目的 探讨黄连上清胶囊联合替硝唑治疗慢性牙周炎的临床效果。方法 选取2018年6月—2019年6月北京市中关村医院收治的474例（共615颗患牙）慢性牙周炎患者，随机分成对照组（n=237）和治疗组（n=237）。对照组口服替硝唑胶囊，1 g/次，1次/d，首次剂量加倍，饭后服用。治疗组在对照组基础上口服黄连上清胶囊，2粒/次，2次/d。两组均连续治疗7 d。观察两组的临床疗效，两组治疗前后行牙周探诊检查[主要观察探诊深度（PD）和附着丧失（AL）变化]，运用龈沟出血指数（SBI）、菌斑指数（PLI）分别评估患者的牙龈炎症状况和口腔卫生状况，采用视觉模拟评分法（VAS）评估患者主观牙龈肿痛程度，并采取酶联免疫法测定龈沟液中肿瘤坏死因子（TNF）-α、可溶性细胞间粘附分子-1（sICAM-1）及血清E-选择素（E-sel）、降钙素基因相关肽（CGRP）水平，使用免疫比浊法检测血清C反应蛋白（CRP）。结果 治疗组总有效率为95.4%显著高于对照组87.3%，两组比较差异有统计学意义（P<0.05）。与治疗前对比，两组治疗后PD、AL均显著减小（P<0.05），SBI、PLI则均显著降低（P<0.05）；但治疗后，治疗组以上各项牙周临床指标的改善效果均显著优于对照组同期（P<0.05）。两组治疗后龈沟液中TNF-α、sICAM-1均显著低于治疗前（P<0.05），且治疗组下降更显著（P<0.05）。与治疗前相比，两组治疗后疼痛VAS评分及血清E-sel、CRP水平均显著下降（P<0.05），而血清CGRP浓度均显著增高（P<0.05）；且治疗组治疗后上述各项指标的改善效果均更显著（P<0.05）。结论 应用黄连上清胶囊联合替硝唑治疗慢性牙周炎具有较好的临床疗效，能有效缓解患者牙龈肿痛症状，改善牙周组织功能及生理形态，减轻牙周局部及全身炎症反应，延缓或阻止病情发展，整体疗效良好，且安全性较好。

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,

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