臺灣博碩士論文加值系統

牙菌斑是引起牙齦炎最主要的原因。聚集在牙齒表面的牙菌斑往往會造成牙齦組織的發炎，如果將牙菌斑清除乾淨則可以恢復牙齦組織的健康。因此想要擁有一口良好的牙齒與健康的牙齦，維持口腔的清潔是必需的。牙膏的使用經常可以減少口腔內致病菌的數量，因為牙膏通常含有可以抵抗口內大部分細菌生長的成份，而這些成份大多是合成的化學物質，可以用來輔助刷牙而達到預防牙齦炎或甚至於減輕牙齦炎的症狀。然而，這些化學成份往往會引發對人體有害的反應。近年來，有關自然草藥植物及其萃取物的研究發現某些成份具有減輕牙齦炎症狀的效果，而根據之前的基礎研究結果發現，中藥配方「牙得安牙粉」在人體外也具有抑制牙周病菌生長與繁殖的能力。
本實驗的主要目的即是要比較中藥配方「牙得安牙粉」與不含中藥主成份之安慰劑(placebo)牙粉，對於抑制牙菌斑的生長及牙齦炎的控制之評估。本實驗之設計為雙盲、安慰劑控制、平行試驗，並以隨機方式將患者分為二組，最後共計有八十六位受測者完成全程檢測。所有受測者皆至少有二十顆自然牙，牙周篩選記錄(PSR)需小於或等於2，而且牙菌斑指數需大於或等於2。在八個星期的試驗過程中，所有的受測者需使用所分配到的牙粉配合牙刷的使用，一天兩次。在檢測開始前、進行中及結束時，皆對受測者的牙齦炎、牙菌斑及口腔軟組織狀況加以記錄。
經過八個星期的試驗檢測，完成所有的數據收集並經統計分析處理，發現兩組之牙菌斑及牙齦炎的情況皆有改善，但在第二、四、六個星期時，兩組之間並無統計學上的差異。到了第八個星期時，使用安慰劑牙粉的檢體，其牙齦指數為1.01±0.48、牙菌斑指數為1.70±0.66，而使用「牙得安牙粉」的檢體，其牙齦指數為0.80±0.38、牙菌斑指數為1.44±0.69，兩組之間的比較具有統計學上的顯著差異(p<0.05)。此外，在第六及第八個星期時，兩組在舌側面(lingual surface)及鄰接面(proximal)區域的牙菌斑指數都有達到統計學上的差異(p<0.01)。
根據實驗結果我們獲得一個結論，中藥配方「牙得安牙粉」配合早、晚刷牙使用，相較於不含中藥主成份的安慰劑牙粉，對於牙菌斑的控制及減輕牙齦炎有較好的效果。

A strong correlation has been established between plaque and gingivitis. Unremoved microbial plaque usually leads to gingival inflammation and may be reversed with effective oral hygiene. Since, maintenance of the balance of normal microbiologic flora in the mouth is essential for proper oral health to be maintained. Therefore, regular use of dentifrices designed to reduce the levels of pre-existing microbes in the mouth through the activity of antimicrobial compounds should inhibit the growth of microbes in a broad spectrum, without allowing the growth and proliferation of opportunistic pathogens. Numerous chemical agents have been evaluated for the supplementation of mechanical plaque control and thus the reduction or prevention of gingivitis. However, adverse effects usually occur according to the chemical agents used by individuals. Research on medicinal plant and their active ingredients have demonstrated the effect of herbal substances on reduction and prevention of gingivitis. Suprisingly, a recent study performed in our department found that “ YA-DR-AN dentifrice ”, active ingredients obtained from Chinese herbs, is able to inhibit the growth of periodontal pathogens in vitro.
The purpose of the present study was to evaluate the efficacy of a Chinese-based dentifrice (YA-DR-AN) on the control of plaque and gingivitis compared with a placebo dentifrice which does not contain active Chinese herbal component.
This clinical trial was a double-blind placebo-controlled, randomized parallel design. Eighty-six subjects with gingivitis completed the 8-week study. All participants had at least twenty natural teeth with a PSR score not greater than 2 and a plaque index of 2 or more at baseline. Plaque index and gingival index were balanced at baseline for both groups. The subjects were instructed to brush their teeth twice daily for a 8-week period using the allocated dentifrices. All participants in this study were subjected to a thorough examination including measurements of gingival inflammation, plaque accumulation, and oral soft tissue health before, during, and after the 8-week clinical study.
The results showed at 2-, 4- and 6-week, there were no statistically significant differences in plaque and gingivitis between the Chinese herbal-based dentifrice and placebo. At 8- week, however, significant differences in plaque and gingivitis were found for the Chinese herbal-based dentifrice group (GI:0.80±0.38, PI:1.44±0.69) compared to those of the placebo group (GI:1.01±0.48, PI:1.70±0.66) (p<0.05). In addition, at 6- and 8-week, the data also demonstrated a significant difference between the two groups for the plaque score on the lingual and proximal regions (p<0.01).
In conclusion, the use of the Chinese herbal-based “ YA DR AN ” dentifrice twice daily in conjunction with brushing significantly reduced plaque and gingivitis compared to a placebo when used over a period of 8 weeks.

Ⅰ.中文摘要……………………………………………………………1
Ⅱ.英文摘要……………………………………………………………3
Ⅲ.前言…………………………………………………………………5
Ⅳ.文獻回顧……………………………………………………………8
Ⅴ.實驗目的……………………………………………………………23
Ⅵ.材料與方法…………………………………………………………24
Ⅶ.結果…………………………………………………………………32
Ⅷ.討論…………………………………………………………………35
Ⅸ.結論…………………………………………………………………48
附表…………………………………………………………………… 49
附圖…………………………………………………………………… 52
參考文獻……………………………………………………………… 62
附錄……...……………………………………………………………79

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