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Article(id=1322923704786760138, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923490592043032, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.05.040, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=null, receivedDateStr=null, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793339189954, onlineDateStr=2026-10-30, pubDate=1746806400000, pubDateStr=2025-05-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339189954, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339189954, creator=13701087609, updateTime=1793339189954, updator=13701087609, issue=Issue{id=1322923490592043032, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='5', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='1746806400000', pubDateStr='2025-05-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793339138887, creator='13701087609', updateTime=1793340572227, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322929502539612595, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923490592043032, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322929502539612596, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923490592043032, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=218, endPage=221, ext={EN=ArticleExt(id=1322923706468676043, articleId=1322923704786760138, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Clinical Effect of Qingwei Guchi Prescription（清胃固齿方）Combined with Tinidazole in Treatment of Chronic Periodontitis in Elderly Patients and Its Influence on Inflammation and Distribution of Periodontal Plaque, columnId=1256183365644968140, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Platform of Provincial Project, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the clinical effect of Qingwei Guchi Prescription（清胃固齿方）combined with tinidazole on inflammation and the distribution of periodontal plaque in elderly patients with chronic periodontitis.

Methods

A total of 101 elderly patients with chronic periodontitis admitted from January 2021 to February 2023 were divided into two groups by random number table method，namely control group（50 cases）and observation group（51 cases）. The control group received periodontal basic treatment and tinidazole and the observation group was combined with Qingwei Guchi Prescription on the basis of the control group. During the study，1 patient fell off in the control group and 1 fell off in the observation group. The clinical efficacy，symptom improvement time（swollen gums，bad breath，loose teeth），changes of TCM syndrome scores（gum pain，bleeding，hot breath，thirst for cold drinks，dry stool，etc.）before and after treatment，plaque index（PLI）and probing depth（PD）of periodontal pockets，sulcus bleeding index（SBI），attach loss（AL）and other periodontal related indicators，the levels of interleukin-6（interleukin-6）and tumor necrosis factor-α（TNF-α）in gingival crevicular fluid，changes in the score of Oral Health Impact Profile（OHIP-14）and adverse reactions were compared.

Results

The clinical effect of the observation group（94.00%，47/50）was better than that of control group（79.59%，39/49）（P<0.05）. Compared with that in the control group，the improvement time of symptoms（swollen gums，bad breath，loose teeth）in the observation group was shorter（P<0.05）. Before treatment，TCM syndrome scores（gingival pain，bleeding，hot breath，thirst for cold drinks，dry stool，etc.），periodontal related indexes（PLI，PD，SBI and AL），the levels of IL-6 and TNF-αand OHIP-14 scale scores were not significant between two groups（P>0.05）. After treatment，TCM syndrome scores（gum pain，bleeding，hot breath，thirst for cold drinks，dry stool，etc.），periodontal related indexes（PLI，PD，SBI and AL），the levels of IL-6 and TNF-αand OHIP-14 scale scores were improved in both groups. After treatment，TCM syndrome scores（gingival pain，bleeding，hot breath，thirst for cold drinks，dry stool，etc.），periodontal related indexes（PLI，PD，SBI and AL），the levels of IL-6 and TNF-αand OHIP-14 scale scores in the observation group were superior to those in the control group（P<0.05）. The total adverse reaction rate of the observation group was lower than that of the control group（P<0.05）.

Conclusion

In elderly patients with chronic periodontitis，Qingwei Guchi Prescription combined with tinidazole has good clinical effect，which can effectively reduce the inflammatory response of the body and improve the distribution of periodontal plaque in patients，so as to improve the condition and quality of life of patients. The treatment is safe and reliable and less adverse reaction.

, authors=Haibing MA, Pengqiang YANG, Yongshou HU, Jingli ZHU, Bizhou ZHAO, Jialing TIAN, Li ZHAO, authorsList=Haibing MA, Pengqiang YANG, Yongshou HU, Jingli ZHU, Bizhou ZHAO, Jialing TIAN, Li ZHAO, authorCompany=null, correspAuthors=Li ZHAO, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322923708599382486, articleId=1322923704786760138, tenantId=1146029695717560320, journalId=1255847919539208197, language=CN, title=清胃固齿方结合替硝唑治疗老年慢性牙周炎临床效果及对炎症水平、牙周菌斑分布影响, columnId=1256183369033965799, journalTitle=中华中医药学刊, columnName=省级项目平台, runingTitle=null, highlight=null, articleAbstract=
目的

