【作者】 杨艳；

【导师】 邹季；

【作者基本信息】 湖北中医药大学 ， 中医骨伤科学， 2011， 博士

【摘要】 为了观察中药方剂对于生理性肾虚质牙周炎大鼠正畸的作用,我们选择十二月龄雌性SD大鼠建立生理性肾虚质牙周炎正畸模型,参照前面方法评估空白对照组、建模对照组和建模给药组情况,进一步探讨八珍汤加减中药方剂对牙周炎正畸牙移动时炎症和骨改建的影响。结果SD大鼠建模后,牙龈指数、牙周袋深度、牙齿松动度和牙槽骨吸收值与正常组对照有统计学差异,磨牙区与前牙的间距缩小的均值在2mm以上；其病理表现可见牙周袋形成,附着上皮破坏,牙槽嵴顶有大量骨吸收陷窝和多核破骨细胞。大鼠牙周炎正畸移动模型建立成功。本实验的中药方剂按照辨证施治的原则,依据君臣佐使的方剂结构,由八珍汤加减而成。在牙周病正畸模型的基础上给药,运用口腔内检查、组织学切片和免疫学实验(ELISA)观察IL-6、TGF-β1,、OC、OPG各指标,该中药方剂能很好的控制炎症和骨改建。在改变实验动物(十二月龄雌性SD大鼠)后建立生理性肾虚质牙周炎正畸模型,运用大体观察、组织学切片和免疫学实验(ELISA)等方法,发现中药方剂对肾虚质牙周炎大鼠正畸时的炎症反应和骨改建有很好的正性作用,且结果更为明显。结论结扎磨牙区牙颈部及高糖饮食既机械性的破坏了牙周结构,又提供了牙周炎形成的条件,是可以推广运用的SD大鼠牙周炎造模方法。比起激素局部注射,外源性引入因素少,全身刺激小,很好的再现了治疗过程中的炎症反应和骨改建过程。中药方的灌服,使牙周炎正畸的大鼠在牙周组织破坏减小的情况下得到较好的牙移动。ELISA方法检测牙周组织中四个因子的含量,表明在建模的牙周炎SD大鼠正畸过程中,中药的服用能起到很好的抗炎和利于治疗性骨改建的作用。在中药方对生理性肾虚质牙周炎大鼠正畸的影响作用研究中,中药方的使用,模型对照组和模型给药组有差异性,且差异大于非生理性肾虚质大鼠。推测此中药方可能对老年病人中或是肾虚体质病人有更好的疗效。更多还原

【Abstract】 ObjectiveBuilding an experimental tooth movement animal model of periodontitis according with the treatment of traditional Chinese medicine,lays the foundation for the study of periodontitis orthodontic treatments of integrated traditional and western medicine.It can provide exact plans for periodontitis patients who need orthodontic treatments.MethodsUseing 0.20mm orthodontic wire ligate the cervical margin of SD rats maxillary molar, and with the method of high carbohydrate diet to establish periodontitis model of rats. Using the maxillary molar area ligation wire and the extension spring between maxillary anterior tooth and molar, connected to form a strength device of 50g, create orthodontic reason mobile conditions. By gross observation, oral examination and HE staining, we can evaluate the orthodontic movement of periodontitis rat model.80 SD rats were randomly divided into three groups, namely the control group (N,20 rats), periodontitis orthodontic group (OP,30 rats), periodontitis orthodontic treatment group (OPY,30 rats). After the periodontitis modeling was completed, gave a daily medicine gastric lavage to the OPY group, with the same volume of saline water to the other groups. Traditional Chinese medicine was Bazhen decoction, selecting astragalus, liquiritia glycyrrhiza, Angelica, white peony, baikal skullcap root, Poria cocos, the rhizome of chuanxiong, Drynaria. Through filtration and concentration, the medicine were administered to SD rats enlarging 15 times adult doses. Evaluate the orthodontic move-ment of each group by gross observation and oral examination after three weeks.Meanwhile, the influence of traditional Chinese medicine on periodontal inflammation in orthodontic tooth movement in rats was evaluated through the gingival index(GI), depth of pocket(DP) and tooth mobility(TM) assessment. ELISA assay of SD rats molar periodontal tissue interleukin 6(IL-6) content, after standardization of each group within IL-6 content, can evaluate the control function of this prescription for inflammation.For the influence of traditional Chinese medicine to the perio-dontitis rat bone remodeling during orthodontic movement, it is through the tooth spacing values, tooth mobility(TM), frontal resorption(FR) and periodontal modeling area organization osteocalcin (OC), trans-forming growth factorβ1 (TGF-β1) and osteoprotegerin(OPG) to evaluate the content.In order to observe the prescriptions for the quality of periodontitis in rats kidney physiological impact of orthodontic, we had chosen twelve months old female SD rats to established the kidney physiological impact orthodontic periodontitis model, with reference to the previous methods to evaluate the control group, model control group and treatment group situations.ResultsAfter build the SD rat model, GI, DP, TM and alveolar bone absorption value with the normal group were significantly different, the space between molar teeth and anterior teeth decrease above 2mm, the periodontitis rat orthodontic treatment model was successfully builded.In this study, according to syndrome differentiation of traditional Chinese medicine principle, the prescription is formed by the Bazhen decoction. The periodontitis orthodontic treatment group is distinctly superior through the evaluation of the oral examination, histological and immunological test (ELISA) observed each index (IL-6,TGF-β1,OC, OPG).The prescription can be good medicine control of inflammation and bone remodeling.Using the rat of kindney deficiency physique to establish an experimental tooth movement animal model of periodontitis,the result becomes more apparent with the same evaluation method.ConclusionLigation of the neck of molar teeth and high carbohydrate diet not only can destroy the periodontal structures, but also provide the conditions for the formation of periodontitis.It can promote the modeling methods of the SD rat periodontitis. Compared to hormone injection, it introduces less exogenous factors and has good reproducibility of the clinical treatment of inflammation and bone remodeling.The rats fed in traditional Chinese medicine of the prescription get a proper orthodontic tooth movement in the case of reduced periodontal tissue destruction.The four factors in periodontal tissue indicate that the traditional Chinese medicine can be a very good anti-inflammatory and beneficial treatment effect of bone remodeling during the process of orthodontic treatment model periodontitis in modeled rats.In the study of twelve months old female SD rats, the traditional Chinese medicine also has good effect in anti-inflammatory action and bone remodeling during the process of orthodontic movement. It has a significant difference between JN group and JY group, and the difference is greater than the rats of the normal physique. The prescription may be speculated that it has better clinical effect in elderly patients or patients of kindney deficiency physique.更多还原