清胃泻火方联合替硝唑辅助根管充填对牙周牙髓联合病变患者牙周微生态环境、龈沟液中炎症因子水平和预后的影响  

Effect of Qingwei Xiehuo Recipe Combined with Tinidazole-Assisted Root Canal Filling on Periodontal Micro-Ecological Environment,Inflammatory Factor Levels in Gingival Crevicular Fluid and Prognosis in Patients with Combined Periodontal-Endodontic Lesions

作　　者：黄毓秋 隋晶 HUANG Yuqiu;SUI Jing(Dept.of Stomatology,Integrated Traditional Chinese and Western Medicine Hospital of Tongzhou District,Beijing 101100,China)

机构地区：[1]北京市通州区中西医结合医院口腔科,北京101100

出　　处：《中国医院用药评价与分析》2021年第9期1032-1035,1038,共5页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：北京市科技计划项目(No.Z171100001017545)。

摘　　要：目的:探讨清胃泻火方联合替硝唑辅助根管充填对牙周牙髓联合病变患者牙周微生态环境和龈沟液中白细胞介素(IL) 1β、IL-4、超敏C反应蛋白(hs-CRP)水平及预后的干预效果。方法:选取2019年1月至2020年4月北京市通州区中西医结合医院收治的牙周牙髓联合病变患者100例,采用1∶1配对随机化原则分为观察组和对照组,每组50例。对照组患者予以替硝唑辅助根管充填治疗,观察组患者予以清胃泻火方联合替硝唑辅助根管充填治疗,持续服用清胃泻火方1个月。比较两组患者的疗效,治疗前、治疗2周和治疗1个月后疼痛程度评分(visual analogue scale,VAS)、牙周微生态环境指标[菌斑指数(PLI)、龈沟出血指数(SBI)、牙龈指数(GI)和牙周袋深度(PD)]和氧化应激反应指标[丙二醛(MDA)、超氧化物歧化酶(SOD)]水平,龈沟液中IL-1β、IL-4和hs-CRP水平;治疗后随访6个月,统计两组患者患牙预后情况。结果:观察组患者治疗1个月后的总有效率为88.0%(44/50),明显高于对照组的62.0%(31/50),差异有统计学意义(P<0.05)。治疗2周、1个月后,观察组患者的VAS评分、PLI、SBI、GI和PD明显低于对照组,龈沟液IL-1β、IL-4和hs-CRP水平明显低于对照组,差异均有统计学意义(P<0.05)。观察组患者治疗2周、1个月后的血清MDA水平较对照组明显更低,血清SOD水平较对照组明显更高,差异均有统计学意义(P<0.05)。随访6个月,观察组牙周炎、牙齿扣痛和牙齿松动患者所占比例较对照组低,差异有统计学意义(P<0.05)。结论:清胃泻火方联合替硝唑辅助根管充填用于牙周牙髓联合病变患者,可降低炎症反应,减轻氧化损伤,调节牙周微生态环境,有利于增强治疗效果,减轻疼痛程度,改善预后。OBJECTIVE: To probe into the effect of Qingwei Xiehuo recipe combined with tinidazole-assisted root canal filling on periodontal micro-ecological environment,gingival crevicular fluid interleukin( IL)-1β and interleukin( IL)-4,high-sensitivity C-reactive protein( hs-CRP) levels and prognosis in patients with combined periodontalendodontic lesions. METHODS: Totally 100 patients with combined periodontal-endodontic lesions admitted into the Integrated Traditional Chinese and Western Medicine Hospital of Tongzhou District from Jan. 2019 to Apr. 2020 were selected and divided into observation group and control group via 1 ∶ 1 pairing randomization,with 50 cases in each group. The control group was given tinidazole-assisted root canal filling,while the observation group was given Qingwei Xiehuo recipe for 1 month combined with tinidazole-assisted root canal filling. The clinical efficacy,visual analogue scale( VAS) of before treatment,2 weeks and 1 month after treatment,indicators of periodontal micro-ecological environment [dental plaque index( PLI),sulcus bleeding index( SBI),gingival index( GI) and periodontal pocket depth( PD) ]and oxidative stress response [malondialdehyde( MDA) and superoxide dismutase( SOD) ],gingival crevicular fluid IL-1β,IL-4 and hs-CRP levels were compared between two groups;at 6-month follow-up visit after treatment,the prognoses of both groups were collected. RESULTS: The total effective rate of observation group at 1 month after treatment were 88. 0%( 44/50),which was significantly higher than that of the control group( 62. 0%,31/50),with statistically significant difference( P<0. 05). At 2 weeks and 1 month after treatment,the VAS score,PLI,SBI,GI and PD levels of observation group were significantly lower than those of the control group,and the gingival crevicular fluid IL-1β,IL4 and hs-CRP levels were significantly lower than those of the control group,with statistically significant differences( P<0. 05). The serum MDA levels of observation group at 2 weeks and 1 month after trea

关 键 词：清胃泻火方 替硝唑 根管充填 牙周牙髓联合病变 牙周微生态环境 预后 

分 类 号：R932[医药卫生—生药学]