探讨老年慢性牙周炎患者应用清胃固齿方结合替硝唑治疗的临床效果及对患者炎症水平、牙周菌斑分布影响。

方法

纳入101例老年慢性牙周炎患者，采取随机数字表法分为两组，分别为对照组50例和观察组51例，对照组患者进行牙周基础治疗，并给予替硝唑治疗，观察组患者在对照组治疗基础上结合清胃固齿方治疗，研究过程中对照组脱落1例，观察组患者脱落1例。观察各组数据：临床疗效、患者症状改善时间（牙龈肿痛、口臭、牙齿松动）、治疗前后患者中医证候积分（牙龈作痛、出血、口气热臭、渴喜冷饮、大便干结等）变化、菌斑指数（plaque index，PLI）与牙周袋探诊深度（probing depth，PD）、龈沟出血指数（sulcus bleeding index，SBI）、牙周附着丧失（attach-ment loss，AL）等牙周相关指标变化、龈沟液白细胞介素-6（interleukin-6，IL-6）与肿瘤坏死因子α（tumor necrosis factor-α，TNF-α）、口腔健康影响程度量表（oral health impact profile，OHIP-14）评分变化、治疗不良反应情况。

结果

观察组患者临床疗效（94.00%，47/50）优于对照组（79.59%，39/49），差异有统计学意义（P<0.05）；与对照组比较，观察组患者症状改善时间（牙龈肿痛、口臭、牙齿松动）均更短，差异有统计学意义（P<0.05）；治疗前各组患者中医证候积分、牙周相关指标（PLI、PD、SBI及AL）、IL-6及TNF-α水平、OHIP-14量表评分比较，差异无统计学意义（P>0.05），治疗后各组患者中医证候积分、牙周相关指标（PLI、PD、SBI及AL）、IL-6及TNF-α水平、OHIP-14量表评分均改善，而观察组患者治疗后中医证候积分（牙龈作痛、出血、口气热臭、渴喜冷饮、大便干结等）、牙周相关指标（PLI、PD、SBI及AL）、IL-6及TNF-α水平、OHIP-14量表评分均优于对照组患者，差异有统计学意义（P<0.05）；观察组患者总不良反应率低于对照组，差异有统计学意义（P<0.05）。

结论

老年慢性牙周炎患者应用清胃固齿方结合替硝唑治疗的临床效果良好，可较好降低机体炎症反应，改善患者牙周菌斑分布情况，以改善患者病情及生活质量，且治疗不良反少，安全可靠。

, authors=马海冰, 杨鹏强, 胡永寿, 祝静莉, 赵弼洲, 田佳灵, 赵瑮, authorsList=马海冰, 杨鹏强, 胡永寿, 祝静莉, 赵弼洲, 田佳灵, 赵瑮, authorCompany=null, correspAuthors=赵瑮, authorNote=

马海冰（1983-），女（回族），甘肃兰州人，副主任医师，硕士，研究方向：口腔临床（全科）。

, correspAuthorsNote=
赵瑮（1973-），女，甘肃兰州人，副主任医师，学士，研究方向：牙体牙髓病及颞颌关节病。E-mail：。
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马海冰（1983-），女（回族），甘肃兰州人，副主任医师，硕士，研究方向：口腔临床（全科）。

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马海冰（1983-），女（回族），甘肃兰州人，副主任医师，硕士，研究方向：口腔临床（全科）。

