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目的 探讨牙周炎患者局部应用大黄素温敏凝胶对其龈沟液中Ⅱ型胶原酶(COL-Ⅱ)活性的影响及其临床疗效.方法 选取40例慢性牙周炎患者,采用同一口腔内病情相同牙齿的自身对照研究设计,分为观察组40个牙和对照组40个牙,在基线前须完成全口龈上洁治及口腔卫生宣教,基线时试验牙取龈沟液样本(测定胶原酶),记录菌斑指数、探诊深度、附着丧失和齿沟出血指数及牙齿松动度,然后行龈下刮治术,用药侧每周放1次药,共4次,对照侧按常规治疗.分别于治疗前及治疗后4周收集患牙的龈沟液并记录相关临床指标.采用双抗体夹心酶联免疫法检测龈沟液中COL-Ⅱ活性.结果 两组治疗前COLⅡ水平及牙菌斑指数、齿沟出血指数、牙周袋深度、牙周附着水平、牙齿松动度等差异均无统计学意义(均P＞0.05)；治疗1个疗程后,观察组龈沟液中COL-Ⅱ水平及牙菌斑指数、齿沟出血指数、牙周袋深度、牙周附着水平、牙齿松动度与对照组差异均有统计学意义(t =3.46、4.02、4.18、3.03、2.79、4.29,均P＜0.05).结论 应用大黄素温敏凝胶作为牙周炎基础治疗的辅助疗法,能有效降低龈沟液中Ⅱ型胶原酶活性,从而有效阻止牙周组织的破坏.

Objective To observe the effect of the emodin thermosensitive hydrogel on collagenase in gingival crevicular fluid of patients with chronic periodontitis and to evaluate the clinical efficacy.Methods Forty patients with chronic periodontitis were selected.For each patient after scaring and root planning,the one teeth on one side in a person was assigned at the test group and treated with the emodin thermosensitive hydrogel in the pocket once a week for four weeks.The teeth on the other side were assigned as the control group,just with the primary periodontal treatment.The PLI、SBI、PD、AL、MD and content of collagenase in gingival crevicular fluid were examined at baseline,before administration and after administration four weeks.The COL-II level in GCF was detected using ELISA method.Results There were no significant differences in PLI、SBI、PD、AL、MD and content of collagenase in gingival crevicular fluid before the treatment(P ＞ 0.05).While there are some evidences that periodontal indexes dropped down and the type Ⅱ collagenase level in gingival crevicular fluid also declined after using the emodin thermosensitive hydrogel than the control group(t =3.46,4.02,4.18,3.03,2.79,4.29,all P ＜ 0.05).Conclusion Ultrasonic scaling using the emodin thermosensitive hydrogelas was more effective in reducing the type Ⅱ collagenase level in gingival crevicular fluid.And improving clinical parameters associated with periodontal health in patients with chronic periodontitis.