CAJ | 학술논문

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30mL/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。
목적：관찰대황오배자함수액치료만성아주염（위화상염증）적림상료효화체외억균작용。방법：림상료효관찰부분：채용완전수궤안위제평행대조적연구방법，장100례환자수궤분위시험조50례화대조조50례。시험조채용대황오배자함수액+아주기출치료，대조조부급여공백안위제함수액+아주기출치료，함수액30mL/차，매차보류5min，일3차，료정3개월。통과관찰균반지수（plaque index, PLI）、간구출혈지수（sulcus bleeding index，SBI）、아주대탐진심도（probing depth , PD）、아간지수（gingival index，GI）등지표래진행종합료효평개화단항적분평개，동시진행중의증후적분적분석，작위차요지표。체외억균작용연구부분：분별검측대황、오배자단미약급복방대아주염최상견적림상치병균아간자질포균（Pg）적최저억균농도（MIC）。결과：경잡방분석，시험조유현솔위38%，대조조유현솔위6%，P＜0.01；시험조유효솔위80%，대조조유효솔위34%，P＜0.01，량조유현솔화유효솔균유현저통계학차이。량조재단항지표개선，PD 적분무통계학차이，Gl、SBI、PLI 등적분균유통계학차이，시험조적분저우대조조，설명시험조재아간지수 Gl、아간출혈지수 SBI、균반지수 PLI 방면개선우우대조조。체외억균실험중 MIC치유고도저분별시：오배자수제액＜대황오배자복방수제액＜대황수제액。결론：재아주기출치료동시사용대황오배자함수액가이현저제고만성아주염（위화상염증）적림상료효。대황대아간자질포균（Pg）적체외항균작용최강，기차시대황화오배자복방，항균작용최약적시오배자。림상료효최가적복방조합병비억균작용최강적대황수제액，인차，만성아주염적료효여억균강도불성정비，대림상중치료제공신사로。
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, Gl 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 lowest antibacterial effect is Wubeizi. The best effective Compound antimicrobial effect is Daihaung extract. So the curative effect and the antibacterial activity of chronic periodontitis is not directly proportional providing a new thought to the clinical treatment.