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Er：YAG激光辅助龈下刮治和根面平整术治疗慢性牙周炎伴2型糖尿病的临床疗效［J］. 北京口腔医学，2023，31（2）：105-108., articleTitle=Er：YAG激光辅助龈下刮治和根面平整术治疗慢性牙周炎伴2型糖尿病的临床疗效, refAbstract=null), Reference(id=1322923719856894492, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923704786760138, doi=null, pmid=null, pmcid=null, year=2023, volume=39, issue=4, pageStart=224, pageEnd=227, url=null, language=null, rfNumber=［3］, rfOrder=2, authorNames=贺颖, 贾迎春, 佘文哲, journalName=临床口腔医学杂志, refType=null, unstructuredReference=贺颖，贾迎春，佘文哲. 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rfNumber=［27］, rfOrder=26, authorNames=王婧, 李召宝, 李艳霞, journalName=长春中医药大学学报, refType=null, unstructuredReference=王婧，李召宝，李艳霞. 石菖蒲挥发油促进牙周炎牙周膜干细胞增殖及迁移的作用机制研究［J］. 长春中医药大学学报，2023，39（4）：400-406., articleTitle=石菖蒲挥发油促进牙周炎牙周膜干细胞增殖及迁移的作用机制研究, refAbstract=null), Reference(id=1322923721731748405, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923704786760138, doi=null, pmid=null, pmcid=null, year=2023, volume=49, issue=1, pageStart=98, pageEnd=101, url=null, language=null, rfNumber=［28］, rfOrder=27, authorNames=吴泽钰, 宋洁, 赵今, journalName=江苏医药, refType=null, unstructuredReference=吴泽钰，宋洁，赵今. 中药活性成分防治牙周炎的研究进展［J］. 江苏医药，2023，49（1）：98-101., articleTitle=中药活性成分防治牙周炎的研究进展, refAbstract=null), Reference(id=1322923721815634486, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923704786760138, doi=null, pmid=null, pmcid=null, year=2022, volume=45, issue=8, pageStart=867, pageEnd=879, url=null, language=null, rfNumber=［29］, rfOrder=28, authorNames=姬晓炜, 冯凯, 吴泽钰, journalName=新疆医科大学学报, refType=null, unstructuredReference=姬晓炜，冯凯，吴泽钰，等. 基于网络药理学和分子对接探讨香加皮防治牙周炎的作用机制［J］. 新疆医科大学学报，2022，45（8）：867-879., articleTitle=基于网络药理学和分子对接探讨香加皮防治牙周炎的作用机制, refAbstract=null), Reference(id=1322923721874354743, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923704786760138, doi=null, pmid=null, pmcid=null, year=2022, volume=22, issue=8, pageStart=904, pageEnd=909，914, url=null, language=null, rfNumber=［30］, rfOrder=29, authorNames=李梦佳, 王宏, 董臣林, journalName=中国医院用药评价与分析, refType=null, unstructuredReference=李梦佳，王宏，董臣林，等. 基于网络药理学探讨玉女煎治疗牙周炎的作用机制［J］. 中国医院用药评价与分析，2022，22（8）：904-909，914., articleTitle=基于网络药理学探讨玉女煎治疗牙周炎的作用机制, refAbstract=null), Reference(id=1322923721945657912, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923704786760138, doi=null, pmid=null, pmcid=null, year=2022, volume=28, issue=15, pageStart=201, pageEnd=206, url=null, language=null, rfNumber=［31］, rfOrder=30, authorNames=汪小毅, 王泽茜, 黄毅, journalName=中国实验方剂学杂志, refType=null, unstructuredReference=汪小毅，王泽茜，黄毅，等. 基于中西医临床病证特点的牙周炎动物模型分析［J］. 中国实验方剂学杂志，2022，28（15）：201-206., articleTitle=基于中西医临床病证特点的牙周炎动物模型分析, refAbstract=null)], funds=[Fund(id=1322923717831045657, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923704786760138, awardId=1606RJYA278, language=CN, fundingSource=甘肃省科学技术厅项目(1606RJYA278), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1322923708851040727, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923704786760138, xref=null, ext=[AuthorCompanyExt(id=1322923708859429336, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923704786760138, companyId=1322923708851040727, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Gansu Provincial Hospital of Traditional Chinese Medicine，Lanzhou 730050，Gansu，China), AuthorCompanyExt(id=1322923708872012249, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923704786760138, companyId=1322923708851040727, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=甘肃省中医院，甘肃 兰州 730050)])], figs=[ArticleFig(id=1322923716149129739, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923704786760138, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数显效有效无效总有效
对照组4921（42.86）18（36.73）10（20.41）39（79.59）
观察组5036（72.00）11（22.00）3（6.00）47（94.00）
χ2值----4.503 8
P值----0.033 8
), ArticleFig(id=1322923716509839884, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923704786760138, language=CN, label=表1, caption=

两组老年慢性牙周炎患者疗效比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数显效有效无效总有效
对照组4921（42.86）18（36.73）10（20.41）39（79.59）
观察组5036（72.00）11（22.00）3（6.00）47（94.00）
χ2值----4.503 8
P值----0.033 8
), ArticleFig(id=1322923716614697485, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923704786760138, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数牙龈肿痛口臭牙齿松动
对照组494.22±0.377.23±1.1112.65±1.56
观察组502.36±0.415.02±0.789.45±1.05
t值-23.681 811.480 611.995 3
P值-0.000 00.000 00.000 0
), ArticleFig(id=1322923716732137998, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923704786760138, language=CN, label=表2, caption=

两组老年慢性牙周炎患者治疗后症状改善时间比较（±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数牙龈肿痛口臭牙齿松动
对照组494.22±0.377.23±1.1112.65±1.56
观察组502.36±0.415.02±0.789.45±1.05
t值-23.681 811.480 611.995 3
P值-0.000 00.000 00.000 0
), ArticleFig(id=1322923716920881679, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923704786760138, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗时间牙龈作痛出血口气热臭渴喜冷饮大便干结
对照组49治疗前2.16±0.252.11±0.232.02±0.161.95±0.241.98±0.26
治疗后0.68±0.14a0.61±0.10a0.57±0.12a0.55±0.10a0.58±0.09a
观察组50治疗前2.14±0.232.09±0.212.01±0.131.96±0.221.99±0.25
治疗后0.21±0.07ab0.19±0.05ab0.17±0.06ab0.15±0.03ab0.17±0.04ab
), ArticleFig(id=1322923717008962064, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923704786760138, language=CN, label=表3, caption=

