目的 探討黃連上清膠囊聯(lián)合替硝唑治療慢性牙周炎的臨床效果。方法 選取2018年6月—2019年6月北京市中關(guān)村醫(yī)院收治的474例（共615顆患牙）慢性牙周炎患者，隨機(jī)分成對(duì)照組（n=237）和治療組（n=237）。對(duì)照組口服替硝唑膠囊，1 g/次，1次/d，首次劑量加倍，飯后服用。治療組在對(duì)照組基礎(chǔ)上口服黃連上清膠囊，2粒/次，2次/d。兩組均連續(xù)治療7 d。觀(guān)察兩組的臨床療效，兩組治療前后行牙周探診檢查[主要觀(guān)察探診深度（PD）和附著喪失（AL）變化]，運(yùn)用齦溝出血指數(shù)（SBI）、菌斑指數(shù)（PLI）分別評(píng)估患者的牙齦炎癥狀況和口腔衛(wèi)生狀況，采用視覺(jué)模擬評(píng)分法（VAS）評(píng)估患者主觀(guān)牙齦腫痛程度，并采取酶聯(lián)免疫法測(cè)定齦溝液中腫瘤壞死因子（TNF）-α、可溶性細(xì)胞間粘附分子-1（sICAM-1）及血清E-選擇素（E-sel）、降鈣素基因相關(guān)肽（CGRP）水平，使用免疫比濁法檢測(cè)血清C反應(yīng)蛋白（CRP）。結(jié)果 治療組總有效率為95.4%顯著高于對(duì)照組87.3%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。與治療前對(duì)比，兩組治療后PD、AL均顯著減?。?i>P<0.05），SBI、PLI則均顯著降低（P<0.05）；但治療后，治療組以上各項(xiàng)牙周臨床指標(biāo)的改善效果均顯著優(yōu)于對(duì)照組同期（P<0.05）。兩組治療后齦溝液中TNF-α、sICAM-1均顯著低于治療前（P<0.05），且治療組下降更顯著（P<0.05）。與治療前相比，兩組治療后疼痛VAS評(píng)分及血清E-sel、CRP水平均顯著下降（P<0.05），而血清CGRP濃度均顯著增高（P<0.05）；且治療組治療后上述各項(xiàng)指標(biāo)的改善效果均更顯著（P<0.05）。結(jié)論 應(yīng)用黃連上清膠囊聯(lián)合替硝唑治療慢性牙周炎具有較好的臨床療效，能有效緩解患者牙齦腫痛癥狀，改善牙周組織功能及生理形態(tài)，減輕牙周局部及全身炎癥反應(yīng)，延緩或阻止病情發(fā)展，整體療效良好，且安全性較好。

Objective To investigate the clinical effect of Huanglian Shangqing Capsules combined with tinidazole in treatment of chronic periodontitis. Methods A total of 474 patients with chronic periodontitis admitted to Beijing Zhongguancun Hospital from June 2018 to June 2019 (a total of 615 teeth) were randomly divided into control group (n=237) and treatment groups (n=237). The control group was po administered with Tinidazole Capsules, 1 g/time, once daily, double the first dosage after meals. The treatment group was po administered with Huanglian Shangqing Capsules on the basis of the control group, 2 grains/time, twice daily. All subjects were treated for 7 days. The clinical efficacy of the two groups was compared. The periodontal probing examination [main observation probing depth (PD) and attachment loss (AL) changes] was performed before and after treatment. The patients were evaluated by sulcus bleeding index (SBI) and plaque index (PLI). The gingival inflammatory condition and oral hygiene status were evaluated by visual analog scale (VAS), and the degree of subjective gingival swelling and pain was measured. Enzyme-linked immunosorbent assay (ELISA) was used to determine tumor necrosis factor (TNF)-α and soluble intercellular adhesion in gingival crevicular fluid. Molecular-1 (sICAM-1) and serum E-selectin (E-sel), calcitonin gene-related peptide (CGRP) levels, serum c-reactive protein (CRP) content was determined by immunoturbidimetry. Results The total effective rate of the treatment group was 95.4%, which was significantly higher than that of the control group 87.3%, and there were differences between two groups (P<0.05). Compared with before treatment, PD and AL in two groups were significantly decreased after treatment (P<0.05), and SBI and PLI were significantly decreased (P<0.05). However, after treatment, the improvement effect of the above periodontal clinical indicators in the treatment group was significantly better than that in the control group (P<0.05). The levels of TNF-α and sICAM-1 in gingival crevicular fluid in two groups were significantly lower than those before treatment (P<0.05), and the treatment group decreased more significantly (P<0.05). Compared with before treatment, the pain VAS scores, serum E-sel and CRP levels in two groups were significantly decreased (P<0.05), but serum CGRP concentrations were significantly increased (P<0.05). The improvement effect of all indicators was more significant (P<0.05). Conclusion Huanglian Shangqing Capsules combined with tinidazole has good clinical effect in treatment of chronic periodontitis, and can effectively alleviate the symptoms of gingival swelling and pain, improve the function and physiological morphology of periodontal tissues, and also can reduce the local and systemic inflammatory response of the periodontitis,

R988.2