目的 探討固齒散聯(lián)合人工牛黃甲硝唑膠囊治療慢性牙周炎的臨床療效。方法 選擇2018年6月—2021年6月在西安交通大學(xué)口腔醫(yī)院治療的61例慢性牙周炎患者為研究對(duì)象，根據(jù)藥物使用的差別分為對(duì)照組（30例）和治療組（31例）。對(duì)照組口服人工牛黃甲硝唑膠囊，2粒/次，3次/d；治療組在對(duì)照組基礎(chǔ)上牙齦處涂抹固齒散，0.5 g/次，2次/d，每次涂擦2 min。兩組患者均經(jīng)2周治療。觀察兩組患者臨床療效，比較治療前后兩組患者癥狀改善時(shí)間，一般自我效能感量表（GSES）、口腔健康影響程度量表（OHIP-14）、菌斑指數(shù)（PLI）、后齦溝出血指數(shù)（BI）和牙齦指數(shù)（GI）評(píng)分，及血清C反應(yīng)蛋白（CRP）、降鈣素基因相關(guān)肽（CGRP）、高遷移率族蛋白-1（HMGB-1）、白細(xì)胞介素-6（IL-6）和可溶性細(xì)胞間黏附分子-1（sICAM-1）水平。結(jié)果 治療后，治療組臨床有效率為96.77%，顯著高于對(duì)照組（80.00%,P<0.05）。治療后，治療組患者癥狀改善時(shí)間均早于對(duì)照組（P<0.05）。治療后，兩組GSES評(píng)分明顯升高，而OHIP-14、PLI、BI和GI評(píng)分明顯降低（P<0.05），并以治療組評(píng)分改善最為顯著（P<0.05）。治療后，兩組患者血清CRP、HMGB-1、IL-6和sICAM-1水平均明顯降低，而CGRP水平明顯升高（P<0.05），且治療組上述細(xì)胞因子水平明顯好于對(duì)照組（P<0.05）。結(jié)論 固齒散聯(lián)合人工牛黃甲硝唑膠囊治療慢性牙周炎可有效改善患者口腔癥狀和牙周狀態(tài)，有利于降低機(jī)體炎癥因子水平，促進(jìn)口腔健康和自我效能感，降低患者不良心里感受。

Objective To investigate the clinical efficacy of Guchi Powder combined with Galculus Bovis and Metronidazole Capsules in treatment of chronic periodontitis. Methods Patients（61 cases） with chronic periodontitis in Hospital of Stomatological of Xi’an Jiaotong University from June 2018 to June 2021 were divided into control（30 cases） and treatment（31cases） group based on different treatments. Patients in the control group was po administered with Galculus Bovis and Metronidazole Capsules, 2 grains/time, three times daily. Patients in the treatment group were po administered with Guchi Powder on the basis of the control group, 0.5 g/time, twice daily, applying for 2 min each time. Patients in two groups were treated for 2weeks. After treatment, the clinical evaluation was evaluated, and the improvement time of symptom, the scores of GSES, OHIP-14, PLI, BI and GI, the levels of serum CRP, HMGB-1, IL-6, sICAM-1, and CGRP in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 96.77%, which was significantly higher than that of the control group（80.00%, P ＜ 0.05）. After treatment, the time of symptom improvement in the treatment group was earlier than that in the control group（P ＜ 0.05）. After treatment, the GSES scores in two groups were significantly increased, while the scores of OHIP-14, PLI, BI and GI were significantly decreased（P ＜ 0.05）, especially in the treatment group（P ＜ 0.05）. After treatment, the serum levels of CRP, HMGB-1, IL-6 and sICAM-1 in the two groups were significantly decreased, while the level of CGRP were significantly increased（P ＜ 0.05）, and the level of above-mentioned cytokines in the treatment group was significantly better than that in the control group（P ＜ 0.05）. Conclusion Guchi Powder combined with galculus bovis and metronidazole in treatment of chronic periodontitis can effectively improve patients’ oral symptoms and periodontal state, reduce the level of inflammatory factors, promote oral health and self-efficacy, and reduce patients’ bad feelings.

R988.2

西安市科學(xué)技術(shù)計(jì)劃項(xiàng)目(SFLG2022-02)