两组老年慢性牙周炎患者中医证候积分变化比较（±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗时间牙龈作痛出血口气热臭渴喜冷饮大便干结
对照组49治疗前2.16±0.252.11±0.232.02±0.161.95±0.241.98±0.26
治疗后0.68±0.14a0.61±0.10a0.57±0.12a0.55±0.10a0.58±0.09a
观察组50治疗前2.14±0.232.09±0.212.01±0.131.96±0.221.99±0.25
治疗后0.21±0.07ab0.19±0.05ab0.17±0.06ab0.15±0.03ab0.17±0.04ab
), ArticleFig(id=1322923717084459537, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923704786760138, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗时间PLI/（分）PD/（mm）SBI/（分）AL/（mm）
对照组49治疗前3.22±0.355.46±0.413.11±0.345.55±0.98
治疗后2.16±0.27a3.02±0.52a2.11±0.26a3.56±0.76a
观察组50治疗前3.23±0.365.48±0.423.09±0.315.57±0.99
治疗后1.63±0.30ab2.18±0.36ab1.68±0.22ab2.60±0.48ab
), ArticleFig(id=1322923717155762706, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923704786760138, language=CN, label=表4, caption=

两组老年慢性牙周炎患者患者治疗前后牙周相关指标变化比较（±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗时间PLI/（分）PD/（mm）SBI/（分）AL/（mm）
对照组49治疗前3.22±0.355.46±0.413.11±0.345.55±0.98
治疗后2.16±0.27a3.02±0.52a2.11±0.26a3.56±0.76a
观察组50治疗前3.23±0.365.48±0.423.09±0.315.57±0.99
治疗后1.63±0.30ab2.18±0.36ab1.68±0.22ab2.60±0.48ab
), ArticleFig(id=1322923717227065875, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923704786760138, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗时间IL-6TNF-α
对照组49治疗前107.63±10.64132.64±11.65
治疗后65.36±8.64a47.65±5.62a
观察组50治疗前107.61±10.59132.62±11.70
治疗后43.27±9.56ab37.59±4.95ab
), ArticleFig(id=1322923717302563348, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923704786760138, language=CN, label=表5, caption=

两组老年慢性牙周炎患者IL-6及TNF-α水平变化比较（±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗时间IL-6TNF-α
对照组49治疗前107.63±10.64132.64±11.65
治疗后65.36±8.64a47.65±5.62a
观察组50治疗前107.61±10.59132.62±11.70
治疗后43.27±9.56ab37.59±4.95ab
), ArticleFig(id=1322923717382255125, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923704786760138, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗前治疗后t值P值
对照组4931.26±4.9216.26±3.7616.956 70.000 0
观察组5031.24±4.9612.25±2.1624.821 00.000 0
t值-0.020 16.522 9--
P值-0.984 00.000 0--
), ArticleFig(id=1322923717470335510, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923704786760138, language=CN, label=表6, caption=

两组老年慢性牙周炎患者OHIP-14量表评分变化比较（±s）

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组别例数治疗前治疗后t值P值
对照组4931.26±4.9216.26±3.7616.956 70.000 0
观察组5031.24±4.9612.25±2.1624.821 00.000 0
t值-0.020 16.522 9--
P值-0.984 00.000 0--
), ArticleFig(id=1322923717541638679, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923704786760138, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数恶心呕吐食欲不振口腔金属味总不良反应
对照组496（12.24）4（8.16）2（4.08）12（24.49）
观察组502（4.00）1（2.00）0（0.00）3（6.00）
χ2值----6.581 0
P值----0.013 0
), ArticleFig(id=1322923717604553240, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923704786760138, language=CN, label=表7, caption=

两组老年慢性牙周炎患者不良反应比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数恶心呕吐食欲不振口腔金属味总不良反应
对照组496（12.24）4（8.16）2（4.08）12（24.49）
观察组502（4.00）1（2.00）0（0.00）3（6.00）
χ2值----6.581 0
P值----0.013 0
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马海冰 , 杨鹏强 , 胡永寿 , 祝静莉 , 赵弼洲 , 田佳灵 , 赵瑮
中华中医药学刊 | 省级项目平台 2025,43(5): 218-221
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中华中医药学刊 |省级项目平台 2025 , 43 (5) : 218 -221
清胃固齿方结合替硝唑治疗老年慢性牙周炎临床效果及对炎症水平、牙周菌斑分布影响
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马海冰（1983-），女（回族），甘肃兰州人，副主任医师，硕士，研究方向：口腔临床（全科）。

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马海冰, 杨鹏强, 胡永寿, 祝静莉, 赵弼洲, 田佳灵, 赵瑮
作者信息
  • 甘肃省中医院，甘肃 兰州 730050
通讯作者:
赵瑮（1973-），女，甘肃兰州人，副主任医师，学士，研究方向：牙体牙髓病及颞颌关节病。E-mail：。
作者简介:

