observation on treatment of chronic periodontitis by Daihuang Wuweizi Gargle and study on antibacterial activity in vitro

作　　者：姚旭[1] 蔡玲玲[1] 杨柳[2] 李元文[1] 张丰川[1] 赵凤珠[1] 

机构地区：[1]北京中医药大学东方医院,北京丰台100078 [2]天津市中医药研究院附属医院,天津和平300020

出　　处：《中医临床研究》2014年第33期73-76,共4页Clinical Journal Of Chinese Medicine

基　　金：北京中医药大学优秀中青年教师资助项目

摘　　要：目的:观察大黄五倍子含漱液治疗慢性牙周炎(胃火上炎证)的临床疗效和体外抑菌作用。方法:临床疗效观察部分:采用完全随机安慰剂平行对照的研究方法,将100例患者随机分为试验组50例和对照组50例。试验组采用大黄五倍子含漱液+牙周基础治疗,对照组仅给予空白安慰剂含漱液+牙周基础治疗,含漱液30m L/次,每次保留5min,日3次,疗程3个月。通过观察菌斑指数(plaque index,PLI)、龈沟出血指数(sulcus bleeding index,SBI)、牙周袋探诊深度(probing depth,PD)、牙龈指数(gingival index,GI)等指标来进行综合疗效评价和单项积分评价,同时进行中医症候积分的分析,作为次要指标。体外抑菌作用研究部分:分别检测大黄、五倍子单味药及复方对牙周炎最常见的临床致病菌牙龈紫质孢菌(Pg)的最低抑菌浓度(MIC)。结果:经卡方分析,试验组愈显率为38%,对照组愈显率为6%,P<0.01;试验组有效率为80%,对照组有效率为34%,P<0.01,两组愈显率和有效率均有显著统计学差异。两组在单项指标改善,PD积分无统计学差异,Gl、SBI、PLI等积分均有统计学差异,试验组积分低于对照组,说明试验组在牙龈指数Gl、牙龈出血指数SBI、菌斑指数PLI方面改善优于对照组。体外抑菌实验中MIC值由高到低分别是:五倍子水提液<大黄五倍子复方水提液<大黄水提液。结论:在牙周基础治疗同时使用大黄五倍子含漱液可以显著提高慢性牙周炎(胃火上炎证)的临床疗效。大黄对牙龈紫质孢菌(Pg)的体外抗菌作用最强,其次是大黄和五倍子复方,抗菌作用最弱的是五倍子。临床疗效最佳的复方组合并非抑菌作用最强的大黄水提液,因此,慢性牙周炎的疗效与抑菌强度不成正比,对临床中治疗提供新思路。Objective： To observe the clinical efficacy of Daihuang Wuweizi Gargle and study on antibacterial activity in vitro in the treatment of chronic periodontitis. Methods： Clinical efficacy observation： 100 cases were randomly divided into a trial group with 50 cases and a control group with 50 cases by the method of randomized placebo parallel control. The trial group was given Daihuang Wuweizi Gargle＋periodontal treatment, the control group was given blank placebo gargle＋periodontal treatment, 30ml/time for 5 mins every time,three time per day, 3 months as a course. Comprehensive evaluation of curative effect and single integral evaluation were taken according to PLI, SBI,PD,GI.At the same time, the analysis of TCM syndrome was given as a secondary index. Study on antibacterial activity in vitro： Bacteria gingival porphyrin cinerea induced by rhubarb, Chinese gall clinical single drug for the most common minimum inhibitory concentration （Pg） of periodontitis were respectively detected. Results： By chi square analysis,the curative rate of the trial group was 38%, while that of the control group was 6%, P〈0.01; the effective rate of the trial group was 80%, while that of the control group was 34%, P〈0.01. The differences of the curative rate and the effective rate of the two groups were statistically. The two group improved in single index, no significant difference between the PD integral, G1 integral, SBI, PLI etc. there were statistical differences between the trial group and the control group. The MIC value in vitro bacteriostasis experiment from the highest to the lowest was Wuweizi extract water〈 Compound Daihaung Wuweizi water extract 〈 Daihuang extract. Conclusion： The simultaneous application of Daihuang Wuweizi Gargle in periodontal treatment can significantly improve the chronic periodontitis （stomach shangyanzheng） clinical efficacy. Daihuang on gingival porphyrin cinerea （Pg） the strongest antibacterial activity in vitro, followed by compound Daihuang and Wuweizi, the

关 键 词：大黄五倍子含漱液 牙周炎 胃火上炎证 牙龈紫质孢子菌 

分 类 号：R781.05[医药卫生—口腔医学]