目的 探讨人工牛黄甲硝唑胶囊联合盐酸米诺环素软膏治疗慢性牙周炎的临床疗效。方法 选取2019年1月—2020年12月天津市职业病防治院口腔科收治的98例（患牙118颗）慢性牙周炎患者作为研究对象，按照随机数字表法将98例患者分为对照组（49例，患牙58颗）和治疗组（49例，患牙60颗）。对照组将盐酸米诺环素软膏注入患牙的牙周袋内，1次/周。治疗组在对照组基础上口服人工牛黄甲硝唑胶囊，2粒/次，3次/d。两组患者连续治疗4周。观察两组的临床疗效，比较两组患者的主观疼痛程度、牙周指标和龈沟液炎症因子。结果 治疗后，治疗组的总有效率为93.88%，明显高于对照组的79.59%，差异有统计学意义（P<0.05）。治疗后，两组的VAS评分显著降低，差异有统计学意义（P<0.05）；治疗后，治疗组VAS评分比对照组低，差异有统计学意义（P<0.05）。治疗后，两组的探诊深度、菌斑指数、附着丧失显著降低，差异有统计学意义（P<0.05）；治疗后，治疗组的探诊深度、菌斑指数、附着丧失比对照组低，差异有统计学意义（P<0.05）。治疗后，两组的龈沟液角质细胞生长因子-1（KGF-1）、单核细胞趋化蛋白-1（MCP-1）、基质金属蛋白酶-8（MMP-8）水平显著降低，差异有统计学意义（P<0.05）；治疗后，治疗组的龈沟液KGF-1、MCP-1、MMP-8水平比对照组低，差异有统计学意义（P<0.05）。结论 人工牛黄甲硝唑胶囊联合盐酸米诺环素软膏治疗慢性牙周炎的疗效确切，可有效减轻患者的疼痛程度和牙周指标，降低龈沟液的炎症反应，安全性良好。

Objective To investigate the clinical efficacy of Galcus Bovis and Metronidzaole Capsules combined with Minocycline Hydrochloride Ointment in the treatment of chronic periodontitis. Methods Patients (98 cases, 118 affected teeth) with chronic periodontitis in Tianjin Occupational Diseases Precaution and Therapeutic Hospital from January 2019 to December 2020 were randomly divided into the control group (49 cases, 58 affected teeth) and the treatment group (49 cases, 60 affected teeth). Patients in the control group were given Minocycline Hydrochloride Ointment, and the drug was injected into the periodontal pocket of the affected teeth, once weekly. Patients in the treatment group were po administered with Galcus Bovis and Metronidzaole Capsules on the basis of the control group, 2 grains/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacies were evaluated, and subjective pain, periodontal index; and gingival crevicular fluid inflammatory factors levels in two groups were compared. Results After treatment, the total effective rate of the treatment group was 93.88%, which was significantly higher than 79.59% of the control group, and the difference was statistically significant (P < 0.05). After treatment, the VAS score of two groups were significantly decreased, and the difference was statistically significant (P < 0.05). After treatment, the VAS score of the treatment group was lower than that of the control group, and the difference was statistically significant (P < 0.05). After treatment, the probing depth, plaque index, and attachment loss of two groups were significantly decreased, and the difference was statistically significant (P < 0.05). After treatment, the probing depth, plaque index, and attachment loss of the treatment group were lower than those of the control group, and the difference was statistically significant (P < 0.05). After treatment, the levels of KGF-1, MCP-1, and MMP-8 of gingival crevicular fluid in two groups were significantly decreased, and the difference was statistically significant (P < 0.05). After treatment, the levels of KGF-1, MCP-1, and MMP-8 of gingival crevicular fluid in the treatment group were lower than those in the control group, and the difference was statistically significant (P < 0.05). Conclusion Galcus Bovis and Metronidzaole Capsules combined with Minocycline Hydrochloride Ointment has clinical curative effect in treatment of chronic periodontitis, can effectively reduce the degree of pain and periodontal indicators, reduce the inflammatory reaction of gingival crevicular fluid, with good safety.

R988.2

河南省中医药科学研究专项课题（20-21ZYZD09）