马海冰（1983-），女（回族），甘肃兰州人，副主任医师，硕士，研究方向：口腔临床（全科）。

Clinical Effect of Qingwei Guchi Prescription（清胃固齿方）Combined with Tinidazole in Treatment of Chronic Periodontitis in Elderly Patients and Its Influence on Inflammation and Distribution of Periodontal Plaque
Haibing MA, Pengqiang YANG, Yongshou HU, Jingli ZHU, Bizhou ZHAO, Jialing TIAN, Li ZHAO
Affiliations
  • Gansu Provincial Hospital of Traditional Chinese Medicine，Lanzhou 730050，Gansu，China
出版时间: 2025-05-10 doi: 10.13193/j.issn.1673-7717.2025.05.040
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摘要
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目的

探讨老年慢性牙周炎患者应用清胃固齿方结合替硝唑治疗的临床效果及对患者炎症水平、牙周菌斑分布影响。

方法

纳入101例老年慢性牙周炎患者，采取随机数字表法分为两组，分别为对照组50例和观察组51例，对照组患者进行牙周基础治疗，并给予替硝唑治疗，观察组患者在对照组治疗基础上结合清胃固齿方治疗，研究过程中对照组脱落1例，观察组患者脱落1例。观察各组数据：临床疗效、患者症状改善时间（牙龈肿痛、口臭、牙齿松动）、治疗前后患者中医证候积分（牙龈作痛、出血、口气热臭、渴喜冷饮、大便干结等）变化、菌斑指数（plaque index，PLI）与牙周袋探诊深度（probing depth，PD）、龈沟出血指数（sulcus bleeding index，SBI）、牙周附着丧失（attach-ment loss，AL）等牙周相关指标变化、龈沟液白细胞介素-6（interleukin-6，IL-6）与肿瘤坏死因子α（tumor necrosis factor-α，TNF-α）、口腔健康影响程度量表（oral health impact profile，OHIP-14）评分变化、治疗不良反应情况。

结果

观察组患者临床疗效（94.00%，47/50）优于对照组（79.59%，39/49），差异有统计学意义（P<0.05）；与对照组比较，观察组患者症状改善时间（牙龈肿痛、口臭、牙齿松动）均更短，差异有统计学意义（P<0.05）；治疗前各组患者中医证候积分、牙周相关指标（PLI、PD、SBI及AL）、IL-6及TNF-α水平、OHIP-14量表评分比较，差异无统计学意义（P>0.05），治疗后各组患者中医证候积分、牙周相关指标（PLI、PD、SBI及AL）、IL-6及TNF-α水平、OHIP-14量表评分均改善，而观察组患者治疗后中医证候积分（牙龈作痛、出血、口气热臭、渴喜冷饮、大便干结等）、牙周相关指标（PLI、PD、SBI及AL）、IL-6及TNF-α水平、OHIP-14量表评分均优于对照组患者，差异有统计学意义（P<0.05）；观察组患者总不良反应率低于对照组，差异有统计学意义（P<0.05）。

结论

老年慢性牙周炎患者应用清胃固齿方结合替硝唑治疗的临床效果良好，可较好降低机体炎症反应，改善患者牙周菌斑分布情况，以改善患者病情及生活质量，且治疗不良反少，安全可靠。

老年慢性牙周炎  /  替硝唑  /  清胃固齿方  /  炎症水平  /  牙周菌斑分布  /  疗效  /  不良反应
Objective

To investigate the clinical effect of Qingwei Guchi Prescription（清胃固齿方）combined with tinidazole on inflammation and the distribution of periodontal plaque in elderly patients with chronic periodontitis.

Methods

A total of 101 elderly patients with chronic periodontitis admitted from January 2021 to February 2023 were divided into two groups by random number table method，namely control group（50 cases）and observation group（51 cases）. The control group received periodontal basic treatment and tinidazole and the observation group was combined with Qingwei Guchi Prescription on the basis of the control group. During the study，1 patient fell off in the control group and 1 fell off in the observation group. The clinical efficacy，symptom improvement time（swollen gums，bad breath，loose teeth），changes of TCM syndrome scores（gum pain，bleeding，hot breath，thirst for cold drinks，dry stool，etc.）before and after treatment，plaque index（PLI）and probing depth（PD）of periodontal pockets，sulcus bleeding index（SBI），attach loss（AL）and other periodontal related indicators，the levels of interleukin-6（interleukin-6）and tumor necrosis factor-α（TNF-α）in gingival crevicular fluid，changes in the score of Oral Health Impact Profile（OHIP-14）and adverse reactions were compared.

Results

The clinical effect of the observation group（94.00%，47/50）was better than that of control group（79.59%，39/49）（P<0.05）. Compared with that in the control group，the improvement time of symptoms（swollen gums，bad breath，loose teeth）in the observation group was shorter（P<0.05）. Before treatment，TCM syndrome scores（gingival pain，bleeding，hot breath，thirst for cold drinks，dry stool，etc.），periodontal related indexes（PLI，PD，SBI and AL），the levels of IL-6 and TNF-αand OHIP-14 scale scores were not significant between two groups（P>0.05）. After treatment，TCM syndrome scores（gum pain，bleeding，hot breath，thirst for cold drinks，dry stool，etc.），periodontal related indexes（PLI，PD，SBI and AL），the levels of IL-6 and TNF-αand OHIP-14 scale scores were improved in both groups. After treatment，TCM syndrome scores（gingival pain，bleeding，hot breath，thirst for cold drinks，dry stool，etc.），periodontal related indexes（PLI，PD，SBI and AL），the levels of IL-6 and TNF-αand OHIP-14 scale scores in the observation group were superior to those in the control group（P<0.05）. The total adverse reaction rate of the observation group was lower than that of the control group（P<0.05）.

Conclusion

In elderly patients with chronic periodontitis，Qingwei Guchi Prescription combined with tinidazole has good clinical effect，which can effectively reduce the inflammatory response of the body and improve the distribution of periodontal plaque in patients，so as to improve the condition and quality of life of patients. The treatment is safe and reliable and less adverse reaction.

senile chronic periodontitis  /  tinidazole  /  Qingwei Guchi Prescription（清胃固齿方）  /  inflammation levels  /  periodontal plaque distribution  /  curative effect  /  adverse reaction
马海冰, 杨鹏强, 胡永寿, 祝静莉, 赵弼洲, 田佳灵, 赵瑮. 清胃固齿方结合替硝唑治疗老年慢性牙周炎临床效果及对炎症水平、牙周菌斑分布影响. 中华中医药学刊, 2025 , 43 (5) : 218 -221 . DOI: 10.13193/j.issn.1673-7717.2025.05.040
Haibing MA, Pengqiang YANG, Yongshou HU, Jingli ZHU, Bizhou ZHAO, Jialing TIAN, Li ZHAO. Clinical Effect of Qingwei Guchi Prescription（清胃固齿方）Combined with Tinidazole in Treatment of Chronic Periodontitis in Elderly Patients and Its Influence on Inflammation and Distribution of Periodontal Plaque[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (5) : 218 -221 . DOI: 10.13193/j.issn.1673-7717.2025.05.040
正文
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慢性牙周炎是临床常见疾病，该病是由于细菌导致牙周组织炎症反应，破坏牙周支持组织，进而出现牙周袋与牙槽骨吸收与附着丧失，最终出现牙齿松动、脱落情况，影响患者日常生活[1-3]。老年慢性牙周炎发病率较高，可能与患者年迈体弱，免疫力下降等因素相关[4-5]。目前，临床治疗慢性牙周炎疾病多采取龈上洁治与龈下刮治，同时结合抗生素进行治疗，取得一定效果，临床应用广泛[6-7]。替硝唑为临床常用的、新型抗生素，该药的抗炎以及抗菌活性均较强，且抗菌谱广，治疗各种口腔厌氧菌感染疾病效果良好，但长期服药容易出现依赖性及不良反应，加重患者痛苦，影响治疗效果[8]。为了进一步提升慢性牙周炎疾病的临床治疗效果，降低不良反应，在临床基础治疗与替硝唑治疗基础上，结合中医药清胃固齿方治疗，取得较好疗效[9]。故而纳入101例老年慢性牙周炎患者分组观察清胃固齿方与替硝唑结合治疗的效果，报道如下。
1　资料与方法
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1.1　一般资料
纳入2021年1月—2023年2月收治的101例老年慢性牙周炎患者，采取随机数字表法分为两组，分别为对照组50例和观察组51例。研究过程中，观察组与对照组各脱落1例。对照组49例，女21例，男28例，年龄20～56岁（39.65±4.32）岁，病程6～17个月（13.23±1.25）个月，其中轻度19例，中度30例。观察组50例，女21例，男29例，年龄21～55岁（39.62±4.35）岁，病程7～16个月（13.25±1.27）个月，其中轻度19例，中度31例。两组患者资料比较，差异无统计学意义（P>0.05）。
1.2　诊断标准
西医诊断老年慢性牙周炎参照《牙周病学》[10]：牙龈出血及肿胀、口臭、牙周袋形成，袋内科探查到牙结石，引发出血、牙松动等。中医诊断老年慢性牙周炎（胃火炽盛证）参照《中医病证诊断疗效标准》[11]：牙龈作痛、出血、口气热臭、渴喜冷饮、大便干结、牙龈疼痛红肿、舌红及苔黄、脉数等。
1.3　纳入排除标准
纳入标准：①自愿加入研究，均符合老年慢性牙周炎临床诊断，中医辨证为胃火炽盛证；②年龄范围为20～58岁；③在近6个月时间内未接受其他治疗；④可接受替硝唑与清胃固齿方治疗；⑤伦理会批准研究进行。排除标准：①既往口腔手术患者；②精神及心理存在疾病的患者；③妊娠者、哺乳期者；④牙本质敏感；⑤正畸装置患者等。
1.4　治疗方法
对照组：接受基础治疗，包括清洁牙齿，刮治，采取3%过氧化氢溶液与生理盐水冲洗牙龈与牙周袋，于局部涂抹碘甘油，保证患者口腔清洁。同时接受替硝唑（山西津华晖星制药有限公司；国药准字H20023791）治疗，1次/d，1 g/次，治疗时间1个月。观察组：在对照组治疗基础上，联合清胃固齿方进行治疗，清胃固齿方：生地黄15 g，大黄12 g，牡丹皮12 g，当归12 g，墨旱莲12 g，黄连10 g，怀牛膝10 g，甘草9 g。1剂/d，以水煎煮，取汁400 mL，早晚温服200 mL，治疗时间1个月。
1.5　观察指标
①疗效标准[12]：显效-患者治疗后牙龈充血、红肿、胀痛等症状基本消失，牙周指标显著改善，咀嚼功能恢复正常；有效-患者治疗后牙龈充血、红肿、胀痛等症状改善，牙周指标好转，咀嚼功能改善；无效-患者治疗后牙龈充血、红肿及胀痛等症状、牙周指标等未见改善。总有效率＝显效率＋有效率。②比较两组症状改善时间（牙龈肿痛、口臭、牙齿松动）。③比较两组治疗前后中医证候积分（牙龈作痛、出血、口气热臭、渴喜冷饮、大便干结等）变化，各项积分0～3分，分值越高表示症状越严重[13]。④比较两组治疗前后菌斑指数（plaque index，PLI）及牙周袋探诊深度（probing depth，PD）、龈沟出血指数（sulcus bleeding index，SBI）、牙周附着丧失（attach-ment loss，AL）等牙周相关指标变化。PLI：采用菌斑染色剂测定患者牙颈部菌斑覆盖面积占牙面比例，分值0～5分，分值越高表示患者的病情越严重。PD：采取牙周探针探及患者龈缘至龈沟底距离。SBI：采取钝头牙周探针慢慢探及龈沟，根据出血情况计分0～5分，分值越高表示龈炎越严重。AL：采取牙周探针探及患者龈沟底至釉牙骨质界距离，每个牙齿测3个位点，取平均值。⑤比较两组治疗前后龈沟液白细胞介素-6（interleukin-6，IL-6）与肿瘤坏死因子α（tumor necrosis factor-α，TNF-α）水平。收集患者治疗前后龈沟液，应用酶联免疫吸附法进行测定。⑥比较两组治疗前后口腔健康影响程度量表（oral health impact profile，OHIP-14）评分变化。OHIP-14量表评分[14]：包括14个项目，总分0～56分，分值越高表示患者的口腔病情越严重。⑦观察不良反应。
1.6　统计学方法
采用SPSS 26.0软件处理本文数据，计数资料与计量资料分别实施χ2检验、t检验，P<0.05，差异具有统计学意义。
2　结果
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2.1　临床疗效比较
表1显示，观察组患者临床疗效（94.00%）优于对照组（79.59%），P<0.05。
2.2　治疗后症状改善时间比较
表2显示，对照组比较，观察组患者症状改善时间（牙龈肿痛、口臭、牙齿松动）均更短，P<0.05。
2.3　治疗前后中医证候积分变化
表3显示，治疗前各组患者中医证候积分（牙龈作痛、出血、口气热臭、渴喜冷饮、大便干结等）比较，P>0.05，治疗后各组患者中医证候积分均降低，观察组治疗后中医证候积分低于对照组，P<0.05。
2.4　治疗前后牙周相关指标变化
表4显示，治疗前两组患者牙周相关指标（PLI、PD、SBI及AL）比较，P>0.05，治疗后两组患者牙周相关指标均改善，观察组治疗后牙周相关指标优于对照组，P<0.05。
2.5　治疗前后IL-6与TNF-α水平变化
表5显示，两组患者治疗前IL-6与TNF-α水平对比，P>0.05，两组患者治疗后IL-6与TNF-α水平均下降，观察组治疗后IL-6与TNF-α下降水平高于对照组，P<0.05。
2.6　治疗前后各组OHIP-14量表评分变化
表6显示，两组患者治疗前OHIP-14量表评分对比，P>0.05，两组患者治疗后OHIP-14量表评分均下降，观察组比对照组评分更低，P<0.05。
2.7　不良反应
表7显示，观察组患者的总不良反应率比对照组更低，P<0.05。
3　讨论
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老年慢性牙周炎近年发病率显著上升，对患者日常生活造成影响，引起临床的重视[15-18]。老年慢性牙周炎疾病需及时、有效治疗，避免患者牙齿脱落，出现严重危害，临床关于该病的治疗相关研究报道较多，不断对其进行探究[19-22]。临床常规治疗老年慢性牙周炎多采取龈上洁治与龈下刮治等基础治疗，以清除牙菌斑与牙石，同时配合抗生素抑制炎症反应，避免疾病复发，取得一定效果[23]。替硝唑为临床常用的一种抗生素，该药具有广谱抗菌，且抗菌抗炎效果好的作用，对老年慢性牙周炎患者口腔细菌具有较好的调节作用，治疗效果良好[24]。但患者长期服药抗生素容易增加耐药风险，且存在较多不良反应，存在一定局限性，为了积极预防老年慢性牙周炎疾病复发与提升疗效，临床不断探究更好的治疗方法，发现中医对该病具有积极的影响，值得研究[25]。
中医将慢性牙周炎疾病归属于“牙宣”等范畴[26-27]。中医对其认识较深。《诸病源候论》记载：“牙齿痛者，是牙齿相引痛，牙齿是骨之所终，髓之所养。手阳明之支脉入于齿，若髓气不足，阳明脉虚，不能荣于牙齿，为冷风所伤，故疼痛也。”中医认为，牙齿为骨之余，由髓所濡养，而齿属肾生于牙床，上下床属于阳明大肠和胃[28]。《医贯》记载：“肾主骨，齿者，骨之标，其龈则属胃土。”饮食不节，浊邪壅积于胃，久蕴化热；或操劳过度，久病等耗损肾阴，致使肾阴不足，相火上炎。《明医杂注》记载：“肠胃伤于美酒，厚味、膏粱、甘腻之物，以致湿热上攻，则牙床不清而为肿、为痛，或出血、或生虫……”胃火炽盛证老年慢性牙周炎是临床比较常见的中医证型，治疗该病可采取滋阴补肾及清热消肿之法[29]。清胃固齿方是由生地黄、大黄及牡丹皮、当归、墨旱莲、黄连及怀牛膝、甘草等中药组成，本方中生地黄可滋阴补肾与清热凉血；大黄可泻下攻积、清热泻火及凉血解毒；牡丹皮具有清热凉血以及活血化瘀等功效；当归可补血活血与调经止痛；墨旱莲可滋阴益肾及凉血止血；黄连可清热除湿与泻火解毒；怀牛膝可活血祛瘀以及补肝肾；甘草具有补脾益气及止痛等功效。全方诸药配伍，可较好滋阴补肾、清胃凉血、补肾虚及阴液，胃热得清，炎火可消，消除诸症，达到治疗老年慢性牙周炎疾病目的，疗效甚佳。现代药理指出，生地黄可消炎及改善肾功能；大黄可抗菌，改善肾功能，助消化；牡丹皮可解热、镇痛、利尿；当归可调节机体免疫功能；墨旱莲具有保肝及抗菌、镇痛镇静作用；黄连解热、抗炎、镇痛作用显著；怀牛膝可抗衰老及增强机体免疫功能；甘草可调节胃肠功能、抗肝损伤及肺损伤、解毒及调节免疫、延缓衰老[30-31]。总之，本方可较好调节机体免疫功能，还可较好抗炎抑菌、镇痛镇静，调节机体胃肠道功能。本次数据显示，观察组患者临床疗效优于对照组患者，差异有统计学意义（P<0.05），提示清胃固齿方结合替硝唑治疗老年慢性牙周炎效果良好。与对照组比较，观察组患者症状改善时间（牙龈肿痛、口臭、牙齿松动）均更短，差异有统计学意义（P<0.05），提示老年慢性牙周炎患者采取清胃固齿方结合替硝唑治疗其症状改善更快；观察组治疗后的中医证候积分（牙龈作痛、出血、口气热臭、渴喜冷饮、大便干结等）、牙周相关指标（PLI、PD、SBI及AL）、IL-6及TNF-α水平、OHIP-14量表评分均优于对照组患者，差异有统计学意义（P<0.05），提示清胃固齿方结合替硝唑可较好改善老年慢性牙周炎患者炎症状态，可改善患者牙菌斑分布，改善患者口腔健康。观察组患者总不良反应率低于对照组，差异有统计学意义（P<0.05），可见清胃固齿方结合替硝唑治疗老年慢性牙周炎安全可靠。
综上所述，清胃固齿方结合替硝唑治疗老年慢性牙周炎效果佳，患者症状改善，恢复更快，且可较好抑制机体炎症反应，改善牙菌斑分布，从而改善患者口腔健康，治疗安全可靠，值得应用。
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  • 甘肃省科学技术厅项目(1606RJYA278)
文献
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参考文献 引证文献
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2025年第43卷第5期
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doi: 10.13193/j.issn.1673-7717.2025.05.040
  • 首发时间：2026-10-30
  • 出版时间：2025-05-10
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基金
甘肃省科学技术厅项目(1606RJYA278)
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    甘肃省中医院，甘肃 兰州 730050

通讯作者:

赵瑮（1973-），女，甘肃兰州人，副主任医师，学士，研究方向：牙体牙髓病及颞颌关节病。E-mail：。
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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